Objective To investigate the anesthesia and perioperative blood management of patients with Marfan syndrome (MS) undergoing scoliosis surgery.Methods The clinical data of MS patients underwent scoliosis surgery from January 2013 to December 2015 in Peking Union Medical College Hospital were collected and compared with patients received the same surgery but without MS.Perioperative information and data on anesthesia and blood management were analyzed.Results Compared with control group,MS patients were found with more preoperative comorbidities with statistical significance,including eye disease,echocardiographic abnormalities,and ventilatory defects.MS patients had significantly more blood loss,more intraoperative and postoperative allogeneic and autologous blood transfusion.The operation time,anesthesia time,and length of postoperative hospital stay were all significantly longer in MS patients.Conclusions MS patients are common with multi-system involvement and comorbidities.Considering the high risk of perioperative bleeding,the anesthesia and blood management for MS patients undergoing scoliosis surgery should be with extra caution.Blood management should be applied and appropriate invasive monitoring methods should be considered when necessary.

Objective To explore the imaging characteristics and the diagnostic value of primary ureter cancer.Methods 24 cases of primary ureter carcinoma underwent ultrasound(US), intravenous pyelography(IVP),retrograde pyelography and CT scan.Those imaging features were analyzed retrospectively.Results The postive rate of US,IVP,retrograde pyelography and CT was 45.8%(11/24),37.5%(9/24),88.8%(16/18)and 62.5%(10/16).Conclusion Ultrasound(US) is a more value examination for making the choice of cases; IVP is an essential method for understood function of the kidneys, showing carcinoma; retrograde pyelography is most value in the diagnosis of primary ureter carcinoma;CT scan is more important diagnostic values in area,properties and extent of tumor.

AIM: To establish a fluorogenic quantitative polymerase chain reaction (FQ-PCR) method for the routine examination of c-erbB-2 gene expression in breast cancer. METHODS: The c-erbB-2 standard gene was obtained by in vitro amplification of cloned c-erbB-2 fragment in plasmid PGEM-T easy vector. FQ-PCR product was detected by using a 7700 ABI PRISM sequence detector system and c-erbB-2 standard curve was obtained to quantity c-erbB-2 in unknown samples. RESULTS: “S” kinetics curve of FQ-PCR amplification was generated by relating the fluorescence signal intensity (△Rn) to the cycle number. The standard curve of c-erbB-2 was constructed by the linear relationship between the cycle threshold (ct) and the log of starting copy number. The high correlation (0.999) revealed the reliability of FQ-PCR. CONCLUSION: The FQ-PCR is a rapid, sensitive, reliable method for quantity of c-erbB-2 gene expression.

BACKGROUND:It is reported that the cellsurface antigen may be damaged by the trypsin enzyme in some extent and the cellactivity may also be influenced, as a result of which, the subsequent separation and fol ow-up-test wil be affected. Accutase enzymes possess the activities of protease and col agen enzyme and need no special termination or cleaning at the end of digestion. Another special function of accutase enzyme is to protect cellsurface antigen and thus it has been widely applied in the stem celldigestion and culture.
OBJECTIVE:To compare the digestive effect of accutase enzymes and trypsin enzyme in the separation and original culture of spermatogonial stem cells.
METHODS:The testes of 5-7 days male Kunming mice (n=45) were col ected and primarily digested with col agenas. The suspension of digested tissue was divided into three parts with the same volume named accutases enzyme group, trypsin enzyme group and mixed enzyme group (trypsin enzyme and hyaluronidase). For the comparison of testis digestive status and the time required for the formation of single cells, the micrographs were taken at 1, 3 and 5 minutes respectively after enzyme digestion. The total number and the mortality of the single cells were estimated and compared. The leydig cells and sertoli cells were removed by differential adherent method and the remained spermatogenic cells were then treated with CD90.2 immune magnetic beads. The selected spermatogonial stem cells were subsequently labeled by glial cellline-derived neurotrophic factor receptor alpha-1 and sorted with flow cytometry. The number of spermatogonial stem cells positive for glial cellline-derived neurotrophic factor receptor alpha-1 in CD90.2+and CD90.2-cells was compared within different groups.
RESULTS AND CONCLUSION:The digestive capacities of different enzyme were different. Accutases enzyme obtained the single cellsuspension more quickly than trypsin enzyme and mixed enzyme, and had the least cellmasses and broken cellmembrane than the other two groups. After the differential attached treatment, the highest total number of CD90+spermatogonial stem cells and lowest cellmortality could be found in the accutases group, when compared with the other groups. The results of cellsorting by flow cytometry showed a higher rate (72.24%) of GFRα1+/CD90+cells in the accutases group than the trypsin group (51.16%) and mixed enzyme group (71.27%). The GFRα1+/CD90-number in the accutases group was lower (15.03%) than that of the trypsin group (18.8%) and mixed enzyme group (24.23%), respectively. The results indicate a better effect of accutases enzyme on the primary separation of spermatogonial stem cells than that of trypsin or mixed enzyme.

Background In recent years,incidence of drug-induced keratopathy is increasing highly.Druginduced keratopathy is lack of typical clinical features and offen confused with the primary disease.Therefore,summarizing and concluding the clinicals feature and standard treatments of drug-induced keratopathy are key problem need to be solved urgently for us.Objective This study was to retrospectively analyze the clinical features and therapeutic procedure of drug-induced keratopathy.Methods A retrospective case series analysis method was adopted.The clinical data of 36 eyes (31 patients) with drug-induced keratopathy were collected by Shandong Eye Hospital from 2008 to 2012,including eye disease history,medication history,medication dosage and duration.A series of relevant examinations were performed,including best corrected visual acuity (BCVA) before and 1 month after treatment,Schirmer test Ⅰ (S Ⅰ t),tear film break-up time (BUT),meibomian gland findings,the location of the keratopathy,the characteristics of keratophthy before and after fluorescein staining.The treating were given,including cessating of the original drugs,applying corneal repair promotion and anti-inflammatory drugs as well as the comprehensive treatment for meibomian gland embolization and dry eye,such as the hot packs and massage in the eyes with meibomian gland dysfunction and a tear dot embolization therapy in the eyes with S Ⅰ t ＜ 5 mm and BUT＜5 s.Paired t test and repeated measured one-way analysis of variance in SPSS 17.0 software were used to compare the BCVA,BUT and S Ⅰ t outcomes.The correlation between corneal repair duration and S Ⅰ t results was analyzed by Pearson linear correlation analysis.Results The primary cause of drug-induced keratopathy was irrational use of drugs,including antiviral drugs,antibiotics,hormone,antiallergic,lowering-intraocular pressure drugs,turn for 23 eyes,12 eyes,10 eyes,1 eye and 1 eye,respectively.Improper route of administration included 25 cases of overuse of eye drops and 6 cases of subconjunctival injection.BCVA was 0.69 ± 0.28 1 month after treatment,which was significantly improved in comparison with before treatment (0.32 ± 0.26) (t =11.02,P ＜ 0.01).Clinical manifestations included corneal epithelial diffusive and point-like roughness,corneal epithelial defect and even corneal ulcer for severe cases,corneal edema,Descemet membrane folds and partially visible corneal filiform.Drug-induced keratophthy was mainly located in the central and lower cornea.Comprehensive therapy was effective with the treating duration about 1 week to 8 weeks.A negative correlation was found between the corneal restore duration and S Ⅰ t results (r =-0.835,P＜0.01).Conclusions Corneal changes secondary to topical medications may affect all layers of the cornea.Clinicians should be mindful of drug-induced ocular disorders.The early diagnosis of druginduced keratopahthy depends on the medical history and clinical features.A comprehensive treating based on ocular surface conditions is available.

Objective: To investigate the antitumor actions of polysaccharide extracts from the fruiting body of coriolus versicolor (CVE). Methods:Hepatoma HepA cells were injected into mice subcutaneously. Different doses of CVE were given by gavage. On the 7 th and 14 th day, tumor inhibitive rates were calculated. ELISA was performed to measure the serum IgG level; MTT was used to examine CVE′s effects on the proliferation of T lymphocytes of thymus. Immunohistochemistry was used to determine CVE′s influence on the expression of tumor related genes P53 and VEGF in liver. Results: CVE may evidently inhibit the growth of the transplanted HepA tumors. Its effects on the serum IgG level and on the proliferation of T lymphocytes of thymus were also significantly. Also, CVE markedly decreased the expression of P53, VEGF genes in liver. Conclustion: CVE had significant antitumor effects in vivo . The mechanisms may involve immune modulation effects and antimetastasis actions.

Objective To investigate the role of purinergic 2X7 receptor (P2X7R) and its downstream target-NLRP3 inflammasome activation in the process of pancreatic fibrosis in a mouse model of chronic pancreatitis (CP). Methods Forty C57BL/6 mice were randomly divided into normal control group, CP group, P2X7R antagonist oxidized ATP (OxATP) group and brilliant blue G (BBG) group. The chronic pancreatitis model was induced by repeated intraperitoneal injection of the cholecystokinin analogue caerulein with the dose of 50μg/kg for six weeks. Normal saline, OxATP (20μL, 300μmol/L) or BBG (20μL, 10μmol/L) were administered for CP group, OxATP group and BBG group for two weeks after the last caerulein injection. Then all mice were sacrificed and the histopathological changes of the pancreas, especially the fibrotic degrees were evaluated by HE stain, fibrosis score, Sirius red staining and α-SMA immunohistochemical stain. The pancreatic P2X7R, NLRP3 and Caspase-1 expressions were detected by immunohistochemistry respectively to compare the changes between the groups, and explore the role of P2X7R-NLRP3 signaling pathway in pancreatic fibrosis. Results Compared with the normal control group, the scores of pancreatic fibrosis and the expressions of P2X7R, NLRP3 and Caspase-1 in pancreas were significantly increased in CP model group (P<0.05). Compare to CP group, the pancreatic chronic inflammation and the fibrosis indices such as HE fibrosis score, Sirius red staining and α-SMA immunohistochemical stain were ameliorated obviously in OxATP and BBG groups (P<0.05). And expressions of P2X7R, NLRP3 and Caspase-1 in the pancreas were allreduced greatly in both OxATP and BBG groups (P<0.05). Conclusion P2X7R antagonist OxATP and BBG can significantly decrease pancreatic chronic inflammation and fibrosis in the mouse model of CP, which suggests that the blockade of P 2X7R-NLRP3 inflammasome signaling pathway may represent a novel therapeutic strategy for CP and its fibrotic process.

Objective To investigate the differences of hand and foot morphology and genetic phenotypic characteristics in adults of Hui and Han nationality in Southwestern Henan.Methods The indicators of height,weight,hand and foot were measured by the morphological measurements,the hand and foot genetic phenotype classification was observed and performed the statistical analysis.Results The hand width,foot length and foot width of the Hui adult men and women in Southwestern Henan were(8.27±0.55,23.10±1.20,9.34±0.83)cm and(7.41±0.44,20.50±1.23,8.79±0.69) cm,respectively,while which of the Han adult men and women were(8.56±0.09,24.57±1.33,9.47±0.70)cm and(7.74±0.36,22.46±1.21,8.91±0.85) cm,respectively.The total number of both hands fingerprint ridge line in Hui adult men and women were(135.06 ± 19.87) and (125.50 ±20.44)respectively,and which in Han adult men and women were (144.46 ±14.08) and (129.20 ± 20.34)respectively,the difference was statistically significant(P＜0.05).The tPD,atd angle and a-b crest line number among the Hui and Han nationalities were 16.07± 6.46,(44.61±8.66)°,34.04±5.47 and 16.53±6.27,(43.19±9.52)°,36.73±4.22 respectively.And the handedness,fingernail form,thumb type,footedness,right type ratio of foot and toe length of the Hui and Han nationalities were 90.01％,38.52％,85.59％,70.47％,56.92％ and 89.33％,45.26％,70.91％,96.98％,74.89％,respectively,the difference between the Hui and Han nationalities was statistically significant(P＜0.05).Conclusion The national differences and gender differences exist in the multiple indicators of hand and foot morphology,finger and palm prints,and genetic phenotype among the Hui and Han adults in Southwestern Henan.

Inferior vena caval (IVC) tumor thrombus with cardiac extension is a very rare phenomenon,which proliferates fast and could be very challenging to the surgery.This paper was designed to investigate the clinical value of transesophageal echocardiography (TEE) for the surgical resection of IVC tumor thrombus extending into right cardiac cavities.Six cases from our medical institute,preoperatively diagnosed as IVC tumor thrombus with cardiac extension and scheduled for the surgical resection,were retrospectively analyzed.In addition to real-time and dynamic monitoring,comprehensive TEE exams were performed for all the patients respectively after anesthesia induction,namely before tumor resection and after tumor resection.Cardiac extension was defined by the preoperative finding of cardiac mass originated from IVC tumor thrombus by transthoracic echocardiography,computerized tomography or CT angiography.In all the cases,intraoperative TEE provided an accurate and excellent view of the IVC tumor thrombus.For case three,the IVC tumor thrombus was found at the IVC entrance to right atrium without further cardiac extension; for case five,the IVC tumor thrombus proliferated into right atrium but the extended cardiac mass was very slim and flexible and the tricuspid valve was untouched; for case four,the IVC tumor thrombus extended into right atrium and even cross the tricuspid valve but the extended cardiac mass was also very slim and flexible.Based on the TEE-provided information,the originally scheduled surgical decision was modified and the surgical resection was performed without cardiopulmonary bypass (CPB).For the other three cases,the intraoperative TEE showed similar results to preoperative findings.The huge IVC tumor thrombus extended into the right heart,presented almost no flexibility and dramatically compromised the intracardiac blood flow.For the three cases,CPB support was indispensable for the tumor resection.The full TEE exam after tumor resection in all the six patients displayed clear surgical resection without tumor residuals,but in those three patients suffered with severely compromised cardiac extension,severe tricuspid regurgitation was noticed.All the six patients were closely monitored until discharged,and no TEE-related complications were observed.This paper reports about TEE' s utilization in a series of consecutive patients undergoing surgical resection of IVC tumor thrombus with cardiac extension.In addition to its safety and effectiveness,TEE can provide valuable information for surgical decision making,surgical intervention assessment and anesthesiamanagement strategies.

As a model organism, zebrafish have many advantages over other animal models and is suitable for studies on establishment of human disease model and mechanism.In zebrafish, there are two phases of endocrine formation during early development, which are directed by concomitant activity of many signaling pathways.Zebrafish pancreas possess similar cell structure with that of other animals, which can express various endocrine hormones including insulin.The main organs required for metabolic control, such as the pancreas, islet, and insulin sensitive tissue (muscle, liver) are conserved in zebrafish, and the mechanisms of glucose regulation in zebrafish is similar to that seen in mammalian models.These render it an excellent model to study glucose metabolism.Hyperglycemia in zebrafish model can be induced by administration of the diabetogenic drug, streptozotocin (STZ), alternatively immersion of the fish in glucose solution and water, or disturbing of signaling pathways associated with glucose metabolism.Glucose levels in adult zebrafish blood or embryo tissue and phenotype of retinal cell layers or retinal vasculature are the commonly used measurement organs in zebrafish diabetic models.