ObjectiveTo study the feasibility of ex vivo gene transfer to donor heart by delivering i ntracoronarily a reporter gene (Lac-Z gene) to donor heart at the time of trans plantation.MethodsThe model of heterotopic heart transplantation in murine was established and the method of perfusing intracoronarily was performed. Twelve male BALB/c mice were divided into 2 groups randomly: gene-transfer group (group 1) and control grou p (group 2). In group 1, plasmid vector (PSV-?-gal containing Lac-Z gene)/li posome (DOSPER) was perfused intracoronarily into each donor heart at the time o f transplantation. In group 2, normal saline was perfused. Donor hearts were har vested 3 days after transplantation. Freezing sections were made for detection o f the transfer and expression of Lac-Z gene by histochemical staining (X-gal). ResultsThe expression of Lac-Z gene was detected in the donor hearts of group 1. In tw o donor hearts, the expression of Lac-Z gene was detectable in the myocardial c ells in the mid-layer of ventriculus; In one donor heart the expression was fou nd in the myocardial cells under epicardium. But no expression of Lac-Z gene wa s detected in donor hearts of group 2.ConclusionEx vivo gene transfer intracoronarily to donor heart in the form of plasmid vector /liposome complex at the time of transplant ation is feasible.

Objective To investigate the relationship between continuous hyperglycemia and the progression of early acute pancreatitis (AP) Methods Five hundred and twelve AP patients were included in this study, in which 418 patients were mild acute pancreatitis (MAP) and 94 were severe acute pancretitis (SAP) Fasting blood sugar was determined and APACHE Ⅱ score was calculated on admission, 2nd and 3rd day of hospitalization respectively Serum tumor necrosis factor (TNF?) and C reaction protein (CRP) levels were determined on the 2nd day of hospitalization Results The incidence of hyperglycemia was higher in SAP patients than that in MAP patients (74 5% vs 25 8%, P =0 001) In SAP, APACHE Ⅱ score in continuous hyperglycemia group (CHG) was significantly higher than that of non continuous hyperglycemia group (NCHG) on admission, 2nd and 3rd day of hospitalization respectively (13?4 vs 11?3, P =0 017; 13?4 vs 11?3, P =0 010; 14?4 vs 10?4, P =0 010, respectively) Continuous hyperglycemia was related to the severity of SAP ( ? 2=7 77, P =0 005) Moreover, serum TNF? and CRP levels of the CHG were also markedly higher than that of NCHG (20?14 vs 14?11, P =0 019; 123?81 vs 93?55, P =0 036, respectively) Conclusion Continuous hyperglycemia might be a risk factor for the aggravation of early acute pancreatitis

Objective To explore the difference of DNA methylation levels between normal Schwann cells (NSCs) and activated Schwann cells (ASCs) in rats. Methods The adult Wistar rats were received sciatic nerve ligation and fed for 7 days. The ASCs and NSCs were separated from ligated sciatic nerves and brachial plexus respectively. Immunocytochemical staining of S-100 antibody was used to identify the cells. The growth condition of cells was detected by CCK-8 method. Methylated DNA immunoprecipitation sequencing (MeDIP-Seq) was applied to filter the differentially methylated regions in ASCs and NSCs. The distribution of differentially methylated genes related with axonal regeneration in chromosome was analyzed, and Gene ontology(GO)and PATHWAY analysis were also conducted. Results High purity of ASCs and NSCs were obtained successfully, which were both positive for S-100 antibody. In the same culture condition, ASCs showed a faster proliferation than that of NSCs. A total of 177 176 differentially methylated regions were found by MeDIP-Seq. Among them, 1 097 were located in the promoter (≤1 kb), 1 136 in the promoter (1-2 kb) and 567 on the CpG. After functional annotation of differentially methylated genes, 214 differentially methylated genes related with axonal regeneration were found in ASCs and NSCs. Compared with NSCs, 191 genes were up-regulated and 23 genes were down-regulated in ASCs. These genes were located on different chromosomes, most of which on chromosome 12 (22 genes) and the least on chromosomes M (2 genes). GO analysis indicated that the differential methylated genes were involved in axon growth, axon formation, axon elongation and axon guidance. The MAPK, cell adhesion molecules, Ras signaling pathway may be related with the differential methylated genes. Conclusion The methylation levels between ASCs and NSCs are significantly different, which are probably related with axon regeneration.

Objective To investigate the clinical value of preventive analgesia in patients with radical gastrectomy for gastric cancer.Methods The clinical data of 161 patients undergoing radical gastrectomy for gastric cancer at the Xijing Hospital from July 2012 to June 2013 were prospectively analyzed.A single-blind,randomized,controlled study was performed in the eligibe patients who were randomly divided into the preventive analgesia group and the control group based on a random number table.All the patients received major gastrectomy + Billroth Ⅱ anastomy or total gastrectomy + esophagojejunastomy,and then they received vein combined anesthesia and tracheal intubation.In the preventive analgesia group,10 mg dexamethasone and 200 mg parecoxib were administered by intravenous infusion before operation,7-8 mL ropivacaine (0.5％) were injected at the incisional site and transversus abdominis infiltration at open and close surgery and celecoxib was taken orally for 3 days.In the control group,vein analgesia pump was used after operation.The visual analogue scale (VAS),proportion of patients with postoperative out-off-bed activity time ＞ 8 hours,time of flatus,time of defecation and duration of hospital stay were recorded between the 2 groups.The measurement data with normal distribution were presented as x ± s.The comparison between groups was evaluated with the t test and repeated measures ANOVA.The data with skew distrubution and ordinal data were analyzed by the analysis of variance,and the count data were analyzed using the chi-square test.Results All the 161 patients who were screened for eligibility were randomly divided into the preventive analgesia group (87 patients) and the control group (74 patients).The scores of the VAS at postoperative day 1,2 and 3 were 2.8 ± 0.6,2.6 ± 0.4 and 1.8 ± 0.4 in the preventive analgesia group,and 5.3 ± 0.5,4.2 ± 0.6 and 2.4 ± 0.3 in the control group,with a significant difference between the 2 groups (F =4.25,P ＜ 0.05).The proportion of patients with postoperative first abmulation time ＞ 8 hours at postoperative day 1,2 and 3 were 8,17 and 20 in the preventive analgesia group,and 0,3 and 11 in the control group,with a significant difference between the 2 groups (x2 =7.60,10.26,3.16,P ＜ 0.05).The time of flatus,time of defecation and duration of hospital stay were (51 ± 24) hours,(61 ± 24) hours and (5.5 ± 3.0) days in the preventive analgesia group,compared with (71 ± 23) hours,(83 ± 30) hours and (6.3 ± 2.1) days in the control group,showing a significant difference between the 2 groups (t =5.32,5.04,0.17,P ＜ 0.05).All the patients in the 2 groups normally survived after surgery without respiratory depression,incision infection and adverse drug reaction.Conclusions Preventive analgesia in the perioperative treatment of patients with radical gastrectomy for gastric cancer could relieve the postoperative pain of patients,improve the bowel function and enhance the recovery of patients.Registry This study was registered with the Chinese Clinical Trial Registry with the registry number of ChiCTRTRC-11001440.

Objective To investigate the diagnostic value of helical CT study in pulmonary thromboembolism.Methods A retrospective analysis was made on 16 misdiagnosed cases,studied previously with plain CT scanning.Results All of the 16 cases had positive findings on CT scanning,with sensitivity 100%.Among them,11 cases were misdiagnosed as pleural effusion plus pneumonia;3 pleural effusion;and 2,each of organized pneumonia and peripheral lung cancer.Conclusion The strong evidence of the disease could be given even with plain CT studies.The procedure is simple,safe and reliable,If a patient is suspected with the disease,and if CT is available in the hospital,CT should be the first choice in the study.

Huntington disease (HD) rat model was produced by injection of ibotenic acid (IA) into the head of right caudate putamen (CP). One month post lesion, fetal (El5-17) striatal cell suspension was implanted into the lateral ventricle ipsilateral to the lesion, and the rats were devided into four groups; group I normal control rats (n=8), group II model control rats (n=10), group III simple transplanted with fetal striatal cell suspension, (n=10, ST group), group IV grafted with striatal cell suspension containing laminin (n=6, LST group). Three and six months after grafting, active avoidence test was carried, the results showed that there were significant differences bewteen grafted groups and model control group at three and six months, and no significant differences between LST group and normal group either in three or six months whereas between ST group and normal group no significant difference only can be found at six months. Overnight locomotor activity was measured in each group at six months post grafting, the results indicated that the locomotor behaviour of model control group was hyperactive whereas the overnight hyperactivity was compensated completely in the grafted groups. After the behavioural test, the rat brain was investigated morphologically. The head of the lesioned CP was atrophied and the graft was located at the dorsal part of the atrophied CP and projected into the lateral ventricle. The volume of the graft area of LST group was larger than that of ST group. ChAT, GABA and Leu-ENK positive neurons were found in the graft area of the two grafted groups and their shape and size were similar to those of nomal CP. The processes of AChE positive neurons in the graft of LST group were more and longer than that in the graft of ST group. The results indicated that the fetal striatal neurons implanted into the lateral ventricle of HD model rats not only can survive and grow well but also ameliorate the behavioural deficits of the IA lesioned rats and the laminin may supports the neuronal suvival and growth in vivo.

Surgical excision and postoperative radiotherapy are widely accepted therapeutic modalities for sinonasal teratocarcinosarcoma (SNTCS). Previous studies have shown that intensity-modulated radiation therapy (IMRT) is safe and effective for the treatment of some sinonasal malignancies. We hypothesize that use of IMRT for SNTCS may result in clinical benefits. We report here two cases of SNTCS that were treated by IMRT. One patient was given extensive IMRT involving elective neck irradiation. Follow-up examinations revealed no recurrence and metastasis 3.5 years after IMRT. Another patient simultaneously suffered from multiple systematical diseases and was administered involved-field radiotherapy. He was found to have a marginal recurrence during the follow up and eventually died 8 months after disease diagnosis. It was suggested in this study that appropriate use of IMRT for the treatment of SNTCS may achieve excellent local control.

Objective To analyze the prognostic factors associated with three-year survival outcome in patients with serous ovarian adenocarcinoma by classification tree.Methods Retrospectively we analyzed 81 cases with serous ovarian adenocarcinoma who had 3-year clinical outcomes and were hospitalized in People's Hospital from Jan 1991 to Dec 2003 by classification and regression trees(CART)software.Establish the classification tree.Results Among the factors that were associated with the 3-year survival rate,age was the most important factor,other factors in turn were International Federation of Gynecology and Obstetrics(FIGO)stage,lymphoid metastasis,residual size after operation,chemotherapy and pathologic grade.By substitution variable analysis,it was demonstrated that there was cross interaction between age and residual size as well as age and chemotherapy.Conclusion Age,FIGO stage,lymphoid metastasis,residual size after operation,chemotherapy and pathologic grade are important prognostic factors related with three-year survival probability of serous ovarian adenocarcinoma patients.

BACKGROUND: Autologous bone, bone substitute materials and guided bone regeneration (GBR) technique can repair jaw defects, but the absorption speed of bone substitute materials and GBR membrane are faster than the formation speed of new bone, therefore, it affects the volume and shape of new bone.OBJECTIVE: To investigate the role of personalized prefabricated titanium template, autologous bone and nano-hydroxyapatite on restoration of maxillary defect in rabbit.METHODS: A total of 18 rabbits were randomly divided into two groups, and maxillary alveolar defect with 10 mm length and 5 mm high was created. The template was implanted in both two groups, and fastened with titanium screws. Autologous and nano-hydroxyapatite were placed into the defect in experimental group; neither autologous bone nor bone substitute materials were implanted into the defect in control group. New bone formation, X-ray findings, and histological changes with HE stain were carded out 4, 8 and 12 weeks postoperatively.RESULTS AND CONCLUSION: The quality of new bone in experimental group was batter than that in control group 4 weeks postoperatively, but the quality of new bone was almost the same 8 and 12 weeks postoperatively. By paired t-test, there was significant difference in new bone density between the experimental group and the control group 4 .weeks after operation (P<0.01), but there was no significant difference in new bone density between the experimental group and the control group 8 and 12 weeks after operation (P > 0.05). Autologous bone and nano-hydroxyapatite can restore the defect of maxillary alveola.Personalized prefabricated titanium template can play an important role of screen membrane and external scaffold in new bone formation, and remain shape of new bone.

Objective To investigate clinical effect of surgical repair and reconstruction of traumatic floating shoulder injuries (FSI). Methods Sixteen patients with FSI were treated with open re-duction and reconstructive internal plate fixation. Of all, one patient was with transverse clavicle fracture, six with oblique clavicle fracture and nine with comminuted clavicle fracture. There was one patient with type Ⅰ scapula fracture, three with type Ⅱ, four with type Ⅲ, six with type Ⅳ and two with type Ⅴ. The combined injuries included rib fracture plus hemopneumothorax in six patients, traumatic moist lung in two, craniocerebral injuries in two, hepatic and splenic rupture in two and brachial plexus damage in one. The average time from primary injury to operation was seven days (3-21 days). Results Fifteen out of 16 patients were followed up for 6-28 months (average 11 months). All patients obtained bone u-nion, without infection, loosening or breakage of internal fixation. According to Herscvici evaluation standard of function, the shoulder joint outcome was rated as excellent in 11 patients, good in three and fair in one, with excellence rate of 93%. Conclusion The surgical repair and reconstruction of FSI can, to a greatest extent, recover the anatomical structure and stability around the shoulder joint and shorten the immobilization period of joint, which is beneficial to functional restoration of the joint and de-crease of occurrence of complications.