Objective To discuss and improve the scheme of circulating fluid replacement in the polyuria stage after simultaneous islet cell-renal transplantation.Methods Nursing data of 26 patients after simultaneous islet cell-renal transplantation during the polyuria stage were analyzed retrospectively,the impact on spend-and-tax circulating fluid replacement on the outcome after surgery was observed.Results In 26 patients,3 case suffered graft function recovery delay,23 patients' renal function recovered smoothly without water-electrolyte and acid base disorders in period of diuresis,compared with the 16 cases with traditional fluid replacement in the same time,serum creatinine (SCr),blood urea nitrogen (BUN) and blood glucose (BG) decreased significantly in 72 h.Conclusions Using spend-and-tax fluid replacement can reduce postoperative complications such as water-electrolyte and acid-base disorders in simultaneous islet cell-renal transplantation patients,and promote the functional recovery of transplanted islet cells and kidney.

Objective To discuss the clinical efficacy of closed reduction and plaster splint fixation ( CRPSF) in the treatment of gerontal patients with distal radius fractures ( DRF) .Methods 76 elderly patients with DRF who treated by CRPSF were selected .According to AO classification of fractures ,the patients were divided into three groups,the A group had 27 cases;B group had 26 cases,C group had 23 cases.The treatment effect was evalua-ted by analyzing the follow-up data,the corresponding imaging measurement parameters and clinical scores .Results All patients had 12-month clinical and imaging follow-up.In the last follow-up, the arm-shoulder-hand dysfunction score and palmar angle ,ulnar deviation angle of A and B group were significantly better than those of C group , the differences were statistically significant(all P<0.05),the difference between A and B group was not statistically sig-nificant (P>0.05).In the last follow-up,the satisfaction score of C group was slightly lower than that of the A or B group,but had no statistically significant difference (P>0.05).Conclusion CRPSF in the treatment of gerontal pa-tients with DRF has good function and imaging effects ,and the improvement level has a certain relationship with the degree of fracture,but has no significant impact on the patients'satisfaction.

Objective To evaluate the effect of dezocine on the c-fos expression in neurons in the midbrain periaqueductal gray in a rat model of incisional pain.Methods Thirty-six pathogen-free healthy adult male Wistar rats,weighing 250-300 g,were divided into 3 groups (n =12 each) using a random number table:control group (group C),incisional pain group (group I) and dezocine group (group D).A 1 cm longitudinal incision was made through skin,fascia and muscle of the plantar aspect of the right hind paw in sevoflurane-anesthetized rats.In group C,the rats were only anesthetized and underwent no operation.In group I,0.9％ sodium chloride solution 2 ml was injected via the caudal vein at 15 min before the model was established.In group D,dezocine 1 mg/kg (diluted to 2 ml in 0.9％ sodium chloride solution) was injected via the caudal vein at 15 min before the model was established.At 24 h before operation (T0) and 2,6 and 24 h after operation (T1-3),the mechanical paw withdrawal threshold (MWT) and cumulative pain score were measured.After measurement of the pain threshold at T3,the whole brain was removed for determination of the c-fos expression in neurons in the midbrain periaqueductal gray by immunohistochemistry.Results Compared with group C,the MWT was significantly decreased,cumulative pain scores were increased,and the expression of c-fos in neurons in the midbrain periaqueductal gray was upregulated at T1-3 in I and D groups (P＜0.05).Compared with group I,the MWT was significantly increased,the cumulative pain score was decreased,and the expression of c-fos protein in neurons in the midbrain periaqueductal gray was down-regulated at T1.3 in group D (P＜0.05).Conclusion Dezocine mitigates incisional pain through inhibiting the expression of c-fos in neurons in the midbrain periaqueductal gray of rats.

Objective To study the effects of serum of the Zhuartgguqiang jin tablets on the proliferation and osteogenic differentiation of bone marrow stromal stem cells (BMSCs) of aged rats.Methods The BMSCs were obtained from male SD rats of 18 months.The cell surface markers CD34,CD31,CD29 were detected by flow cytometry.The proliferation of BMSCs treated by different concentration of medicated serum (2.5％,5％,10％) at 24,48,72hours was detected by CCK-8 method.The BMSCs were divided into 4 groups,which were osteogenic induction group,the Chinese medicated osteogenic induction group,Chinese medicine group,the blank group.After the BMSCs were cultured for 7 days,alkaline phosphatase (ALP) vitality was detected.After the BMSCs were cultured for 14 days,the BMSCs were stained by alizarin red,the mRNA of ALP and osteocalcin(OC) was detected.Results The expressionof CD29 was positive,and the expression of CD31 and CD34 were negative.2.5％,5％ of the medicated serum could promote cell proliferation.The ALP vitality of osteogenic induction group[202.76 ± 15.44(U/gprot)],the Chinese medicated osteogenic induction group [240.48 ± 18.55 (U/gprot)],Chinese medicine group [178.87 ± 17.29 (U/gprot)]were significantly higher than that of blank group [111.24 ± 20.71 (U/gprot)] (t =22.50,7.985,3.535,all P ＜0.01).The ALP activity of Chinese medicated osteogenic induction group was higher than that of osteogenic induction group (t =3.103,P ＜ 0.05).The ALP gene relative OD value of osteogenic induction group (0.40 ± 0.20) and Chinese medicated osteogenic induction group (0.60 ± 0.06) were higher than the blank group (0.09 ± 0.03) (t =2.372,9.547,all P ＜0.01).The ALP gene expression of Chinese medicated osteogenic induction group was obviously higher than that of the osteogenic induction group(P ＜0.05).The OC gene relative OD value of osteogenic induction group(0.58 ± 0.09) and Chinese medicated osteogenic induction group(0.76 ± 0.11) were higher than the blank group(0.41 ± 0.02) (P ＜ 0.05,P ＜ 0.01).The OC gene expression of Chinese medicated osteogenic inductiongroup was obviously higher than that of the osteogenic induction group(t =2.673,P ＜ 0.05).Conclusion Medicated serum of Zhuangguqiangjin tablets can promote the proliferation and osteogenic differentiation of BMSCs of aged rats,which may be the mechanism of prevention senile osteoporosis.

Objective To evaluate the role of glycogen synthase kinase-3 beta (GSK-3β) in spinal cord ischemia/reperfusion (I/R) injury in rats.Methods Forty-eight male Sprague-Dawley rats,aged 3 months,weighing 250-300 g,were randomly divided into 3 groups (n =16 each) using a random number table:sham operation group (group S),group I/R and I/R+ GSK-3β inhibitor LiCl group (group LiCl).The animals were anesthetized with intraperitoneal 10％ chloral hydrate 300 mg/kg.Spinal cord ischemia was induced by 45 min occlusion of the abdominal aorta followed by reperfusion.In I/R and LiCl groups,normal saline 5 ml and LiCl 15 mg/kg were injected,respectively,via the caudal vein at 30 min before ischemia.The animals were sacrificed at 48 h of reperfusion and the lumbar segment (L4-6) of spinal cords was removed for microscopic examination and for determination of neuronal apoptosis in the anterior horn of the spinal cord (by TUNEL),and the expression of interleukin-6 (IL-6),IL-8 and IL-10 was detected (by immunohistochemistry).The apoptosis rate was calculated.Results Compared with group S,the apoptosis rate was significantly increased,IL-6 and IL-8 expression was upregulated,and IL-10 expression was down-regulated in I/R and LiCl groups.Compared with group I/R,the apoptosis rate was significantly decreased,IL-6 and IL-8 expression was down-regulated,IL-10 expression was up regulated,and the pathological damage was attenuated in LiCl group.Conclusion Activated GSK-3β is involved in the development of spinal cord I/R injury possibly by promoting synthesis and release of inflammatory factors in rats.

Objective To evaluate the relationship between serum tissue inhibitors of metaUoproteinase-1 and children with myocarditis,and provide evidences to support the measurement of serum tissue inhibitors of metallopro- teinase-1. Methods Tissue inhibitors of metalloproteinaee-1 and bioehem indexes of the harvested specimens and e -chocardiogram were measured from children with myocarditis(age: 1～14 years old, n = 9) and healthy young chil- dren(age: 1～14 years old, n = 9). Results Children with myocarditis showed reduced ejection fraction and dilated left ventricular compared with healthy children. Tissue inhibitors of metalloproteinaee-1 in children with myocarditis was significantly reduced compared with healthy children. Aspartie acid transanainase, lactate dehydrogenase,creatine kinase, hydroxybutyrie acid dehydrogenase, MB isoenzyrne of creatine kinase, cardiac troponin Ⅰ , C reactive protein showed no difference between two groups. Conclusion The reduced serum level of tissue inhibitors of metallopro- teinase-1 may show the severity of children with myocarditis and maybe one of the mechanisms of children with di- lated cardiomyopathy following myocarditis.

Objective Studies on the application of fast track surgery ( FTS) are comparatively limited in urologic proce-dures.This randomized controlled study was to evaluate the impact of FTS on recovery after retroperitoneal laparoscopic adrenalectomy . Methods Eighty patients undergoing retroperitoneal laparoscopic adrenalectomy were randomly assigned to an FTS and a control group of equal number to receive an FTS recovery program and conventional perioperative care , respectively .Comparisons were made between the two groups in the time of the first flatus , first oral nutrition , and first mobilization , the incidence of gastrointestinal tract complica-tions, the time of drainage and transurethral catheterization , the length of postoperative hospital stay , hospitalization expenses , visual analogue scale (VAS) pain scores, and general state of the patients . Results The FTS group, in comparison with the control, showed significantly earlier time of first flatus ([20.6 ±8.3] vs [39.8 ±18.3]h, P<0.05), first oral nutrition ([21.1 ±9.9] vs [51.8 ±16.9]h, P<0.05), and first mobilization ([23.6 ±9.0] vs [55.6 ±18.5]h, P<0.05), markedly shorter time of drain-age ([20.9 ±7.9] vs [70.6 ±18.9]h, P<0.05), transurethral catheterization ([20.2 ±8.3] vs[62.5 ±27.1]h, P<0.05), and postoperative hospital stay ([2.43 ±0.94] vs [5.46 ±1.60] d, P<0.05), remarkably less expenses of hospitalization ([21.7 ± 3.2] vs [28.6 ±6.5] ￥1000, P<0.05), and lower postoperative pain scores at 12 h (0.93 ±0.89 vs 1.80 ±1.38), at 24 h while coughing (1.27 ±0.99 vs 4.65 ±1.33), and at 24 h at rest (0.70 ±0.61 vs 1.40 ±0.84) (P<0.05).The general state score was dramatically higher in the FTS patients than in the control on postoperative day (POD) 1 (6.85 ±1.00 vs 4.28 ±1.11) and POD 2 (8.30 ±0.94 vs 5.53 ±1.24) (P<0.01).No significant differ-ences were observed in the general state of the patients between POD 2 and the baseline (P>0.05), nor in the incidence of gastrointesti-nal tract complications between the FTS and control groups ( P >0.05). Conclusion By improving the general state and accelera-ting the recovery of the patients , FTS can be applied safely and effectively in retroperitoneal laparoscopic adrenalectomy .

The present study aimed to find out dynamic changes of apoptosis in human cytomegalovirus (HCMV) infected cells and the influence of HCMV infection on activation of caspase3 and the expression of apoptosis-regulating genes, bcl-2 and fas mRNA. The sequential changes of apoptotic cell rate in high and low MOI (MOI= 2.5 and 0.25 respectively) of HCMV infected human embryonic lung fibroblasts (HELFs) at 1 h, 12 h, 24 h, 36 h, 48 h, 72 h and 96 h post-infection were measured by flow cytometry. The expression levels of caspase-3 protein and bcl-2 and fas mRNA in HCMV infected cells (MOI=0.25) at 72 h post-infection were detected by Western blot and in situ hybridization methods, respectively. It was found that the ratio of apoptotic cells in normal controls was consistently lower, but the rates in low and high MOI infected cells were gradually increased with time prolonged, reached peak at 96 h (8.85 %) and 72 h (25.63 %), respectively. By Western blot analysis, only a narrow band of 32 kD (1 kD=0. 992 1 ku) procaspase-3 was found in normal cells, but a wider procaspase-3 band and a much wider band of 17 kD proteins (p17) appeared in the infected cells. Meanwhile, the expression of bcl-2 mRNA was higher and that of fas mRNA was lower in the normal HELF cells, whereas there were significantly lower bcl-2 mRNA and higher fas mRNA expression levels in HCMV infected cells. It was concluded that HCMV was a stronger inducer of apoptosis in HELF cells. Caspase-3, as the marker of undergoing apoptosis,was expressed increasingly and activated in the infected cells, indicating its action in HCMV-inducing apoptosis. Down-regulating bcl-2 mRNA expression and up-regulating fas mRNA expression were also involved in the mechanism of HCMV-induced apoptosis.

AIM:To explore the effects of pentoxifylline (PTX) on ventricular remodeling and cardiac function in dilated cardiomyopathy (DCM) rats.METHODS: Lewis rats were randomly allocated to a myocin-induced dilated cardiomyopathy (DCM) group receiving saline (n=10), a DCM group receiving PTX (PTX group; 25 mg?kg-1?d-1, ip, for 30 days, n=10) or healthy control group (n=10). The levels of tumor necrosis factor-? (TNF-?), interleukin-6 (IL-6) and IL-10 in the blood plasma were analyzed by ELISA. The extent of fibrosis was estimated using Masson's staining and immunohistochemistry analyses. Cardiac structure and function were measured by echocardiography.RESULTS: PTX decreased plasma levels of TNF-? and IL-6, and increased IL-10 level in DCM animals compared with DCM group [TNF-?: (7.21?0.24) ?g/L vs (19.30?1.31) ?g/L, P

Objective To report the efficacy of closed pry reduction and cross Kirschner wiring in the treatment of refractory flexion-type fracture of supracondylar humerus in children.Methods A retrospective analysis was done of 19 children who had been treated for refractory flexion-type fracture of supracondylar humerus by closed pry reduction and cross Kirschner wiring at Department of Orthopaedics,Shaoyang Orthopaedic Hospital from March 2015 to March 2017.They were 9 boys and 10 girls,aged from 2 to 12 years (mean,6.37 years);10 left and 9 right sides were involved.According to the severity of fracture displacement,11 cases had rotational displacement with their broken ends obviously inserted into one another,and 8 cases complete displacement with no contact of the broken ends.All the fractures were closed,treated with closed reduction by leverage and cross fixation with Kirschner wire.Postoperative complications were recorded and the elbow function was evaluated by the Flynn assessment system at the last follow-up.Results The operation time for the 19 patients ranged from 15 to 60 minutes,with an average of 30 minutes.The patients were followed up for 12 to 24 months (average,18.0 months).All the fractures united after 2 to 4 months (average,2.8 Months).At the last follow-up,according to the Flynn system,the elbow function was evaluated as excellent in 10 cases,good in 7,and fair in 2.No ossifying myositis,cubitus varus or iatrogenic injury to the ulnar nerve was observed in any patient.Nails had to be removed in one case due to implant loosening after pin-hole infection.Conclusion Closed reduction and Kirschner wire cross fixation is an ideal surgical treatment for refractory flexion-type supracondylar fracture of humerus in children,because its intraoperative closed pry reduction can reduce the rate of incision.