The authors have studied the changes in the concentration of glutathione of the red blood cell (RBC-GSH) and plasma malondialdehyde (MDA) in 54 patients with acute brain stroke. The results indicated that the concentration of RBC-GSH reduced obviously and that of plasma MDA increased markedly within 72 hours after illness. However, there is no obvious difference between the cases of hemorrhagic cerebrovascular diseases and cerebral infarction group. The RBC-GSH level rised again in the 7th day, while the plasma MDA still remained higher level, they were normal during the convalescent period. The pathological basis of the change may be the response of the free radicals in human body.

Objective To investigate the clinical features and treatment points of diabetes patients compli-cated with parapharyngeal abscess .Methods The clinical data of 12 diabetes mellitus patients complicated with parapharyngeal abscess were analyzed .Results 12 patients were all cured and discharged without concurrent medias-tinal abscess ,intracranial infection and serious complications such as bleeding .Conclusion The development of dia-betes mellitus complicated with parapharyngeal abscess is rapid ,we must confirm the diagnosis ,timely implementation of abscess incision and drainage ,effective drainage of pus ,keep the airway open ,actively control the infection at the same time strictly control the fluctuations in blood sugar ,strengthen supportive therapy ,thus to improve treatment and reduce the incidence of complications .

Objective To investigate the treatment of inverted nipple by continual extension with S tractors made of Kirschner wires on the base of preliminary clinical obervation.Methods Under local anesthesia,with the inverted nipples being dragged out by a presutured thread or a pair of towel clips,a Kirschner wire of 10 cm long and 0.5-1.0 mm in diameter was transversly penetrated through the base of inverted nipple.Then the Kirschner wire was bended at both points of 1.5 cm distantly from the nipple center in clockwise cemicircularly.Two cemicircular Kirschner wires were folded downward hingelikely and the center axis was supported by two cemicircles.This folded S tractor pushed and supported the inverted nipple forwardly and constantly.The hinge angle was adjusted during the treatment according to the traction requirment.It was nessessary for wearing these S tractors for at least 6 months before the Kirschner wires were being taken out.During referrals,the hinge angle was revised for mentaining the extension efforts.Results We treated 32 cases of inverted nipple,total 58 moderate and severe lesions,with this method effectively.No infection was observed during the treatment.The nipple form was naturally and stably outstanding after Kirschner wires taken out.No relapses were observed during a mean 6 monthe following up.Conclusions This procedure is simple and convenient without the need of complicated surgical procedures or perplexed equipments.The nipple shaps are observed natural and stable after Kirschner wire is removed.No recurrences are observed.There are no damages to breastfeeding function.The obvious drawback of this method is its reqairing of long continuously wearing and its inconvenience.

Objective To investigate the impacts of preoperative portal vein thrombosis (PVT) on intraoperative or postoperative parameters in patients receiving orthotopic liver transplantation (OLT). Methods The clinical data of 836 patients undergoing OLT in our hospital from February 2002 to February 2007 were retrospectively analyzed. Of the 836 patients, 71 had preoperative PVT (PVT group) and the other 765 had not (control group). Intraoperative patameters (operative dura-tion, anhepatic phase duration, blood transfusion volume) and postoperative parameters (ICU stay and hospitalization time, portal rethrombosis posttransplantation, graft function, portal vein flow, death rate in perioperation and 1-, 3-, 5-year survival rate) were compared between the 2 groups. Results The operative duration and anheptic phase duration were significantly higher in the PVT group than in the control (792. 47±62. 29 min vs 516. 18±86. 30 min, P<0. 01, 77. 53±24. 76 min vs 48. 55±31. 20 min, P<0. 05). Perioperative blood transfusion volume, average ICU stay and hospitalization duration were not significantly different between the 2 groups. The incidence of postoperative portal rethrombosis was remarkably higher in PVT group than in the control (9. 86% vs 1. 44% , P<0. 01).No significant differences in the graft function and portal vein flow (PVF) between the 2 groups except for a higher PVF in the PVT group on the 90th d(41. 43±17. 19 vs 19. 85±11. 39, P<0. 05). We noticed slightly higher death rate in perioperative and lower 1-, 3-, 5-year survival rate in the PVT group. Conclusion Preoperative PVT can gain the same favorable outcomes as in those without PVT in spite of readily intraoperative complex.

Objective To evaluate the influence of L-ornithine-L-aspartate (LOLA) on model for end stage liver disease(MELD) score and liver function of patients with chronic liver failure (CLF). Methods Sixty patients consecutively admitted to our hospital from May, 2002 and November, 2008 were enrolled into the study and randomly divided into low dose group (LD group, LOLA:10 g/d) and high dose group (HD group, LOLA :20 g/d)After treatment of LOLA, the clinical data ( serum NH3 , MELD score and liver function ) were compared between the two groups. Results Compared to serum NH3 level before treatment, serum NH3 decreased ( 62.59 + 27.87 )μmoL/L in the HD group and (49.36 + 27.34 ) μmol/L in the LD group, and both decreasements were statistical significant (Ps ＜ 0. 05 ). Compared to MELD before treatment, MELD score decreased ( 8.38 ± 2. 24 ) and ( 14.57 + 7.68), respectively ( Ps ＜ 0.05 ). Compared to LD group, all indices of liver function in the HD group improved more compared to those of the LD group ( Ps ＜ 0.05 ). Conclusions LOLA could significantly decrease serum NH3 and MELD score and improve liver function in CLF patients.

Aim To investigate the drug-containing serum of Rhizoma drynariae on osteogenesis differentiation of bone marrow mesenchymal stem, and discuss the possible mechanism.Methods BMSCs were cultured in media with different concentrations of medicine containing serum.BMSCs proliferation ability was detected in 3,5,7,9 days by CCK-8.ALP activity was detected after 7,10,14 days′ induction.After 3 weeks culturing, alizarin red staining was performed to observe the formation of calcium nodules.The expression of β-catenin,LRP5,RUNX-2 and Osteriex mRNA were detected using RT-PCR.The protein expression of β-catenin,LRP5 was detected using Elisa method.Results Rhizoma drynariae drug-containing serum could obviously promote the proliferation of BMSCs and calci-fied nodule formation.Besides, the ALP activity was improved in a certain period of time.The expression of β-catenin,LRP5,GSK-3β,RUNX-2 and Osteriex mRNA were significantly up-regulated,and the protein expression of β-catenin,LRP5 was up-regulated too.The expression of GSK-3β was down-trgulated.Conclusions Rhizoma drynariae drug-containing serum promotes mineralization and osteogenic differentiationof BMSCs, and the mechanism is closely related with activating WNT/beta-catenin signaling pathway, raising the beta-catenin, LRP5, RUNX-2, and Osteriex mRNA expression, beta-catenin, LRP5 protein expression,and down-regulation of GSK-3β mRNA expression.

OBJECTIVE To investigate the effect ofγ-secretase inhibitor N-[N-(3,5-difluorophen?acetyl)-L-alanyl]-S-phenylglycine t-butyl ester(DAPT)on phenotypic transformation and matrix accu?mulation induced by aristolochic acid(AA) in renal tubular epithelial cells(NRK-52E)and explore the mechanism. METHODS NRK-52E cells were divided stochastically into normal cell control group,AA 10 mg·L-1 group and AA 10 mg·L-1+DAPT 1 and 10μmol·L-1 group. After 24 h,the mRNA expressions of Notch1,Jagged1,Numb,E-cadherin,transforming growth factor-β1(TGF-β1),α-smooth muscle actin(α-SMA),bone morphogenic protein 7 (Bmp7),typeⅠ a1 (Col1a1) and Ⅲ collagens a1 (Col3a1)were quantified by quantitative real-time RT-PCR. The protein expressions of Notch1,Jagged1,α-SMA,and Col3a1 in NRK-52E cel s were detected by immunofluorescence staining. RESULTS In NRK-52E cells,AA enhanced the expression of TGF-β1,α-SMA and Col3a1 mRNA(P<0.05),reduced the expression of E-cadherin mRNA(P<0.05),up-regulated the mRNA expression of Notch1 mRNA(P<0.01)and Jagged1(P<0.05),and down-regulated the mRNA expression of Numb mRNA(P<0.05) compared with normal cell control group,indicating that phenotypic transformation and matrix accumu?lation occurred in AA-treated NRK-52E cells,accompanied by activated Notch signaling. Treatment with DAPT inhibited Notch signaling by decreasing the expression of Notch1 and Jagged1 (P<0.05),and increasing the expression of Numb mRNA(P<0.05). Furthermore, DAPT also down-regulated the expression levels of TGF-β1,α-SMA,Col1a1 and Col3a1 mRNA(P<0.05), and up-regulated the expression level of Bmp7 and E-cadherin mRNA(P<0.05) compared with AA group,suggesting that DAPT inhibited phenotypic transformation and matrix accumulation in AA-treated NRK-52E cells. CONCLUSION AA induces phenotypic transformation and matrix accumulation in renal tubular epithelial cells,which is inhibited by DAPT treatment. The possible mechanism is that DAPT suppresses the activation of Notch signaling,resulting in the reduction of epithelial-to-mesenchymal transition and matrix deposition.

Objective To study the diagnosis,prophylaxis and treatment of splenic artery steal syndrome (SASS),and to evaluate their clinical outcomes in recipients who underwent orthotopic liver transplantation (OLT).Methods 1 385 consecutive patients who suffered from liver cirrhosis and had undergone OLT in our hospital between Jan,2004 and Dec,2013 were studied.We hypothesized that patients were at risk of SASS when the calibre of the splenic artery (SA) was 1.5 times larger than the common hepatic artery (CHA) together with splenomegaly (318 patients,23.0％).Further surveillance with Doppler ultrasound (DUS) was carried out immediately at CHA reperfusion during operation.When a sluggish peak systolic velocity (PSV) ＜ 30 cm/s or no flow was detected in a patent hepatic artery,prophylactic SA banding (SAB) was considered.127 patients (39.9％) who fulfilled these criteria were recruited to the intervention group to undergo SAB.Eventually,patients who developed SASS were treated with coil-embolization of the SA (SAE),re-anastomosis of the HA to aorta (HTA),ligation of SA (SAL) or splenectomy (SPT),or retransplantation.Results SAB resulted in immediately increase in the mean PSV of the HA from 19.3 ±5.5 cm/s to 45.9 ± 9.1 cm/s (P ＜ 0.05),and resistance index (RI) of the HA rehabilitated to reasonable levels (0.5 ～0.8),without any HA or biliary related complication in all the 127 patients.17 patients in the control group were identified to have SASS (8.9％).5 of these 17 patients required emergency treatment by coil-embolization.Of the remaining 12 patients,11 who developed hepatic artery thrombosis secondary to SASS required to undergo embolectomy or thrombolysis followed by HTA (4 patients),SAL (3 patients),SPT (5 patients).Three of these patients finally required re-OLT.All these patients obtained acceptable results by these salvage strategies,except 2 out of the 12 patients who died from liver failure.Conclusions SASS is an important but it is often and under-diagnosed cause of graft ischemia after OLT.Prophylactic SAB should be introduced to patients at risk of developing SASS in order to obtain satisfactory results.Coil-embolization of SA shortly after diagnosis is an effective salvage intervention to prevent further progression to develop devastating consequences.

AIM:To investigate the effect of cyclopamine on Hedgehog (HH) signaling, phenotypic transfor-mation and matrix accumulation induced by aristolochic acid (AA) in renal tubular epithelial cell NRK-52E.METHODS:NRK-52E cells were randomly divided into control group (treated with solvent only), AA group (treated with AA at con-centrations of 1, 5, 10 mg/L) and cyclopamine group (treated with AA at concentration of 10 mg/L plus cyclopamine at concentrations of 1, 5, 10μmol/L).After cultured for 24 h, the mRNA expression of Ptch1, Smo,α-SMA, E-cadherin, ZO-1, BMP-7, type I collagen and type III collagen was quantified by real-time PCR.The protein levels of Shh and TGF-β1 were detected by ELISA .Immunofluorescence staining was used to evaluate the expression of Ptch 1, Smo,α-SMA, E-cadherin and type III collagen in the NRK-52E cells.RESULTS: AA increased the expression of TGF-β1, α-SMA and type III collagen, decreased the expression of E-cadherin and ZO-1 protein, and down-regulated the expression of Ptch1, Shh and Smo mRNA in the NRK-52E cells, indicating that AA activated HH signaling , and phenotypic transformation and matrix accumulation occurred in AA-treated NRK-52E cells.Treatment with cyclopamine inhibited HH signaling by decrea-sing Smo expression and increasing Ptch 1 expression.Moreover, cyclopamine also down-regulated the expression of TGF-β1,α-SMA, type I collagen and III collagen , and up-regulated the expression of BMP-7, ZO-1 and E-cadherin.CON-CLUSION:AA induces phenotypic transformation and matrix accumulation in renal tubular epithelial cells , which can be inhibited by cyclopamine treatment .The possible mechanism is that cyclopamine suppresses the activation of HH signaling , resulting in the reduction of epithelial-to-mesenchymal transition and matrix deposition .

OBJECTIVE To investigate the molecular mechanisms of resveratrol( Res)in renal interstitial fibrosis(RlF)in rats with unilateral ureteral obstruction(UUO). METHODS Forty-eight Spra-gur-Dawley rats were randomly divided into UUO( normal saline,n = 16),UUO with Res treatment (Res,20 mg·kg-1 ,n=16),and sham-operation(sham,n=16)models. The kidneys were excised on the 7th and 14th day. The deposition of collagen fiber in the kidney was detected with HE and Masson staining. The levels of sonic hedgehog(SHH,an inducer of SHH pathway)in kidney tissues were deter-mined by ELlSA. lmmunohistochemical analysis was performed to evaluate the protein expression of SHH signaling-related molecules,including SHH,smoothened(Smo),patched-1(Ptch1),and Gli1, proliferating cell nuclear antigen(PCNA)and matrix component typeⅢ collagen. The mRNA expression levels of Smo,Ptch1 and Gli1 were detected by real-time RT-PCR. RESULTS The degree of RlF observed with HE and Masson staining was obviously increased in UUO kidneys,but decreased in Res-treated kidneys. Enhanced expression levels of typeⅢ collagen and PCNA in UUO rats were suppressed by Res treatment(P﹤0.05). Res administration decreased the expression levels of SHH,Smo,and Gli1 (P﹤0.05),but increased the expression of Ptch1(P﹤0.05),suggesting that Res inhibit the obstruction-induced activation of SHH signaling. CONCLUSION Res can attenuate RlF in UUO rats,and the possi-ble mechanism is that Res down-regulates the activity of SHH signaling and inhibits cellular proliferation, resulting in inhibition of matrix accumulation in renal interstitium of UUO rats.