Humans ; Kidney ; metabolism ; pathology ; Kidney Failure, Chronic ; metabolism ; therapy ; Kidney Transplantation ; Leptin ; metabolism ; Renal Replacement Therapy

Objective To explore the role of miR-184 in Oxygen-Glucose-Deprivation (OGD) induced SK-N-SH cell ischemic injury and its regulation on AKT2 level. Method We used a combination of oxygen and glucose deprivation to imitate ischemic conditions in vivo. MiR-184 mimic and inhibitor were transfected into SK-N-SH cell to alter miR-184 levels. The expression of miR-184 and AKT2 were determined by using Real-time PCR. The extent of SK-N-SH cell survival rate was assessed by thiazolyl blue tetrazolium bromide (MTT) assay. Result Here, we observed that miR-184 was significantly inhibited in SK-N-SH cell after OGD (P<0.05). The changes of miR-184 level altered the expression of AKT2 mRNA. In addition, alteration of miR-184expressionsignificantly affected cell survival rate after OGD. Conclusion miR-184 plays an important role in ischemic injury through negatively regulating AKT2 level, which may provide a potential therapeutic target for ischemic stroke in miRNA levels.

Objective: To establish a simple,rapid and novel Rayleigh light scattering(RLS)method for rapid determination of mexiletine hydrochloride in drugs. Methods: In the presence of acid Tris-HCl medium and cetylpyri- dinium bromide,eosin Y reacted with mexiletine hydrochloride to form a ternary ion association complex with two charac- teristic scattering peaks by electrostatic attraction. The detection wavelengths were 368 and 586 nm. There was a linear relationship between the mexiletine hydrochloride concentration in a certain range and the Rayleigh light scattering en- hancement intensity(ΔIRLS)of the association complex. Single-wavelength Rayleigh scattering(SWO-RLS)method or dualwavelength Rayleigh light scattering(DWO-RLS)method was used to determine the content of mexiletine hydrochloride, and the mexiletine hydrochloride content was calculated according to the regression equation of standard curve. Results: The linear ranges of mexiletine hydrochloride were 0.005-0.65 mg/L(SWO-RLS method,368 nm),0.004-0.65 mg/L (SWO-RLS method,586 nm)and 0.004-0.65 mg/L(DWO-RLS method,368 nm+586 nm),respectisely. Detection lim- its were 0.0033(SWO-RLS method,368 nm),0.0040(SWO-RLS method,586 nm)and 0.0018 mg/L(DWO-RLS method, 368 nm+586 nm),respectisely. The recovery and relative standard deviation(RSD,n=5)for a SWO-RLS method were 98.6-103% and 1.4-1.8%,respectively(SWO-RLS method,368 nm). Conclusion: The method is simple,rapid, highly sensitive and high selectie.

Objective To assesses the value of the Pipkin fracture classification on the treatment and prognosis of Pipkin fracture. Methods A total of 71 patients with Pipkin fractures treated from January 2002 to January 2007 were followed up and the detailed information of 63 patients were obtained. The clinical and radiographic evaluation criteria of Thompson was employed to evaluate the outcome, analyze the results and discuss the correlation between Pipkin fracture type and prognosis and hence propose the significance of Pipkin classification on the prognosis. Results There was no statistical difference in aspect of the outcome between type Pipkin Ⅰ , Ⅱ injury and type Pipkin Ⅳ injury (types Pipkin Ⅰ and Ⅱ injury combined with minimum fracture, with fragment ＜ 1 cm,P＞0. 05). There showed statistical difference in outcome between types Pipkin Ⅰ , Ⅱ injury and type Pipkin Ⅳ injury (types Pipkin Ⅰ and Ⅱ injury combined with acetabular rim fracture, P ＜0. 05). Conclusions Pipkin fracture classification system needs a further improvement. The type Pipkin Ⅳ injury that is combined with types Pipkin Ⅰ , Ⅱ , Ⅲ injuries with minimum fracture (fragment ＜ 1 cm) of the acetabular rim should be incorporated into types Pipkin Ⅰ ,Ⅱ , Ⅲ injury. Type Pipkin Ⅳ injury refers to types Pipkin Ⅰ ,Ⅱ , Ⅲ injuries, with major fracture of the acetabular rim and the hip joint instability. In addition, the Pipkin fracture type involving the fracture line, femoral neck and intertrochanteric region is hard to treat clinically and has poor prognosis, suggesting that this type of injury should be considered as special type Pipkin Ⅲ injury.

BACKGROUND: Antiviral drugs can reduce the incidence of early-onset cytomegalovirus(CMV)disease,but are associated with strong toxicity and the development of late-onset CMV disease.In order to prevent CMV disease better,cytotoxic T lymphocytes(CTL)may play a critical role in controlling CMV reactivation.Fluorescent HLA-peptide tetramers are used to monitor the recovery of CMV CTL in recipients of allogeneic transplants.OBJECTIVE: To explore the effect of HLA-peptide tetramers and adoptive immunotherapy in treating CMV disease.METHODS: A computer-based online search of Pubmed and Wanfang databases was performed for articles related to CTL detection,application of antiviral drugs and HLA-peptide tetramers,and adoptive immunotherapy with key words"HLA-peptide tetramers,cytomegalovirus,specific CTL,adoptive immunotherapy"in English and Chinese.Repetitive articles were excluded and 29 articles were included.RESULTS AND CONCLUSION: Adoptive immunotherapy with CMVs cytotoxic T cells as preemptive therapy is a very elegant strategy; however,generation of these cells is costly and time-consuming,and therefore the therapy is not available at every transplantation center.Magnetic selection of CMVs CD8+T cells from peripheral blood of CMV-seropositive donors by using HLA-peptide tetramers may be very hopeful,which simplifies adoptive immunotherapy.

BACKGROUND:In recent years, increasing research emphasizes the puncture position of the foramen ovale in skul , but most of the positin methods require a higher personal experience of surgeons and lack of individualized quantitative parameters. OBJECTIVE:To establish a visualized digital model of the foramen ovale in skul , explore the reasonable puncture path and puncture depth of percutaneous treatment of foramen ovale puncture for trigeminal neuralgia, and develop the individualized treatment of trigeminal neuralgia. METHODS:Head CT images from healthy adult male volunteers were obtained and were input into three-dimensional reconstruction software MIMICS 10.01, the three-dimensional visualized models of the skul and skin were established. Using the models, the puncture path of the foramen ovale was designed and the preliminary model of the puncture locator was plotted. RESULTS AND CONCLUSION:The three-dimensional visualized digital model of the foramen ovale puncture path was established with CT scan images by using MIMICS software, which provides reliable anatomical data for clinical teaching and lays the groundwork for the simulation of puncture surgery. On the three-dimensional models, the“needle points”,“target points”, and“midpoint”were determined, and the triangle consisted of the three points was regarded as“positioning plane”. Using these parameters, the positioning instrument is characterized by simple structure, convenient operation, high positioning precision and short period of exposure to radiation, it simulates the foramen ovale puncture needle depth and needle direction in a precise and individualized manner.

Objective To study the mechanism of restenosis following percutaneous transluminal coronary angioplasty(PTCA),and to replicate a dynamic model of cell proliferation and remoulding of vascular wall at different time points in rabbits after intimal injury.Methods The model of restenosis in common carotid artery was established by balloon injury in 70 rabbits.The indexes such as lumen area,thickness and area of intima and media,and cross sectional area bounded by the external elastic lamina(EELA) were respectively measured by computer image analysis technology at the 1st,3rd,5th, 7th,14th,28th and 35th day after the injury.Results Endothelial cells were denudated at the 1st day after injury.The proliferation of vascular smooth muscle cell(VSMC) was detected on the surface of lumen at 3 days after injury.At the 7th day after injury,the neointima was formed and continuously thicken.The thickness and area of the neointima as well as extracellular matrix were gradually increased after 14 days,and were maximal after 35 days.The thickness and area of media were also gradually increased during 3～14 days and decreased after 28 days.Compared with non-injured vessel,the medial area was obviously increased at the 14th day.The lumen area was decreased at the 5th～7th day after injury and was obviously less than that of non~injured vessel after 14 days.The EELA was gradually increased at the 1st～7th day after injury,and reached its maximum at the 14th day.The EELA was declined gradually after 28 days.Conclusion The progress of restenosis(RS) can be simulated through the model of restenosis in common carotid artery of rabbit established by balloon injury.The intimal proliferation and vascular remodeling are the leading pathogenesis of restenosis.

Objective Based on active monitoring MRSA carriage for hospitalized patients, the relationship between colonization pressure and MRSA cross transmission in wards without rigorous contactisolation measures was analyzed, and the role of colonization pressure in predicting MRSA cross transmission was further evaluated. Methods From March to December 2009, active MRSA colonization screening was performed for 240 hospitalized patients in emergency ward and 94 cases in RICU in our hospital. rep-PCR method was employed to do homology analysis on MRSA strains obtained in this study. MRSA weekly colonization pressure, threshold colonization pressure ,cross transmission rate were calculated respectively. RR of MRSA cross transmission under higher level of colonization pressure and lower level of colonization pressure was analyzed. Results MRSA carriage rates on admission for patients in emergency wards and RICU were 6. 25% (15/2A0) and 13. 83 % (13/94) ,and MRSA cross transmission occurred in 13 weeks and 14 weeks in above two units, respectively. Threshold colonization pressures for above two units were 6. 49%and 17. 66%, respectively. For emergency ward, the MRSA cross transmission rate under higher level of colonization pressure was significantly higher than that under lower level of colonization pressure (x2 = 7. 10,P＜0. 01), the RR of MRSA transmission was 9. 61 (95% CI:1. 25-74.00). For RICU, the MRSA cross transmission rate under higher level of colonization pressure was significantly higher than that under lower level of colonization pressure(x2 = 12. 60, P＜0. 01 ), the RR of MRSA transmission was 15.87 (95% CI:2. 06-122. 10). Conclusions Higher level of colonization pressure is an important risk factor for MRSA transmission, and average colonization pressure can be used as a prediction index for MRSA transmission and strengthening prevention and control measures.

Objective To discuss the operative methods, timing and outcomes of severe open Pilon fractures. Methods From April 2003 to July 2008, 21 patients with open Pilon fractures were admitted. All the patients were type C fracture according to AO/OTA classification, including 17 cases of type C2 and 4 cases of type C3. According to Gustilo classification, there were 18 cases of type Ⅱ, 2 cases of type ⅢA, 1 case of type ⅢB. The patients were treated in two different ways: one-stage minimally invasive osteosynthesis for reconstruction of the articular surface with transarticular external fixation of the ankle (19 cases),which included 16 cases of Gustilo Ⅱ AO/OTA C2, 2 cases of type Gustilo Ⅱ AO/OTA C3 and 1 case of type Gustilo ⅢA AO/OTA C2. Formal open reconstruction of the articular surface by plating and external fixation was performed when the condition of soft tissue had improved (2 cases), which included 1 cases of type Gustilo ⅢA AO/OTA C3 and 1 cases of type Gustilo Ⅲ B AO/OTA C3. Results All the patients were followed up from 6 to 48 months, with the mean of 24 months. The outcome of reduction was evaluated by the Burwell-Charnley score. Anatomical reduction was found in 6 cases, function reduction was in 14 cases and poor reduction was 1 case. The heal-time ranged from 2.5 to 11 months, with the mean of 4.7 months. The delayed union occurred in 2 cases. The rate of delayed union was 9.5%. Two patients experienced skin superficial necrosis. There were superficial infection in 2 cases and deep infection in 1 case. The infection rate was 14.3%. Eight cases experienced early traumatic arthritis. The incidence of this complication was 38.1%.According to American Orthopedic Foot Ankle Society (AOFAS) scale for ankle joint, the result of the treatment was 66-94, with an average of 85.2. Conclusion It is important to have the optimal timing of surgery and reliable fixation according to fracture classification, the condition of soft tissue and time after injury. It is the key to evaluate the condition of soft tissue and protect the blood supply.

Animals ; China ; Elapidae ; Humans ; Male ; Snake Bites ; Snake Venoms ; poisoning ; Young Adult