Objective To observe the expression changes of cytokine RhoA,stress fiber and Vinculin in the formation of hepatic fibrosis in rats, and investigate the role of RhoA in hepatic fibrosis. Methods Forty male SD rats were divided into two groups:model group and control group. The rats in the model group were given 60% CCl 4 by subcutaneous injection(1 ml/kg). The liver tissue was taken out for research at 1st、4th and 8th week respectively, RhoA and Vinculin mRNAs were detected by RT PCR, Vinculin and F actin proteins were detected by immunohistochemistry and immunofluorescence respectively, RhoA and Vinculin proteins were detected by Western blotting. Results Compared with control group, the expressions of mRNA of RhoA and Vinculin, the proteins of Vinculin, F actin and RhoA were all significantly increased( P

Objective To explore the clinical effect of escitalopram combined with xingnaojing in post-stroke depression (PSD).Methods Seventy-four cases with PSD were divided into treatment group (38 cases) and control group (36 cases) by random digits table,control group was given escitalopram,treatment group was given escitalopram and xingnaojing.Hamilton depression scale (HAMD),mental state examination (MMSE),memory quotient (MQ) and activities of daily life (ADL) score,clinical curative effect and adverse reaction were compared between 2 groups.Results The HAMD,MMSE,MQ,ADL score after treatment in 2 groups were significantly better than those before treatment [control group:(14.26 ± 2.61)scores vs.(29.73 ± 5.17) scores,(23.26 ± 3.75) scores vs.(21.24 ± 3.38) scores,(86.53 ± 6.49) scores vs.(82.35 ± 5.42) scores,(61.37 ± 3.72) scores vs.(45.32 ±4.48) scores;treatment group:(10.31 ± 2.08)scores vs.(29.57 ± 6.09) scores,(27.83 ± 4.31) scores vs.(21.63 ± 3.82) scores,(95.63 ± 6.41) scores vs.(82.30 ± 7.48) scores,(69.15 ± 6.39) scores vs.(45.27 ± 4.28) scores,P ＜ 0.05].The HAMD,MMSE,MQ,ADL score after treatment in treatment group were significantly better than those in control group (P ＜0.05).The total effective rate in treatment group was significantly higher than that in control group [97.4％(37/38) vs.86.1％(31/36),P ＜ 0.05].There was no significant difference in rate of adverse reaction between 2 groups (P＞ 0.05).Conclusion Escitalopram combined with xingnaojing in PSD is effective and safe,and worth further clinical application promotion.

BACKGROUND:Mesenchymal stem cells have a extreme prospect in orthopedics, which show great potential especially in the treatment of articular cartilage defect disease. Bone marrow is the main source of mesenchymal stem cells, and the iliac puncture is a conventional way to obtain bone marrow, but is restricted by the limited resources and strict technical requirements. Therefore, it is of great significance to explore new effective and convenient sources of mesenchymal stem cells. OBJECTIVE:To explore the feasibility of autologous mesenchymal stem cells derived from the joint drainage fluid after knee arthroscopy.METHODS: We selected eight patients who underwent arthroscopic surgery to collect joint drainage fluid by pre-made sterile blood bag before the wound closure. Precipitation with hydroxyethyl starch and density gradient centrifugation method were performed to isolate and culture mesenchymal stem cells from the joint drainage fluid. Cell morphology, growth curve, surface marker identification were observed and detected using flow cytometry. Then, adipogenic, chondrogenic and osteogenic differentiation of cells were induced and identified by oil red O, toluidine blue staining, and alizarin red staining, respectively. RESULTS AND CONCLUSION:The cultured cells were spindle-shaped, adherently grew and had good proliferation ability, which were positive for CD44, CD90, CD105 and CD73, but not for CD45. Under standard inductions, the cultured cells were induced to differentiate into osteoblasts, adipocytes and chondrocytes. Therefore, these cells were confirmed as mesenchymal stem cells. Mesenchymal stem cells were successfully isolated from the joint drainage fluid of eight patients and had no difference in cell morphology, proliferation and phenotypes. To conclude, the joint drainage fluid is an ideal source of mesenchymal stem cells with the guaranteed quality and quantity.

Objective To review and sum up the clinicopathologic features and surgical therapeutic efficacy of intrathoracic Castleman′s disease (CD). Methods 14 patients with intrathoracic Castleman′s disease, 7 in each sex, aged from 19 to 52, admitted during 1982 to 2005, all underwent surgical treatment, among which 11 with localized type and 3 with multicentric type, were retrospective analyzed on their clinicopathologic features, radiological signs, treatment and prognosis. Results Clinically, 3 patients of localized type were with systematic symptoms; all the patients of multicentric type were with various severity systematic symptoms. Pathological type: 9 cases with hyaline vascular type (HV), 2 cases with Plasma type (PC), and 3 cases with Mixed type (Mix). A different pattern of pathologic alterations existed between HV、PC and Mix types of CD. Radiological features: in localized type of CD, the lesion presented as a solitary soft-tissue mass with a mean diameter of 5.05cm, the mean CT value was 37.39HU. In 3 cases with multicentric type of CD, diffuse mediastinal lymphadenopathy and pleural effusion were observed. All patients survived after surgical resection, long-term survival was achieved in 11 cases with localized type and 2 cases with multicentric type, no recurrence occurred in the 13 patients. Recurrence occurred twice in a patient with multicentric Mix type in the fourth and the ninth year after surgery, respectively, thus the operative treatment followed. Conclusions The diagnosis of CD is based mainly on its histopathological features. The patients with intrathoracic localized type of CD and part of the patients with multicentric type CD could be cured, while part of the patients with multicentric type CD got a poor therapeutic efficacy and unfavorable prognosis even underwent with radiotherapy and integrated treatment.

0.05).The AI of tumor cells was(9.7?0.9)% in mice treated with endostatin compared to that (1.9?0.4)% in the group of control ( P

OBJECTIVE:To determine organic solvent residual volume in fusidic acid by headspace gas chromatography.METHODS:The determination was performed on polyoxyl20000DM-WAX capillary,the column was subjected to tempera-ture programming,the detector temperature was250℃,the carrier gas was helium,the flow rate was7ml/min and the split ratio was1∶1.RESULTS:The linear detective concentration ranges of acetone,methanol and ethanol were2.04～102.50?g/ml(r=0.9992),2.00～99.98?g/ml(r=0.9995)and2.04～102.34?g/ml(r=0.9995),respectively,their average recovery rates were98.7%,99.2%and101.7%,respectively with RSD at2.11%,1.98%and2.01%,respectively.CONCLUSIONS:The method is simple,accurate,and suitable for the determination of organic solvent residual volume in fusidic acid.

Objective To investigate the clinical features of complex posterior communicating artery aneurysms and the outcome of microsurgical clipping.Methods The clinical and imaging data of the patients with posterior communicating artery aneurysm treated by craniotomy microsurgical clipping were analyzed retrospectively.The patients were divided into either a complex type group or a simple type group according to whether they had complex factors of surgical clipping or not.They were divided into a good outcome group and a poor outcome group according to their Glasgow Outcome Scale scores.Results A total of 55 patients with posterior communicating artery aneurysm were enrolled,and 17 (30.9％) of them were in the simple type group and 38 (69.1％) were in the complex type group.The proportion of higher Fisher grade in the patients of the simple type group was significantly lower than that of the complex type group (Z =-2.068,P=0.019).However,there were no significant differences in the proportions of age,sex,preoperative rupture,and Hunt-Hess grade between the two groups (all P ＞ 0.05).In the complex type group,the complex clipping (73.68％) and anterior clinoidectomy (42.11％) were the most common complex factors.Twenty-four patients (63.16％) had a number of complex factors.In the complex type cases,32 had good outcome,6 had poor outcome (3 of them died); in the simple type cases,15 had good outcome,2 had poor outcome (1 of them died).There was no significant difference in the good outcome rate between the complex type group and the simple type group (84.21％ vs.88.24％;x2 =0.153,P=0.696).In 55 patients with posterior communicating artery aneurysm,the age of the good outcome group was significantly lower than that of the poor outcome group (58.23 ± 12.41 years vs.68.38 ± 8.68 years,t =-2.212; P =0.031),and there were no significant differences in sex,Fisher grade,Hunt-Hess grade,factors of surgical complexity,and surgical clipping level (all P ＞ 0.05).Multivariate logistic regression analysis showed that only age was the independent risk factor for poor outcome of the complex posterior communicating artery aneurysm (odds ratio 1.142,95％ confidence interval 1.029-1.266; P =0.012).Conclusions Using the advanced microsurgical techniques,such as anterior clinoidectomy,anterior choroidal artery microdissection,and complex clipping for the treatment of complex posterior communicating artery aneurysm are no less favorable than the simple type,and age is an independent risk factor for the poor outcome of posterior communicating artery aneurysm.

Objective To investigate the clinical efficacy of hydrocortisone sodium succinate for treatment of septic shock patients and their prognoses. Methods A prospective case control study was conducted. 49 patients with septic shock in the Department of Emergency of the First Affiliated Hospital of Xi'an Jiaotong University were enrolled from January 2010 to January 2012,and the patients were sequentially divided into two groups,the treatment group(24 cases)and the control group(25 cases),by the difference in odd or even number. All patients in the two groups accepted the conventional treatment. The treatment group additionally received hydrocortisone sodium succinate injection 200 mg,once a day for 5 days. The levels of serum procalcitonin(PCT),C-reactive protein(CRP)were measured in all the patients before treatment and 24 hours,72 hours and 7 days after treatment. The mortalities were compared in 14 days between the two groups. Results The levels of PCT,CRP before and 24 hours after treatment were not statistically significant different from those of pre-treatment in two groups(all P>0.05). PCT and CRP were decreased at 72 hours and 7 days after treatment in the two groups,and on the 7th day the decline was more significant, and compared with the control group,the levels of PCT and CRP in treatment group were reduced more markedly at 72 hours and on the 7th day〔PCT(μg/L):72 hours 9.73±2.10 vs. 12.36±2.56,7 days 5.33±2.05 vs. 8.76±1.78;CRP(μg/L):72 hours 69.12±13.61 vs. 109.68±16.16,7 days 20.16±9.64 vs. 42.32±13.16,all P<0.05〕. But the mortality in 14 days was not statistically significant different between control group and treatment group(52.0%vs. 45.8%,P>0.05). Conclusion The treatment with hydrocortisone sodium succinate can reduce the inflammation of patients with septic shock,thus it has clinical value in the improvement of the disease situation.

Objective To investigate the safety and efficiency of radiofrequency ablation (RFA) in the treatment of complicated multifetal gestations.Methods There were 6 multifetal pregnant women (gestational age ranged from 14+6 to 27 +2 weeks) diagnosed in the Department of Obstetrics,Provincial Hospital Affiliated to Shandong University:two with twin-twin transfusion syndrome (TTTS) stage Ⅳ,one with reversed arterial perfusion sequence,one with dichorionic triamniotic triplets,one with absence of a lower limb,one with severe intrauterine growth restriction.All of them accepted ultrasound-guided selective fetocide by RFA.Results (1) Blood flow of three reduced fetuses stopped completely after one RFA circulation,whereas the other three stopped after two circulations.One reduced fetus stopped heartbeating in 10 minutes after RFA; three reduced fetuses' heartbeats slowed down and stopped completely in 35 minutes after RFA ; and the heartbeats of the other two cases stopped completely within 3 to 7 minutes after RFA.The heartbeats of the reserved fetuses were normal.All of the operations succeeded.(2) The reserved fetuses received a series of ultrasound examinations after the operations.In Case 1,the ascites of the reserved fetus,which was 4.0 cm× 2.3 cm before RFA,disappeared two weeks later; and the umbilical artery systolic/diastolic (S/D) ratio,which was 3.35 before the operation,decreased to 2.70 six weeks later.Amniotic fluid depth decreased from 44.6 cm to normal two weeks after RFA.The reserved fetus received brain MRI three weeks after RFA and no abnormality was detected.In Case 2,the increased heart size (cardiothoracic ratio ＞ 0.35) of the reserved fetus recovered to normal size ten days after the operation ; and the umbilical artery S/D decreased from 4.69 to 3.39 seven days after the operation.Reserved fetuses of the other three cases were normal on ultrasound and MRI after the operations.In Case 6,the ascites of the reserved fetus,which was 2.3 cm × 1.5 cm before RFA,disappeared sixteen days after the operation.The brain MRI suggested normal three weeks after the procedure.Amniotic fluid depth reduced from 11.0 cm to normal two weeks after the operation.(3) Three women delivered normal premature babies,and the other three got healthy mature infants.At present,all children are still in follow-up,and their physical examinations suggest normal.Conclusions RFA is a safe,efficient,minimal invasive treatment,which provides a new choice for fetocide,especially for complicated monochorionic multifetal gestations.Fetocide by RFA can effectively improve the life quality of the reserved fetuses.

Objective To discuss the clinical manifestation and pathology of papillary renal cell carcinoma (PRCC).Methods From January 2007 to January 2012,the clinical and pathologic data of 25 patients (17 males and 8 females with average age of 54 years ranging from 24-76 years) with PRCC were retrospectively analyzed in combination with review of literature.The clinical stages of the tumor were as follows,Ⅰ in 16 cases,Ⅱ in 5 cases,Ⅲ in 4 cases.And the radiographic inspections of PRCC were compared with that of 100 randomly selected clear renal cell carcinoma (CRCC).Results All the PRCC cases had different imaging presentations compared with CRCC.CT attenuation of CRCC was higher than that of PRCC in corticomedullary,nephrographic and excretory phase (P＜0.05).Heterogeneous enhancement was most commonly seen in CRCC than PRCC (P＜0.05).There were 21 patients underwent radical nephrectomy,and 4 patients underwent laparoscopic nephron sparing surgery.The pTNM stages of the tumor were as follows,pT1N0M0 in 16 cases,pT2N0M0 in 5 cases,pT3aN0M0 in 2 cases,pT1N1M0 in 1 case,,pT2N1M0 in 1 case.Of these 25 patients,8 (32％) and 17 (68％) were diagnosed as type Ⅰ and type Ⅱ PRCC,respectively.All the 25 cases of patients were followed up from 6 to 60 months.One case died of metastasis,1 case died of cerebrovascular disease and the other 23 patients survived with tumor-free.Conclusions PRCC is a special type of RCC with low morbidity.Radiological examination can be used in the differential diagnosis of CRCC and PRCC before surgery.The prognosis after surgical treatment is good,but the adjuvant systemic treatment is to be study.