Objective To evaluate the effects of reduced glutathione (GSH) on contractile and diastolic functions of the thoracic aorta of rats with obstructive jaundice.Methods Twenty-four adult male Sprague-Dawley rats,weighing 200-250 g,were randomly divided into 4 groups (n =6 each) using a random number table:sham operation group (group S),GSH group,bile duct ligation group (group BDL),and GSH + bile duct ligation group (group GSH + BDL).In GSH and GSH + BDL groups,GSH 300 mg/kg was infused via stomach everyday for 7 consecutive days,while the equal volume of normal saline was given in the other two groups.The common bile duct was ligated in the animals on 1 d after the end of intragastric administration in GSH and GSH + BDL groups.In GSH and GSH + BDL groups,after the model was established,GSH 300 mg/kg was infused via stomach everyday for 7 consecutive days,while the equal volume of normal saline was given in the other two groups.On 7th day after the model was extablished,blood samples were collected for determination of the levels of serum total bilirubin (TB),alanine aminotransferase (ALT) and aspartate aminotransferase (AST),tumor necrosis factor-alpha (TNF-α),interleukin-lβ (IL-1β) and 3-nitrotyrosine (3-NT),malondialdehyde (MDA),nitric oxide (NO) and GSH.The thoracic aortic rings were obtained and perfused with different concentrations of norepinephrine (NE),acetylcholine (Ach) and sodium nitroprusside (SNP).The maximum contraction and dilatation of aortic rings were recorded and the percentage was calculated.Some thoracic aortic rings were obtained again and perfused with different concentrations of NE after removal of the endothelium or after being perfused with L-NAME (nitricoxide synthase inhibitor).The maximum contraction of aortic rings was recorded and the percentage was calculated.Results Compared with group S,the serum levels of TB,ALT,AST,TNF-α,IL-1β,MDA,3-NT,NO and GSH were significantly increased in group BDL,and the serum levels of TB,ALT,AST,MDA,GSH and NO were increased in group BDL + GSH,the percentage of the maximum contraction amplitude of aortic rings in response to NE was decreased,and the percentage of the maximum dilatation amplitude of aortic rings in response to Ach and SNP were decreased in groups BDL and BDL + GSH,and no significant changes were found in the parameters mentioned above in group GSH.Compared with group BDL,the serum levels of TB,ALT,AST,TNF-α,IL-1β,MDA,3-NT and NO were significantly decreased,the level of GSH was increased,the percentage of the maximum contraction amplitude of aortic rings in response to NE was increased,the percentage of the maximum dilatation amplitude of aortic rings in response to Ach was increased,and no significant change was found in the percentage of the maximum dilatation amplitude of aortic rings in response to SNP in group BDL + GSH.Compared with the aortic rings from which the endothelium was removed or which were perfused with L-NAME in group BDL,no significant change was found in the percentage of the maximum contraction amplitude of aortic rings after removal of the endothelium or after being perfused with L-NAME in response to NE in group BDL + GSH.Conclusion GSH can improve the contractile and diastolic functions of thoracic aorta of rats with obstructive jaundice and this effect depends on the vascular endothelium.

Hepatocellular carcinoma is one of the most common malignancies in the worldwide.Selected patients with hepatocellular carcinoma are candidates for curative resection,but nevertheless there is a high risk of tumor recurrence.Microvascular invasion (MVI) is an aggressive biological behavior and has repeatedly been identified as a risk factor for prognosis after curative treatment,meanwhile,it is now becoming increasingly concerned.It would be of great significance to distinguish MVI in an early stage and choose an appropriate treatment timely to get a definite improvement for the long-term survival in patients with hepatocellular carcinoma after curative treatment.This review focuses on some certain issues of MVI.

Objective To investigate the expression of survivin in keloid, and its significance in the development of keloid. Methods Tissue samples were obtained from 25 patients with keloid (12 males and 13 females, aging from 4 to 44 years with a disease course of 1-18 years), and 15 normal skin samples obtained from surgical operation served as the controls. Streptavidin-biotin-peroxidase complex (SABC) method was applied to detect the expression of survivin in these samples. Results No expressin of survivin was observed in normal controls, while it was expressed in 80.0% (20/25) of the keloid samples with the predominant distribution in fibroblasts and vascular endothelial cells. The positivity rates of survivin were 57.14% (4/7), 81.81% (9/11) and 100% (7/7) in tissues of low-grade, moderate-grade and high-grade keloid, respectively, with no significant difference among the three groups (P = 0.133 ). Similarly, no signifi- cant difference was observed in the positivity rate of survivin between recurrent patients and untreated patients (90.91% (10/11 ) vs 71.43% (10/14), P = 0.341 ). Conclusion Survivin might play a role in the development of keloid.

Objective To explore the effect of preoperative antiviral therapy on hepatitis B virus ( HBV ) reactivation and postoperative liver function in perioperative patients with HBV-DNA-negative hepatocellular carcinoma(HCC).Methods 74 patients with preoperative HBV-DNA-negative scheduled which were analyzed.Patients were divided into two groups according to antiviral therapy or not:20 cases in antiviral treatment group received antiviral therapy for three days, 54 cases in non-antiviral teatment group did not receive antiviral therapy, and both groups received antiviral therapy after post-operative resuming to diets.The indicators of liver function and HBV-DNA levels were detected on pre-operative, post-operative 3rd and 7th day in two groups, and HBV-DNA-positive ( HBV-DNA>500 IU/mL) was defined as reactivation, conversely as inactivation.The indicators of liver function on pre-operative, post-operative 3rd and 7th day were compared between reactivation group and inactivation group.Results The reactivative rate was 21.6%(16/74) in all patients;27.7%(15/54) in pre-operative non-antiviral teatment group, 5.0%(1/20) in antiviral teatment group, and there was significant differences in reactivative rate between two groups ( P=0.035 ).The results of Logistic regression showed that pre-operative nonantiviral therapy was an independent risk factor of post-operative HBV reactivation (OR=13.952,95% confidence interval[CI]:1.358-143.379,P=0.027).The recovery of albumin (ALB) on post-operative 3rd, 7th days in antiviral treatment group was faster than those in nonantiviral treatment group, respectively (P=0.035,0.043).The recovery of ALB and alanine aminotransferase (ALT) on post-operative 7th day in reactivation group were slower than those in inactivation group, respectively (P=0.016, 0.048).Conclusion The pre-operative nonantiviral therapy is an independent risk factor of post-operative HBV reactivation in patients with HBV-DNA-negative HCC.The pre-operative antiviral therapy could inhibit post-operative HBV reactivation effectively and accelerate the post-operative recovery of liver function.

Objective To investigate the correlation of PICC tip position and weight gaining in very low birth weight infants.Methods We performed a retrospective study using chest X-ray films of very low birth weight infants in NICU who had PICCs inserted in a tertiary hospital.We recorded the tip positions on plain radiographs and calculated the position change,and calculated weight gaining ratio.Spearman regression model was used to analyze the relationship between tip position migration and weight gaining ratio.Results A total of 57 cases of very low birth weight infants were included,containing 246 X-ray films.On the first day of taking X-ray,weight was 0.6-1.46 (1.06±0.25) kg,the median and interquartile spacing are 5(3,7)d.The last time of taking X-ray was(24.0±9.1) dafter PICC placement;weight gaining ratio was 11.8％～114.8％,the median and interquartile spacing are 41.5％ (27.1％,65.3％).All PICCs tip position changed,75％ of which migrated more than 2 vertebrae,50％ of which migrated 3 vertebrae,and the median and interquartile spacing are 3 (1.8,3.5) vertebrae.The distances of tip migration were correlated with weight gaining ratio.With an approximate 2,3 and 4 vertebrae of PICC tip migration,the corresponding weight gaining ratio was about 40％,70％ and 100％.The correlation coefficient between PICC tip position migration and weight gaining ratio was-0.7(P＜0.01),but there was difference in different insertion sites.Conclusion PICC tip position is greatly influenced by weight gaining among very low birth weight infants.By considering the initial placement position,the crucial moment to assess catheter location is at 40％ and 70％ weight gaining ratio.After 100％ weight gaining,PICCs should be removed or replaced.PICCs can easily be affected by bone growth and limb movement,require higher frequency of catheter localization.

Objective To explore the clinical value of color Doppler flow imaging(CDFI) combined with quantitative analysis technique to evaluate renal flow perflusion. Methods Twenty patients with different renal diseases matched with healthy control subjects were examined with Philips iU22 CDFI system. CDFI system and Qlab quantitative technique were used to measure renal restrictive index(RI), vascularization index(VI), flow index(FI), vascularization-flow index (VFI). The patients all received renal single-photon emission computed tomography (SPECT) examination. Results The RI of 32 kidney with lower flow perfusion in SPECT were higher than in the contol group (P <0.01). VI,FI, VFI were lower than those in control(VI, VFI, P <0.01 ;FI, P <0.05). Conelusious The renal blood flow perfusion of patients with renal diseases are lower than that of healthy people. It has high clinical value using CDFI combined with quantitative analysis technique to evaluate the renal perfusion of the patients with renal diseases.

Objective To evaluate the effect of indwelling nasointestinal tube for enteral nutrition (EN) support on patients with severe craniocerebral trauma undergoing mechanical ventilation (MV). Methods A total of 100 severe craniocerebral trauma patients undergoing MV admitted to intensive care unit (ICU) of the 117th Hospital of People's Liberation Army from February 2015 to February 2017 were enrolled, and they were divided into nasogastric tube group in which the EN was fed by nasogastric tube and nasal jejunal feeding tube group (nasointestinal tube group) by random digits table, with 50 patients in each group. Blood urea nitrogen (BUN), hemoglobin (Hb), serum albumin (Alb), acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) score, Glasgow coma scale (GCS) score before and 10 days after treatment, duration of MV, hospitalization time, and the incidences of ventilator-associated pneumonia (VAP) and reflux wrong aspiration of the two groups were observed and compared. Results There was no statistically significant difference in BUN, Hb, Alb, APACHEⅡscore or GCS score before treatment between the two groups. Ten days after treatment, BUN and APACHEⅡ score in the nasointestinal tube group were significantly lower than those in the nasogastric tube group [BUN (mmol/L): 6.3±1.6 vs. 8.0±2.2, APACHEⅡscore: 17.9±3.2 vs. 20.8±6.3, both P < 0.05], Hb, Alb, GCS score were significantly higher than those in nasogastric tube group [Hb (g/L): 125.9±19.7 vs. 113.5±19.6, Alb (g/L): 35.9±6.2 vs. 31.9±6.2, GCS score: 9.7±1.9 vs. 8.2±5.7, all P < 0.05], duration of MV and hospitalization time were significantly less than those in the nasogastric tube group [duration of MV (days):14.7±3.4 vs. 17.5±2.9, hospitalization time (days): 15.4±5.6 vs. 19.2±7.3, both P < 0.05], and the complication rate in nasointestinal tube group was obviously lower than that in nasogastric tube group [10% (5/50) vs. 36% (18/50), P < 0.05]. Conclusion For patients with severe craniocerebral trauma treated with MV, the EN treatment by means of indwelling nasointestinal tube is helpful for the recovery of consciousness, improvement of nutritional indexes, reduction of incidences of complications such as reflux aspiration, etc. and shortening the course of disease, thus the method can obviously improve the patients quality of life.

Objective To analyze transthoracic echocardiographic characteristics of cardiac amloidosis (CA).Methods Fifteen cases of biopsy-proven CA were retrospectively reviewed.Results Interventricular septal thickening(＞1.3 cm)of varing degrees were found in all cases.In 11 cases,the posterior of left ventricular wall were thickened.Myocardial echoes of interventricular septum and free wall of left ventricular were enhanced evidently and distributed unevenly.The echoes presented as ground glass-like images,with some spotty hyper echoes.Both atria were enlarged,and LVEF decreased,with diastolic function impaired,and mild-moderate hydropericardium found in the CA.Conclusions Transthoracic echocardiography is a relatively sensitive and highly specific non-invasive mothod tO diagnose CA.

Objective To assess the value of quantitative color Doppler sonography in patients with systemic lupus erythematosus (SLE). Methods The right renal in 21 patients with SLE and 22 normal subjects were examined with Philips IU22 ultrasonic diagnostic device. Resistence index (RI) of interlobar artery and interlobular artery were measured with color Doppler sonography, vascularity index (VI), flow index (FI) and vascularization flow index (VFI) which reflecting the renal cortical blood flow were calculated with quantitated analysis software. All the parameters between two groups were compared and analyzed. Results The color signals of renal cortical blood flow in patients with SLE were inferior to those of the normal group, especially in the area near the edge of renal. No statistical difference of RI was found between the two groups (P>0.05), while VI, FI and VFI in SLE group were significantly lower than those of the normal group (VI, VFI, P<0.01, FI, P=0.01). Conclusion Color Doppler sonography combined with blood flow quantitative technique provide a helpful, sensitive and convenient tool to detecte the renal changes in SLE patients.

BACKGROUND:Amyotrophic lateral sclerosis is a progressive neurodegenerative disease,which often leads to the death of neurons in the brain and spinal cord.The pathogenesis of amyotrophic lateral sclerosis is extremely complex,with high refractory rate and mortality rate.There are only two kinds of drugs for its treatment,so it is urgent to develop new treatment methods to improve the prognosis of patients. OBJECTIVE:To review the mechanism of Chinese medicine and mesenchymal stem cells regulating the immune response in the treatment of amyotrophic lateral sclerosis. METHODS:"Traditional Chinese medicine,medical stem cells,ALS,immune response"were Chinese and English search terms.Articles were retrieved from WanFang,CNKI,PubMed,Web of Science and other databases from 2010 to 2023.Finally,69 articles were included for review. RESULTS AND CONCLUSION:(1)The article summarizes in detail the five mechanisms of traditional Chinese medicine regulating the immune response in the treatment of amyotrophic lateral sclerosis:mainly including the promotion of expression of closed zone protein-1 and closed protein-5 by traditional Chinese medicine such as borneol and astragaloside IV to rebuild the integrity of the blood central nervous system barrier.Fufangteng Mixture can regulate the receptor molecules on the surface of the natural killer cells to inhibit their autotoxicity.The complement system factors such as Scutellaria barbata and patchouli can inhibit their abnormal activation.Tripterygium wilfordii and Uncaria rhynchophylla inhibit the activation of microglia by mediating the production of extracellular signal-regulated kinase 1/2 attenuated inducible nitric oxide synthase.Zuogui Pill and Trichosanthes kirilowii Root promote the expression of interleukin-10 and regulate T cells to improve the immune environment.(2)Through existing research,five mechanisms of mesenchymal stem cells regulating the immune response in the treatment of amyotrophic lateral sclerosis have been summarized,mainly including reducing the expression of aquaporin 4 and reducing endothelial nitric oxide synthase signal transduction to repair the integrity of the immune barrier;releasing indoleamine 2,3-dioxygenase,prostaglandin E2 and other factors to resist natural killer cell toxicity;secretion factor H interferes with the activity of invertase and inhibits abnormal activation of the complement system;regulating the CX3CL1/CX3CR1 system axis or secreting transforming growth factors β,which can change the phenotype of microglia and inhibit its activity by other ways;increasing the expression of interleukin-10 or activating the STATS phosphorylation pathway to restore T cell function.(3)At present,there are few studies on the combination of traditional Chinese medicine and mesenchymal stem cells in the treatment of amyotrophic lateral sclerosis.Relevant research reports have shown that Jiweiling Injection can promote stem cell proliferation and differentiation and that Buyang Huanwu decoction combined with bone marrow mesenchymal stem cells can significantly improve the integrity of the blood-brain barrier.In the future,further exploration is needed to explore the synergistic treatment effect of both on refractory amyotrophic lateral sclerosis.