Objective To analyze the features of dynamic contrast-enhanced CT of blunt hepatic injury in rabbits. Methods The model of blunt hepatic injury was established in 40 New Zealand white rabbits with a steel ball falling down to the xiphoid process of the animals. Plain CT scan and dynamic contrast-enhanced CT scan (Hispeed spiral CT/2i, GE, America) of the liver were performed. Arterial,portal and balanced phases were respectively at 8-10 s, 35-40 s and 120-150 s after initiation of the contrast medium injection. The non-enhanced and enhanced images were compared in aspects of location and range of injury, tear of the liver capsule, active bleeding, involvement of the main hepatic veins and CT features of abdominal hemorrhage, which was further compared with the results of gross anatomy. Results The rate of plain CT scan was obviously lower than that of dynamic contrast-enhanced CT scan,which defined single tear in 13 patients, multiple lacerations in 18, liver subcapsular hematoma in seven,liver hematoma in nine, liver coated gap in 17, active bleeding in nine and main hepatic vein injury in five, with coincidence rates with the results of gross observation for 13/13,18/18,7/9,9/9,25/30,9/5and 5/4 respectively. According to Moore' s classification, CT/Laparotomy performed from grade Ⅰ to grade Ⅵ were 5/4 patients at grade Ⅰ , 15/13 at grade Ⅱ, 9/11 at grade, 5/6 at grade Ⅳ, 1/2 at grade Ⅴ, O at grade respectively. Conclusion Dynamic contrast-enhanced CT scan, especially at portal and balanced phases, is of great value for diagnoses of liver injuries and determination of injury severity.

ChildA (4.54%,x~2= 21.992,P=0.000);Among the HBeAg positive patients,the mortality of MELD≥ 18 patients (17.24%) was higher than the MELDChild A (0%,x~2= 5.363,P=0.021).Multivariate analysis showed that death rate was independently predicted by old age,higher Child -Pugh and the ALT persistent elevation in hepatitis B e antigen-negative patients with liver cirrhosis (P

Graft Rejection ; Hepacivirus ; isolation & purification ; Hepatitis C, Chronic ; etiology ; immunology ; prevention & control ; Humans ; Liver Transplantation ; adverse effects ; RNA, Viral ; blood ; Risk Factors ; Secondary Prevention

American Medical Association ; Humans ; Liver Failure, Acute ; diagnosis ; therapy ; Liver Transplantation ; Practice Guidelines as Topic ; United States

Female ; Hepatitis C, Chronic ; psychology ; Humans ; Male ; Quality of Life ; Sickness Impact Profile

[ ABSTRACT] AIM:To investigate the effect of polysaccharide from Fructus corni ( PFC) on cardiomyocytes against hypoxia/reoxygenation ( H/R) injury and its possible relationship with ROS/PKC/p38 MAPK pathway.METHODS:Prima-ry cardiomyocytes were isolated from neonatal SD rats and randomly divided into normal group, H/R group, PFC (20 mg/L, 100 mg/L and 200 mg/L) preconditioning+H/R groups, chelerythrine+PFC (100 mg/L)+H/R group and SB203580+PFC (100 mg/L)+H/R group.The cell viability was measured by inverted microscopic observation.Apoptosis in the car-diomyocytes was detected by Hoechst 33258 staining and fluorescence microscopy.The levels of lactate dehydrogenase ( LDH) and superoxide dismutase ( SOD) in the cell culture supernatants, and the reactive oxygen species ( ROS) in the cells were also measured by microplate reader.The protein levels of PKC, p-p38 MAPK and HSP70 in the cells were detec-ted by Western blotting.RESULTS:Compared with normal group, the cell viability and beating frequency were decreased in H/R group.LDH and ROS contents, apoptotic rate and p-p38 MAPK level increased significantly (P<0.01).Compared with H/R group, PFC preconditioning increased beating frequency, SOD activity and the protein level of PKC and HSP70, and decreased ROS production, the protein level of p-p38 MAPK and cell apoptotic rate.However, the effect of PFC was in-hibited by chelerythrine or SB203580.CONCLUSION:PFC may protect cardiomyocytes from hypoxia/reoxygenation injury. Its mechanism is possibly involved in the inhibition of ROS via increasing the activity of SOD and the activation of PKC, and suppression of excessive activation of p38 MAPK.

Objective To investigate the safety and clinical response of dendritic cells (DC)vaccine loaded with HLA-A2-restricted peptides MAGE-3、 Tyr、 MART-1 and GP-100 against malignant melanoma. Methods Twenty three HLA-A2 positive patients with malignant melanoma were enrolled.Peripheral blood mononuclear cells were separated into adherent cells for induction of DC loaded with four peptides. DC vaccine was administered subcutaneously once a week in inguinal region. The immunological responses and clinical responses were evaluated. Results Dendritic cell vaccination were well tolerated in all patients and there was no toxicity observed. Serum levels of IL-2, IL-12 and IFN-γincreased significantly after first vaccination and fourth vaccination. The positive rate of DTH test was 50% (5/10), and 2 fold increase of CD8+ IFN-γ+ cells were observed in 6 of 10 patients. Stable disease was observed in 11 of 23 patients, one patient had a complete metastasis regression, four patients had 50% regression of metastasis,four patients had a minor response, and disease progressed in three patients. Conclusion DC vaccines loaded with peptides MAGE-3、 Tyr、 MART-1 and GP-100 can elicit non-specific and specific immune responses, leading disease control. DC vaccine is considered one of safe and effective treatments for malignant melanoma.

OBJECTIVETo study the effect of Modified Dachengqi Decoction (MDD) as whole course therapy on mediators of inflammation in severe acute pancreatitis (SAP) model rats, and to compare interventional advantages over intestinal mucosal barrier (IMB) of SAP rats between whole course therapy of MDD and early stage therapy of MDD.

METHODSTotally 190 SD rats were divided into five groups according to random digit table, i.e., the sham-operation group, the model group, the octreotide (OT) group, the early stage MDD treatment group, the whole course MDD treatment group, 38 in each group. SAP models were established with retrograde injection of 5% sodium taurocholate into the pancreaticobiliary duct. Three hours after modeling normal saline (NS) was administered to rats in the sham-operation group and the model group by gastrogavage, once per 12 h.1.35 µg/100 g OT was subcutaneously injected to rats in the OT group, once every 8 h. 0.4 mL/100 g MDD was administered to rats in the early stage MDD treatment group, and 6 h later changed to NS (once per 12 h).0.4 mL/100 g MDD was administered to rats in the whole course MDD treatment group, once every 12 h. The accumulative survival rate and morphological manifestations of pancreas and small intestine were observed under microscope 48 h after modeling. Pathologic scores of the pancreas and small intestine were conducted at 4, 6, 24, and 48 h after modeling. Contents of serum amylase (AMY), alanine transaminase (ALT), and TNF-α were also detected. The expression of high mobility group box protein 1 (HMGB1) in the small intestine tissue was also detected by Western blot. The positive rate of bacterial translocation in mesenteric lymph nodes (MLNs) was observed within 48 h. Correlations between serum TNF-α or HMGB1 in small intestinal tissue and pathological scores of the pancreas or the small intestine were analyzed.

RESULTSThe accumulative survival rate was 100. 0% in the sham-operation group, 79. 2% in the whole course MDD treatment group, 70. 8% in the OT group, 45. 8% in the early stage MDD treatment group, and 37.5% in the model group. At 6 h after modeling, pathological scores decreased more in the whole course MDD treatment group, the early stage MDD treatment group, the OT group than in the model group (P < 0.05). At 24 and 48 h after modeling, pathological scores of the pancreas and the small intestine decreased more in the whole course MDD treatment group and the OT group than in the early stage MDD treatment group (P <0. 05). At 6, 24, and 48 h after modeling, serum contents of AMY and ALT both decreased more in the whole course MDD treatment group, the early stage MDD treatment group, the OT group than in the model group (P < 0.05). At 48 h after modeling serum contents of AMY and ALT both decreased more in the whole course MDD treatment group and the OT group than in the early stage MDD treatment group (P < 0.05). At 6 h after modeling serum TNF-α levels decreased more in the whole course MDD treatment group, the early stage MDD treatment group, the OT group than in the model group (P < 0.05). At 6, 24, and 48 h after modeling the level of HMGB1 in the small intestinal tissue decreased more in the whole course MDD treatment group, the early stage MDD treatment group, the OT group than in the model group (P < 0.05). Of them, HMGB1 levels at 24 and 48 h were lower in the whole course MDD treatment group and the OT group than in the early stage MDD treatment group (P < 0.05). The number of MLNs bacterial translocation at 48 h after modeling was lower in the whole course MDD treatment group and the OT group than in the early stage MDD treatment group and the model group (P < 0.05). Serum TNF-α contents within 6 h were positively correlated with pathological scores of pancreas (r = 0.579, P < 0.01). ROC curve showed that serum TNF-α contents could predict the severity of SAP (ROC = 0.990, 95% Cl: 0.971 to 1.000). HMGB1 in the small intestine was positively correlated with pathological scores of the small intestine (r = 0.620, P < 0.01).

CONCLUSIONSEarly stage use of MDD could effectively reduce the release of TNF-α, while whole course use of MDD could effectively inhibit the expression of HMGB1. The latter could preferably attenuate injuries of the pancreas and the small intestine, lower MLNs bacterial translocation, and elevate the survival rate.

Animals ; Bacterial Translocation ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; HMGB1 Protein ; Intestinal Mucosa ; drug effects ; Octreotide ; Pancreas ; Pancreatitis ; drug therapy ; Plant Extracts ; pharmacology ; therapeutic use ; Rats ; Rats, Sprague-Dawley ; Taurocholic Acid ; Tumor Necrosis Factor-alpha

OBJECTIVE To investigate the epidemic,drug resistance and gene distribution of ESBLs-producing Klebsiella pneumoniae (KPN) from Jiangxi TCM Hospital. METHODS The susceptibility of KPN was detected by MIC PCR was used to detect ESBLs gene. RESULTS There were 42 strains with ESBLs isolated,the positive rate was 35.0%. The drug resistance rate of KPN with ESBLs was higher than that without ESBLs,PCR typing result:TEM 33 (78.6%),SHV 8 (19.0%) and CTXM 29 (69.0%). CONCLUSIONS The ESBLs-producing bacteria have multiple drug resistant genes;TEM and CTXM are the main drug resistant genes in our hospital.

Objective To investigate the prevalence and risk factors of renal injury in chronic hepatitis C patients(CHC).Methods The clinical data of 213 CHC patients,who were hospitalized in the People's Hospital of Peking University from Jan.2002 to Oct.2007,were collected.The eGFR was caculated by MDRD equation.The prevalence and risk factors of renal injury in the CHC patients was analyzed by SPSS software.Results The patients has an average age of (53.5?14.7)years old,with male patients accounting for 59.6% and female accounting for 40.4%.We also found that 22.1% patients had hypertension,25.8% had diabetes mellitus,and 94.8% had serum positive HCV RNA.The prevalence of CKD was 26.3%,the prevalence of proteinuria was 14.6%,and the rate of hematuria was 2.8%.Serumpostive HCV RNA was the independent risk factor of proteinuria as demonstrated by multiple variation logistic regress analysis(P=0.028,OR:2.610,95%CI:1.107~6.151).Proteinuria(P=0.02,OR:3.759,95%CI:1.227~11.521),age(P=0.004,OR:1.058,95%CI:1.018~1.100)and blood uric acid(P