Objective:To study the protective effect of platelet-rich plasma on never function in the rats with traumatic brain injury (TBI),and to clarify its mechanisms. Methods:Sixty SD rats were randomly divided into sham group (opened skull bone window only),TBI group and platelet-rich plasma treatment group (PRP group) (n=20).The rats in PRP group were injected with platelet-rich plasma through vessel on the 1st day,the 2nd day and the 6th day after operation while the rats in sham group and TBI group were treated with saline at the same time.The neurological function defects were assessed with modified neurological severity score (mNSS)on the 1st, 3rd and 7th after operation.Then 10 rats were taken from each group and executed,and the brain tissues were taken.The brain sections were prepared for the histological observation and the others of each group were tested with Morris water maze.Results:Compared with sham group,the mNSS scores of the rats in TBI and PRP group were increased (P <0.05);the mNSS score of the rats in PRP group was decreased compared with TBI group (P <0.05).The injured volume of rat brain tissue was reduced significantly in PRP treated group compared with TBI group (P <0.05).The Nissl staining results showed that the injury area in PRP group had a more neat rows and a larger number of new blood vessels compared with TBI group.The immunohistochemical staining results showed the injured area had a higher level expression of GFAP+ cells in TBI group compared with PRP group,but the amount of neuN+ cells was smaller than that in PRP group (P <0.05).The Morris water maze test results showed that there were a shorter escape latency time,more times acrossing platform and a larger swimming time during platform quadrant in PRP group compared with TBI group (P < 0.05).Conclusion:Platelet-rich plasma has a significant role in protecting the neurological function of TBI rats.

Objective:To investigate the effect of chronic alcohol consumption on both left ventricular myocardial collagen and diastolic function in rats,and their relationship thereof.Methods:Twenty-four male Wistar rats were randomly divided into 2 groups:control group(n=12)and ethanol group(n=12).The changes in cardiac diastolic function were evaluated by echocardiography and tissue Doppler imaging(TDI).The value of myocardial hydroxyproline content was determined by hydroxyproline reagent kit.The expressions of collagen Ⅰ and collagen Ⅲ mRNA were detected by RT-PCR analysis.Results:It was found that mitral E and mitral annulus Ea were decreased,mitral annulus Aa was increased,and isovolumic relaxation time(IVRT)was prolonged in the ethanol group compared with those in control group(P＜0.05).The value of Ea/Aa ratio was greater than 1 in control group and less than 1 in ethanol group(P＜0.01).It was found that myocardial hydroxyproline content,collagen Ⅰ,collagen Ⅲ mRNA expression and their ratio significantly increased in ethanol group compared with those in the control group(P＜0.01).There was positive correlation between hydroxyproline content,collagen Ⅰ,collagen Ⅲ mRNA expression,and collagen Ⅰ /collagen Ⅲ mRNA ratio with IVRT(P＜0.05),and negative correlation between hydroxyproline content,collagen Ⅰ,collagen Ⅲ mRNA expression,and collagen Ⅰ /collagen Ⅲ mRNA ratio with the Ea/Aa ratio(P＜0.01).Conclusion:Chronic ethanol consumption can induce increase in left ventricular myocardial collagen synthesis and impairment in diastolic function in rats.Left ventricular diastolic dysfunction correlates with increase in myocardial collagen synthesis positively.

Objective To explore the monitoring methods for pancreatic graft function after upper abdominal cluster transplantation.Methods Analysis of the clinical data of 5 cases of successful upper abdominal(cluster) transplantation in our center.Results The patients recovered well after the operation.Endocrine and exocrine functions of all the pancreas graft returned to normal without any rejection.Conclusions Dynamic monitoring of blood glucose,C-peptide,blood insulin,blood amylase,urine amylase,amylase in abdominal drainage and duodenal tube decompression drainage,in addition to Doppler color ultrasound examination,can effectively detect the endocrine and exocrine function of the pancreas graft.

Objective To analyze the surgical procedure and effect of living-related small bowel transplantation(LR-SBTx) on intestinal function failure caused by short bowel syndrome.Methods A boy, 15 years of age with short gut syndrome, who had only 8 cm of residual small intestine, associated with serious malnutrition and poor D-xylase absorption test (0.226/5h). The donor was the boy's mother. They had a match of 4 loci in HLA. In the first stage of the surgical procedure, 120 cm of ileum from the patient′s mother was transplanted into the recipient. Both ends of the transplanted intestine were exteriorized as stomas on the patient′s abdominal wall. The second stage of reconstruction of the intestine was carried out 6 months after his first operation. The residual small bowel of the recipient was transected, and both of its ends were respectively anastomosed end-to-side to the proximal and distal segments of the graft. The stomas of the graft were left in place. Results The donor and recipient operation went on smoothly. Acute rejection and infection of CMV developed postoperatively and were cured after treatment. The patient was followed-up for 8 months, the graft function recovered gradually postoperatively with increase of body weight. He can ingest a semifluid diet and take care of himself independently. Conclusions LR-SBTx is an effective way to treat short bowel syndrome. The reconstruction of the intestine in two stages for LR-SBTx decreased the risk of complications. Rejection and infection are important risk factors of LR-SBTx.

Objective To investigate the methods and effectiveness of heterotopic reconstruetion of hepatic artery in orthotopic liver transplantation. Methods The methods of heterotopic hepatic artery reconstruction and postoperative management of 36 cases of recipient vascular anomalies among 440 cases of liver transplantation performed in our hospital over a ten year period,were retospectively analysed. Results In 10 of 36 recipients the donor hepatic artery was anastomosed to recipient infrarenal aorta ,10 to the suprarenal aorta ,4 to the left gastric artery and 2 to the splenic artery. Five patients died perioperatively with patency of hepatic artery, and 31 recipients have survived for 3 to 48 months without hepatic artery complications; 1 patient had to receive liver retransplantation because of ischemic necrosis of bile duct. Conclusions In cases of disease or anomaly of recipient hepatic artery during liver transplantation,the heterotopic reconstruction of donor hepatic artery to the infarenal or suprarenal aorta,splenic artery or left gastric artery of the reeipient is indicated,and the results are satisfactory.

Objective To investigate the prevention effect of curcumin loaded nano - liposomes on diabetic cardiomyopathy. Methods The curcumin-loaded nano-liposomes were prepared by Film dispersion and ultrasonic hydration technology and their quality inspections were also investigated.Sixty SD rats were randomly divided into normal control group,model control group,blank and curcumin-loaded nano-liposomes group ( n＝15). Diabetes model was induced by intraperitoneal single injection of STZ(70 mg·kg-1).After two weeks of STZ injection,the rats with model control were used for this study.The curcumin loaded nano-liposomes treatment group rats were treated with curcumin loaded nano-liposomes ( 5 mg·kg-1) via caudal vein administration for 12 weeks (three times a week).Rats of normal control group,blank nano-liposomes treated group and model control group were administrated equivalent volume of 0. 9% sodium chloride solution or blank nano-liposomes solution. After treatment for 12 weeks,the experimental animals underwent ultrasonic heart function examination.Then the rats were sacrificed and their hearts were arrested after saline perfusion. The myocardial cell collagen volume fraction ( CVF) and apoptosis index were detected. Results Curcumin loaded nano-liposomes showed good morphology and curcumin encapsulation efficiency ( 88. 37 ± 1.21) %with high stability and dispersibility. From the animal experiments, the evaluation indexes in curcumin loaded nano-liposomes treated group including LVIDd and LVFS were significantly higher than model control group and nano-liposomes treated group(P<0.05),and the LVPW,CVF and apoptosis index were significantly lower than model control group and nano-liposomes treated group(P<0.05). Conclusion Curcumin loaded nano-liposomes can improve the cardiac function of diabetic rats by reducing the fibrosis and apoptosis index of myocardial cells in diabetic rats, which could be used to prevent the diabetic cardiomyopathy.

Objective To investigate the expression levels of connective tissue growth factor(CTGF)and hepatocyte growth fac-tor(HGF)in the serum of patients with nephropathy and the relationship with renal fibrosis.Methods Levels of serum CTGF, HGF,blood urea nitrogen(BUN),creatinine(Cr)and Cystatin C(SCys C)in 87 patients with chronic nephropathy and 40 healthy persons(control group)were determined by enzyme-linked immunosorbent assay(ELISA)and the automatic biochemical analyzer. The correlation of indexes like serum CTGF with glomerular sclerosis and renal tubule interstitial fibrosis score in patients with chronic nephropathy was analyzed by Pearson correlation analysis.Results The levels of serum BUN,Cr and Cys-C and in patients with grade Ⅲ and grade Ⅳ chronic nephropathy were significantly higher than those in the control group(P<0.05).The levels of serum CTGF and HGF in patients with grade Ⅱ,grade Ⅲ and grade Ⅳ chronic nephropathy were significantly higher than those in the control group(P<0.05).For patients with gradeⅢ - Ⅳ chronic nephropathy,the levels of Cys-C and serum CTGF increased with the increase of grade(P<0.05).Pearson correlation analysis showed that serum CTGF,HGF,BUN,Cr and Cys-C were signif-icantly positively correlated with glomerular sclerosis score and renal tubule interstitial fibrosis score(P<0.05).Conclusion Serum CTGF and HGF may be involved in the occurrence and renal fibrosis of chronic nephropathy.

Objective:To explore the value of nomogram based on arterial spin labeling (ASL) MRI perfusion parameters and clinicopathological features in predicting the response to chemoradiotherapy (CRT) in advanced nasopharyngeal carcinoma (ANPC, stage Ⅲ and Ⅳ).Methods:From June 2018 to January 2021, 70 patients with ANPC confirmed by pathology were prospectively enrolled in Affiliated Hospital of Jiangnan University. Nasopharyngeal MRI plain scan, ASL and contrast-enhanced scan were performed before CRT, and routine MRI re-examination was performed within 1 week after the end of CRT. The pre-CRT perfusion parameter tumor blood flow (TBF) from ASL and clinicopathological features were recorded, and the maximum diameter (MD) of the tumor on T 1WI images was measured. The patients were divided into CRT effective group (48 cases) and ineffective group (22 cases) according to the response evaluation criteria in solid tumors. The independent sample t test was used to compare the differences of TBF, age and MD between effective group and ineffective group. The χ 2 test was used to compare the differences of gender, clinical stage and pathological type between the 2 groups. Using binary logistic regression analysis, clinicopathological model and TBF combined clinicopathological model were constructed, and the nomogram of combined model was constructed. The diagnostic efficacy of the models was obtained by receiver operating characteristic (ROC) curve analysis, and the area under the ROC curves (AUC) of the 3 models were compared by DeLong method. The calibration curve for the nomogram was generated, and the concordance index (C index) was acquired. Results:The TBF of the effective group and the ineffective group were (113±9) and (97±14) ml·100 g -1·min -1, with a statistical difference ( t=5.17, P<0.001). The MD value of the effective group was smaller than that of the ineffective group, with a statistical difference ( t=-2.24, P=0.028). There were statistical differences in clinical stage and pathological type between the 2 groups (χ 2 values were 12.21 and 12.95, respectively, both P<0.001). Three independent predictors, including TBF (OR=7.749), clinical stage (OR=0.129) and pathological type (OR=5.228), were included in logistic regression analysis. The AUC, sensitivity and specificity of TBF model in predicting the response to CRT were 0.843, 87.5% and 72.7%, of clinicopathological model were 0.822, 80.2% and 59.1%, of the nomogram model were 0.893, 81.2% and 90.9%. There was no statistical difference of AUC between the nomogram model and TBF model ( Z=1.23, P=0.215). However, the AUC of the nomogram model was greater than that of the clinicopathological model ( Z=2.47, P=0.031). The calibration curve showed that there was a good concordance index (C index=0.892) between the predicted value of nomogram and the actual clinical observation value. Conclusion:TBF, clinical stage and pathological type are independent predictors of the response to CRT in ANPC patients, and the nomogram based on these three factors has a good ability in predicting the response to CRT.

OBJECTIVETo assess the impact of transfection with recombinant adenovirus vector-mediated Klotho gene on myocardial remodeling in a rat model of heart failure (HF) by intraperitoneal injection of isoproterenol.

METHODSRats were divided into 5 groups by table of exponential random numbers: normal control group, HF group, saline-control HF group, recombinant adenovirus vector transfection group (Ad.EGFP group, 2 × 10¹⁰ pfu, 0.5 ml/rat), pDC316-CMV-EGFP-rKlotho transfection group (Ad.Klotho group, n=5 each). Left ventricular ejection fraction (LVEF) was obtained by echocardiography, hemodynamic parameters obtained by multi-channel physiological recorder, myocardial tissue underwent pathohistological examination. Additionally, the green fluorescin expression was observed on frozen heart section. Myocardial fibrosis correlated gene expression including Klotho gene, collagen I and III was detected by real time-PCR. Moreover, plasma levels of B-type natriuretic peptide (BNP) were measured with ELISA.

RESULTSCompared to saline control HF group, LVEF, LVSP and ±dp/dtmax were significantly increased, myocardial fibrosis and myocardial remodeling were significantly attenuated in the Ad. Klotho group and there was green fluorescin distribution in myocardial tissues of Ad. Klotho group. Klotho expression was down-regulated and collagen I and III expression was upregulated in HF rats compared to normal control group (all P<0.05) and these changes could be significantly reversed in Ad. Klotho group (all P<0.05). Plasma BNP level was also significantly lower in Ad. Klotho group than in HF group (P<0.05).

CONCLUSIONSKlotho gene transfection could improve cardiac function and attenuate cardiac remodeling and reducing myocardial fibrosis.

Adenoviridae ; Animals ; Disease Models, Animal ; Echocardiography ; Gene Expression ; Genetic Vectors ; Glucuronidase ; Heart Failure ; Hemodynamics ; Isoproterenol ; Myocardium ; Natriuretic Peptide, Brain ; Rats ; Transfection ; Ventricular Function, Left

Objective:To investigate the mechanism of levosimendan on acute kidney injury after cardiopulmonary resuscitation (CPR) in rats.Methods:Twenty-five healthy adult male SD rats were randomly divided into three groups: control group ( n=5), levosimendan group ( n=10) and experimental group ( n=10). A cardiac arrest-cardiopulmonary resuscitation model was established using smothering method in the experimental group and levosimendan group. The levosimendan group was treated with levosimandan during and after resuscitation, while the experimental group was given equivalent volume of saline solution during and after resuscitation, and the control group was only given equivalent volume of saline without performance of CPR. The rats in the three groups were sacrificed at 6 h after resuscitation. The serum and kidney tissue samples were collected. Serum biochemical indicators [serum creatinine (Scr), blood urea nitrogen (Bun), interleukin-1β (IL-1β), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α)] were measured. HE staining and Paller score were used to identify the degree of kidney damage. Apoptosis was estimated by TUNEL staining. Western blot was used to detect the expression levels of phosphorylation of extracellular regulated protein kinases (p-ERK). One-way analysis of variance was used to compare the mean values of normally distributed measurement data between groups. Comparisons between groups were performed using the least significant difference t-test. Results:Scr (85.02±1.31) μmol/L, Bun (7.36±0.13) mmol/L, Paller score (7.3±0.2), IL-1β (302.20±17.35) pg/mL, IL-6 (564.60±23.24) pg/mL and TNF-α (1346±83.73) pg/mL in the experimental group were significantly higher than those of the control group [(15.94±0.96) μmol/L, (2.95±0.18) mmol/L, (0.7±0.2), (7.27±0.44) pg/mL, (51.30±2.87) pg/mL, and (10.39±0.52) pg/mL] (all P<0.01). Compared with the experimental group, Scr (63.88±2.01) μmol/L, Bun (5.45±0.47) mmol/L, paller score (4.8±0.2), IL-1β (78.61±3.66) pg/mL, IL-6 (297.90±13.64) pg/mL and TNF-α (276.2±20.18) pg/mL were significantly decreased in the levosimendan group (all P<0.01). TUNEL staining showed that levosimendan could improve the apoptosis of renal cells ( P<0.01). The expression of p-ERK protein in the levosimendan group was significantly higher than that in the experimental group ( P<0.01). Conclusions:Lovosimendan could attenuate acute kidney injury following cardiac arrest and cardiopulmonary resuscitation via suppression apoptosis. The mechanism of levosimendan protective effect might be associated with activation of ERK signaling pathway.