Objective: To search for a satisfactory method for establishing Stanford B type aortic dissection model in canine. Methods: Totally 12 adult dogs were used in the present study. The proximal descending aorta was clamped partially and laterally after a left thoracotomy; half circumference of the aorta, including the media and adventitia,was cut open transversely, with the intima kept intact. The aortic wall was then separated inferiorly, laterally and superiorly at a special dissecting space with a unique dissecting device. Then the intima at the same site was also cut open transversely and the two ends of the distal intimal flap were sutured to the adjacent aorta to allow blood entry. The distal adventitia and media were sutured to the proximal aorta to close the incision. Follow-up was carried out with pigtail catheter guided digital subtraction angiography (DSA) using omnipaque (16-18 ml/s) via either of the common iliac arteries and color Doppler ultrasound. Results: Formation and distal extension of aortic dissections were observed immediately after the procedure and were further confirmed by intra-operative color Doppler ultrasound, DSA, and post-operative biopsy at different time points. Conclusion: The present two-end intimal flap suturing method can be used for establishing Stanford B type aortic dissection model in canine; the model is similar to human Stanford B type aortic dissection.

Objective: To explore the prognostic capacity of RALE scoring system in children with hematologic malignancies complicated with acute respiratory distress syndrome (ARDS). Methods: The clinical data were retrospectively analyzed of 57 ARDS child patients complicated with hematologic malignancies in pediatric intensive care unit (PICU) from Jan. 2014 to Jun. 2018. According to the therapeutic outcome within 28 days, they were divided into survival group (n=23) and non-survival group (n=34). The clinical features of the two groups were compared, and the relativity between RALE score and oxygenation index (P/F value) and the prognostic capacity of RALE score for ARDS were analyzed. Results: For the 57 child patients, the D1 P/F value was lower in non-survival group [116.0(70.0, 192.0)] than in the survival group [189.5(136.5, 251.3)], while the D1 pedicatic risk of mortality score (PRISM) HI, D1 RALE score and D3-D1 RALE score were higher in non-survival group [10.0(8.0, 16.0), 27.0(25.0, 37.0) and 5(0, 8), respectively] than in the survival group [7.6(4.0, 13.4), 24.0(13.8, 35.3) and -3.5(-7, 1), respectively]. The D1 RALE score was negatively correlated with the D1 P/F value (r=-0.831, P<0.001). A larger value of D3-D1 RALE score was an independent risk factor for 28 day mortality. The survival rate was higher in children when D1 RALE score ≤23 and the D3-D1 RALE score ≤-3 at D28. Conclusion: The RALE score can reflect the oxygenation status of ARDS, which is helpful for risk stratification and screening the high-risk patients.

OBJECTIVETo explore the clinical effects of Dynesys system combined with posterior lumbar interbody fusion (PLIF) in treating multiple lumbar degenerative disease.

METHODSThe clinical data of 46 patients with multiple lumbar degenerative diseases treated by Dynesys system combined with PLIF from September 2010 to May 2013 were retrospectively analyzed. There were 17 males and 29 females, aged from 38 to 68 years old with an average of (56.38±11.63) years. Operation section was in L2-L5 of 16 patients (6 with fusion of L4,5 and 10 with fusion of L4,5,L5S1) and in L3-S1 of 30 patients (11 with fusion of L5S1 and 19 with fusion of L4,5,L5S1). Patients were followed up for three times: postoperative 3 months, 1 year and final follow-up. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) were used to assess clinical symptoms preoperatively and postoperatively. All patients underwent flexion/extension radiographs examinations before surgery and at final follow-up. Range of motion (ROM) and disc height index (DHI) were recorded.

RESULTSAll patients were followed up from 16 to 48 months with the mean of (23.23±7.34) months. At third follow-up after operation, ODI and VAS of lumbago and leg pain were significant improved than that of preoperative (P<0.01). DHI of fusion segment was significantly increased than that of preoperative (P<0.05). There was no significant difference in adjacent non-fusion segment between preoperative and postoperative (P>0.05). Postoperative ROM of fusion and non-fusion segments were obviously decreased than that of preoperative. There was no significant difference in ROM of upper adjacent non-fusion segment between 3 months and 1 year after operation (P>0.05), but at final follow-up, the ROM was increased (P<0.05).

CONCLUSIONThe preliminary clinical results of the Dynesys system combined with PLIF in the treatment of multiple lumbar degenerative diseases are satisfactory. It can be determined in fusion or non-fusion according to the individual needs and can reserve the some intervertebral motion, prevent the early degeneration of adjacent segments. However, its long-term clinical efficacy should be verified with long time.

Humans ; Lumbar Vertebrae ; surgery ; Range of Motion, Articular ; Retrospective Studies ; Spinal Diseases ; physiopathology ; surgery ; Spinal Fusion ; methods ; Visual Analog Scale

Objective To discuss and to compare the curative effects of interventional embolization with different embolic agents in treating giant hepatic cavernous hemangiomas. Methods From 2008 to 2010, a total of 30 cases with clinically proved hepatic cavernous hemangioma were treated with interventional embolization. According to the embolic agents used , the patients were divided into pingyangmycin-lipiodol emulsion mixed with sodium alginate microspheres group(PLE+KMG, group A, n=15) and pingyangmycin-lipiodol emulsion group (PLE, group B, n=15). CT scanning was performed one, 3, 6, 12 months after the treatment to evaluate the curative effect. Results The technical success rate was 100%in both groups. The mean PLE dose used in group A and B was (10.9 ± 5.2) ml and (11.4 ± 4.9) ml respectively, the difference between the two groups was not significant (P > 0.05). CT reexamination performed one, 3, 6 months after the treatment showed that a reduction in tumor volume over 50%in group A was seen in 9, 11 and 14 cases respectively, while in group B it was 0, 3 and 5 cases respectively (P <0.05). One week after the procedure, the degree of pain in patients of group A was more severe than that in patients of group B, the difference between the two groups was statistically significant (P < 0.05). Slight abnormal hepatic function was seen in some patients of both groups, which presented mainly as an elevation of aminotransferase, which returned to normal after symptomatic medication. Follow-up with questionnaire indicted that patients of group A were more satisfied with the treatment than the patients of group B. Conclusion Transhepatic infusion of pingyangmycin-lipiodol emulsion is a safe and effective treatment for giant cavernous hemangioma of the liver. Combination use of pingyangmycin-lipiodol emulsion and sodium alginate microspheres can obviously reduce the tumor size mainly in the first and the third month after the treatment, besides it produces instant clinical effect although the pain is more severe than in patients treated with pure pingyangmycin-lipiodol emulsion.

OBJECTIVE:To establish the quality standard of Belamcandin standard substance.METHODS:Different indices of standard Belamcandin were examined with quantitative and quantitative analyses according to the corresponding measures stipulated in the Appendix of pharmacopoeia of people's republic of China(part Ⅱ)published in 2005.RESULTS:The specific rotatory power of 3 batches of standard Belamcandin was —28?～—30?([?]25 D,c0.11,Pyridine);the E1% 1 cmwas 790～830;the melting point was 252～254 ℃ and the ash content was less than 0.5%.The content of Belamcandin in the products was above 99.5% as revealed by HPLC.CONCLUSION:All of the indices were shown to meet the standards for standard substances and the established standard can be used for the quality control of standard Belamcandin.

Objective To explore the relationship of perioperative INVOS cerebral oxygen saturation (rSO2) and postoperative cognition function alteration of geriatric patients under combined intravenous and volatile anesthesia with creatine phosphate disodium to provide guidance for clinical anesthesia. Methods Sixty ASA I-II patients aged >60 years scheduled for selective abdominal surgeries or surgeries on lower limb were enrolled in the study. The patients were randomly divided into 3 groups of 20 patients: creatine phosphate disodium group 1 (CPD1), creatine phosphate disodium group 2 (CPD2), control group (C). All the patients were not premedicated with atropine 0.5mg until entering the operation room. Anesthesia was induced with intravenous infusion of propofol, fentanyl and cisatracurium slowly, and maintained by inhalational anesthetics sevoflurane 1 MAC plus intravenous infusion of propofol (6-8mg·kg-1·min-1) and remifentanyl (0.2-0.4μg·kg-1·min-1), and intravenous bolus cisatracurium (0.07-0.10mg·kg-1). After tracheal intubation, all the patients were mechanically ventilated with PETCO2 in the normal range. rSO2 was continuously monitored and recorded during the operation. The Mini-Mental State Examination (MMSE), Trailmaking Test and Grooved Pegboard Test were used to access cognitive function 24h before surgery and 4, 8, 12, 24h after surgery. Results (1) There were no significant differences in general status between the three groups (P>0.05). (2) The scores of MMSE, Trail-making Test and Grooved Pegboard Test were not different 24h before the operation between the three groups (P>0.05). (3) The scores of cognitive tests were higher in group CPD2 and group CPD1 than in group C (P<0.05), but the rSO2 was identical for the three groups (P>0.05). Conclusion CPD can reduce the occurrence of postoperative cognitive dysfunction in geriatric patients under combined intravenous and inhalational anesthesia.

Objective： The current study was designed to investigate SSTR subtype gene expression in tissue of primary hepatic carcinoma. Methods： The expression of SSTR-2 and SSTR-3 mRNA in the tumor tissue of hepatic carcinoma and the adjacent tissue of cancer in 27 patients with primary hepatic carcinoma was examined by RT-PCR. Results： The positive rate of expression of SSTR-2 mRNA in the tissues of hepatic carcinoma was 81.5％ ( 22/27) , and the positive rate of expression in the adjacent tissues of cancers was 96.3％ (26/27). The positive rate of SSTR-3 mRNA in tumor tissues and the adjacent tissues of hepatic carcinoma were 66.7％ ( 18/27) and 51.9％ (14/27), respectively. Conclusion： There are more than one SSTR subtype genes expression in tumor tissues of primary hepatic carcinoma.

To verify the differential expression of non-metastasis cell 3 (NME3) protein in HL-60 cells when they were induced to differentiate into monocyte and granulocyte like cells, and study its value in diagnosis of acute myeloid leukemia, all-trans retinoic acid (ATRA) and a new steroidal drug NSC67657 were employed to induce acute myeloid leukemia HL-60 cells into monocyte and granulocyte like cells. Then the cell differentiating direction was observed by chemical staining, the degree of differentiation was determined by surface antigen CD11b/CD14 detection, and the apoptosis was excluded by phosphatidylserine valgus analysis, by which cellular differentiating model was constructed. Furthermore, RT-PCR and Western blot were employed to verify the differentially expression of NME3 before and after differentiation of HL-60 cells. At last, samples from bone marrow nucleated cells of 26 patients with myeloid leukemia, which were diagnosed definitely by clinical doctors, and 5 normal people were chosen. Then the expressing trend of NME3 protein in these testing groups was analyzed by means of comparison. The results showed that ATRA (2 µmol/L for 5 d) and NSC67657 (10 µmol/L for 5 d) could induce HL-60 cells to differentiate into monocyte and granulocyte like cells above 90% without cell apoptosis. The expression of NME3 gene and protein were down-regulated by the inducers, which was accorded with the screening results that was got using proteomics technology in the former research. The expression of NME3 protein in bone marrow from acute myeloid leukemia patients was elevated significantly as compared to normal persons. It is concluded that the expression level of NME3 protein is down-regulated after cellular differentiation, according with the changing trend in leukemia patients, which imply that NME3 protein may be a potential biomarker for diagnosis of acute myeloid leukemia.
Adolescent ; Adult ; Aged ; Bone Marrow ; metabolism ; Case-Control Studies ; Child ; Child, Preschool ; HL-60 Cells ; Humans ; Leukemia, Myeloid, Acute ; genetics ; metabolism ; Mesylates ; pharmacology ; Middle Aged ; NM23 Nucleoside Diphosphate Kinases ; metabolism ; Steroids ; pharmacology ; Tretinoin ; pharmacology ; Young Adult

Objective:To investigate the expression of Slug,EMMPRIN and E-cadherin in salivary adenoid cystic carcinoma (SACC)and its correlation with clinicopathological characteristics,and the correlation among themselves.Methods:Slug,EMMPRIN and E-cadherin expression in 1 1 5 SACC cases of SACC was examined by immunohistochemical staining.The results and clinicopatho-logical data were statistically analyzed.Results:High positive expression frequencies of Slug(76.5%)and EMMPRIN(69.6%)and low positive expression frequency of E-cadherin(51 .3%)were found in 1 1 5 SACC cases.The expression of Slug and EMMPRIN was positively associated with the histopathological types,clinical stages,perineural invasion,recurrence and distance metastasis(P <0.05).The expression of E-cadherin was negatively associated with the histopathological types,clinical stages,perineural invasion and distance metastasis(P <0.05).There was a significant correlation between Slug and EMMPRIN expression(P <0.05),negative correlation between EMMPRIN and E-cadherin expression(P <0.05)and between Slug and E-cadherin expression(P <0.05).Con-clusion:The expression of Slug,EMMPRIN and E-cadherin is closely correlated to the clinicopathological characteristics of SACC.

BACKGROUND:Distraction osteogenesis is one of the most important tissue engineering technologies. However, the exact signaling pathway controling mesenchymal stem cel-osteoblast lineage (MSC-OB) migration during distraction osteogenesis has not yet been elucidated. More efforts should be paid to make a ful understanding of the mechanism on MSC-OB lineage migration, which can improve the clinical efficacy of distraction osteogenesis.
OBJECTIVE:To evaluate the effects of mechanical stretch on the ability of MSC-OB mobility and expression of mammalian target of rapamycin (mTOR) signaling pathway as wel as matrix metaloproteinases (MMPs) in MSC-OB, and to make clear the mechanism by which controls MSC-OB migration during distraction osteogenesis.
METHODS:Twelve Sprague-Dawley rats were randomized into two groups: experimental group (n=6), anin vivo rat mandibular distraction osteogenesis model was established on the right side of rats; non-stretch group (n=6), only the mandibular resection was done but with no distraction osteogenesis. Immunohistochemical staining was used to detect phosphorylated mTOR expression in new osteotylus at 15 days after operation. In addition, an in vitro cel stretch model was made in the mandibular mesenchymal stem cels from healthy Sprague-Dawley rats under resting tension force (6%, 4 hours); no distraction was done in control group. The ability of MSC-OB mobility, the expression of mTOR, Raptor, p70S6K and MMPs were evaluated using experiment methods including immunohistochemistry staining, real-time PCR and scratch assay.
RESULTS AND CONCLUSION: The expression of phosphorylated mTOR in MSC-OB was upregulated in the mandibular bone calus of the stretch group than the non-stretch group (P < 0.05). In thein vitro experiments, MSC-OB applied with mechanical stretch (6%, 4 hours) showed elevated gene expression levels of mTOR, Raptor, p70S6K, MMP-2, MMP-9 and MMP-13 compared with the control group (0%, 4 hours). Meanwhile, MSC-OB in the experiment group (6%, 4 hours) showed a greater ability of mobility, as demonstrated by a farther distance after 48 hours of observation (P < 0.05). The present study suggests that the enhancement of MSC-OB mobility correlates with increase of the gene expression of MMPs and mTOR signaling pathway. Mechanical stretch may promote MSC-OB migration through activation of mTOR/MMPs signaling pathway.