The effect of TRH on endotoxic shock in rats was studied, iv 0. 22-2 mg ?kg-1 TRH significantly reversed hypotension induced by iv coli E. endotoxin (40 mg ?kg-1) into rats and caused a 4. 2 kPa rise in mean arterial pressure (MAP). MAP after TRH administered could be stablized over a higher level than control for 30 min and maintained for 3 h during observation. Interestingly enough, the MAP rose gradually in TRH-treated rats as contrast with increasingly falling of that in control group during the late shock. TRH also improved 24 h sur-vival of shock rats. The dose-response relationship could be observed between 0. 22 ~0. 67 mg ?kg-1 TRH and disappeared over a highest dose (2 mg ?kg-1). It was shown that the best dose to reverse hypotension and to improve survival was 0. 67 mg ?kg-1 TRH. Naloxone 2 mg ?kg-1 showed the nearly same effect as 0. 22 mg ?kg-1 TRH in increasing MAP, but the former had higher 24 h survival of rats than the later.

Objective To analyze catheter-related bloodstream infections due to Rhizobium radiation (R.radiobacter) in pediatric patients.Methods Clinical data of 1 014 pediatric patients with intravascular catheterization were collected from February 2012 to February 2014,including age,length of time a catheter remained in place,laboratory findings and outcome of R.radiobacter bloodstream infection in order to explore the factors for R.radiobacter infection.Results There were 26 children contracting R.radiobacter bloodstream infection children,and of them,21 were under 2 years old (80.77％),and the length of time for catheter dwelt in vessel longer than 5 days in 20 children (76.92％).There were significant differences in age under 2 years old,length of time longer than 5 days for catheter remained in place,CD4 and CD4/ CD8 between 26 children with R.radiobacter infection and uninfected children (P ＜ 0.01).The re-infection with different varieties of bacterial strains was found in 12 of all R.radiobacter infection children (46.15％) after treatment,and of them,R.radiobacter bloodstream infection was detected twice in 2 children,and 2 died (7.69％).Conclusions Age under 2 years old,the length of time for intra-vascular catheter remained in place longer than 5 days,and weakened immunity are the important risk factors of R.radiobacter bloodstream infection,and the improper medical care may be the cause of re-infections in pediatric patients with prolonged intra-vascular catheter-dwelling.

Objective To analyze and evaluate neoadjuvant chemotherapy's value and significance in combining with surgical treatment for limited small cell lung cancer(LD-SCLC).Methods A total of 94 LD-SCLC patients underwent complete resections combined with chemotherapy between January 2000 and January 2011 in Shanghai Pulmonary Hospital.Among these cases,initial two cycles of neoadjuvant chemotherapies were performed for all pathologically confirmed patients (Group A),and initial operations followed by adjuvant chemotherapy were administered to patients without pathology (Group B).The survival rate was analyzed by log-rank test and Kaplan-Meier method.Multivariate analysis of the prognostic factors was performed using Cox's regression model.Results Group A included 43 cases and Group B included 51 cases.The mean age was (56.37 ± 10.18) years.According to the 6th edition of Tumor,Node,Metastasis(TNM) classification of lung cancer,54 cases were at stage Ⅰ or Ⅱ,40 cases were at stage Ⅲ.Overall 5-year survival(5-YS) was 27％.The 5-YS for patients with stage Ⅰ-Ⅱ was notably better than that of stage Ⅲ (34％ vs 20％,P =0.033).For patients with stage Ⅲ,the 5-YS of Group A was significantly better than that of Group B(34％ vs 12％,P =0.020),besides median overall survival for Group A and Group B were 46 and 15 months(P =0.009).Furthermore,the results of multivariate analysis showed that neoadjuvant chemotherapy,surgery and histopathology of SCLC were independent factors that strongly affected survival and prognosis.Conclusion In combined surgical treatment for LD-SCLC,neoadjuvant chemotherapy obviously improved the prognosis of patients with stage Ⅲ.Therefore,it was very important and necessary that pre-surgical neoadjuvant chemotherapy was administered to resectable stage Ⅲ LD-SCLC patients.

Objective To investigate genotypes and antimicrobial susceptibility of Rhizobium radiobacter (R.radiobact-er)isolated from pediatric patients with bacteremia.Methods R.radiobacter strains from blood cultures of pediatric pa-tients with bacteremia from February 2013 through February 2014 were collected.16S rDNA fragment was amplified by polymerase chain reaction(PCR),bacterial genotypes were identified by pulsed-field gel electrophoresis (PFGE),antimi-crobial susceptibility testing were performed by Kirby-Bauer disk diffusion method.Results 13 isolates of R.radiobacter were isolated from 12 children with positive blood culture,which including 3 genotypes,the homology of 16S rDNA fragment and R.radiobacter IFM 10623 was up to 99%.According to CLSI 2003 standard,these 13 R.radiobacter were resistant to ceftazidime,piperacillin,ticarcillin,piperacillin/tazobactam,ticarcillin/clavulanic acid,aztreo-nam and polymyxin B,but sensitive to cefepime,doripenem,imipenem,meropenem,tobramycin,netilmicin,cip-rofloxacin,levofloxacin,and norfloxacin.In addition,cefotaxime and ceftriaxone showed larger inhibition zone. Conclusion Therapy of R.radiobacter infection should be based on antimicrobial susceptibility testing results;cefo-taxime and ceftriaxone are better selection for the therapy of R.radiobacter infection in pediatric patients.

OBJECTIVE To investigate the etiology, prevention and treatment of colon ischemia after operation for abdominal aortic aneurysm (AAA). METHOD Seven of 140 cases complicated with colon ischemia who had received AAA operation were analyzed retrospectively. RESULTS Three cases underwent emergency operation. The seven cases were subjected to removal of AAA, implantation of prosthesis, and ligation of the inferior mesenteric artery. Two cases had the ligation of the bilateral internal iliac artery (IIA). Epilateral IIA was ligated in 2 cases. Bowel resection was carried out in 3 cases, 1 of which received reconstruction of the inferior mesenteric artery (IMA). Three cases received conservative therapy, but died from multiply organ failure. CONCLUSION Correct prevention and management of colon ischemia can effectively reduce the operative morbidity of AAA patients.
Aged ; Aged, 80 and over ; Aortic Aneurysm, Abdominal ; surgery ; Colon ; blood supply ; Humans ; Ischemia ; etiology ; prevention & control ; therapy ; Male ; Mesenteric Artery, Inferior ; surgery ; Middle Aged ; Postoperative Complications ; etiology

OBJECTIVETo generate mice which are specific for peroxisomproliferator-activated receptor-γ coactivator-1(PGC-1α) knockout in the GABAergic interneuron.

METHODSConditional mice specific for PGC-1αwere introduced from the Jackson Laboratory, USA and initially inbred to obtain homozygote PGC-1αmice. The PGC-1αconditional mice were further crossed with Dlx5/6-Cre-IRES-EGFP transgenic mice to achieve specific knockout of PGC-1α in the GABAergic interneuron.

RESULTSThe offspring with specific knockout PGC-1α gene were successful for the generation of GABAergic interneuron, with the resulting genotype being PGC-1α.

CONCLUSIONThe PGC-1αmice were obtained through a proper crossing strategy, which has provided a suitable platform for studying the function of PGC-1α in neuropsychiatric diseases.

Animals ; Female ; Humans ; Interneurons ; metabolism ; Male ; Mice ; Mice, Knockout ; Neurodegenerative Diseases ; genetics ; Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha ; genetics ; gamma-Aminobutyric Acid ; metabolism

Objective To analyze the causes of revision surgery after percutaneous transforaminal endoscopic discectomy (PTED) for lumbar spinal stenosis,and to provide references for indications and operative methods.Methods From January 2015 to October 2017,206,491 and 60 patients of lumbar spinal stenosis were treated with PTED in Tianjin Hospital,Shanxi People's Hospital,Ningbo Sixth Hospital,respectively;among them,4,10 and 4 cases received revision surgery.Another 13 patients of lumbar spinal stenosis were treated with revision surgery due to poor results after PTED in other hospitals.Among 31 cases of reoperation,there were 16 males and 15 females,aged 27-82 years (average,66.2±12.7 years).The lesion segments included 1 case of L3,4,23 cases of L4,5,5 cases of L5S1,1 cases of L3-L5,and 1 cases of L4-S1.Patients were followed up after reoperation from 3 to 24 months (average,12.1 months).The causes of poor result and revision surgery were analyzed according to preoperative,intraoperative and postoperative data.Results All of 757 cases of lumbar spinal stenosis were treated with PTED in three hospitals,of which 18 cases (2.4％) were re-operated.The causes of reoperation included:bone slice displacement in 1 case;nerve injury in 4 cases;lumbar instability in 4 cases;disc protrusion in 10 cases (residual or recurrence);insufficient decompression in 21 cases;planed staging operation in 4 cases with bilateral or two-level stenosis.32 revision surgeries were performed for 31 patients,including PTED in 15 cases,microendoscopic discectomy (MED) in 1 case,mobile MED (MMED) in 5 cases,MMED assisted fusion in 2 cases,transforaminal lumbar interbody fusion (TLIF) in 4 cases,Minimally invasive TLIF (Mis-TLIF) in 2 cases,and open decompression and fusion in 3 cases.All patients experienced relieve of symptoms after revision surgery.At final follow-up,VAS leg pain deceased form 7.1±3.9 before revision surgeries to 1.9±1.2,VAS low back pain decreased form 6.3±3.2 to 1.8±1.3,ODI score decreased from 35％± 14％ to 7.6％±5％.According to the MacNab score,the result was excellent in 11 cases,good in 16 cases,and fair in 4 cases.Conclusion The treatment of lumbar stenosis with PTED has high technical requirements,the indications of PTED for lumbar stenosis should be strictly controlled according to technical conditions,and appropriate operative methods should be chosen according to the specific conditions of the lesions.Insufficient decompression,disc protrusion,lumbar instability and nerve injury are the common causes of reoperation.Suitable indications and proper operation should be selected.

Objective:To investigate the efficacy of single locked-plate internal fixation combined with autologous iliac bone graft in the treatment of Rorabeck type II periprosthetic distal femural fracture (PDFF) after total knee arthroplasty (TKA).Methods:A retrospective case series study was made on 13 patients suffering from Rorabeck type II PDFF after primary TKA together with severe osteoporosis (T value≤ -2.5 SD) admitted to 940th Hospital of Joint Logistics Support Force of PLA from January 2016 to December 2020, including 4 males and 9 females, aged 65-85 years [(75.2±6.5)years]. All patients were treated with single locked-plate internal fixation combined with autologous iliac bone graft. Anti-osteoporosis and early standardized joint function rehabilitation were undertaken postoperatively. The operation time and intraoperative blood loss were recorded. The range of motion of knee joint was compared before operation, at postoperative 3, 6 and 12 months and at the last follow-up. The Hospital for Special Surgery (HSS) knee score was assessed at postoperative 3, 6 and 12 months and at the last follow-up to evaluate the recovery of knee joint function. The bone mineral density was reexamined at postoperative 6 months and 12 months to evaluate the therapeutic effect of anti-osteoporosis. Complications were detected as well.Results:All patients were followed up for 12-72 months [(43.2±19.9)months]. The operation time was 90-135 minutes [(103.8±12.6)minutes], with the intraoperative blood loss of 100-250 ml [(150.0±45.6)ml]. The range of motion of knee joint was (114.6±7.8)°, (90.4±8.0)°, (97.3±4.8)° and (98.1±6.3)° before operation and at postoperative 3, 6 and 12 months (all P<0.05). The HSS knee score was (80.2±2.2)points, (84.6±2.9)points and (87.3±3.3)points at postoperative 3, 6 and 12 months (all P<0.05). The knee joint function was excellent in 10 patients and good in 3 at postoperative12 months, and the excellent and good rate was 100%. The T value of bone mineral density was (-3.8±0.6)SD, (-3.4±0.6)SD and (-2.9±0.6)SD preoperatively and at postoperative 6 months and 12 months (all P<0.05). One patient experienced nonunion and was cured after secondary autologous iliac bone grafting combined with recombinant human bone morphogenetic protein-2 (rhBMP-2) bone grafting. Three patients developed venous thrombosis of lower limbs and were cured with oral administration of rivaroxaban. One patient had mild knee flexion and extension limitation and was improved after manual release under femoral nerve block anesthesia and subsequent functional rehabilitation. Conclusion:For patients with Rorabeck type II PDFF after TKA, single locked-plate internal fixation combined with autologous iliac bone graft has advantages of short operation time, few intraoperative bleeding, satisfactory knee range of motion and functional recovery as well as significant improvement of bone mineral density.

Objective To investigate the effect of intracarotid administration of bone marrow stem cells (BMSCs) on learning and memory abilities of vascular dementia (VD) rats and the variability of expressions of neuron-specific enolase (NSE) and S-100 protein in the serum.Methods BMNCs collected from clean juvenile male Wistar rat femur were isolated; after adherent culture,the 3-4th generation BMSCs were performed induced differentiation.Ninety Wistar rats (age:18 to 24 months old) were randomly divided into three groups:control group,model group and treatment group,and each group was further classified into three subgroups by means of survival times of 2,4 and 8 weeks,which means that every subgroup consisted often rats.All VD rats,which were modeled by modified Pulsinellis 4-vessel occlusion (4VO); and those in the treatment group were injected 0.5 mL 1.2×107/mL BMSCs into the internal carotid artery 24 after operation.The learning and memory abilities of each rat in all subgroups were analyzed by shuttle box testing and the NSE leves and S-100 protein in serum were detected by enzyme-linked immuno sorbent assay (ELISA).Results The mean active avoidance response (AAR) ratios of the rats in the three subgroups (survival time of 2,4,8 weeks) of the model group,were,respectively,lower than those of the control group (P＜0.05),and those of the treatment group were significantly higher than those of the model group (P＜0.05).The serum levels of NSE in the treatment group was significantly lower than that in the model group two weeks after operation (P＜0.05),but it reversed 4 and 8 weeks after operation.The S-100 protein expressions in the treatment group was statistically lower than that in the model group (P＜0.05),however,there is no significant difference between treatment group and control group (P＞0.05).Conclusion Intracarotid administration of BMSCs obviously improves the learning and memory abilities of the VD rats,remarkably reduces the serum levels of NSE and S-100 protein,and efficiently relieves the injury degree of neurons and glial cells,which indicates that BMSCs therapy has effective protection on neural regeneration,neuronal proliferation and synaptic connectivity.