Objective To evaluate the role of autophagy on acute kidney injury after liver transplantation.Method Fifty-six healthy male Sprague-Dawley rats were randomly assigned into 4 groups:sham group,orthotopic liver transplantation (OLT) group,sirolimus pretreated (SRL) group and 3-methyladenine pretreated(3-MA) group.OLT model was established.Then the rats were sacrificed at 6 h after reperfusion.The renal function and the extent of oxidative stress relative proteins malondialdehyde (MDA) and superoxide dismutase (SOD) were observed.The levels of apoptosis relative genes caspase-3 and cyt c and the expression of autophagy relative proteins were detected.The pathological changes were microscopically examined in renal tissues.TUNEL staining was used to observe the apoptosis of tubular epithelial cells.Transmission electron microscopy was applied to observe the ultrastructure changes of tubular epithelial cells.Result As compared with sham group,OLT and 3-MA groups showed a serious renal injury including cellular vacuolization,loss of brush borders,and a significant rise in BUN,Cr and MDA,while a decrease in SOD activity.The levels of caspase-3 mRNA and cyt c rnRNA were increased significantly.Whereas compared to OLT and 3-MA groups,renal function and oxidative stress levels in SRL group ameliorated,and histopathologic damage and apoptosis alleviated after OLT.Simultaneously,the levels of caspase-3 mRNA and cyt c mRNA were decreased.The expression of beclin-1 and LC3-]Ⅱ was effectively upregulated.Conclusion Autophagy could alleviate acute kidney injury after liver transplantation through inhibiting oxidative stress and apoptosis.

Objective To explore the impact of Th17 cells adoptive immunity on tumor growth of diffuse large B cell lymphoma (DLBCL)-bearing mice.Methods The CD4+ CD62L+ na(i)ve T cells purified by Mini MACS immunomagnetic beads were stimulated under the condition of TGF-β, IL-6, anti-IFN-γ, anti-IL-4, IL-23.IL-17 expression was detected by ELISA.SCID mice were inoculated with DLBCL cells line SUDHL-4 to estaldish the model of DLBCL-bearing mice, and then they received Th17 cells adoptive immunotherapy at the 0, 8 th or 18th day (3 groups in total, 5 mice pre-group).The tumor volume and the survival of tumor model were observed.Results Formation of tumor nodules in mice was observed at about the 8th day after the mice received the Th17 SUDHL-4 cells.The tumors volume of DLBCL-bearing mice that had received Th17 cells adoptive immunotherapy was obviously smaller than that of the mice had not (P ＜ 0.05).The survival time of the tumor-bearing mice that had received Th17 cells adoptive immunotherapy was also longer than that of the tumor-bearing mice had not (P ＜ 0.05).Conclusion Th17 cells adoptive immunotherapy displays an anti-tumor effect on DLBCL-bearing mice.

Objective To study the clinical diagnosis value and the clinical significance of combined measurement of CEA, DR70, NSE and CYFRA21- 1 in patients with lung cancer. Methods The serum levels of CEA, DR70, NSE and CYFRA21- 1 were determined by ELISA in 130 patients with lung cancer, 50 patients with benign pulmonary disease and 100 cases of normal controls. Results The levels of serum CEA, DR70, NSE and CYFRA21- 1 in lung cancer patients were significantly higher than that in benign pulmonary disease patients and controls (P

Objective To investigate the killing effect of polymethylmethacrylate (PMMA) on spinal metastasis of transplanted VX2 carcinoma in experimental rabbit models. Methods Spinal metastasis of transplanted VX2 carcinoma model was successfully established in 18 rabbits. The experimental rabbits were randomly and equally divided into three groups with 6 rabbits in each group. Under CT guidance , PMMA or saline was injected into the center of VX2 tumor; in group A 0.3 ml of PMMA was used, in group B 0.1 ml of PMMA was used and in group C (control group) 0.3 ml saline was used. Twenty-four hours after the injection, the animals were sacrificed. Four tissue samples were obtained from the sites at 1 mm , 5 mm, 10 mm and 15 mm away from the PMMA mass in each rabbit of group A and group B , while four tissue samples were collected from different four sites from the tumor ’s center to border in each rabbit of group C. TdT-mediated dUTP nick-end labeling (TUNEL) method was used to determine the tumor cell apoptosis rate. Results After successful establishment of rabbit model, injection of PMMA was performed in sixteen among the eighteen rabbits. Technical success rates were 83.3% in both group A and B, and the success rate was 100% in group C. The difference in technical success rate was not significant. The mean tumor cell apoptosis rates of spinal VX2 carcinoma at 1 mm, 5 mm and 10 mm away from the PMMA mass in group A were (65.75±18.81)%, (50.00±14.24)% and(14.95±8.98)% respectively. The mean apoptosis rate in the control group was (9.79 ±5.24)%; the differences between the group A and the control group were statistically significant (P<0.05). The mean tumor cell apoptosis rate of spinal VX2 carcinoma at 15 mm away from the PMMA mass in group A was (10.30 ±8.13)%, which was not significantly different with that of the control group. The mean tumor cell apoptosis rates of spinal VX2 carcinoma at 1 mm and 5 mm away from the PMMA mass in group B were (49.20±15.57)% and(17.75±9.28)% respectively, which was significantly different with that of the control group(P<0.05); the mean tumor cell apoptosis rates at 10 mm and 15 mm away from the PMMA mass in group B were not significantly different with those of the control group. Statistically significant differences in the mean tumor cell apoptosis rates determined at 1 mm, 5 mm and 10 mm away from the PMMA mass existed between group A and group B(P<0.001). Conclusion PMMA can promote the apoptosis of tumor cells, properly increasing the injected amount of PMMA can enlarge the extent of tumor cell apoptosis.

Objective To know the prevalence of chronic obstructive pulmonary disease(COPD) in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS) in Kunming Yunnan Province, and the clinical symptom of OS.Methods Retrospective study of 4 636 cases of patients with snoring, excluding COPD in addition to chronic respiratory disease and assess the patient`s condition.The test included AHI, BMI, Epworth sleepiness scale, lung function.The index of OS was confirmed by AHI>5 times/h and FEV1/FVC<70%.Results During the period of 2006 to 2012, he prevalence of COPD in patients with OSAHS was 10.1% [95% confidence interval (CI) 9.1%-11.1%] in Kunming Yunnan Province.And male`s OS prevalence rate is higher than the female(male 10.2%;female 9.7%).The OS patients` average age was 56.9±14.1, the mean AHI was (47.46±26.79) times/h, and the average FEV1/FVC was 60.09%±23.57%.Polysomnographyresults show that patients suffered obvious hypoxiaat night in both OSAHS group and OS group, but it was more significant in OS group.Pulmonary function test showed that OS patients have more serious chronic obstructive pulmonary disease.Conclusions The prevalence of COPD in OSAHS patients was high in Kunming, Yunnan Province, and the prevalence rate in old group reached more than 24%.In addition, the sympotms of patients with OS were more severe than those with only OSAHS or COPD in lung function and hyoxemia.

Objective:In order to compare the effect of ascending medial open-wedge high tibial osteotomy and descending medial open-wedge high tibial osteotomy on patellar height.Methods:Our group analyzed 77 patients of medical cases which were closely associated with medial open-wedge high tibial osteotomy for the treatment of knee varus deformity and medial compartment osteoarthritis from May 2011 to December 2018 and 77 cases were effectively followed up, including 36 males and 41 females with an average age of 59.4±10.5. By the way, there are 51 cases of ascending osteotomy and 26 cases of descending osteotomy. During these treatment, we adopted some scientific methods full-length standing anteroposterior radiograph,Miniaci method, Insall-Salvati index (ISI), Caton-Deschamps index (CDI) and Blackburne-Peel Index (BPI) to measure the corresponding parameters and changes in patellar height (PH) at different stages.Results:77 patients were enrolled, the mean follow-up time was 20.6 months (range, 12-60 months), ascending and descending high tibial osteotomy (HTO) show the average degree of varus correction (10.43°±2.67° and 11.16°± 2.80°) respectively. And at the same time, in these cases of ascending HTO, PH decreased by 8.1% (CDI method), 2 cases of low PH (the patellar height decreased by 10%, which is the low patellar) were measured (ISI method), 7 cases of low PH occurred (CDI and BPI). Instead, PH decreased by 4.5% (CDI method) in descending HTO,the difference was significant ( t=2.101, P=0.040). 22 cases of ascending HTO with varus correction less than 10 degrees, the PH decreased by 6.9%. By the way, the ISI method did not detect the occurrence of low PH, but we found one by CDI and BPI. The 29 cases with varus correction of more than 10 degrees in ascending HTO, and PH decreased by 10.4%. There were 2 low PH (ISI method), and 6 low PH (CDI and BPI), the difference was significant ( t=2.310, P=0.028). Conclusion:In ascending HTO, the low PH is closely related to the degree of varus correction. Conversely, The descending HTO did not influence PH.

ObjectiveTo observe the effect of pulsed electromagnetic fields (PEMFs) on bone mineral density (BMD) of spinal cord injuried (SCI) patients. MethodsThe PEMFs group was composed of 12 SCI patients received regular PEMFs treatment as the treatment group, 12 SCI patients treated without PEMFs were as the control group.BMD of total proximal femur, Ward's trigonum and great trochanter of all patients were detected by dual-energy X-ray absorptiometry before and after treatment.ResultsBMDs of total proximal femur and great trochanter of patients of the treatment group were a little increased after PEMFs treatment, with no significant difference (P>0.05), but BMD change was significantly different compared with the control group (P<0.05～0.01).ConclusionPEMFs treatment along with routine exercise may help to reduce the loss of bone after SCI.

Objective To compare the cognitive function of patients with carotid stenosis combined with white matter lesions (WML)after carotid artery stenting (CAS). Methods Total 166 patients with carotid artery stenosis were collected.According to MRI imaging,30 patients with no white matter lesions were included in the control group and 136 patients with white matter lesions were included in the white matter lesions group. They were treated with carotid artery stenting and underwent evaluation on the safety and efficacy of perioperative surgery. CAS failed in two patients because of the inability of guidewire crossing in WML group. Two patients died after CAS (one for cardiac death and one for traumatic accident) in WML group. 162 patients received 1 year follow-up. Cognitive function was assessed before and after CAS. Results Before CAS,WML group's MMSE, digit span forward/backward test, verbal fluency test and MoCA scores (21.8±3.3、6.3±2.1、4.1±1.0、15.1±3.6、20.6±3.1) were lower compared with control (24.3±3.9、7.3±2.6、4.7±1.8、17.7±5.2、22.7±4.2) and ADAS-Cog score was higher compared with control ((15.1±3.3) vs.(12.7±3.3)), P=0.000、0.026、0.039、0.012、0.000、0.011.Three months after CAS,the MMSE,digit span forward test and MoCA scores (23.7±3.6,7.5± 2.4, 23.1±6.9) was higher significantly than those before treatment (21.8±4.3, 6.3±2.09, 20.6±4.13), P<0.05.And the scores of ADAS-Cog was lower((13.2±4.)vs.(15.1±4.3),P<0.05).The scores of digit span backward test in 6 months after treatment was significant higher than those before treatment (4.9 ±2.8,4.1 ±2.2,P<0.05). After 1 year of CAS, the improvement in scores of MMSE, digit span forward test, ADAS-Cog and MoCA in patients with carotid stenosis complicated with WML(3.5±1.3,1.6±0.6,-2.6±0.8,3.6±1.1)was higher significant than control(2.7±1.8, 1.2±0.8, -2.0± 1.3, 2.7 ±1.5),P<0.05. Conclusion CAS can improve cognitive function in Patients with carotid artery stenosis complicated with WML than those who without WML.

Objective:To clarify the anatomical characteristics and adjacent relationship of the superior segment of the inferior vena cava during laparoscopic surgery.Methods:In December 2018, two frozen and two fresh adult cadavers were dissected. The chest of the frozen cadavers was opened along the bilateral midline of the clavicle, the anterior pericardial wall was opened, and the superior vena cava and the inferior vena cava was dissected. The abdominal cavity was opened along the midline of the abdomen, the left and right hepatic lobes were turned over, the inferior vena cava and the second hilum of the posterior segment of the liver were exposed, and the hiatus of the inferior vena cava was opened and entered the pericardium.The anatomical characteristics and adjacent relationship of the superior segment of the inferior vena cava were observed, and the length of the superior segment of the inferior vena cava was measured. The fresh frozen cadaver patients underwent laparoscopic surgery.Five 12 mm trocars were placed at the side of umbilicus, right rectus abdominis about 4 cm from umbilicus, midline of abdomen about 6 cm above umbilicus, right axillary front about 2 cm below inferior edge of liver, left midline of clavicle about 2 cm below inferior edge of liver. Laparoscopic-assisted turning of the left and right hepatic lobes, exposing the posterior inferior vena cava and the second hilum of the liver, opening of the vena cava hiatus into the pericardium.The anatomical characteristics and adjacent relationship of the upper diaphragmatic segment of the inferior vena cava were observed.Results:In two autopsies, the inferior vena cava entered the chest through the cava sulcus of the liver and the phrenic foramen cava, and then through the fibrous pericardium into the right atrium. The length from the diaphragm of inferior vena cava to the right atrium was 1.67 cm, 2.57 cm. In laparoscopic operation, the diaphragm entrance of the posterior segment of the liver inferior vena cava, the second hepatic portal and the inferior vena cava could be well exposed.The diaphragm could be opened along the hole of the vena cava with a relatively non vascular anatomical layer of adipose tissue.There was a large anatomical gap between the pericardium and the right atrium, and the inferior vena cava, the superior vena cava and the right atrium could be well exposed, and the whole diaphragm could be completely and continuously exposed from the bottom to the inferior vena cava at the entrance segment of the right atrium.Conclusions:There was a relatively avascular anatomical layer beside the inferior vena cava. During laparoscopic operation, opening the diaphragm through the abdominal cavity could safely enter the pericardium and expose the inferior vena cava, the superior vena cava and the right atrium, which provides a possibility for the removal of Mayo Ⅳ grade inferior vena cava tumor thrombus through this approach.

Dura mater, rich in vasculature and immune cells, is the outermost layer of the central nervous system, and thus acts as the first barrier to protect brain. Meningeal lymphatic vessels and immune cells are main components of dural immunity, which respond to a variety of central nervous system diseases. Meanwhile, compared with brain parenchyma, dura mater communicates more with peripheral tissues and is more susceptible to medical interventions. Therefore, dura mater is a promising target to prevent, diagnose and treat intracranial diseases. Here dural immunity is clarified based on meningeal lymphatic vessels and dural immune cells, and current researches inquiring the role of dural immunity in infectious and immune diseases of central nervous system are summarized.