Objective:To explore change of serum level of growth differentiation factor-15 (GDF-15)in patients with heart failure (HF)after myocardial infarction,and its correlation with cardiac function and myocardial fibrosis indexes.Methods:A total of 100 HF patients after acute myocardial infarction (AMI)were enrolled as HF group,and 50 healthy subjects were selected as healthy control group.GDF-15 level change was measured,its correlation with cardiac function [left ven-tricular end-systolic diameter (LVESd),left ventricular end-diastolic diameter (LVEDd)and left ventricular ejection frac-tion (LVEF)]and relative indexes of myocardial fibrosis [brain natriuretic peptide (BNP),serum transforming growth fac-tor (TGFβ),type I and III procollagen amino-terminal peptides (PINP,PIIINP)]were analyzed in two groups.Results:Compared with healthy control group,there were significant rise in serum levels of GDF-15 [(623.56±70.21)ng/L vs. (2003.53±163.2)ng/L],TGFβ[(21.5±6.89)ng/ml vs.(58.93±12.81)ng/ml],PINP [(150.58±32.57)ng/ml vs. (233.15±26.94)ng/ml]and PIIINP [(17.56±8.72)ng/ml vs.(48.64±9.28)ng/ml]in HF group,P <0.05~<0.01. Along with NYHA cardiac function class increased (II~IV),GDF-15 level significantly elevated [(1521.32±98.23)ng/L vs.(2311.92±108.52)ng/L vs.(3023.54±129.36)ng/L,P <0.01 all].Pearson correlation analysis indicated that in HF patients after myocardial infarction,serum GDF-15 level was inversely correlated with LVEF (r =-0.574,P <0.05), and positively correlated with LVESd and LVEDd (r =0.688,0.752,P <0.05 both);GDF-15 level was positively correla-ted with plasma BNP level,serum levels of PINP,PIIINP and TGFβ(r =0.568~0.82,P <0.05 all).Conclusion:Growth differentiation factor-15 is involved in ventricular remodeling in patients with heart failure after myocardial infarction.

Objective To investigate the predictive value of Alberta stroke program early CT score on diffusion-w eighted imaging (DWI-ASPECTS) for predicting new cerebral microbleeds (CMBs) in patients w ith acute middle cerebral artery infarction. Methods The patients w ith acute middle cerebra artery infarction w ere enroled prospectively. MRI examinations w ere completed w ithin 48 h on admission and they w ere examined again at 10 to 14 d after onset. Susceptibility-w eighted imaging (SWI) w as use to detect
CMBs. DWI-ASPECTS w as used to assess the infarction extent. Results A total of 82 patients w ith acute middle cerebra artery infarction w ere enroled, including 27 females and 55 females. Their ages w ere 71.7 ± 8.9 years. Eighteen patients (22.0%) had old CMBs, 25 (30.5%) had new CMBs, 57 (69.5%) did not have new CMBs. Compared w ith the non-new CMB group, DWI-SPECTS (3.20 ±1.73 vs.7.11 ±1.69;t = 9.573, P <0.001) w as low er, NIHSS scores (16.20 ±4.06 vs.12.63 ±5.06; t = 3.111, P = 0.003) w ere higher, there w ere more patients w ith atrial fibrilation ( 40.0% vs.15.8%; χ2 = 5.722, P = 0.017), proportion of intensive antiplatelet therapy ( 0% vs.28.1%; P = 0.002) w as low er, there w ere more large artery atherosclerosis type ( 60.0% vs.29.8%; χ2 = 6.650, P = 0.010 ), more cardiogenic cerebral embolism type (36.0% vs.5.3%; P = 0.001), and less smal artery occlusion type ( 0% vs.57.9%; P <0.001) in the new CMB group, and there w ere no statistical differences in the other indexes. Multivariate logistic regression analysis show ed that after adjusting age, sex, alcohol, histories of hypertension, hyperlipidemia, diabetes, atrial fibrilation and previous stroke or transient ischemic attack history, the higher the DWI-ASPECT scores ( > 5), the risk of new CMBs w ould decrease 86 % (odds ratio 0.14, 95%confidence interval 0.17 -0.48; P < 0.001). Receiver operating characteristic curve analysis show ed that the sensitivity of prediction of DWI-ASPECTS ≤5 for the new CMBs w as 87.7%, specificity w as 88.3%, and the area under the curve w as 0.940. Conclusions DWI-ASPECTS can effectively predict the new CMBs in patients w ith acute middle cerebra artery infarction.

Adolescent ; Adult ; Carrier State ; metabolism ; pathology ; Collagen Type III ; blood ; Collagen Type IV ; blood ; Female ; Hepatitis B, Chronic ; complications ; metabolism ; pathology ; Humans ; Interleukin-17 ; metabolism ; Liver ; metabolism ; pathology ; Liver Cirrhosis ; etiology ; metabolism ; pathology ; Male ; Middle Aged ; Severity of Illness Index ; Young Adult

OBJECTIVETo establish a probabilistic model for evaluation of dietary exposure to lead and construct age-related exposure centiles for the residents in Jiangsu.

METHODSLead contamination data were obtained from the national food contamination monitoring program during 2001 - 2006 and 2791 samples from 232 food products in Jiangsu were included. Food consumption data were from the national diet and nutrition survey conducted in 2002, including 3938 subjects in Jiangsu. A non-parametric probabilistic model using Monte Carlo simulation was applied to derive the intake distribution. The intake data was then analyzed using the LMS method, which constructs exposure percentiles adjusted for the median (M), the coefficient of variation (S) and the skewness (L) of the intake distribution.

RESULTSThe median and P(99) of the lead exposure for the residents in Jiangsu were 1.02 µg×kg(-1)×d(-) and 9.29 µg×kg(-1)×d(-1), respectively.6.38% of the total population showed to have a lead intake exceeding the tolerable limit, which for the urban and rural population were 4.31% and 7.06%, respectively. The exceeding rate for children of 2 - 10 years old from the urban and rural areas were 13.17% and 17.70%, respectively.

CONCLUSIONThere was a large variation in the lead exposure level of the population in Jiangsu; People in rural areas are in greater risk for higher lead exposure than urban people; The dietary exposure to lead for children and the high-end population was serious.

Child ; Child, Preschool ; China ; Environmental Exposure ; Food Contamination ; analysis ; Humans ; Lead ; analysis ; Risk Assessment

OBJECTIVETo investigate the feasibility of construction of tissue-engineered skin in vitro.

METHODSFibroblasts were seeded on the dermal surface of acellular dermal matrix (ADM). 7 days later, epidermal cells (5 x 10(5)/cm2) were mixed with fibroblasts (0.2 x 10(5)/cm2) and then seeded on epidermal surface of ADM. The culture medium was the mixture liquor containing K-SFM in half and the culture supernatants of fibroblasts in half. In the control group, only epidermal cells (5 x 10(5)/cm2) were seeded and cultured with K-SFM. After composite skin was cultured for 1 week and 3 week, samples were harvested respectively for morphological study and to receive identification by immunohistochemistry.

RESULTSAfter 3-week culture, there were 3-4 continuous layers of cells in the epidermis in the experiment group. The epidermis was attached tightly to the dermis with trochanterellus. But in the control group, there were just 1-2 layers of cells in the epidermis which was not connected to the dermis. Strong positive dye of Laminin indicated that basement membrane was thoroughly formed in the experiment group. The same result was demonstrated by transmission electron microscope.

CONCLUSIONSThe mix-seeding of epidermal cells and few fibroblasts would promote the adhesion and proliferation of epidermal cells on ADM, and the formation of basement membrane.

Animals ; Cells, Cultured ; Coculture Techniques ; Epidermis ; cytology ; Fibroblasts ; cytology ; Skin, Artificial ; Swine ; Tissue Engineering ; Tissue Scaffolds

Objective To investigate the effect of single dose intraosseous injection of simvastatin on tumor vascular structure and function in murine breast cancer. Methods BALB/c mice and 4T1 murine breast cancer cells were used to establish a subcutaneous xenograft model. The mouse model of orthotopic breast cancer received intraosseous injection of a single dose of simvastatin (50 μg) or vehicle only. Frozen tumor tissue sections were prepared for co-immunostained with CD31 andα-SMA. Evans blue dye was injected into the tail vein to observe the vascular permeability. The expression level of HIF-1αwas detected by immunohistochemistry. Results Immunofluorescence dual staining showed that intraosseous injection of simvastatin increased the number of perivascular pericytes in the tumor vessel(P < 0. 05), Evans blue dye content showed that in vivo vessel permeability in the tumor tissue was significantly decreased(P < 0. 05), and the immunohistochemistry results showed that local hypoxic area was significantly improved. Conclusions Single dose intraosseous injection of simvastatin can promote the normalization of tumor vasculature by improving the coverage of pericytes.

Objective To analyze the relationship between the measurement error of oxygen concentration and service time of oxygen cell of the ventilator. Methods The present situation of the ventilator was analyzed. Some cases of alarms for oxygen concentration failures were taken in statistical analysis on 3-a quality control detection results of the ventilators in some hospital. Results There was an approximately linear correlation between the measurement error of oxygen concentration and service time of oxygen cell, and the measurement error of oxygen concentration was increased significantly 430 days after the oxygen cell enabled. Conclusion The measurement error of oxygen concentration quality control could be used as a reference for performance evaluation and replacement of oxygen cell.

OBJECTIVETo assess the clinical outcomes of brachiocephalic artery-sparing aortic arch repair combined with stent-graft elephant trunk technique for treatment of Stanford type A aortic dissection.

METHODSTwenty-three patients with Stanford type A aortic dissection requiring arch replacement underwent brachiocephalic artery-sparing aortic arch repair combined with stent-graft elephant trunk technique. The operations were performed within 72 h (20 cases) or 3-14 days (3 cases) after the onset of aortic dissection.

RESULTSThere was no perioperative death in these cases. The mean extracorporeal circulation time was 209∓52 min, the aortic cross clamp time was 85∓21 min, and the mean chest tube output within the first 24 h after the operation was 570∓263 mL; none of the patients required chest reopening for management of bleeding. Postoperative acute renal failure requiring hemodialysis occurred in 3 cases, transient neurologic dysfunction in 2 cases, paraplegia in case and hematosepsis in 1 case. No such complications as permanent neurologic deficit or postoperative visceral malperfusion occurred in these cases. All the patients survived and were discharged from hospital without experiencing severe complications in the follow-up for 6-18 months.

CONCLUSIONBrachiocephalic artery-sparing aortic arch repair combined with stent-graft elephant trunk technique is a safe and simple procedure with controllable bleeding and can serve as an optional procedure for aortic arch replacement.

OBJECTIVETo evaluate the feasibility and effectiveness of using 3D printing and computer-assisted surgical simulation in preoperative planning for acetabular fractures.

METHODSA retrospective analysis was performed in 53 patients with pelvic fracture, who underwent surgical treatment between September, 2013 and December, 2015 with complete follow-up data. Among them, 19 patients were treated with CT three-dimensional reconstruction, computer-assisted virtual reset internal fixation, 3D model printing, and personalized surgery simulation before surgery (3D group), and 34 patients underwent routine preoperative examination (conventional group). The intraoperative blood loss, transfusion volume, times of intraoperative X-ray, operation time, Matta score and Merle D' Aubigne & Postel score were recorded in the 2 groups. Preoperative planning and postoperative outcomes in the two groups were compared.

RESULTSAll the operations were completed successfully. In 3D group, significantly less intraoperative blood loss, transfusion volume, fewer times of X-ray, and shortened operation time were recorded compared with those in the conventional group (P<0.05). According to the Matta scores, excellent or good fracture reduction was achieved in 94.7% (18/19) of the patients in 3D group and in 82.4% (28/34) of the patients in conventional group; the rates of excellent and good hip function at the final follow-up were 89.5% (17/19) in the 3D group and 85.3% (29/34) in the conventional group (P>0.05). In the 3D group, the actual internal fixation well matched the preoperative design.

CONCLUSIONS3D printing and computer-assisted surgical simulation for preoperative planning is feasible and accurate for management of acetabular fracture and can effectively improve the operation efficiency.