Objective To establish the model of pancreatoduodenal allotransplantation in pigs with enteric drainage (ED) and portal venous drainage (PVD). Methods Forty-six hybrid landraces were divided into two groups (donor and recipient groups) randomly, for pancreatoduodenal allotransplantation. Donors were perfused via abdomial aorta without clamping the portal venous outflow with UW solution after heparinization. Whole pancreatoduodenal graft was harvested with segments of abdomial aorta and portal vein and shaped under cold UW solution. Then, the end-to-end anastomosis was performed with the donor iliac artery bifurcation “Y” graft to the recipient superior mesenteric arteries and celiac artery. Furthermore, type Ⅰdiabete model was made by removal of the recipient pancreas. The venous anastomosis was reconstructed between the donor portal vein and the recipient superior mesenteric vein. Meanwhile, the end-to-side anastomosis was performed with the donor common iliac artery bifurcation “Y” graft to the recipient abdomial aorta and the side-to-side intestinal anastomosis was performed between the donor duodenum and the recipient jejunum. External jugular vein was intubated for transfusion. The levels of blood glucose, insulin and glucagon in blood were measured before and during the operation and 1, 3, 5, 7 d after operation. Results Twenty-three cases of pancreatoduodenal allotranplantations were performed on pigs. One died from complication of anesthesia. Success rate of operation was 95.7%.Complications of operation happened in 2 cases in which one was phlebothrombosis, incidence 4.5% and the other was duodenojejunal anastomotic leak, incidence 4.5%. The level of blood glucose increased within 30 min and recovered on the 2nd day after removal of pancreas. The levels of insulin and glucagon decreased within 30 min and recovered on the 2nd day after removal of pancreas. Rejection curred at the 1st day and reached the worst level on the 9th day after transplantation without the change of insulin and glucagon in blood and clinical symptoms of rejection. Conclusion Pancreatoduodenal transplantation in pigs can treat type Ⅰ diabete. ED and PVD can keep the function of endocrine in normal. The techni- que of duodenal transplantation with ED and PVD may pave the way for the further development of pancreas transplantation in clinic.

Objective To explore the clinical treatment of Doppler guided hemorrhoid artery ligation (DG-HAL) combined with ultrasound-knife excision for severe hemorrhoids. Methods Eighty-seven patients with sever hemorrhoids were divided into 2 groups by the different admission months, the patients in group A (odd-numbered month) were treated by DG-HAL combined with ultrasound-knife excision, and the patients in Group B (bimonthly) were treated by procedure for prolaps and hemorrhoids. The clinical date were compared between 2 groups. Results There were no statistical differences in postoperative pain score and total efficient rate between 2 groups (P>0.05). The operating time, total hospitalization expenses and the incidences of postoperative bleeding, long term postoperative anal discomfort in group A were significantly lower than those in group B: (25.5 ± 2.8) min vs. (36.8 ± 4.6) min, (7 859 ± 564) yuan vs. (10 728 ± 733) yuan, 0 vs. 12.8%(5/39) and 2.1%(1/48) vs. 17.9%(7/39), the patient satisfaction score was significantly higher than that in group B: (9.3 ± 0.7) scores vs. (8.1 ± 0.6) scores, and there were statistical differences (P<0.05). Conclusions DG-HAL combined with ultrasound-knife excision to treat severe hemorrhoids has the definite treatment, less trauma, fewer complications and cheaper hospitalization expenses.

BACKGROUND:It is particularly important to establish an ideal animal model of pulmonary fibrosis to investigate the underlying pathogenesis and screen effective drugs to prevent and control pulmonary fibrosis. OBJECTIVE: To establish a modified scheme of establishing mouse models that can reflect pulmonary fibrosis formation in humans. METHODS: Fifty-six male C57BL/6 mice were randomly divided into two groups: A (a single large-dose injection) and B (multiple smal-dose injections). Mice in group A were subjected to a single intravenous injection of bleomycin 200 mg/kgviathe tail vein; and mice in group B received intravenous injections of bleomycin 50 mg/kg via the tail vein per week, totaly for 6 weeks. 

Institute of Pediatric,Suzhou University Affiliated Children's Hospital,Suzhou 215003,China Objective To explore the long-term effects of physical exercise on neonatal seizure-induced learning,memory deficit and the expression of zinc transporter-3(ZnT3)in rat hippocampus.Methods Sprague Dawlev rats aged 6 days were randomly divided into a recurrent-seizure group(RS)and a control group. At postnatal dav 6(P6),the recurrent seizures were induced by inhalation of the volatile agent flurothyl once a day for consecu tive 6 davs.The rats in the control group were placed in the container for an equal period of time as those in the RS group without exposure to flurothyl. Y-maze test was performed to evaluate learning and memory capacity at postnatal day 29 to 35 and 61 to 67,respectively.During the period of postnatal day 51 to 56,all the animals in the RS andcontrol groups were subject to a 30-minute daily aerobic exercise program for consecutive 6 days.All the animals weresacrificed at postnatal day 78,and the in situ hybridization method was used to detect the expression of ZnT3 mRNA in hippocampus. Results ①The number of trials needed for getting correct response to the electric stimulation in the first Y-maze test was(60±14.1)and(37.5±17.2)for the RS and control groups,respectively(P＜0.05),while that in the second Y-maze test carried out 24 hours later was(27.5±14.1)and(21±11.01)for the RS and the control groups,respectively(P＞0.05).②Memory test revealed no significant difference between the RS and thecontrol groups(P＞0.05).③In situ hybridization detection showed that the expression of ZnT3 mRNA in hippocam pus was not significantly different between the two groups.However,there showed a significant difference between the dentate gyrus and CA3 in the RS group with regard to the expression of ZnT3 mRNA(P＜0.05). Conclusions Physical exercise improves the learning capacity of neonatal seizure-induced cognitive deficit and might have effects on the regulation of zinc transporter gene expressions in hippocampus.

BACKGROUND:The molecular mechanism of periprosthesis osteolysis is not yet completely clear. Periprosthetic osteolysis and absorption is the pathological and physiological process typical of artificial joint loosening. Interleukin-1 can affect bone resorption process through a mitogen-activated protein kinases (MAPK) signaling pathway.
OBJECTIVE:To explore the effects of siRNA-induced interleukin-1 receptor-associated kinase-4 gene (IRAK-4) silence on MAPK expression in MG63 cells, which may provide experimental basis for treatment and prevention of periprosthesis osteolysis.
METHODS:The siRNA sequences of the target gene, IRAK-4, were constructed and transferred into MG63 cells using Lipofectamine 2000. There were three groups:blank group=MG63 cells, control group=MG63 cells transfected with scrambled IRAK-4siRNA, and silence group=MG63 cells transfected with specific IRAK-4 siRNA. The protein level of extracellular regulated kinase (ERK), c-Jun N-terminal kinase (JNK) and p38 mitogen-activated protein kinases (p38MAPK) were detected by western blot assay.
RESULTS AND CONCLUSION:The expression of IRAK-4 mRNA and protein in the silence group was significantly decreased compared with the control group. Compared with the blank and control groups, 48 hours after the transfection, IRAK-4 gene silencing in MG63 cells decreased protein expression of p-JNK1/2P46, p-ERK1/2 and p-p38MAPK (P<0.05). IRAK-4 silencing inhibited ERK, JNK and p38MAPK expression in osteoblast-like cells.

Objective To explore the clinical treatment of procedure for prolapse and hemorrhoids (PPH) combined with transrectal Block for rectocele (Block procedure).Methods Eighty-six hospitalized patients with rectocele were divided into two groups according the odevity of month:A group (odd month,PPH combined with Block procedure group,49 cases) and B group [even month,stapled trans-anal rectal resection (STARR),37 cases].The treatment conditions were compared between two groups.Results There were no statistical differences in degree of postoperative pain,healing rate between two groups (P ＞ 0.05).The operating time,postoperative hemorrhage rate,cost of hospitalization,patient satisfaction score and rectocele depth after 1 year in A group were significantly better than those in B group [(25.5 ± 2.8) min vs.(36.8 ± 4.6) rmin,2.0％(1/49) vs.13.5％(5/37),(7 359 ± 580) yuan vs.(10 928 ± 610) yuan,(9.1 ± 0.8) scores vs.(8.2 ± 0.7) scores,(5.02 ± 0.71) mm vs.(9.73 ± 1.31) mm],there were statistical differences (P ＜ 0.05).Conclusions PPH combined with Block procedure for rectocele had a significant clinical effect,it is a safe new method with small surgical trauma,a better choice to prevent the recurrence of rectocele,reduces the patients economic pressure obviously.So it is worth to clinical promotion.

The business process reengineering is accomplished by setting up at the operation room a pre-op ready room,an anesthesia induction room,and an anesthetic recovery room.With the aid of the computerized management system,a system platform is built to connect anesthetists,blood bank and pathology lab.This can optimize operation room management,shorten turn-over time before operations,improve efficiency,and cut back hospital costs for an all-win outcome.

Thirteen patients with colorectal lesions underwent laparoscopic surgery from January to December 2019. Before surgery, 5.0 ml autogenous blood was injected under colonoscopy into the inferior margin and opposite sides of the lesion for localization. The operation time，success rate，complications，location efficiency and postoperative pathology were evaluated. The autologous blood tattooing was easily applied for all patients without complication. At laparoscopic surgery，the lesions of all patients were clearly visualized except one obese patients with rectal tumors, because the tumor was located below the retroperitoneal fold. No blood diffusion and leakage，and local inflammatory responses were observed. The surgical margins of all samples were tumor negative. Preoperative tattooing with autologous blood is recommended as an easy，safe and economical procedure for colonoscopic surgery in patients with colorectal lesions.

Objective To investigate the clinical efficacy of a needle knife in treating knee meniscus injury. Methods One hundred patients with knee meniscus injury (112 knee joints) were randomly allocated to treatment and control groups, 50 cases each. The treatment group received needle knife therapy and the control group, an injection of sodium hyaluronate injectio into knee joint cavity. The main clinical symptoms and signs around the knee joint were observed and the knee function score was recorded in the two groups before and after treatment. the clinical therapeutic effects were evaluated in the two groups. Results There were statistically significant differences in pre-/post-treatment main clinical symptom and sign index (pain score, swelling score, activity score and tenderness index score) difference values between the two groups (P<0.05). There were statistically significant differences in the main clinical symptom and sign index difference values at follow-up compared with before treatment between the two groups (P<0.05). There was a statistically significant differences in the knee function score after treatment and at follow-up compared with before treatment in the two groups (P<0.01,P<0.05). There was a statistically significant differences in the knee function score between the treatment and control groups after treatment and at follow-up (P<0.05). Post-treatment excellence rate and total efficacy rate were 94.0%and 100.0%, respectively, in the treatment group and 72.0%and 98.0%, respectively, in the control group. There was a statistically significant differences in post-treatment excellence rate between the two groups (P<0.05). Follow-up excellence rate and total efficacy rate were 96.0% and 100.0%, respectively, in the treatment group and 76.0% and 98.0%, respectively, in the control group. There was a statistically significant differences in follow-up excellence rate between the two groups (P<0.05). Conclusion Needle knife therapy is an effective way to treat knee meniscus injury.

BACKGROUND:Chronic venous insufficiency is a major health problem worldwide. Clinical treatments include venous valve repair and venous segment containing valve transplantation. However, these are invasive procedures, and the supply of vein containing valves is limited. Significant progress in the fields of tissue engineering and regenerative medicine has been made towards the creation of tissue engineered vascular grafts for the repair of damaged or malformed vessels. It has been reported that using tissue engineering, a tissue engineered vein containing valves constructed with self-derived endothelial cells and al ogeneic acellular matrices can provide the complex physiological valve structure and mechanical stability, but this elicited an immunogenic response.
OBJECTIVE:To create a viable and functional vein containing valves, which has the ability to grow, repair, and imitate natural tissues.
METHODS:Bone marrow mesenchymal stem cells were obtained from Beagle dogs by density gradient centrifugation and adherence methods. Bone marrow mesenchymal stem cells were cultured in vitro. Fol owing isolation and culture the cells were examined using flow cytometry and identified by direct induction towards the osteogenic and adipogenic lineages. We fabricated biodegradable venous scaffold containing valves using the method of injection molding combined with thermal y induced phase separation. Based on the self-made cast, a three-dimensional biodegradable vein scaffold containing valves was constructed from poly(lactic-co-glycolic acid). Morphological structure was tested. Bone marrow mesenchymal stem cells were used as seed cells to be seeded onto the lumen of the tissue engineered vein scaffold containing valves in vitro and then incubated for 2 weeks.
RESULTS AND CONCLUSION:Scanning electron microscopy images showed that the scaffold demonstrated sufficient porosity. Cultured cells expressed mesenchymal cellmarkers, CD44 and CD29, but did not express hematopoietic cellmarkers, CD34 and CD45 at the same time point. Scaffolds were nontoxic to cells and were favorable for the growth and migration of bone marrow mesenchymal stem cells. cells attached on the surface of poly(lactic-co-glycolic acid) scaffolds formed a confluent layer after incubation. The cellular constructs were tested in vitro, and the valve leaflets were functional y capable of opening and closing when stimulated. These results suggested that the tissue engineered vein containing valves have been successful y constructed by using a three-dimensional poly(lactic-co-glycolic acid) scaffold and bone marrow mesenchymal stem cells as seed cells. Tissue engineered vein containing valves is potential y useful for the substitution and regeneration of vein valves.