BACKGROUND:The relationship between placing time after stem cel preparation and cel survival is the basis of safety and effectiveness for the clinical application. OBJECTIVE: To observe effects of different preservation solutions and different storage time on survival rate of umbilical cord-derived mesenchymal stem cels, and to provide important evidence for identifying effectiveness of stem cels. METHODS:Umbilical cord-derived mesenchymal stem cels were selected to prepare stem cel preparation, which was preserved in physiological saline, medium, medium+physiological saline, physiological saline containing epidermal growth factor, and medium containing low molecular heparin calcium suspension. Cold closet was selected for imitating celular transport conditions. Samples were obtained at 0, 6, 12, 18, 24, 30, 36, 42 and 48 hours. Total cel number and cel survival rate were detected. RESULTS AND CONCLUSION:The difference in cel number and survival rate was not great within 24 hours in each group. Twenty-four hours later, total cel number and survival rate were better in the medium and medium containing low molecular heparin calcium groups than in the physiological saline containing epidermal growth factor, physiological saline, and medium+physiological saline groups. These findings suggest that after stem cel preparation, the cel survival rate can reach more than 90% within 24 hours under refrigerated transport conditions. Nutritional ingredients and proper pH value of preservation solution can make the cel survival rate increased greatly.

Objective　To evaluate the changes and clinical s ignificances of serum growth hormore (GH) and GH binding protein (GHBP) in patie nts with obstructive jaundice (OJ). Methods　Serum levels of GH, GHBP, insulin-like growth factor-Ⅰ (IGF-Ⅰ), endotoxin, prealbumin concentr ation and liver function in 60 male in patients with OJ were detected 1 d preope ratively and 1, 3, 7 d postoperatively. And 40 male patients with simple gallbla dder stone hospitalized in the same period were served as control. Resu lts　The levels of GH, GHBP and IGF-Ⅰ were significantly lower in pati ents with obstructive jaundice than in control group(P<0.01), which was corr elated with the levels of bilirubin, endotoxin and prealbumin (P<0.01). Conclusion　The obviously downregulation of GH/GHBP axis in patients with OJ probably results from the inbibition of expression of GH receptor due t o nutritional dysfunction and endotoxemia, and further aggravate the nutritional dysfuction and endoxemia, which may be one of the important factors in the path ophysiological changes of OJ.

Objective To discuss the diagnosis and surgical treatment of the primary right ventricular tumors.Methods The results of surgical treatment of 7 patientss (5 males,2 females; median age,48 years,range,37 to 68 years) with primary right ventricular tumors hospitalized from Jan,1999 to May,2012 were analyzed.By preoperation echocardiography,cardiac myxoma was diagnosed in 2 cases,and cardiac space-occupying lesion was diagnosed in 5 cases.Median sternotomy were performed in all the 7 cases for biopsy or resection of tumor.when resection of tumor,extracorporeal circulation and cardiac arrest were performed.Results The 7 patients accounted for 4.96％ of patients with cardiac tumors surgically treated in the corresponding period.Complete resection of tumor was performed in 5 cases,and only biopsy in 2 cases.The pathological diagnoses included myxoma in 2 cases,lipoma in 1 case,liomyoma in 1 case,undifferentiated sarcoma in 1 case,and mesenchymal sarcoma in 2 cases.There was no in-hospital death.During a follow-up of 1 ～ 51 months (median,38 months),the 3 cases of sarcoma died,and the other patients were good and showed no recurrence.Conclusion The incidence rate of primary right ventricular malignant tumor is relatively high.Echocardiography is the most important diagnosis method.The prognosis of right ventricular malignant tumor is poor.The results of surgical treatment of right ventricular benign tumor are satisfactory.

Objective To evaluate the treatment results and psychological changes in female patients with stress urinary incontinence (SUI) before and after TVT-O.Methods Fifty-six female patients with SUI underwent TVT-O from Nov.2011 to Mar.2012.Preoperative and postoperative International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) score,Incontinence Quality of Life Questionnaire (I-QOL) score,one hour urine pad test,Self-rating Anxiety Scale (SAS) score,and Self-rating Depression Scale (SDS) score were recorded and analyzed.Results Followed up for 3 months,the subjective satisfactory rate was 94.6％ (53/56),the objective efficiency rate was 91.1％ (51/56),and there was no recurrence in this group.Before operation and 3-month after operation,ICIQ-SF scores were 15.9±3.2(13-20) and 8.6±2.7 (4-13),t=6.02,P=0.01 ; I-QOL scores were 40.3±18.9 (33-62) and 87.6±11.2(76-102),t=6.81,P=0.01; The urine leakages in one hour urine pad test were 26.7±7.1 (9-51)g and 5.2±2.5 (1-8)g,t=7.13,P=0.00; SAS scores were 59.3±8.3 (48-72) and 42.6±4.6 (39-52),t=9.15,P =0.01; SDS scores were 57.2±5.6 (49-69) and 40.2±3.4 (36-54),t=8.63,P=0.01,respectively.No serious and long-term complication occurred.Conclusions TVT-O is a safe and effective treatment option for female SUI.This treatment can improve the quality of life and psychological status of the patients.

Objective To evaluate valvular functionality after transcatheter pulmonary valve replacement in sheep using a novel polymeric prosthetic pulmonary valve.Methods In this study,we designed a novel polymeric trileaflet transcatheter pulmonary valve with a balloon-expandable stent,and the valve leaflet was made of 0.1 mm expanded polytetrafluoroethylene (ePTFE).We chose bovine pericardium valve as control.Pulmonary valve stents were implanted in situ by right ventricular apical approach in 8 healthy sheep(6 for polymeric valve and 2 for bovine pericardium valve) weighing an average of(22.8 ± 2.2) kg.Angiography was performed after implantation to assess immediate valvular function.Color Doppler echocardiography and 64-row computed tomography were used to assess valvular function 4 weeks after implantation.Results Implantation was successful in 8 sheep.Angiography at implantation showed one polymeric valve was located below the ideal position and most of the stent was in the outflow tract of right ventricle.While,all the other prosthetic valves demonstrated orthotopic position and exhibited normal open and close functionality.Echocardiography 4 weeks after implantation showed all the prosthetic valves exhibited normal functionality and no significant insufficiency.The peak-peak transvalvular pressure gradient of the polymeric valves was (18.8 ± 6.0) mmHg,while that of two bovine pericardium valves were 9 mmHg and 20 mmHg.CT 4 weeks after implantation demonstrated orthotopic position of the stents except the above-mentioned one and all the stents had no deformation.Conclusion The success rate of transcatheter pulmonary valve replacement by right ventricular apical approach is satisfactory.The early valvular functionality of the novel ePTFE pulmonary valve after transcatheter pulmonary valve replacement in sheep is good.

Objective　To investigate the expression of LPS receptor-CD14(CD14) on the membrane of Kupffer′s cells (KCs) induced by Lipopolysaccharide (LPS )and its role in activation of KCs and production of cytokines. Methods　KCs were isolated by collagenase perfused Wistar rats and routinely cultured in 24-well dishes for 12 h. Cells were harvested and adjusted to a concentration of 1×106/ml/well and were devided into two groups. Group of LPS: KCs were induced with different concentration of LPS (0, 100 ng/ml, 1 μg/ml and 100 μg/ml). Group of PI-PLC: KCs were pre-incubated for 30 min with one unit of phophatidy linositol specific phospholipase C (PI-PLC) before different concentrations of LPS were added. KCs were cultured for 30 and 60 min respectively. Supernatants were then collected for measuring the level of TNFα and IL-6. Cells were stained by indirect immunofluorescent method ( rabbit anti-CD14 antibody and goat anti-rabbit IgG conjugated with FITC ) and analyzed with flow cytometer (FCM). The percentage and mean fluorescence intensity (FI) of CD14-positive cells were taken as the indexes. Results　In LPS group, after incubation of cells with increasing concentration of LPS, a significant increase in the percentage of CD14 positive KCs were found and the mean FI was stronger when compared with the control points or the group of PI-PLC. The levels of TNFα and IL-6 in supernatant also increased (P<0.01). In group of PI-PLC, decreased percentage of CD14 positive KCs and weakened mean FI were found when compared with group of LPS. The increasing production of TNFα and IL-6 slowed down in the group of PI-PLC. Conclusion　CD14 expression of KCs might be up-regulated by LPS with increase of some cytokines. The production of cytokines in KCs induced by LPS is partially inhibited by PI-PLC.

OBJECTIVETo investigate the anti-tumor immune response of dendritic cells (DCs) acquiring antigens from apoptotic cholangiocarcinoma cells and their therapeutic effects on cholangiocarcinoma cells.

METHODSDCs from human peripheral blood monocytes which acquired antigen capturing and processing capacity, characteristics of maturation, were established in vitro using granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin-4 (IL-4). Then cholangiocarcinoma cells were induced to apoptosis with mitomycin. The three groups included (1) coculture of DCs, apoptotic cancer cells and T cells, (2) coculture of DCs, necrotic cancer cells and T cells, (3) coculture of DCs, cultured cancer cells and T cells. After 7 days, DCs and T cells were riched separately to perform anti-tumor cells test and immune response test.

RESULTSthese cells had typical dendritic cell morphology, expressed high levels of CD1a and B7, acquired antigen from apoptotic cells caused by mitomycin and could stimulate T cells to inhibit, even kill cholangiocarcinoma cells.

CONCLUSIONSThe DCs from peripheral blood monocytes induced by GM-CSF and IL-4 can efficiently present antigen derived from apoptotic cells caused by mitomycin, and stimulate T cells activity obviously. It maybe become an effective therapy for tumor.

Antigens, Neoplasm ; immunology ; Apoptosis ; drug effects ; Bile Duct Neoplasms ; immunology ; pathology ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; immunology ; pathology ; Coculture Techniques ; Dendritic Cells ; drug effects ; immunology ; Granulocyte-Macrophage Colony-Stimulating Factor ; pharmacology ; Humans ; Interleukin-4 ; pharmacology ; Mitomycin ; pharmacology ; T-Lymphocytes ; immunology ; Tumor Cells, Cultured

OBJECTIVETo explore the value of anal sphincter electromyography (ASEMG), orthostatic hypotension (OH), and dizziness in diagnosing multiple system atrophy (MSA).

METHODThe characteristics of ASEMG and OH were compared among patients with dizziness (MSA and non-MSA), patients without OH (MSA and non-MSA), and patients with probable MSA (OH and non-OH).

RESULTSTotally 476 patients underwent ASEMG examinations. Dizziness was the onset symptom in 69 patients. Between the MSA group and non-MSA group, the mean duration of dizziness [(14.6 +/- 2.1) vs. (12.8 +/- 2.0) ms, P < 0.01] and satellite potential occurrence rate [(22.7 +/- 11.8)% vs. (12.2 +/- 8.9)% , P < 0.01] were significantly different, while the OH rate (84.6% vs. 55.2% ) and the difference of the blood pressure between standing and supine positions were not significantly different. In 162 patients with symptom of dizziness, the mean duration of dizziness [(15.3 +/- 2.7) vs. (12.8 +/- 1.9) ms, P < 0.001], satellite potential occurrence rate [(25.4 +/- 12.8)% vs. (13.5 +/- 10.4)%, P < 0.001] , and difference of the diastolic blood pressure [(18.5 +/- 17.0) vs. (11.7 +/- 12.7) mmHg, P < 0.05] were significantly different between the MSA group and non-MSA group, while the normal rate of blood pressure at standing position (60% vs. 41.9%) and the difference of systolic blood pressure were not significantly different. In 146 patients with abnormal blood pressure at standing and supine positions, the mean duration of dizziness [(15.0 +/- 2.4) vs. (12.8 +/- 1.7) ms, P < 0.001] and satellite potential occurrence rate [(22.0 +/- 12.2)% vs. (10.6 +/- 8.5)%, P < 0.001] were significantly different between the MSA group (n = 61) and non-MSA group (n = 85). In 125 patients with probable MSA, the mean duration of dizziness [(15.5 +/- 2.4) vs. (15.9 +/- 2.2) ms, P > 0.05] and satellite potential occurrence rate [(24.3 +/- 12.6)% vs. (22.7 +/- 12.4)%, P > 0.05] were not significantly different between those with OH and those without OH. The rates of dizziness and the percentage of dizziness as the onset symptom were 93.2% and 52.3% in OH group and 44.4% and 8.3% in non-OH group.

CONCLUSIONSASEMG is better than OH in diagnosing patients with dizziness suspected as MSA. Neurogenic lesion can be found by ASEMG in patients without OH, which is helpful in the early diagnosis of MSA.

Adult ; Aged ; Aged, 80 and over ; Anal Canal ; chemistry ; physiopathology ; Dizziness ; physiopathology ; Electromyography ; Female ; Humans ; Hypotension, Orthostatic ; physiopathology ; Male ; Middle Aged ; Multiple System Atrophy ; diagnosis ; physiopathology

OBJECTIVESTo evaluate the protective effects of affiliating portasystemic shunt on small-for-size graft in liver transplantation.

METHODSFifteen Chinese Bama miniature pigs were divided into three groups: group A (small-for-size liver transplantation), group B (distal splenorenal shunt + small-for-size liver transplantation), and group C (mesocaval H-shape shunt + small-for-size liver transplantation). Animals were followed up for 7 days with survival, dynamical liver function biochemical parameters, liver biopsies, portal venous pressure (PVP) and portal blood flow (PBF).

RESULTSAnimal survivals were as follows: group A, 1/5, group B, 3/5 and group C, 5/5.Group A resulted in abnormal liver function parameters that were significantly ameliorated in group B and C. The histological examination of graft in group A displayed severe pathologic changes including hepatocyte vacuolar change or necrosis, sinusoidal congestion, parenchymal hemorrhage. Affiliating portasystemic shunt significantly alleviated graft injuries in group B and C. PVP rose and peaked up to 28.6 mm Hg (1 mm Hg = 0.133 kPa), PBF fluctuated after reperfusion in group A, but group B and C with affiliating portasystemic shunt showed significantly lower PVP and maintained rather stable PBF after reperfusion. There were also statistical differences in PVP or PBF between group B and C.

CONCLUSIONSAffiliating portasystemic shunt effectively might protect small-for-size graft from injuries after reperfusion.

Animals ; Female ; Liver ; pathology ; Liver Transplantation ; Male ; Models, Animal ; Portal Pressure ; Portal Vein ; physiology ; Portasystemic Shunt, Surgical ; methods ; Random Allocation ; Regional Blood Flow ; Survival Rate ; Swine ; Swine, Miniature

Animals ; Humans ; Liver Failure, Acute ; surgery ; Liver Transplantation ; methods ; mortality ; physiology ; Living Donors