Objective To analyze the clinical efficacy and safety of different ways iron therapy in hemodialy -sis patients with renal anemia .Methods 68 cases of chronic renal failure patients treated with hemodialysis were randomly divided into two groups according to the digital form ,each group had 34 cases.The control group was treated with oral iron while the observation group took intravenous iron ,the clinical efficacy of the two groups was observed . Results The total effective rate of the observation group was 61.76% significantly higher than that of the control group′s 32.35%(χ2 =4.781,P=0.029);Two groups of patients′Hb,Hct,SF,TSAT were significantly improved after treatment than before(t =4.931,4.213,5.429,5.107,7.018,6.472,7.821,7.530,all P <0.05),these parameters of the observation group were significantly improved than that of the control group ( t =4.082,3.968, 4.395,4.139,all P <0.05).Conclusion Intravenous iron approach can significantly improve anemia state in patients with CRF hemodialysis , increased serum iron indicators significantly , improved erythropoiesis , and quickly replenish iron stores,correct anemia in patients with CRF .

Objective To investigate the effects of hyperbaric oxygen preconditioning (HBOP) on brain edema, inflammatory reaction and neuronal cell apoptosis induced by experimental hemorrhage in rats. Method Eighteen male Spraque-Dawley rats, weighing 300 - 350 g,received five successive sessions of HBOP with 3 atmosphere absolute pressure and 100% O2 one hour daily for five successive days, and other eighteen rats received five successive sessions of pretreatment with one atmosphere absolute pressure, air, one hour daily for five successive days. Twenty-four hours after the final pre-conditioning, rats received an infusion of 100 μL autologous blood into the basal ganglion. Seventy-two hours later, rats were sacrificed for brain edema measurements in 12 rats of each group. The histopathological changes around the hematoma were observed microscopically, and the neuronal cell apoptosis was detected by using the terminal deoxynucleotidyl transferase-mediated nick end labeling (TUNEL) in six rats of each group. Data of brain water content were analyzed by using Stata 7.0 software and statistical analysis was carried out by two-tailed Student t -test. Results Compared with the control group, HBOP significantly attenuated brain edema 72 hours after intra-cerebral hemorrhage in experimental rats (81. 6± 0. 7% vs. 82. 8± 0.9%, P < 0.01). Inflammatory cell infiltration and neuronal cell apoptosis were also significantly decreased in the HBOP group. Conclusions HBOP protects the rats against brain edema formation, and quells inflammatory reaction and neuronal cell apoptosis following intra-cerebral hemorrhage in experimental rats.

Two patients underwent liver transplantation of blood type incompatibility were collected from Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA. Case 1: A male who had primary hepatic carcinoma underwent classic orthotopic liver transplantation; the blood of donor was type A, and the blood of recipient was type O. Case 2: A female having history of type B hepatitis underwent classic orthotopic liver transplantation due to pregnancy combining with severe liver disease and coagulation disorder; the blood of donor was type B, and the blood of recipient was type O. Immunohistochemistry staining was used to observe pathological changes and deposition of various immunoglobulin and complement in two cases following liver transplantation of blood type incompatibility under optic microscope and to investigate diagnostic standard of humoral rejection. The results showed that linear or granular depositions of IgG, IgM, IgA, C4c, C4d, and Clq were found in endothelial cells of hepatic sinusoid, suggesting that IgG and other immunoglobulin exhibited a strongly positively diffused deposition on the endothelial cells of hepatic sinusoid, while expression of C4d and other complements was also found. All those mentioned above could be considered as evidences to prove onset of humoral rejection in transplanted liver tissue.

Telomeres are protective caps located at the ends of human chromosomes. Telomeres shorten with each successive cell di-vision in normal human cells, whereas they are continuously elongated by human telomerase in over 85%of tumors. This simple and attractive difference steers the development of anticancer drugs targeting telomeres and telomerase. Many promising current telo-mere/telomerase-targeting agents, such as GRN163L and GV1001, showed good therapeutic effect both in preclinical studies and phaseⅠ/Ⅱclinical trials. These agents have even entered phaseⅢclinical trials in patients with various tumors. Most therapeutics are more effective when used in combination with standard chemotherapies. Moreover, pharmacological interference with tumor-cell telomere biology to reduce telomere length and/or telomere stability could enhance the effectiveness and safety of radiotherapy. Therapeutics targeting telomere/telomerase may play a key role in radiotherapy in the era of personalized medicine in the future.

Objective To explore the clinical efficacy,adverse effect and prognosis of infliximab in treatment of the patients with juvenile idiopathic arthritis (JIA).Methods Thirty-two cases of infliximab-treated JIA patients and 30 cases of JIA control patients were investigated in this prospective study,and their tender joint count (TJC),swollen joint count (SJC),erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),visual analog scale for general health (GH),disease activity score (DAS) 28,as well as adverse reactions of treatment and follow-up outcomes were analyzed.The infliximab-treated patients were intravenously infused with infliximab at the low dose of ＜ 5 mg/(kg · time) or the high dose of ≥ 5 mg/(kg · time) in 0,2nd,6th,14th,22nd,30th week.The JIA control patients were treated with conventional therapy.Results The treatment of infliximab ameliorated the TJC,SJC,ESR,CH,CRP and DAS28 of JIA patients.In the dynamical analysis of these clinical indexes of the infliximab-treated JIA patients,the index of SJC was found to fall firstly in the 2nd week,the indexes of TJC,ESR,CH and DAS28 were found to decline secondly at 6th week,the indexes of TJC,SJC,ESR,CRP and DAS28 continued dropping till 22nd week,and only the index of GH progressively declined to 30th week.The high-dose infliximab-treated group had lower levels of ESR,GH and CRP than the low-dose infliximab-treated group (t =2.14,3.04,2.33,P =0.04,0.01,0.04).But there were no statistical difference in TJC,SJC,DAS28 and the incidence of recent adverse reactions between the high and low infliximab dose groups.In the infliximab treated group,2 cases of patients (6.25％) failed in the therapy of infliximab;9 cases of patients (28.13％) continued therapy with infliximab to 46th-62nd week; 7 cases of patients (21.88％) stopped therapy with infliximab in the 30th week had good improvement of joint symptoms and inflammatory indexes; 14 cases of patients (43.75％) relapsed and retreated by infliximab after cease the first course of treatment; 1 case of patient died of severe chickenpox infection after therapy with infliximab was ceased.Conclusions Infliximab can alleviate the joint symptoms,inflammatory indexes and DAS28 of JIA patients,and is an effective and safe therapy for JIA patients in the short-term study.

Objective To study the predictive validity of general movements (GMs) assessment for motor development outcomes in neonatal purulent meningitis.Methods According to the inclusion criteria,excluding other cerebral injury diseases,a total of 34 cases of neonatal purulent meningitis,who took part in our follow-up clinic after discharged from neonatal intensive care unit of the Second Affiliated Hospital of Wenzhou Medical University from December 2012 to December 2013,were confirmed as the participants.Infants' GMs recordings during writhing movements period (at least once at 0-3 months) and fidgety movements period (at least once at 3-5 months) were collected and assessed.Motor development outcomes was determined at least after one year old with Alberta Infant Motor Scale(AIMS).Predictive validity in each period were calculated with AIMS results as the golden standard.Results Among the 34 cases,there were 24 males and ten females,and four preterm infants and 30 term babies.The age at follow-up was from 12 months to 23 months old.Ultimately,one (3％) infant with spastic cerebral palsy,seven (21％) with motor retardation and 26 (76％) with normal motor development were diagnosed.The sensitivity,specificity,positive predictive value,negative predictive value,Youden index and residual error rate for the writhing movements period in prediction of motor development outcomes were 87.5％,46.2％,33.3％,95.6％,33.7％ and 12.5％,respectively.And the corresponding figures for the fidgety movements period were 87.5％,88.5％,70.0％,95.8％,76.0％ and 12.5％,respectively.Conclusions GMs assessment could be an accurate predictive tool for later motor developmental outcomes in neonates with purulent meningitis,especially in fidgety movements period.

Objective To study the protective effects of parathyroid hormone (PTH) on radiationinduced hematopoietic damage in mice.Methods A total of sixty male C57 mice were irradiated by 60Co γ-rays to induce hematopoietic injuries,and then the mice were randomly divided into PTH and control group.The PTH-treated group was treated with PTH ( 80 μg· kg- 1 · d - 1 ) intraperitoneally everyday.The control group was given equivalent volume saline.Peripheral blood cell number,bone marrow mononuclear cell number,granulocyte-macrophage colony forming units ( CFU-GM ) and CD34 positive cells in bone marrow were detected.Results With the whole post-irradiation period,the WBC and bone marrow mononuclear cell numbers in PTH-treated mice were significantly higher than those in saline-treated mice (t=6.32,9.19,11.18,7.44 and 4.42,P ＜ 0.05).The RBC numbers in PTH-treated mice were significantly higher than those in control mice at 10 d,15 d and 20 d post-irradiation (t =6.48,3.66 and 4.98,P ＜0.05 ).The PLT numbers in PTH-treated mice were significantly higher than those in control group at 5 and 30 d post-irradiation ( t =2.57 and 3.10,P ＜ 0.05 ).PTH increased CD34 positive cell and CFU-GM numbers in bone marrow after irradiation ( t =16.12,7.82 and 20.00,P ＜ 0.05 ).Conclusions PTH could improve the hematopoietic recovery after irradiation.

BACKGROUND: Marrow stromal cells (MSCs) own the characteristic of migration. However, the mechanisms underlying the migration of these cells remain unclear. OBJECTIVE: To explore the roles of stromal cell-derived factor-1 (SDF-1) and its receptor CXCR4 in trafficking of MSCs migration. DESIGN, TIME AND SETTING: The in vivo cytology experiment was performed at Department of Anatomy, National University of Singapore from March 2007 to June 2007. MATERIALS: MSCs were isolated and purified from a Wistar neonatal rat. Forty adult female Wistar rats were randomly divided into sham operation and experimental groups, with 20 animals in each group. METHODS: The chemotaxis assay was performed at a 48 well Boyden chamber, and a total of 25 μL SDF-1 was added to the lower layer of chamber, covered with 8 μm polycarbonate membrane filter; SDF-1 cultured in DMEM conditioned medium was served as a blank control group. Cell concentration was regulated to 1.5×109L-1/L. 50 μL and cell suspension was added into the upper layer of chamber, cultured at CO2 incubator with temperature of 37 ℃ for 10 hours. Rats in the experimental group were prepared for transected spinal cord injury models, and in the sham operation'group, only the vertebral plate was opened. 1.0 mL (1×109L-1/L) MSCs suspension labeled with 5-(and-6)-carboxyfluorescein diacetate succinimidyl ester (CFDA-SE) was injected through internal jugular vein at 1 hour after completely transected spinal cord. MAIN OUTCOME MEASURES: Expression of chemokine receptor CXCR4 in MSCs, as well as the effect of SDF-1 on the migration of MSCs was observed by immunofluorescence, change of SDF-1 in lesion site of spinal cord was detected by real-time PCR analysis, as well as the in vivo migration of intravenously injected MSCs was detected by fluorescence microscopy. RESULTS: The pudfied MSCs were positive to CXCR4. Compared to the blank control group, SDF-1 with concentrations of 5, 50, and 500 μg/L could accelerated the migration of MSCs (P < 0.05), which reached a peak with concentration of 500 μg/L. The expression of SDF-1 RNA was obvious increased in the experimental group than that of the sham operation group (P < 0.05), and returned to a normal level at 14 days. At 2 weeks after cell injection, the number of MSCs migrated to the lesion site of completely transected spinal cord was significant increased than sham operation group (P < 0.05). CONCLUSION: SDF-1 may contribute to MSCs migration in vitro and in vivo. SDF-1 and its receptor CXCR4 are involved in the migration of injected MSCs to the lesion site of completely transected spinal cord.Ding P, Xue LP, Yang ZY, Wang CQ, Wang JH, Feng ZT, Ling EA.Chemokine stromal cell-derived factor-1 and its receptor CXCR4 mediate migration of marrow stromal ceils into the lesion site of completely transected spinal cord.

BACKGROUND: Enophthalmos deformity is the most common complication caused by orbital blow-out fractures, and others are diplopia and worsening of visual acuity. Since the therapeutic result of orbital blow-out is not satisfactory and many complications exist after operation, it is still a dispute to select implantation materials and therapeutic regimens.OBJECTIVE: To observe the therapeutic effect and assess the improvement of visual function by surgical reconstruction with porous high-density polyethylene (Medpor) for the correction of enophthalmos deformity caused by orbital blow-out fractures.DESIGN: A pre-and postoperative controlled study.SETTING: Beauty Center for Trauma Repair,Plastic Surgery Hospital,Peking Union Medical College, Chinese Academy of Medical Science .PARTICIPANTS: Totally 56 patients with orbital blow-out fractures who had enophthalmos deformity caused by fists or traffic accidents, treated at Beauty Center for Trauma Repair,Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Science, were selected in this study from December 1996 to March 2004. Final diagnosis were made with case history, X-ray film, two-demensional and three-dimensional CT before operation. 24 cases were accompanied with other areas fractures such as zygoma and nasal bone, 34 cases with diplopia, 35 cases with visual acuity worsening after injured.METHODS: ①Material implantation: Exposure of the orbital floor, inferior and medial walls could be performed through a 2 mm inferior subciliary incision of 3 cm long. To approach the orbital rim via a dissection plane anterior to the orbital septum, sub-periosteal dissection was then performed over the orbital rim, and along the orbital floor to the orbital apex. Mobilized the soft tissue from the bone throughout the entire area of fractures and re-position it to its proper position. Took Medpor (Type 6331) sheets as the implantation materials, trimmed Medpor sheets according to the radian and anatomic form, and 2 mm larger than the defect rim was needed.If other operations were needed during the operation, they could be done.Mannitol and dexamethasone should be used just postoperatively to decrease edema of the orbital contents and reduce inner orbital excessive pressure. ②Functional evaluation standard: Diplopia: completely disappear meant recovered, less diplopia residual meant improvement, no improvement meant inefficacy. Enophthalmos: marked improvement meant the degree of enophthalmos stabilizated at below 2 mm, less improvement meant stabilizated at above 2 mm.MAIN OUTCOME MEASURES: ①Improvement of enophthalmos; ②Improvement of diplopia ; ③Improvement of visual acuity.RESULTS: ①All 56 cases of enophthalmos deformities caused by orbital blow-out fractures improved greatly. ② Of all the 34 patients with diplopia, 27 recovered. ③ 9 patients' visual acuity of 35 improved with different degrees. No diplopia or visual acuity worsening occurred. With a follow-up ranging from 2 months to 5 years, the degree of enophthalmos stabilizated at below 2 mm, and no relapse and other complications occurred.CONCLUTION: Medpor has such advantages as better histocompatibility,fewer complications and better visual function improvement, so it is the preferred implantation material for correcting enophthalmos deformity caused by orbital blow-out fractures.

Objective To investigate the therapeutic action and molecular mechanisms of Oxalis comiculata L. extracts on rats with alcoholic liver disease. Methods Forty-two male Sprague Dawley(SD)rats were randomly divided into normal control group(n=10),model group(n=8),moderate dose oxalis group(n=8),high dose oxalis group(n=8)and prednisone group(n=8). The model of rat with alcoholic liver disease was established by liquor gavage;after 12 weeks,moderate dose oxalis group,high dose oxalis group and prednisone group were given the total extract of oxalis 3.5 g?kg-1?d-1,7 g?kg-1?d-1 or prednisolone acetate 0.9 mg?kg-1?d-1,respectively,the remaining two groups were given the same amount of normal saline by gavage daily for 6 weeks. Levels of indexes of liver function,superoxide dismutase(SOD),malondialdehyde(MDA),antidiuretic hormone(ADH)and aldehyde dehydrogenase(ALDH)in rats were detected. The pathological changes of liver tissues in rats were observed under light microscope;tumor necrosis factor-α(TNF-α) expression level was detected by immunohistochemical staining. Results Compared with the normal control group, the levels of aspartate aminotransferase (AST), alanine aminotransferase(ALT),alkaline phosphatase(AKP),γ-glutamyl transferase(GGT),MDA were increased significantly,while the levels of SOD,ADH and ALDH were obviously reduced in model group. Compared with the model group,AST,ALT,AKP,GGT and MDA contents were decreased significantly,while the levels of SOD, ADH and ALDH were markedly increased in the drug groups,and the changes of levels of AST,ALT,AKP,GGT, SOD,ADH in high dose oxalis group were the most obvious〔AST(U/L):117.38±22.75 vs. 201.62±17.95,ALT (U/L):33.51±11.64 vs. 59.14±9.52,AKP(U/L):95.19±24.85 vs. 169.39±37.21,GGT(U/L):46.54±14.55 vs. 89.37±12.49,SOD(U/mg):137.03±12.03 vs. 80.64±13.45,ADH(U/L):3.48±0.71 vs. 2.05±0.91,P<0.05 or P<0.01〕,and the most significant changes of MDA and ALDH were in oxalis moderate dose group〔MDA (mmol/mg):2.05±0.64 vs. 3.17±0.61,ALDH(U/L):7.59±1.95 vs. 5.71±1.33,both P<0.05〕. In normal control group,no obvious lesion was seen in the rat liver tissues. In the model group,fatty degeneration of liver cells with formation of bullae was found,while in the moderate and high dose oxalis groups,cells with macrovesicular steatosis were significantly decreased. Immunohistochemical staining showed that the expression of TNF-α in the cytoplasm and part of cell membrane of macrophage was significantly decreased in liver tissues in oxalis moderate and high dose groups. Conclusion These results show that the Oxalis comiculata L. extracts possess certain therapeutic effect on alcoholic liver disease.