BACKGROUND: Spinal cord can regenerate after injury in certain microenvironment. Olfactory ensheathing cells (OECs)have the characteristics of astrocytes and Schwann cells and can accelerate the spinal cord axonal regeneration.OBJECTIVE: To make injured thoracic cord rat models and observe the effect of OECs on injured spinal cord axonal regeneration.DESIGN: Observational experiment.SETTING: Second Affiliated Hospital of Sun Yat-Sen University.MATERIALS: The experiment was performed at the Second Affiliated Hospital of Sun Yat-Sen University from January 2001 to November 2002.Totally 20 adult SD male rats with the body mass of (380±20) g were provided by Experimental Animal Center of Sun Yat-Sen University (number of institution license SYXK2004-0020). There were DMEM culture solution with low glucose (L-DMEM, GibcoBRL), fetal calf serum (FCS) (Hyclone), myelin basic protein (MBP) (Sigma) and nerve growth factor receptor antibody (Sigma). They were divided into cell transplantation group and control group by the method of random digits table with 10 in each group.METHODS: The adult SD rats were anaesthetized and decapitated to obtain the whole olfactory bulb and then isolate olfactory nerve with a sterile operation. Thoracic cord injury models were established by modified Allen method. 10μL OECs suspension (2.5×1010 L-1) was injected into injured spinal cord of the cell transplantation group, whereas DMEM/F12 (1:1) culture solution of the same dose was injected in the control group. The influence of OECs on spinal cord axonal regeneration was observed by histological and immunohistochemical method 6 weeks after transplantation.MAIN OUTCOME MEASURES: ①OECs were identified by nerve growth factor receptor antibody staining. ②Repair of myelin sheath was observed by MBP staining. ③Nerve axonal regeneration was observed by argentaffin staining. RESULTS: Two rats in the cell transplantation group and 3 rats in the control group died, so totally 15 rats were involved in the result analysis. ①In the cell transplantation group,injured spinal meninges were integrated,but spinal cord became thin as compared with the normal spinal cord. By hematoxylin-eosin (HE) staining, multipolar cells appeared in injured region and the cells were fused excessively with myeloid tissues. It proved that survival OECs were integrated well within the host. New axons were clustered in bundles and infiltrated by small round lymphocytes. By argentaffin staining, regenerated axons grew in tissues of injured region, which mostly accompanied with fascicular-arranged multipolar cells. In the control group, spinal cord became thin markedly and spinal meninges were integrated. No new axon appeared in the injured spinal cord by HE staining. No regenerated axon appeared by argentaffin staining, either. ②In the cell transplantation group, most multipolar cells were clustered in bundles. A mass of positive granules of nerve growth factor receptor antibody appeared in cytoplasm, which further verified that OECs still survived and integrated well within the host 6 weeks after transplantation. Linear MBP positive fibers appeared in the injured region by MBP staining,which indicated that myelin-like substance appeared and drew closely in both ends of injured region. At the same time,MBP positive substance also appeared in the multipolar cells, which illustrated that transplanted OECs could induce the occurrence of myelin-like substance. No regenerated axon was found in the control group.CONCLUSION: Delayed transplantation of OECs can survive and induce the occurrence of myelin-like substance in injured spinal cord of adult rats.

Objective To investigate the impact of optimal respiratory system dynamic compliance (Cdyn) strategy for titrating positive end-expiratory pressure (PEEP)on the prognosis of acute respiratory distress syndrome (ARDS) in infants.Methods A total of 30 patients with ARDS admitted in Pediatric Intensive Care Unit (PICU) of Guangxi Maternity and Child Health Hospital were divided into 2 groups randomly (n =15).PEEP was set in the control group according to PEEP/FiO2 in American ARDS collaboration while optimal Cdyn was for the treatment group.Pressure control ventilation(PCV) mode and small tidal volume(7 mL/kg)strategy were taken.Respiratory mechanics,hemodynamics and inflammatory cytokines were monitored in each group before and after experiment.The time of assisted ventilation,and the hospital stay in PICU and 28-day mortality were compared.Results (1) There was no significant differences in gender,age and severity of disease between the 2 groups (all P ＞ 0.05).(2) The optimal PEEP of the control group was significant lower than that of the treatment group[(6.4 ± 1.4) cmH2O vs (9.9-± 1.6) cmH2O,P ＜ 0.01].(3) Cdyn and oxygenation index(OI) in 2 groups were all improved,and the degree of improvement in the treatment group was significantly better than that of the control group [Cdyn after the experiment at 2 h:(0.39 ± 0.03) mL/(cmH2O·kg) vs (0.36 ±0.03) mL/(cmH2O · kg),P＜0.05; 24 h:(0.40±0.03) mL/(cmH2O · kg) vs (0.38±0.03) mL/(cmH2O · kg),P ＜0.05; 48 h:(0.43 ±0.02) mL/(cmH2O · kg) vs (0.40 ± 0.02) mL/(cmH2 O · kg),P ＜ 0.01 ; OI after the experiment at 24 h:(20.07 ± 2.12) cmH2O/mmHg vs (21.94 ± 2.05),P ＜0.05 ; 48 h:(17.51 ± 1.64) cmH2O/mmHgvs (19.82 ± 2.07) cmH2O/mmHg,P ＜ 0.01] ; There were no significant differences in heart rate(HR),mean aerial pressure(MAP),cardiac index (CI) before and after the experiment (all P ＞ 0.05).(4) Interleukin-6 (IL-6) in two groups all decreased gradually,and the decrease in treatment group was more obvious than that of control group after the experiment at 24 h:(84.58-± 9.11) ng/L vs (93.18 ± 9.27) ng/L,P ＜ 0.05 ; 48 h:(76.67 ± 9.23) ng/L vs (90.10-± 9.42) ng/L,P ＜ 0.01.(5) The lengths of assisted ventilation and the hospital stay in PICU of the treatment group were significantly less than that of the control group [length of assisted ventilation:(6.62 ± 1.26) d vs (8.06-± 1.44) d ; the hospital stay in PICU:(8.12 ± 1.31) d vs (9.53 ±1.42) d,all P ＜0.05].There had no barotrauma and the mortality was not distinct between the two groups(P ＞ 0.05).Conclusions Optimal Cdyn method for titrating PEEP improves respiratory mechanics of ARDS obviously,shortens the time of assisted ventilation,and has no serious adverse effect on hemodynamics.

Objective To study the influence of the optimized pre-hospital emergency transfer sys-tem on the safety, success rate and prognosis of pediatric patients. Methods A clinical data analysis was made of 1 015 cases of critically ill children delivered with the not-optimized pre-hospital emergency transfer system as group Ⅰ( Jan. 2007-Dec. 2009 ) and those of 1 431 with the optimized pre-hospital emergency transfer system as group Ⅱ(Jun. 2010-Dec. 2012). The preparation time for dispatch,critical illness scores before and after transport,transfer success rates and outcomes were compared between the two groups. Re-sults Before transfer,the critical illness score for group Ⅰ was 81. 73 ± 18. 11,for group Ⅱ78. 45 ± 20. 96, with groupⅡ being more critical(t=4. 154,P<0. 001) and needing respirator supporting and more vasoac-tive agents(50. 5%vs. 30. 2%;60. 8% vs. 51. 6%;P<0. 01). The dispatch delay for groupⅠand groupⅡwere(19. 34 ± 6. 45)min and (16. 19 ± 5. 89)min,respectively,actual time out for groupⅡwas shorter than that for groupⅠ(P<0. 001). The critical illness scores on arrival of ward were 83. 01 ± 16. 73 in groupⅠ, 83. 97 ± 17. 50 in group Ⅱ,the score for group Ⅱ being more improved than that for group Ⅰ( P<0. 05 ) . The transfer success rates, cure and improvement rates were higher in group Ⅱ compared with group Ⅰ(97. 6% vs. 94. 8%;94. 5% vs. 91. 0%;P<0. 01). Conclusion The application of the optimized pre-hos-pital emergency care system can improve the transfer efficiency and success rate,safety and treatment effect, reduce the mortality rate of pediatric patients.

Objective To investigate the clinical application of mobile ICU in long distance inter-hospital transportation of critically ill children.Methods The clinical data of 467 critically ill children admitted in the mobile ICU for long distance inter-hospital transportation during Jan 2011 to Dec 2013 were studied retrospectively.Results A total of 467 critically ill children were transported from 27 hospitals of the counties and cities around Nanning.Of these 467 cases,295 cases were male and 172 female,with ages from 29 days to 11 years(median age was 10 months) and weights from 2.5 to 40.0 kg(median weight was 8.3 kg).The transport distances were from 68 to 436 km(median distance was 157 km);the transport durations ranged from 1.5 to 13.0 h(median duration was 5.3 h),and the average pediatric clinical illness score was 83±10.Of these 107 cases(22.9%,107/467) who required first aid before transfer,63 cases(58.9%) were treated with endotracheal intubation while 26 cases(24.3%) with anti-shock therapy.All the 467 cases received sustained electrocardiographic,blood pressure,blood oxygen saturation monitoring and rehydration therapy for maintaining stable internal environment during the transportation,with 341 cases(73.0%) of them received sedative or analgesic treatment,185 cases(39.6%) received mechanical ventilation,15 cases(3.2%) received high doses of vascular active drugs.All the critically ill children were admitted to our Critical Care Department through the green channel.The vital signs improved significantly than those before transportation[heart rate:(143±19)times/min vs.(165±24)times/min;mean arterial pressure:(76±5)mmHg vs.(71±4)mmHg,1mmHg=0.133 kPa;SpO2:(95±2)% vs (92±2)%;pH:7.37±0.04 vs 7.34±0.03;lactate:(2.5±0.2)mmol/L vs (2.8±0.3) mmol/L].There were significant differences between before and after the transportation(P＜0.01,respectively).Conclusion Mobile ICU is propitious to treat the critically ill children energetically and effectively in long distance inter-hospital transportation and ensures the safety.It is worth promoting.

Objective To explore the expression and clinical relevance of metastasis-associated colon cancer-1 (MACC1) and C-MET proteins in hepatocellular carcinoma (HCC) tissue.Methods The expressions of MACC1 and C-MET were detected in 51 specimens of HCC and paraneoplastic liver tissue,normal liver tissue in 13 healthy cases using immunohistochemistry and Western blotting.The correlations of the expressions of MACC1 and C-MET proteins were evaluated,survival rates were observed,the relationship between the expression of MACC1,C-MET proteins and the clinicopathologic features of HCC were analyzed.Results The positive rate of MACC1 and C-MET proteins was 80.4％ and 76.5％ in HCC tissue,the relative expressions were 0.645 ± 0.047 and 0.504 ± 0.023 respectively,which was significantly different from those in paraneoplastic liver tissue and normal liver tissue (respectively F =173.308,252.817,all P =0.000).The survival analysis showed that the three-year survival rate in patients with positive MACC1 and C-MET expressions was significantly lower than that in patients with negative expressions (respectively x2 =3.934,4.439,all P ＜ 0.05),the positive rate and relative expressions of MACC1 and C-MET were significantly correlated with TNM stage,portal vein cancer thrombus and pathology typing (P ＜ 0.05).Conclusions The expression of MACC1 and C-MET is associated with the malignant progression of HCC.MACC1 may serve as a independent prognostic factor for advanced HCC and a possible therapy target for the treatment of HCC.

A 77-year-old man was admitted to our hospital at July 5th,2010 with an unexplained massive pericardial effusion for 10 years.With dyspnea for one month and normal vital signs without pulsus paradoxus,other physical examination included a small amount of moist rale,normal heart sounds,jugular vein engorgement,positive hepatojugular reflux,hepatosplenomegaly and pitting edema of the extremities.The patient had a complex past history with lymph node tuberculosis,primary artertial hypertension,polycythernia vera,chronic renal insufficiency and hypothyroidism (Hashimoto's thyroiditis),and moreover,received a high dose radiation of 31p in 1967. Family history is negative.The patient had no cardiac tamponade or pericardial constriction during 10 years,he received pericardiocentesis twice,and pericardial effusion was exudative with a high proportion of monocyte.There was no evidences of tuberculosis infection,hypothyroidism,malignant tumor,severe heart failure,uremia,trauma,severe bacterial or fungus infection,chronic myeloid leukemia or bone marrow fibrosis during the admission. The patient refused anti tuberculosis,indwelling catheter drainage or surgical therapy.In this rare case,the aetiology of chronic massive pericardial effusion is most probably chronic idiopathic recurrent pericarditis.

Objective To investigate the correlation between myocardial microcirculation and inflammation in acute myocardial infarction(AMI)by myocardial contrast echocardiography(MCE).Methods Eighty-one AMI patients(AMI group)and 30 healthy adults(normal control group)were enrolled.White blood cell(WBC),hypersensitive C reactive protein(hsCRP)and neutrophilic gtanulocyte percentage(G%)were measured in patients and healthy adults.According to different count of WBC,AMI group was devided into A group(n=40,WBC≥10×109/L)and B group(n=41,WBC＜10×109/L).Myocardial contrast intensity(A),blood flow rate(β)and myocardial blood volume(MBF=A×β)of each segment were measured by MCE during 5-7 days of hospitalization.Results Compared with control group.WBC,hsCRP in A group and hsCRP in B group were significantly elevated(P＜0.05).A,β and MBF in A group were significantly lower than those in B group(P＜0.05).WBC and hsCRP in A group had significant negative correlations with β respectively(BWBC=-0.67,P＜0.05;BhsCRP=-0.5 1,P＜0.05).Conclusions The level of plasma inflammatory factors were remarkably increased after AMI,which had a positive correlation with low microcirculation perfusion.

Objective To screen the optimum conditions carrying murine melanoma B16 cells in spaceflights without cares.MethodsMurine melanoma cells were cultured on micocarriers and grouped depending on cells concentration, serum concentration, microcarrier number and temperature.After 33 days, B16 cells were stained by Giemsa, observed with phase-contrast microscope and counted for surviving percentage.ResultsThe optimum conditions,in which the surviving percentages were 8% and 10%, were obtained in the experiments.B16 cells were carried in the 20th recoverable satellite orbiting 18 days under the optimum conditions. After recovering, 110 strain monocloned cells were survived and the surviving percentage was 1.1%.ConclusionThe optimum conditions carrying murine melanoma B16 cells in spaceflights without cares seems to be obtained,and it did improve the surviving time and percentage of cells in spaceflights without cares.

Objective To observe the value of three-dimensional constructive interference in steady state (3D-CISS) sequence for displaying anterolateral ligament (ALL) of knee joint.Methods MR scans of right knee joint were performed on 30 healthy volunteers,and the protocol included axial and coronal fat saturation proton density weighted imaging (FS-PDWI) and 3D-CISS sequence.MRP and CPR (reconstructive angles including 0°,30°,60°,90°,120°,150° and 180°) images were generated from of 3D-CISS sequence.The visibility rates of the femoral part,meniscal part,tibial part,meniscal insertion,femoral footprint and tibial footprint of ALL were compared among different protocols.Results The visibility rates of tibial footprint and femoral footprint of ALL on 3D-CISS CPR images were both 96.67％ (29/30),and on 3D-CISS MPR images were both 93.33％ (28/30),all of them were higher than those on FS-PDWI images (all P＜0.017).The visibility rates of tibial part,meniscal part and meniscal insertion of ALL on 3D-CISS CPR images were 96.67％ (29/30),83.33％ (25/30) and 83.33％ (25/30),respectively,and all of them were higher than those on FS-PDWI images (all P＜0.05).There was no statistical difference of visibility rate of femoral part between 3D-CISS CPR images and FS-PDWI images (P=0.095).Conclusion 3D-CISS sequence with CPR can significantly enhance the ability to identify ALL.