Objective To establish a simple and feasible method in analyzing the molecular weight distribution of peptides in thymosin.Methods Improved Tricine-SDS-PAGE electrophoresis was applied to detect the molecular weight of peptides and the content of thymosinα1 in thymosin.Results Tested the thymosin preparations on the domestic market using this im-proved method.It was demonstrated that the peptide molecular weight distribution in thymosin preparations was between 3.5~8.5 kD,also could detect the concentration of 1 μg thymosinα1 in thymosin by using this improved method.Conclusion This improved method is suitable for the analysis of peptides molecular weight distribution and the concentration of thy-mosinα1,so it can be used for control quality of thymosin preparations.

AIM: To observe the protein expression of vascular endothelial growth factor 1 (VEGF-1) in pulmonary arterial endothelial cells and VEGF-1 gene expression in lung tissue in rats with hypoxia-induced pulmonary hypertension and treated with heparin. METHODS: Twenty four male adult SD rats were randomly divided into three groups (8 rats each): a control group (group A), a group with hypoxia for 4 weeks (group B) and a group with hypoxia for 4 weeks and injected with heparin to abdominal cavity simultaneously (group C). Mean pulmonary arterial pressure (mPAP), right ventricle hypertrophy index (RVHI) and vessel morphometry were measured. The morphology of pulmonary artery was observed by HE staining. The expression of VEGF-1 protein in pulmonary arterial endothelial cells was determined by immunohistochemistry. The level of VEGF-1 mRNA in lung tissue was measured by reverse transcription polymerase chain reaction (RT-PCR). RESULTS: mPAP, RVHI, pulmonary artery remodeling parameters, VEGF-1 protein expression in pulmonary arterial endothelial cells and VEGF-1 gene expression in lung tissue of the three groups from high to low were group B, group C and group A. It was statistically significant when compared between either two groups of the three (P<0.01). Linear correlation analysis showed that VEGF-1 protein was positively correlated with pulmonary artery remodeling parameters (r=0.974, P<0.01), and VEGF-1 mRNA was positively correlated with VEGF-1 protein (VEGF 120 mRNA, r=0.919, P<0.01; VEGF164 mRNA, r=0.896, P<0.01). CONCLUSION: Heparin may down-regulate the expression of VEGF-1 at the levels of transcription and translation, resulting in the inhibitory effect on rats with hypoxia-induced pulmonary hypertension.

ObjectivesTo detect the effects of P-selectin on deep venous thrombosis (DVT) in nephrotic syndrome (NS). and to evaluate the molecular magnetic resonance imaging (MRI) with a P-selectin targeted conlrost agent in diagnosis of thrombosis in the early phase. Methods(1) Forty-one patients with NS hospitalized in our department from 2005 to 2006 were enrolled in this study. They were assigned into DVT group and non-DVT group according to lower limbs radionuclide imaging (RNV) with 99mTc MAA. Blood P-selectin level was measured by ELISA method. (2) P-selectin was detected both in injured vein and blood immediately, 1 h and 3 h after the dog DVT model was established. (3) The P-selectin-targeted contrast agent was developed by conjugating anti-P-selectin lectin-EGF domain monoclonal antibody (PsL-EGFmAb) which was prepared by our lab. The potential of this contrast agent used in vitro molecular imaging experiment as well as in vivo experiment in dog DVT model was investigated. Results (1) Blood P-selectin level was elevated in patients with NS. It was much higher in DVT group than that in non-DVT group. (2) Blood P-selectin level was also elevated in DVT dogs and P-selectin expressed immediately in tunica intima of injured vein and subsequently in thrombus after the model established. (3) Mural thrombus showed higher signal visualization than surrounding muscle in 30 rain after contrast agent injection. These enhanced signals exhibited P-selectin specificity and persisted from the initiation of intima lesions to 3 h after development of thrombosis. There was signficant Differences in contrast-to-noise ratio (CNR) of the experiment group and the control group (11.50±2.32 vs 2.71±0.86, P＜0.01). The same results were derived from 30 rain to 1 hafter contrast agent being injected in distal to heart part of the injured vessel, and the signal decreased 24 h later. Differences in CNR of the experiment group and the control group were also statistically significant (10.40±2.15 vs 1.93±0.57, P＜0.01). Moreover, the contrast agent did not affect the vital signs of the dog. The function of the heart, lung, liver and kidney functions remained normal after contrast administration. Conclusions P-selectin*targeted new MR contrast can be used to early locate thrombus in vivo in an early stage, which does not compromise the function of the important organs. It may become a new method for early diagnosis of thrombosis.

Objective To explore value of trephine in pedicle subtraction osteotomy (PSO) for old thoracolumbar compression fracture with kyphotic deformity.Methods Thirty seven patients who underwent surgical treatment for old thoracolumbar kyphotic deformity in our hospital from February 2005 to February 2010 were retrospectively reviewed.Among them,21 patients underwent conventional PSO and 16 patients underwent PSO with trephine.In conventional PSO group,there were 14 males and 7 females,the average age was 55.6±3.7 years and the mean Cobb angle was 45.3°±4.6°.In PSO with trephine group,there were 11 males and 5 females,the average age was 53.3±4.2 years and the mean Cobb angle was 47.6°±5.9°.Results All patients were successfully followed up.The duration of follow-up ranged from 12 to 22 months in conventional PSO group,while 13 to 20 months in PSO with trephine group.The operation time,blood loss,amount of blood transfusion were 224±45 min,1043±234 ml,876±300 ml respectively in conventional PSO group,while 180±31 min,785±163 ml,500±230 ml in PSO with trephine group.Immediately after operation,correction rate of Cobb angle was 91.4％ in conventional PSO group and 90.9％ in PSO with trephine group.At final follow-up,the correction of Cobb angle lost 5.8％ in conventional PSO group and 6.2％ in PSO with trephine group.The improvement rate of JOA score was 81.1％ in conventional PSO group and 83.7％ in PSO with trephine group.The VAS score decreased 7.7±1.1 in conventional PSO group and 7.8±0.8 in PSO with trephine group.One patient in conventional PSO group experienced saddle numbness immediately after operation,which alleviated at final follow up.All patients achieved bony fusion at final follow up.No infection,screw loosening or breakage occurred in both groups.Conclusion The use of trephine in PSO for old thoracolumbar compression fracture with kyphotic deformity can reduce operation time,blood loss and improve efficiency of osteotomy.

Objective To explore the surgical technique and clinical effect of percutaneous lumbar endoscopic surgery for central disc herniation.Methods From February 2010 to April 2014,69 consecutive patients (36 males and 33 females) with central lumbar disc herniation underwent percutaneous endoscopic surgery were included in the study.The average age was 31.33±8.27 years,ranging from 16 to 56 years.All operations were performed by increasing the initial puncture angle.First enter the intervertebral space through the ventral nerve root,and then move the guide rod tip step by step to the top of the protrusion.Operative time,intraoperative blood loss and complications were recorded.Visual analogue scale (VAS), Japanese Orthopaedic Association (JOA) and Oswestry disability index (ODI) were followed up before surgery,immediately after surgery,3,12,24 months after surgery.The MacNab criteria were used to evaluate the efficacy at the last follow-up.During the follow-up period,X-ray,CT and MRI were performed to observe the instability and recurrence of the operative segment.Results All of the disc herniations were successfully removed without conversion to open surgery or revision.All patients were followed up for more than 24 months.The VAS scores of low back pain and leg pain were significantly lower than those before operation immediately,3 months,12 months and 24 months after operation (P＜0.01).The JOA score was significantly higher in monthly follow-up (P＜0.01),and ODI was significantly improved in 3 months and 24 months after operation (P＜ 0.01).There were 22 excellent cases (31.88％),44 good cases (63.77％),3 cases (4.35％) during the final follow-up,and the excellent and good rate was 95.65％.Dural sac injuries occurred in 1 patient and discharged from hospital in 2 weeks of symptomatic treatment.Lumbar instability and operative segment recurrence were not found during the follow-up period (2 years).Conclusion The improvement of the puncture angle and the technique innovation of the guide rod moving from intervertebral space to intraspinal canal step by step can effectively reduce the nerve root stimulation and injury during the puncture and the placement of the working passage,and significantly improve the clinical efficacy of percutaneous lumbar endoscopy in the treatment of central lumbar disc herniation.Microscopic management of the posterior longitudinal ligament can effectively reduce the recurrence rate and has no significant impact on spinal stability.

Objective To assess the influence between managements in emergency room(ER) andoutcome of severe traumatic brain injury (TBI),in order to provide inference for treatment.Methods A retrospective analysis was performed in severe TBI patients and recorded next indexes.(1) The managements in ER,including endotracheal intubation and oxygenation,fluid resuscitation,and mannitol intake.(2) The vital signs arriving at ICU,including systolic pressure and blood oxygen saturation.(3) Prognostic indicators including inhospital mortality and days during ICU,the scores of Glasgow outcome scale (GOS) at discharge and 6 months after injury.Results In 140 severe TBI patients,65 patients (46.4％) died during ICU.The mortality of patients with endotracheal intubation [65.0％ (39/60)] was significantly higher than that without endotracheal intubation [32.5％(26/80)](P＜ 0.01).The mortality in whether fluid resuscitation and using mannitol had no significant difference [44.7％ (46/103) vs.51.4％ (19/37),49.2％ (31/63) vs.44.2％ (34/77)] (P ＞0.05).In days during ICU,there was no significant difference among the three treatment measures (P＞ 0.05).In GOS grade at discharge and 6 months after injury,the proportion of 4 and 5 grade were 8.3％ (5/60) and 25.0％ (15/60) in patients with endotracheal intubation,while 27.5％ (22/80) and 52.5％ (42/80) in patients without endotraeheal intubation (P ＜ 0.01).In fluid resuscitation and using mannitol patients,there were no significant difference(P ＞ 0.05).Conclusion Treating severe TBI patients in ER,endotracheal intubation should be carefully chosen,fluid resuscitation and mannitol may not be given.

Objective:To investigate the effect of conventional coronary CT angiography (CCTA) bolus injection of contrast agent on the diameter and angle of the left main coronary artery (LMA) bifurcation area, and to provide a basis for the application of CCTA to accurately measure the coronary artery.Methods:In Cangzhou Central Hospital of Hebei Province from January to December 2020, the clinical data of 54 patients with suspected coronary heart disease who underwent coronary artery calcification score (CACS) and CCTA with conventional bolus injection of contrast agent were retrospectively analyzed. Two physicians measured middle lumen diameter of LMA (d1), proximal lumen diameter of left anterior descending (LAD) (d2), proximal lumen diameter of left circumflex (LCX) (d3) and bifurcation angle between LAD and LCX (∠1). The consistency of 2 physicians was compared, and the results of CACS and CCTA were compared.Results:The consistency analysis result showed that only d3 measured by CCTA had a moderate consistency (intra-group correlation coefficient = 0.717), and the remaining indexes were in good agreement (intra-group correlation coefficient >0.75). There were no statistical differences in indexes measured results between CACS and CCTA ( P>0.05). According to the degree of left coronary artery stenosis, 54 patients were divided into 2 groups: LMA and branches normal or stenosis degree < 50% group (25 cases) and LMA and branches 1 or more branches stenosis degree≥50% group (29 cases). There were no statistical differences in indexes measured results between CACS and CCTA in patients with different disease severity ( P>0.05). Conclusions:In the CCTA examination, the conventional bolus injection of contrast agent does not affect the diameter and angle of the lumen of the LMA bifurcation area of the coronary artery.

Objective To systematically review the risk prediction models for intradialytic hypotension in maintenance hemodialysis patients,with a view to provide references for clinical practice.Methods PubMed,Embase,Web of Science,Cochrane Library,CINAHL,CNKI,VIP,Wanfang and CBM were searched from inception to May 29,2023.2 reviewers independently screened the literature,extracted information and assessed methodological quality using the Prediction Model Risk of Bias Assessment Tool.Results A total of 20 studies and 25 models were included with the sample size of 68～9 292 cases and the incidence of outcome events of 2.1～51％.Baseline systolic blood pressure,age,ultrafiltration rate,diabetes and dialysis duration were the top 5 predictors of repeated reporting of the models.20 models reported the area under the curve of ranging from 0.649 to 0.969,and 5 models reported calibration metrics.There were 9 internal validations and 4 combined internal and external validation models.The overall applicability of the 20 studies was good,but all had a high risk of bias,mainly in data analysis.Conclusion Research on risk prediction models for intradialytic hypotension in maintenance hemodialysis patients is still in the developmental stage.Future studies should improve the research design and reporting process,and validation studies of existing models should be carried out to further evaluate the effectiveness and feasibility in clinical practice.

Objective: To compare the clinical effects between minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) assisted by Microendoscopic discectomy (MED) and Quadrant for the treatment of degenerative lumbar spinal stenosis (DLSS). Methods: All of 59 patients suffered from DLSS treated surgically from May 2015 to October 2017 were reviewed. According to the surgery method, all cases were divided into MED group (27 cases) and Quadrant channel group (32 cases). All patients were followed up for an average of 18.5 months (11-29 months). Comparison was made on the operative time, intraoperative blood loss, postoperative drainage, postoperative time in bed, postoperative creatine kinase (CK), fusion rate and the degree of muscle fibrosis shown in MRI, as well as visual analogue scale (VAS)score and Oswestry dysfunction index (ODI) score in two groups. Results: The duration of operation in MED group was significantly longer than that in Quadrant group (161.7±22.4 min vs. 145.6±19.4 min, t=4.541, P<0. 01), but less intraoperative blood loss (138.1±26.9 ml vs. 155.6±21.5 ml, t=-2.724, P< 0. 01) and shorter time in bed after surgery (2.3±0.7 d vs. 3.5±1.1 d, t=-4.564, P<0.01). Compared with Quadrant group, CK levels were risen slightly on the first and third postoperative day (P<0.01). CK on the fifth postoperative day in both groups returned to normal. VAS score of lower back pain in MED group was lower than that in Quadrant group on the third day and twelfth month after operation (P<0.05). After 3 months, there was no significant difference in VAS score and ODI between the two groups (P>0.05). ODI was lower in MED group than that in Quadrant group after 6 months and 12 months.The fusion rate was88.9%(24/27) in MED group and 93.8%(30/32) in Quadrant channel group. There was no statistical difference in fusion rate of two groups. 10 patients in MED group and 12 patients in Quadrant group underwent MRI examination of lumbar spine one year after operation. The ratio of postoperative and preoperative atrophy of multiplex muscle area was measured. Muscle atrophy of lower back muscle was lighter in MED group (0.12±0.05 vs. 0.22±0.04, t=-2.428, P<0.05). For intraoperative and postoperative complications, 1 case of dural sac rupture occurred in both groups. Gelatin sponge immediately with fibrin glue was used for plugging up, no postoperative cerebrospinal fluid leakage was found. In Quadrant channel group, 1 case had less blood supply of skin incision edges and epidermal necrosis while the other case had fat liquefaction. Conclusion Compared with the aid of Quadrant, MIS-TLIF assisted with MED had less blood loss, less trauma and faster recovery and could reduce the incidence of postoperative incision complication.

Objective To explore the clinical application of antcrolateral thigh flap transplantation in repairing wound around the knee with descending genicular artery as the recipient vessel,when anterior or posterior tibial vessel could not be utilized.Methods From January,2015 to May,2017,free anterolateral thigh flaps obtained from anastomosis of descending genicular artery and great saphenous vein were transplanted to repair the skin soft tissue defect around the knee combined with tendon and bone exposure in 7 patients,after preoperative color Doppler sonography ultrasound (CDU) for precise positioning.There were 4 males and 3 females,with the flap area ranging from 18.0 cm×8.0 cm-38.0 cm×8.0 cm.All of the donor sites were sutured directly.Postoperative followedup was done termly.Results All the patients were followed-up for 6 to 14 months,with an average of 8.9 months.Typically,2 cases had large defect areas,with distal flap necrosis of 6.0 cm and 4.0 cm,respectively,which were resected and achieved secondary skin graft healing on the residual surface.Additionally,4 cases had completely survived flaps and achieved secondary skin graft healing on the residual surface.The remaining 1 case had completely survived flap,but the distal flap near the anteromedial tibia developed bone exposure as a result of the complicated osteomyelitis.As a result,the patient received gastrocnemius myocutaneous flap to repair the wound.Conclusion Anterolateral thigh flap transplantation in repairing skin soft tissue defect wound around the knee,with descending genicular artery as the recipient vessel,can achieve satisfactory clinical efficacy,which can serve as one choice for flap repair in wound around the knee.