Objective Evaluate the outcome of aortic root reconstruction on the analysis of the risk factors influencing surgical results. Methods Between August 1996 and November 2009, 92 patients(56 men, 36 women) aged from 14 to 77years [mean (44.8 ±1.4) years] with aortic root aneurysm underwent aortic root reconstruction. 72 patients had over moderate aortic valve insufficiency. 47 patients suffered from Marfan syndrome. The aortic pathology was aortic dissection in 45. Bentall technique was used in 59 patients, the button technique in 13, the David I with the Valsalva graft in 6 patients and the aortic valve resuspension in 14 patients. Results The hospital mortality rate was 8.7%. The major complications 31. 7%. 18patients died during the period of follow-up. Late complications among 55 survivors were 12. Univariate predictors of the morbidity were the presence of male, non-Marfan, concomitant procedure, deep hypothermia cardiac arrest, aortic cross clamp time and blood infusion. Risk facts for mortality were emergent or urgent operation, aortic dissection, concomitant procedure, aortic cross clamp time and blood infusion. Multivariate analysis revealed risk factors of concomitant procedure and blood infusion were responsible for both morbidity and mortality. The overall long-term survival rate is (97.1 ±2.0)% at 1-year, (88.1 ±4.7)% at 5-year, (54.0 ±9.2)% at 10-year. The mean for survival time is (9.9 ±0.59) years, 95% confidence interval 8.70 -11.01. Conclusion The aortic root restitution procedures are safe and effective in general. The short and long-term outcome is satisfactory. The button technique is the first choice for reimplantation coronary patch. Valve-sparring aortic root reconstructions show promise in safety and applicability.

BACKGROUND:Both osteopontin and hyaluronic acid involve in the pathological process of osteoarthritis, resulting in the abnormal expression levels of various cytokines and enzymes. However, the relationship between the high expression of osteopontin and hyaluronic acid in chondrocytes remains unclear.
OBJECTIVE:To investigate the effect of osteopontin on the expression of hyaluronic acid in human knee osteoarthritic chondrocytes in vitro by modulating the level of osteopontin.
METHODS:Chondrocytes from human knee osteoarthritic cartilage were cultured in vitro, and were then divided into three groups:blank control group without any treatment;osteopontin group and and pontin siRNA group were treated with 1 mg/L recombinant human osteopontin and osteopontin siRNA, respectively. Expression levels of osteopontin, hyaluronic acid synthase 1, 2 and 3 mRNA were detected by real-time PCR, and the levels of hyaluronic acid were measured using ELISA.
RESULTS AND CONCLUSION:Compared with the blank control group, the mRNA expressions of hyaluronic acid synthase 1, 2 and 3 were remarkably increased in the osteopontin group, while siRNA made the significantly inhibitory effects on the hyaluronic acid synthase 1, 2 and 3 mRNA expressions (P<0.05). The level of hyaluronic acid in chondrocytes in the osteopontin group was significantly higher than that in the other two groups (P<0.05). Our results suggest that osteopontin induces the synthesis of hyaluronic acid in osteoarthritic chondrocytes through upregulating the hyaluronic acid synthases expression levels.

Objective To study the effects of Batroxobin( BX) on the intimal proliferation of graft veins. Methods In this study 25 dogs were selected and evenly divided into experimental group, control group and sham operation group. In experiment and control group, a segment of auto- femoral vein were grafted into femoral artery by clean microsurgery technique. In experimental group, BX was given at the dosage of 0. 1 BU/kg, dayly?2 preoperatively, and once a day for consecutive 6 days postoperatively. Plasma NO, ET was determined in the three groups. Computer image analysis system was applied to calculate the thickness of neointima and media in the vein grafts, immunohistochemistry was used to identify PCNA and C-myc. Result The experimental group had a higher level of NO and lower level of ET compared with control group and sham operation group(P 0. 05 ). The PCNA expression in experimental group was statistically different from that of the control group(P

BACKGROUND:Osteopontin, a kind of extracellular matrix glycoprotein, has been found to participate in synthesis and catabolism of osteoarthritic chondrocyte extracellular matrix. However, the effect of osteopontin on the proliferation ability of osteoarthritic chondrocytes is little reported. OBJECTIVE:To investigate the effect of osteopontin on the chondrocyte proliferation in human knee osteoarthritis. METHODS: Cartilage samples were obtained from the patients with knee osteoarthritis undergoing knee arthroplasty at the Xiangya Hospital from January 2012 to June 2012. The chondrocytes were isolated and cultured, and then divided into four groups: blank control, osteopontin, Con-shRNA and osteopontin-shRNA groups. The cell proliferation was detected by MTT and BrdU assays. RESULTS AND CONCLUSION: After transfection of osteopontin-shRNA lentivirus, the infection rate was up to 80%. Compared with the blank control group, osteopontin group showed a significant increase in the absorbance value of osteoarthritic chondrocytes, while after osteopontin-shRNA lentivirus transfection, the absorbance value was significantly decreased (bothP < 0.05). Additionally, after osteopontin-shRNA transfection, the expression level of osteopontin was significantly downregulated (P < 0.05). To conclude, osteopontin can promote the proliferation of osteoarthritic chondrocytes, which is considered as a new treatment target for osteoarthritis.

BACKGROUND:Osteopontin mRNA and protein expressions are highly correlated with the severity of osteoarthritis. OBJECTIVE:To investigate the effect of osteopontin on the gene expression of aggrecan and type II colagen in the human knee osteoarthritic chondrocytes in vitro. METHODS: Chondrocytes were harvested from human osteoarthritic knees and culturedin vitro. The chondrocytes were cultured with 0 (blank control group), 0.1, 1 mg/L osteopontin, respectively, for 48 hours. Real-time PCR was employed to detect the mRNA expression of aggrecan and type II colagen. RESULTS AND CONCLUSION:After 0.1 and 1 mg/L osteopontin intervention, the mRNA expression of aggrecan and type II colagen in osteoarthritic chondrocytes was increased significantly (P< 0.05), and the mRNA expression of aggrecan and type II colagen was higher in the 1 mg/L osteopontin group than the 0.1 mg/L osteopontin group (P< 0.05). In addition, the mRNA expression of aggrecan and type II colagen was positively correlated with the concentration of osteopontin (r=0.751,P < 0.01;r=0.676,P < 0.01). These findings indicate that osteopontin up-regulates the mRNA expression of aggrecan and type II colagen in osteoarthritic chondrocytes of human kneein vitro in a dose-dependent manner.

OBJECTIVEThis investigation aimed at explore the total distribution of neuropeptide Y-like immunoreactive (NPY-LI) fibers and their changes post-trauma in rat temporomandibular joints (TMJs).

METHODSSix groups of rats were killed individually before trauma, 1, 3, 7, 14 and 28 days after trauma. TMJs were extracted totally, and the avidin-biotin-peroxidase complex method and image analysis were employed to detect NPY-LI fibers in frozen sections of TMJs.

RESULTSNPY-LI fibers were distributed extensively in TMJs, except the central disc band and bone, and they were mainly located around blood vessels, especially arteries. The densities of fibers in the six groups were 160.4 +/- 27.5, 95.8 +/- 16.4, 88.6 +/- 14.5, 114.3 +/- 17.0, 135.0 +/- 20.7, 158.6 +/- 19.5 (unit:mm2).

CONCLUSIONNPY-LI nerve fibers are distributed extensively in the periphery of blood vessels of TMJs and densities changed dynamically when TMJs were impacted. NPY may play an important role in pathologic change of TMJ by regulating local blood circulation.

Animals ; Male ; Nerve Fibers ; metabolism ; pathology ; Neuropeptide Y ; analysis ; physiology ; Rats ; Rats, Sprague-Dawley ; Signal Processing, Computer-Assisted ; Temporomandibular Joint ; innervation

Actins ; metabolism ; Aged ; Antigens, Neoplasm ; metabolism ; Carbonic Anhydrase IX ; Carbonic Anhydrases ; metabolism ; Carcinoma, Renal Cell ; metabolism ; pathology ; surgery ; Desmin ; metabolism ; Diagnosis, Differential ; Humans ; Keratin-7 ; metabolism ; Kidney Neoplasms ; metabolism ; pathology ; surgery ; Male ; Nephrectomy ; methods ; Vimentin ; metabolism

BACKGROUND:Progressive fracture of the cartilage is considered the characteristic lesion in later osteoarthritis, the expression of osteoarthritis-related factors such as hyaluronic acid, osteopontin and CD44 in osteoarthritic cartilage is increased.
OBJECTIVE:To investigate the effect of hyaluronic acid on the expression of osteopontin mRNA and CD44 mRNA of chondrocytes in the in vitro cultured chondrocytes of patients with knee osteoarthritis.
METHODThe cartilage samples obtained from osteoarthritic patients were cultured and purified into acquire chondrocytes in vitro, and the cells were divided into three groupblank control group, hyaluronic acid (100 mg/mL) group and hyaluronidase (200 mg/mL) group. After 48 hours of cellculture, real-time quantitative polymerase chain reaction assay was used to detect the expression of CD44 mRNA and osteopontin mRNA. The difference of the expression levels before and after the intervention of hyaluronic acid was compared and analyzed using SPSS 17.0 software.
RESULTS AND CONCLUSION:Compared with the blank control group, hyaluronic acid (100 mg/mL) upregulated osteopontin mRNA expression in the chondrocytes, hyaluronidase (200 mg/mL) also reduced osteopontin mRNA expression in the chondrocytes. The CD44 mRNA expression in the chondrocytes of hyaluronic acid (100 mg/mL) group and hyaluronidase (200 mg/mL) group was lower than that in the blank control group. Hyaluronic acid can upregulate the expression of the osteopontin mRNA expression in the osteoarthritic chondrocytes;the biphasic effects of hyaluronic acid on CD44 mRNA expression in osteoarthritic chondrocytes might be associated with the molecule weight of hyaluronic acid.

Objective To investigate the value of individualized thyroid stimulating hormone (TSH) inhibition therapy in postoperative patients with differentiated thyroid carcinoma.Methods The medical record and follow-up data of the 556 patients with differentiated thyroid carcinoma after total or neartotal thyroidectomy were retrospectively reviewed.Patients were divided into two groups:Group A (304 cases) received TSH suppression therapy without risk assessment.Group B (252 cases) were given TSH suppression therapy in accord with risk assessment of both differentiated thyroid cancer recurrence risk stratification condition and the side effects of TSH suppression therapy risk stratification.Results The 3-year non-recurrence and (or) non-metastasis rate in group B was 99.2％ which was higher than 96.8％ in group A (P =0.044).The hospitalization rate caused by postoperative cardiovascular events or other morbidities in group B decreased 89％ than that in group A.Conclusions Individualized TSH suppression therapy can significantly decrease the recurrence and metastasis rate as well as concurrent morbidities caused by unnecessary TSH inhibition.

Objective To observe the cerebral protective effect of mild hypothermia by semiconductor cooling device on the liver surface in rabbits after cardiac arrest (CA). Methods Eighteen healthy male New Zealand white rabbits were randomly and equally divided into CA control group, ice saline group and semiconductor group. CA was induced by rapid intravenous injection of potassium chloride. Five minutes after onset of CA, CPR was initiated. Compared to the control group, which was not treated by hypothermia intervention after CPR, the ice saline group was treated by 4 ℃ ice saline infusion and the semiconductor group was treated by the semiconductor refrigeration piece device cooling on the liver surface for hypothermia intervention after CPR. We recorded the changes of temperature (tympanic temperature and anus temperature), heart rate (HR), mean arterial pressure (MAP) of rabbits in each group, neurological deficit scores (NDS) at 24, 48, 72 hours after the return of spontaneous circulation (ROSC) and the changes of serum neuron specific enolase (NSE) by enzyme linked immunosorbent assay (ELISA). Pathological changes of the hippocampus tissue, liver tissue and skin tissue were obtained by HE staining. Results There was no significant difference in ROSC time in each group. Two rabbits died at 55 hours and 67 hours after ROSC respectively in the control group. The remaining rabbits survived to 72 hours after challenge. There was no significant difference in the overall survival time in groups. Two hypothermia intervention groups had significantly lower level of serum NSE at 24 hours after ROSC and lower DNS scores at 24, 48, 72 hours after ROSC than control group. And the level of serum NSE after 24 hours of ROSC in the semiconductor group were significantly lower than the ice saline group (μg/L: 6.916±1.161 vs. 8.615±1.430, P < 0.05). DNS scores at 24, 48, 72 hours after ROSC in the semiconductor group were all significantly lower than the ice saline group (scores: 1.33±0.52 vs. 2.00±0.01, 1.01±0.41 vs. 2.00±0.01, 0.92±0.40 vs. 2.10±0.52 respectively, all P < 0.05). Two hypothermia intervention groups had more minor damage of neuronal cell in hippocampus than the control group. And the semiconductor group had more minor damage than the ice saline group. There were no obvious hepatic and subcutaneous tissue injury through which the semiconductor induced hypothermia was performed at corresponding liver surface skin. Conclusion The hypothermia by semiconductor cooling device on the liver surface is a new safe way of protecting brain tissue after CA, which has better cerebral protective effect than ice saline infusion.