BACKGROUND: Hematic protective has arisen widely attention in China and abroad due to the serious blood contamination and transfusion related diseases.OBJECTIVE: To observe hematic protective effect of hypertonic solution chloride hydroxyethy140 injection (HSH) on acute hypervolemic hemodilution (AHH) in maxilla Lefort Ⅰ osteotomy.METHODS: Totally 40 patients were randomly divided into the experimental and control groups, with 20 patients in each group. All patients were operated under tracheal intubation general anesthesia, in the experimental group, 4 Ml/kg HSH was infused with speed of 10 Ml/min, and the infusion was finished within 30 minutes. There was no treatment in the control group. Blood routine examination (including hematocrit, hemoglobin, blood platelets count) and routine coagulation test (including platelet, partial thromboplastin time, fibrinogen) was performed at the points of before AHH (T_0), at the end of AHH (T_1), 30 min after AHH (T_2),60 min after AHH (T_3), 3 hours after AHH (T_4), 1 day after operation (T_5), and 3 days after operation (T_6), respectively.Simultaneously, the capacities of blood transfusion, liquor transfusion, hemorrhage and urine during operation was recorded. RESULTS AND CONCLUSION: All the patients were included in the final analysis. Compared to the control group, the capacity of blood transfusion in the experimental group was smaller than that of the control group (P<0.05), with greater urine volume (P<0.05). However, the differences of liquor transfusion and hemorrhage had no significance (P>0.05). After controlled hypotension,the heart rates of patients at T_2 and T_3 were obvious increased than that of T_1 (P<0.05), the systolic pressure, diastolic pressure,and mean arterial pressure were significantly decreased (P<0.05). At T_1, T_2 and T_3 points, the heart rates of patients in the experimental group were greater than that of the control group (P<0.05). The systolic pressure, diastolic pressure, and mean arterial pressure had no dramatically differences between two groups (P>0.05). After AHH, the hematocrit and hemoglobin were obviously decreased in the experimental group at T_1, T_2, T_3 and T_4 points (P<0.05), with more blood platelets count and prolonged partial thromboplastin time (P<0.05). Compared to the control group, the Na~+, Cl~-was increased in the experimental group at T_1 and T_2 points (P<0.05), with greater hematocrit and hemoglobin at the T_5 and T_6 points (P<0.05). The results demonstrated that HSH can decrease or avoid transfusing blood in maxilla Lefort Ⅰ osteotomy.

Bone marrow mesenchymal stem cells(BMSCs) have the ability of multi-directional differentiation.In different environments,it can be induced into various blastodermic layer cells,such as osteoblast,chondrocyte and so on.Intervertebral disc degeneration(IDD) is mainly the change of nucleus pulposus cells and extracellular matrix.Nucleus pulposus cell is a chondrocyte-like cell.With the progress of cell bioengineering and molecular biology,the tissue engineering nucleus pulposus cells can be regenerated by BMSCs combined with cell carrier.It can be implanted into intervertebral disc to prevent and reverse IDD.It will be a new way for treating IDD.

Objective To investigate the application value of detection of serum miRNA-210,miRNA-23b in the patients with the femoral head necrosis.Methods The serum and clinical data of 135 patients with the internal fixation operation for the femoral neck fracture were collected.The patients were divided into the necrosis group (27 cases) and non-necrosis group (108 cases),used the real-time fluorescent quantitative PCR (Real time-PCR,RT-PCR) technology to detect serum miRNA-210,miRNA-23b expression in comparatively analysizing the relationship between the changes of serum miRNA 210,23b and occurrence of the femoral head necrosis.Results The serum microRNA-210,-23b expression in the necrosis group were 0.19±0.03,0.21±0.05,which in the non-necrosis group were 0.92±0.18 and 0.87±0.17.The serum microRNA-210,-23b expression in the necrosis group were significantly lower than those in the non-necrosis group,the difference had statistical significance (P＜0.01).The analysis results from the receiver-operating characteristic curve (ROC curve) showed that AUC of serum miRNA-210,miRNA-23b expression were 0.790 (95％CI:0.687～0.892,P=0.000) and 0.743 (95％CI:0.633～0.854,P=0.000),respectively.The sensitivity and specificity of miRNA-210 and miRNA-23b at the best threshold in diagnosis of the femoral head necrosis were 95.7％ and 93.9％,91.5％ and 92.3％,respectively.The analysis results showed that the serum miRNA-210,-23b expression had clinical significance in diagnosis of the femoral head necrosis.Conclusion Detection of serum miRNA-210,-23b expression can predict occurrence of the femoral head necrosis,estimate development condition of the desease.

There are many kinds of the scaffolds of tissue engineered cartilage, including collagen, polylactic acid hybrid material, chitosan and decellular extracellular matrix. They all have biocompatibility, safety and stable physicochemical property, which indicate good application value in the field of tissue engineering. Moreover, the composite scaffolds are superior to simple scaffold. It is potential scaffold materials that developing into composite materials, biomimetic materials, modified natural materials, intelligent material and nano-technological materials.

The establishment and perfection of the assessment system for chronic liver diseases have a guiding significance for clinical diag-nosis and treatment.Hepatic venous pressure gradient (HVPG)is of great significance in the progression of chronic liver diseases,and it is the only pathophysiological index for treatment independent of etiology.The current methods for evaluation of chronic liver diseases are sim-ply described,and the application of HVPG in evaluation of chronic liver diseases is systematically summarized,including predicting the se-verity of liver cirrhosis,variceal bleeding risk and outcome of portal hypertension,development of cirrhotic ascites,efficacy of drugs for re-ducing portal hypertension and antiviral drugs,and postoperative outcome of liver cancer.It is thought that HVPG measurement plays an im-portant role in the assessment of the progression and prognosis of chronic liver diseases and is an effective predictor of outcome.

Antithyroid drugs(ATD)is the main treatment for hyperthyroidism and its adverse reactions have been much concerned by physicians. Methimazole(MMI)and propylthiouracil(PTU)are the two common antitithyroid drugs used currently. Generally, the ATD are safe and effective, though their clinical adverse reactions are also relatively common. The toxic effects include liver damage and leukocytopenia, antineutrophil cytoplasmic antibody-associated pulmonary small-vessel vasculitis, hypoglycemia, allergic reactions, muscle impairment,and so on. They are usually reversible and disappear spontaneously when the drug is discontinued. However,the serious rare side effects can also occur and there may have potentially deadly threatening effects which need to be cautious for the clinicians. MMI is usually preferred over PTU because it has significantly fewer side effects. And unlike the dose-dependent side effects of MMI, there has no significant correlation between adverse reaction and drug dosage in using PTU. Moreover, PTU has more severe hepatotoxity than MMI, even fatal liver impairment and liver failure. The risk of liver damage from PTU is an important concern, particularly in children. For this reason, MMI is the first choice for treating children with hyperthyroidism.

Skp2 (S-phase kinase associated protein) is substrate recognition subunit of SCFSkp2 (Cul1-Rbx1-Skp1-F boxSkp2)complex,a kind of ubiquitin ligases (E3s). Skp2 involves in regulating many functions of cell,such as cell cycle progressing,cell proliferation and differentiation,as well as apoptosis.At present many studies indicated that Skp2 is closely related to tumorigenesis and prognosis.With deeper study of Skp2 in tumor, Skp2 has the potential to be a promising drug target and biomarker of prognosis in human cancer.

Bone Marrow Neoplasms ; Humans ; Leukemia, Myeloid ; Proto-Oncogene Proteins c-cbl

Objective To introduce transfusion monitoring system to optimize nursing flow under field conditions.Methods The organization and arrangement of nursing staffs were optimized with high-precision droplet sensor and transfusion monitoring system.A post of caring nurse was added to execute mental healthcare of the patient.Results Humanistic care was carried out by the caring nurse with daily nursing completed,and there's no need for additional nursing staff.Conclusion The transfusion monitoring system is rapid in deployment and withdrawal,optimizes nursing flow and enhances nursing quality,and thus is worthy promoting widely.

Objective To study the influence of anesthetic effect,maternal and infant outcomes and safety of subarachnoid block used sulfentanyl combined with ropivacaine for patients with gestational hypertension in the cesarean section.Methods 180 cases of gestational hypertension ready to cesarean section were selected as study subjects,and they were randomly divided into A group,B group and C group by digital table method,60 cases in each group.A group used 10mg ropivacaine,B group used 13mg ropivacaine,C group used 5μg sulfentanyl combined with 10mg ropivacaine.The anesthetic effect,circulation function,duration of pain,operation time,neonatal Apgar score at 1 and 5 min after birth,neonatal weight,motor block evaluation after operation,adverse reaction and complication were compared in three groups.Results The anesthetic effect between B group and C group had no statistical difference (x2 =1.233,1.465,all P ＞ 0.05).The anesthetic effect of B group and C group was better than that of A group(F =5.633,7.299,all P ＜0.05).The HR and MAP of every time points between A group and C group had no statisticaldifferences (F =1.313,1.265,all P ＞ 0.05).Compared with T0,the HR and MAP of B group at T1,T2,T3,T4 had statistical differences compared with A group and C group(F =5.633,7.299,all P ＜0.05).The operation time of the three groups had no statistical difference(F =0.933,P ＞ 0.05).The duration of pain between B group and C group had no statistical difference(t =0.822,P ＞ 0.05).The duration of pain of A group was longer than that of B group and C group(F =8.316,P ＜0.05).The neonatal Apgar scores at 1 and 5 min after birth and neonatal weight of the three group had no statistical differences(F =0.822,0.929,all P ＞ 0.05).The improved Bromage score between A group and C group had no statistical difference (t =2.627,1.991,all P ＞ 0.05).The improved Bromage score between B group and A,C group had statistical differences(F =6.371,5.693,all P ＜ 0.05).The complete recovery time of motor nerve of B group was much longer than that of A group and C group (F =8.924,P ＜ 0.05).The incidence rates of vomit and nausea of A group and B group were much higher than that of C group(F =3.561,12.581,all P ＜ 0.05).The incidence rate of bradycardia and hypotension of B group was much higher than that of A group and C group (F =8.273,10.833,all P ＜ 0.05).Conclusion During subarachnoid block anaethesia using 5 μg sulfentanyl combined with l0mg ropivacaine can be applied to mild and moderate gestational hypertension,it has advantages such as less adverse reaction,good analgesic effect,less hemodynamic effect,and it is worthy of clinical promotion.