Objective To observe the efficacy of extracorporeal liver support by using less fresh frozen plasma in the treat‐ment of acute‐on‐chronic liver failure.Methods A total of 45 patients with acute‐on‐chronic liver failure were divided into ob‐servation group[plasma perfusion(PP) with a small amount of plasma+ plasma exchange(PE)] ,control group 1(PE) ,control group 2(PP+PE)in terms of the amount of plasma used on the day of treatment. All the patients received artificial liver treatnts 62 times totally.Results The clinical symptoms were improved in the three groups after treatments.There were significant differences in the decrease of alanine transaminase (ALT) ,aspartate transaminase(AST) and direct bilirubin(DBil)rather than the decrease of total bilirubin(TBil)and blood ammonia among the groups.No significant difference was noted in the liver and kidney function among the three groups. The improvement of the coagulation function was poor in the observation group when compared with the control group 1 and control group 2 and there were significant differences.Conclusion During the short sup‐ply of the plasma ,plasma perfusion combined with small amount of plasma can be considered to be used in artificial liver treat‐ments ,which can effectively decrease the level of TBil ,relieve symptoms and decrease the occurrence of complications.

With the development of technology and the deterioration of environment,more and more attention was attracted to the research on fluid dynamics in human upper respiratory tract.In this paper,the methods of research on fluid dynamics in human upper respiratory tract were introduced,and the mechanical models of human upper respiratory tract which were constructed by the scholars in the resent years were summarized.In addition,the current status of research on the airflow movements,the transportation and deposition of the particles in human upper respiratory tract was analyzed.The developing trend of this field was prospected as well.

Objective To analyze the clinical characteristics of systemic lupus erythematosus (SLE) patients with septic arthritis.Methods Twelve SLE patients with septic arthritis admitted to Peking Union Medical College Hospital from January 1990 to December 2012 were retrospectively analyzed.Results The median duration from onset of SLE to septic arthritis was 8.5 months (ranged from 1 to 120 months).All patients had received higher doses of steroid therapy (equal to prednisolone 1 mg ·kg-1 ·d-1) and immunosuppressant,and 5 of them had received methylprednisolone pulse therapy.The infectious manifestations included joint pain (all cases),swelling (5 cases),reduced joint function (8 cases) and fever (10 cases).All patients were oligo-arthritis.The hip and knee joints were most commonly involved.Three patients were infected by Salmonella,4 patients were infected by S.aureus,and 3 patients were infected by tuber culosis.Conclusion When SLE patients with long term steroid and immunosuppressant therapy developedacute joint pain and swelling,septic arthritis should be considered.Synovial fluid Gram stain,culture,blood culture and arthroscopy should be performed promptly.Appropriate antibiotics should be administered,and early treatment can improve the outcomes.

Objective To investigate the effects of human umbilical cord mesenchymal stem cells (UC-MSCs) on vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6) expression in acute myocardium infarction (AMI) rats. Methods The human UC-MSCs were cultured to the 4th generation for experiment. Sixty male Sprague-Dawley (SD) rats were randomly divided into sham group, AMI model group and UC-MSCs group, with 20 in each group. AMI animal model was produced by ligation of anterior descending coronary artery; in the sham group, the threading vein was gone below without ligation. In UC-MSCs group 2×106 UC-MSCs were infused through the caudal vein at 24 hours after successful model production. The animals were sacrificed after 7 days; the myocardial tissue and coronary artery below the ligation line were harvested. The mRNA and protein expressions of IL-6 in myocardium were detected by reverse transcription-polymerase chain reaction (RT-PCR) and Western Blot. The positive expression of VEGF in coronary artery was observed by immunohistochemisty. Results Compared with the sham group, the mRNA and protein expressions of IL-6 in myocardium in AMI model group were increased significantly (gray value: 0.732±0.131 vs. 0.321±0.080, 0.678±0.191 vs. 0.286±0.061, both P < 0.05). Compared with the AMI model group, the mRNA and protein expressions of IL-6 in myocardium in UC-MSCs group were decreased significantly (gray value: 0.300±0.104 vs. 0.732±0.131, 0.312±0.101 vs. 0.678±0.191, both P < 0.05). Observation under light microscope, the VEGF positive cells in AMI model group was increased significantly compared with the sham group (cells/HP: 21.1±2.2 vs. 7.6±1.3, P < 0.05), the VEGF positive cells in UC-MSCs group were increased significantly compared with the AMI model group (cells/HP: 41.5±3.1 vs. 21.1±2.2, P < 0.05). Conclusion Human UC-MSCs could promote angiogenesis by the improvement of VEGF in coronary artery and inhibit the inflammation by the reduction of IL-6 in rats with AMI.

This paper was aimed to study the protective effects and related mechanisms of Zhen-Gan Xi-Feng (ZGXF) decoction containing serum on 6-OHDA-induced oxidative stress in PC12 cells.The ZGXF decoction containing rat serum with low-,medium-,and high-dose (8,16,or 32 g.kg-1) or blank serum was used to preprocess PC12 cells for 1 h,and cultured together with 100 μM 6-OHDA for 24 h.And then,cells were collected.The fluorescent probe 2',7'-dichlorofluorescin diacetate (DCFH-DA) and fluorescence microplate reader were used to detect the level of reactive oxygen species (ROS).Real-time quantitative PCR was used to analyze the mRNA expressions of nuclear factor erythroid 2-related factor 2 (Nrf2),Nfe2l2,heme oxygenase-1 (HO-1),glutamate-cysteine ligase catalytic subunit (GCLc),and GCL modulatory subunit (GCLm).The luciferase report gene system was used to detect the antioxidant response element (ARE) activation.The results showed that ZGXF decoction-containing serum inhibited the 6-OHDA-induced oxidative stress,upregulated the Nfe2l2,HO-1 and GCLc mRNA expressions in cells processed with 6-OHDA.However,it has no significant effect on GCLm mRNA expression.It was concluded that ZGXF decoction-containing serum had protective effects on 6-OHDA-induced oxidative stress in PC 12 cells.Its mechanism may be correlated with the upregulation on Nfe2l2 mRNA expression,which activated ARE and further induced its downstream gene of phase Ⅱ detoxifying enzyme,as well as the HO-1 and GCLc mRNA expressions of antioxidant enzyme gene.

Objective To compare the effects of neutral posture training (NPT) and gas resistance training on balance and motor func-tion in stroke patients. Methods From June, 2014 to February, 2016, 44 hemiplegic patients were randomly divided into control group (n=22) and experimental group (n=22). The control group received conventional decubitus trunk muscle training and sitting gas resistance train-ing. The experimental group received NPT. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Fugl-Meyer Assessment-Lower Extremities (FMA-LE), and Berg Balance Scale (BBS) before and after training. Results There was no significant differ-ence in the scores of FMA-UE, FMA-LE and BBS between two groups (t<0.962, P>0.05). The scores significantly increased after training in both groups (t>12.248, P<0.001), and were higher in the experimental group than in the control group (t>1.972, P<0.05). Conclusion The NPT could improve the motor and balance function of stroke patients, rather than gas resistance training.

BACKGROUND:The type AO-C1 thoracolumbar acute spine injury is a kind of high-energy instable injury, can cause thoracolumbar fracture-dislocation, and mainly associated with spinal nerve injury. Generaly, al needs to posterior open reduction, decompression, bone graft fusion and multiple-segmental internal fixation of pedicle screw rod system, which causes excessive loss of spinal movement segment and a large number of application of internal fixators. OBJECTIVE:To evaluate the treatment effect of posterior pedicle screw mono-segmental internal fixation for treatment of the type AO-C1 thoracolumbar vertebrae fracture-dislocations. METHODS:From January 2008 to December 2013, 17 cases of type AO-C1 thoracolumbar fracture-dislocation were folowed up. Al patients were treated with one-stage posterior open reduction and pedicle screw-rod fixation. Of them, eight cases received four screws and two rods for single-segment fixation in upper and lower vertebrae adjacent to intervertebral space after dislocation (4-screw 2-rod group). Nine cases received eight screws and two rods for multiple-segment fixation in the upper and lower vertebrae adjacent to intervertebral space after dislocation (8-screw 2-rod group). Operative time and intraoperative blood loss were compared between the two groups. The Cobb’s angle was measured on lateral X-ray film of two groups preoperatively and 1 week postoperatively and during the final folow-up. The neurological function was evaluated by Frankel classification. The visual analogue scale was adopted to assess the degree of low back pain. RESULTS AND CONCLUSION:Patients were folowed up for 1 to 5 years. Significant differences were detected in the operative time between the two groups, and operative time was better in the 4-screw 2-rod group than in the 8-screw 2-rod group (P < 0.05). No significant difference was found in intraoperative blood loss between the two groups. The deformity of fracture-dislocation had been corrected, and the pain of low back had significantly relieved in al patients after fixation. According to Frankel classification, two cases at Grade A were improved to Grade E, but eight cases at Grade A got no improvement after treatment. Two cases at Grade B were also improved to Grade E at the final folow-up. Significant differences in Cobb’s angle and visual analogue scale were detectable at 1 week postoperatively and during final folow-up as compared with preoperatively (P < 0.05), but no significant difference was visible between final folow-up and 1 week postoperatively. No significant difference in Cobb’s angle and visual analogue scale was observed between the 4-screw 2-rod group and 8-screw 2-rod group. Results indicate that there was no significant difference in the clinical efficacy between 4-screw 2-rod single-segment and 8-screw 2-rod multiple-segment fixation for treating type C1 thoracolumbar vertebrae fracture-dislocation. Therefore, AO-C1 thoracolumbar vertebrae fracture-dislocation could be treated with 4-screw 2-rod single-segment reduction fixation.

Objective To compare clinical effect of unipolar versus bipolar radiofrequency ablation in treating atrial fibrillation (AF) in elderly patients and discuss the correlated risk factors.Methods From October 2008 to December 2013,a total of 50 elderly patients with organic heart disease and AF underwent radiofrequency ablation surgery.All patients were divided into 2 groups of unipolar (group A,n=20) and bipolar (group B,n=30 patients) radiofrequency ablations.The variations of electrocardiogram (ECG) and ultrasonic cardiogram (UCG) in patients were collected and the complications and the NYHA class of the patients were recorded at 3,6 and 12 months after surgery.The total 43 elderly patients were divided into sinus group and non-sinus group according to their ECG at 12 months after surgery.Results The recovery rates of sinus rhythm at 3,6 and 12 months after surgery were 73.7％(14/19),66.7％(12/18) and 61.1％ (11/18)respectively in group A and 82.8％(24/29),85.2％(23/27)and 88.0％(22/25) respectively in group B.Two groups of the recovery rate of sinus rhythm had a statistically significant difference between the two groups (P＜0.05) at 12 months after surgery.The complication rate in group A was higher than in group B [55.0％ (11 cases) vs.26.7％ (8 cases),P＜0.05].Preoperative history of AF and left atrial diameter were the influencing factors for the sinus rhythm recovery rates (P＜0.05).Conclusions Bipolar radiofrequency ablation for AF is safe and has less complications and high success rate of restoring sinus rhythm.The patients with long preoperative history of AF and left atrium distension have a low success rate of restoring sinus rhythm with a high recurrence rate.

Objective To explore the value of bone marrow megakaryocyte counts in predicting clinical response of thrombocytopenia (TP) in systemic lupus erythematosus (SLE) patients. Methods Thirty-one patients of SLE with severe TP (platelet ≤50×109/L) from Peking Union Medical College Hospital during 2007 to 2014 with appreciable bone marrow aspiration results were retrospectively analyzed. Their therapeutic responses were stratified and the correlation with clinical and laboratory findings including the megakaryocyte counts in bone marrow were evaluated with logistic multivariate regression. Results Totally fifteen patients obtained complete response (CR), eight patients obtained partial response (PR) and eight no response (NR). Megakaryocyte counts in bone marrow were (101±26)/slide, (156±48)/slide and (34±15)/slide respectively with statistically significant difference (χ2=6.632, P=0.036). Those NR patients had less megakaryocytes in their bone marrow compared with those with clinical response (CR+PR) (Z=-2.438, P=0.015). By ROC curve method, we found 20/slide might be a good cutoff of megakaryocyte counts in bone marrow for determining the therapeutic response of immunotherapy with a sensitivity of 91% and a specificity of 63% and a AUC (area under the curve) of 0.793. Those with 20/slide or less megakaryocytes in bone marrows only had a clinical effective response rate of 29% verse a response rate of 88% in those with more megakaryocytes in bone marrow. Conclusion Megakaryocyte counts in bone marrow may provide predictive value for therapeutic response of severe TP in SLE patients. Those patients with equal or less than 20/slide megakaryocytes in their bone marrow tend to have poor therapeutic response.