Objective To detect Nogo-A proteolytic fragment in CNS injury models and investigate its proteolytic mechanism as well as potential functions. Methods Western blot was performed to detect Nogo-A proteolytic fragment after spinal cord transection,brain ischemia and KA-induced cerebral cortex injury in rats. Results We detected Nogo-A proteolytic fragment in spinal cord transection and brain ischemia models,whereas no Nogo-A proteolytic fragment was found in KA-induced cerebral cortex injury model.Conclusion\ CNS mechanical and ischemic injury may induce the degradation of Nogo-A by certain mechanisms.

Objective To investigate the expression pattern and possible function of Nogo-A during neuronal growth. Methods E18 rat hippocampal neurons were primarily cultured both in high-density and low-density conditions. Immunohistochemistry and Western blot were performed to detect Nogo-A expression and distributional changes. Results Nogo-A was found in hippocampal neurons, mainly located in the cytoplasm, plasma membrane and neurites. It was detected at the proximal part of all neurites before axon formation. In axons, Nogo-A was enriched in the distal segment and axonal growth cone. In mature neurons, the fiber net work displayed a large number of Nogo-A immunoreactive varicosities. Conclusion The present results indicate that the neuronal Nogo-A may be involved in the process of neurite outgrowth and axonal projection.

Objective To evaluate the complications and long-term efficacy of inside-out transobturator transvaginal tape ( TVT-O) for the treatment of stress urinary incontinence ( SUI) .Methods From January 2008 to December 2013,236 consecutive female patients (mean age 56 ±9 years,range 44-88 years)with the symptom of incontinence when abdominal pressure increasing (such as walking), underwent TVT-O operation.All these patients needed pads and were diagnosed with SUI by cough test and Marshall -bonny test before surgery , with the mean international consultation committee on incontinence questionnaire short form ( ICI-Q-SF) score of 15.6 ±3.9.Two grouping methods were used:the mid-term group including patients whose follow-up time was between 6 months and 3 years, the long-term group including patients whose follow-up time >3 years,the group of patients who underwent TVT-O only and the group of patients who underwent TVT-O plus pelvic floor repair at the same time . Their clinical and follow-up data , intraoperative and postoperative complications , subjective and objective effects were recorded and analyzed.Results Of these 236 patients,there were 1 case of bladder perforation (0.4%) and 1 case of intraoperative sling exposure to vagina ( 0.4%) .Postoperative complications included 36 ( 19.1%) groin/puncture point pain ,18 (9.5%) de novo frequency of micturition ,8 (4.2%) urinary retention /difficulty of urination.All the complications were relieved after symptomatic treatment or surgery except 2 cases of urinary retention/difficulty of urination.Their symptom kept existing after urethral dilatation and sling dissection and long-term intermittent self-catheterization was needed .One hundred and eighty-nine patients completed more than six months of follow-up, with mean follow-up time of ( 35.0 ±12.5 ) months.One hundred and sixteen (61.4%) cases was arranged to mid-term group and 73(38.6%) was arranged to long-term group.88.9%patients ( 168/189 ) were cured objectively and 9.5% patients ( 18/189 ) improved. There was also a significant subjective improvement ( ICI-Q-SF scores:15.6 ±3.9 preoperative versus 6.7 ± 2.3 postoperative,P<0.01).There was no significant difference of both objective and subjective efficacy between mid-term group and long-term group ( cured +improved rate 97.4% versus 95.9%;ICI-Q-SF scores 14.3 ±2.8 versus 16.7 ±3.4 preoperative ,5.8 ±1.2 versus 7.9 ±2.0 postoperative , P>0.05 ) . Patients who underwent TVT-O and those who underwent TVT-O +pelvic floor repair had no significant difference in efficacy (cured +improved rate 97.8%versus 100.0%,P>0.05).Conclusion TVT-O is a safe,effective and durable treatment for SUI , whether or not with concomitant procedure of pelvic floor repairment.

Objecfive To study the effect of fibronectin(FN)and arginine-glycine-aspartateserine tetrapeptide (RGDS)on chemotherapy sensitivity of hepatocellular carcinoma(HCC)cell lines.Methods A HCC cell lines 7721 was divided into BSA group(BO),FN group(FO),RGDS group(RO)and FN+RGDS group(FR).Mitomycin-C(MMC)was added into each group with different concentrations for 2 h,12 h and 24 h.MTT assay was used to detect the survival rate of the tumor cell at different time,and fluorescent staining method and flow cytometry was used to detect the tumor cell's apoptosis.Results The survival rate and apoptosis rate was significantly different between each group with the treatment of MMC for 12 h or 24 h,and no statistical difference was found after incubation for 2 h.Conclusions With time FN down-regulates MMC induced apoptosis of the HCC cells.making HCC cells 1ess sensitive to chemotherapy,while RGDS enhances the sensitivity of HCC cells to chemotherapy.

Objective To use the laboratory detection indicators and pregnant information to predict severe preeclampsia in preg-nant women.Methods 80 pregnant women with severe preeclampsia were collected as the disease group,and 444 cases were select-ed as the control group.Their laboratory detection indicators and pregnant information were compared.between the two groups.The Logistic regression and the ROC curve were used to analyze the predictive value of each indicator for predicting severe preeclamp-sia.Results BMI,MAP,HCT,PLT in the first trimester of pregnancy and BMI,MAP in the second trimester of pregnancy were positively correlated with severe preeclampsia.HCG and PAPP-A in the first trimester of pregnancy were negatively correlated with severe preeclampsia.The single indicators with large predicting value for severe preeclampsia included PAPP-A in the first trimester and MAP in the first and second trimesters of pregnancy.The combining MAP in the first and second trimester of pregnancy had the largest predictive value.Conclusion PAPP-A in the first trimester and MAP in the first and second trimester of pregnancy can predict subsequent severe preeclampsia.

Objective To explore the cause,treatment and prognosis of delayed massive haemorrhage (DMH) after pancreatic resection.Method Clinical data of 1554 patients undergoing pancreatectomy in our hospital from Aug 2003 to Aug 2013 were retrospectively analyzed.Results 16 patients suffered from DMH,including 13 patients who had undergone pancreaticoduodenectomy,and 3 patients who had had resection of pancreatic body and tail.Gastrointestinal haemorrhage occurred in 6 patients,intra-abdominal haemorrhage occurred in 10 patients,respectively.Reoperations were performed in 11 patients,transcatheter arterial embolization (TAE) undertaken in 2 patients,and endoscopic treatment in 3 patients.10 patients recovered after treatment,6 patients (6/16) died.Conclusions The mortality of DMH after pancreatic surgery is high.Postoperative pancreatic leak and gastrointestinal stress ulcer are the most possible risk factors,intra-abdominal arterial haemorrhage is the main cause of death.

Objective To sum up the experience of application of artificial liver support system (ALSS) combined with liver transplantation(LT) in the treatment of end stage severe hepatitis.Methods Clinical data of 23 patients with end stage severe hepatitis receiving ALSS treatment prior to liver transplantation among 223 patients who underwent LT consecutively between April 1993 and December 2003 were analyzed retrospectively. Twenty three patients with end stage severe hepatitis received 58 courses of ALSS prior to liver transplantation. The 6 month survival rate was compared to those in non ALSS non LT group and non LT group.Results ALSS treatment facilitated improvement of liver function, endotoximia, and the tolerance to LT, thus provided a bridge time for attaining the donor liver. The total serum bilirubin level at LT was significantly lower than that before the first run of ALSS ( P

Objective To investigate the occurrence and influencing factors of early allograft dysfunction (EAD) in patients receiving donation after cardiac death (DCD) liver Transplantation.Methods Forty-five patients received orthotopic liver transplantation in our center during January 2016 and May 2016 were included in this study.Based on the occurrence of EAD,patients were divided into EAD group and non-EAD group.Perioperative data of donors and recipients were collected to analyze the risk factors of EAD and the effect of EAD on the short-term prognosis of patients.Results In 45 patients,the incidence of EAD was 57.8％ (26 cases).During the follow-up period,the mortality of recipients in EAD group and non-EAD group was 15.4％ and 15.8％ respectively,which showed no significant difference.Donor age,preoperative ALT and AST levels,cold ischemia time (CIT) were significantly increased in EAD group than in non-EAD group (43.7 ±2.5 and36.2±2.5,P=0.0409;64.2 ±13.2 and 31.0 ± 5.9,P=0.0407;87.3±16.2 and48.2±6.2,P=0.047 3;629.5 ± 35.2 and 484.6 ± 30.5,P =0.004 0,respectively).Perioperative CRP level in EAD group was significantly higher than in non-EAD group (22.6 ± 5.9 and 4.7 ± 1.1,P =0.012 1).What's more,postoperative platelet level was significantly lower in EAD group than in nonEAD group (73.7 ± 8.0 and 111.7 ±16.0,P =0.0439).However,pre-and post-operative neutrophil-lymphocyte ratio (NLR) in recipients showed no significant difference between EAD group and non-EAD groups.Conclusion Older donor age,high levels of preoperative ALT and AST,prolonged cold ischemic time,as well as high level of preoperative CRP and decrease of postoperative platelet level in recipients are risk factors for the occurrence of EAD after liver transplantation.

Objective To investigate the clinical features and prognosis of patients with de novo digestive system malignancy after liver transplantation.Methods The clinical data of 10 patients with de novo digestive system malignancy out of 1 517 patients undergoing liver transplantation from January 2004 to December 2015 in the First Affiliated Hospital of Zhejiang University were collected.Immunosuppressive agents,type of de novo malignancy,process of treatment and prognosis were analyzed retrospectively.Results The incidence of de novo digestive system malignancy after liver transplantation was 0.7％ (10/1 517),including 3 cases of gastric cancer,3 cases of colon cancer,2 cases of liver cancer,2 cases of pancreatic cancer.All of the 10 patients received the corresponding treatment,and the dosage of immunosuppressive agents was reduced at the same time.The median time from liver transplantation to the diagnosis of de novo malignancy was 40.5 months (23 to 156 months).The median follow-up time was 10.5 months (3 to 61 months) after they had been diagnosed as malignancies,and 6 patients died of tumor progression.Conclusions The prognosis of patients with de novo digestive system malignancy after liver transplantation is poor,and early diagnosis and treatment is an important way to improve prognosis.Liver transplant recipients need to be closely followed up,especially in patients with high risk factors of digestive system malignancy.The modification of immunosuppressive drugs may be an effective way to prevent and improve prognosis.

Objective To explore the clinical usage of allograft vessels for portal venous reconstruction during radical resection for pancreatic cancer.Methods We retrospectively analyzed clinical data of 14 patients who underwent pancreaticoduodenectomy with vascular resection (PDVR) and reconstruction by allograft vascular form June 2009 to May 2013.Results Patient's mean age was (59.1 ±10.4) years old.The mean diameter of tumors was (3.9 ± 1.3) cm,mean lcngth of resected vessels was (4.4 ±0.5)cm,and the R0 resection rate was 71.4％.The implanted vessels in 4 cases were allograft portal veins,and in the other 10 cases were allograft iliac arteries.In morphological classification,9 cases used straight vessels and 5 cases used Y shaped vessels.The overall median survival time of the group was (14.0 ± 3.0) months.The 1,2 year' s survival rate was 52.0％ and 40.0％,respectively.Conclusions Allograft vessels for portal venous reconstruction during PDVR have biological and structural advantages.