Objective To investigate prophylaxis and therapy of early complications following relatives' partial live small bowel transplantation.Methods Four relatives' partial live small bowel transplantations were carried out.Among the 4 patients,there were 3 cases of short intestine syn- drome and one case of non-function of small bowel caused by the absence of nerve ganglion of small in- testine.More than 4 antigens of HLA were completely matched between donators and receptors.In- testines of donators were got from terminal ileum with the length of (150?10) cm.After operations, tacrolimus (FK506),mycophenolate mofetil (MMF),and methylprednisolone were used to prevent rejections.Measures such as use of anticoagulation,improving microcirculation and albumin infusion, aimed at regulating the function of blood coagulation and preventing bleeding and formation of thrombus at anastomotic stoma;famotidine and omeprazole were used to prevent irritable ulcer;use of the third generation of cephalosporins antibiotics,ganciclovir and fluconazol could prevent bacteria,vi- rus and eumycete infections;disinfection and care of easily-infected organs were emphasized;receptors were encouraged to get out of their beds to move frequently;glutamine and enteral nutrition were used early to promote recovery of intestinal function.Results Three days after operation,one patient's lung was infected with baumanii,and the infection had been under control after being treated with the third generation cephalosporins antibiotics;five days after operation,haematoma was detected on an- other patient and was cleared through the second operations growth of eumycete was found in 2 pa- tients' excretion and secretion from enteron,and their situations were improved with fluconazol;acute rejections of the 4 patients were detected 20 days after operation and reversed by the increased use of FK506 combined with methylprednisolone.Among the 4 patients,2 of them have survived for a long time,and the first patient has survived for 6 years and 8 months till now and the other one for 3 years and 2 months;furthermore,other 2 patients respectively died of infections 5 months and 35 days after the operations.Conclusion Because of special constitution of intestine,early complications of rela- tives' partial live small intestine transplantation are frequent and complicated.Therefore,prophylaxis and therapy of early complications are crucial to the success of the transplantation.

Animals ; Cerebral Cortex ; drug effects ; physiology ; Epilepsy ; chemically induced ; physiopathology ; Female ; Flunarizine ; pharmacology ; Hippocampus ; drug effects ; physiology ; Male ; Penicillins ; adverse effects ; Rats ; Rats, Wistar

OBJECTIVETo explore the operation methods and clinical effects of transfer of the medial half of the coracoacromial ligament to reconstruct the coracoclavicular ligament in treating complete acromioclavicular joint dislocation.

METHODSFrom January 2006 to June 2012,26 patients with acute complete acromioclavicular joint dislocation underwent surgery. Transfer of the medial half of the coracoacromial ligament to reconstruct the coracoclavicular ligament, additional clavical hoot plate and Kirschner wires fixation, were performed in all the patients. Among the patients, 18 patients were male and 8 patients were female, with an average age of 36.7 years old (ranged from 25 to 51 years). The duration from injury to operation was from 3 to 12 days with an average of 5 days. According to the Rockwood classification, 4 cases were grade III and 22 cases were grade V . Clinical manifestation included local swelling, tenderness with snapping, limitation of shoulder joint motion. In preoperative bilateral shoulder joint X-rays, the injured coracoclavicular distance was (16.2 ± 5.0) mm which was significantly wider than that of uninjured sides (7.6 ± 1.0) mm. Clinical results were evaluated according to X-rays and Constant-Murley score.

RESULTSAll incisions obtained primary healing after operation without complication of infection, internal fixation breakage, redislocation. All the patients were followed up from 12 to 30 months with an average of 18 months. Kirschner wires and internal fixation plate were removed at 1 month and 8-10 months after operation, respectively. At final follow-up, the motion of shoulder joint recovered to normal and a no pain joint was obtained. According to Constant-Murley score, 24 cases got excellent results and 2 cases good. There was no significant difference after operation between the injured coracoclavicular distance and the uninjured contralateral side [(7.7 ± 1.2) mm vs (7.6 ± 1.0) mm), P > 0.05].

CONCLUSIONTransfer of the medial half of the coracoacromial ligament to reconstruct the coracoclavicular ligament, additional fixation using hook plate and Kirschner wires is the effective surgical method in treating complete acute acromioclavicular joint dislocation.

Acromioclavicular Joint ; injuries ; Adult ; Female ; Humans ; Joint Dislocations ; surgery ; Ligaments, Articular ; surgery ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods

The systematic position of Fritillaria hupehensis has been in dispute. Phylogentic analyses were conducted on sequences of ITS, rpl16, matK sequences for species of F. hupehensis and allies. Lilium davidii was designed as outgroup. The analyses were performed using MP and ML methods. Conclusions could be achieved as follow. The topologies of MP and ML are consistent. The samples of F. hepehensis from different places form a supported clade with a strong bootstrap. And then form a strongly supported clade with F. anhuiensis, F. monantha. The results suggests that although F. hupehensis has a closet relation with the two ones, it exists some difference.
DNA, Plant ; chemistry ; genetics ; DNA, Ribosomal Spacer ; genetics ; Endoribonucleases ; genetics ; Fritillaria ; classification ; genetics ; Molecular Sequence Data ; Nucleotidyltransferases ; genetics ; Phylogeny ; Plant Leaves ; genetics ; Ribosomal Proteins ; genetics ; Sequence Analysis, DNA ; Species Specificity

Adenocarcinoma ; pathology ; surgery ; Aged ; Carcinoma, Signet Ring Cell ; pathology ; surgery ; Cell Differentiation ; Female ; Follow-Up Studies ; Gastrectomy ; methods ; Humans ; Male ; Middle Aged ; Paneth Cells ; pathology ; Stomach Neoplasms ; pathology ; surgery

Hepatic fibrosis models were induced by CCl4 in rats. To explore vascular endothelial growth factor (VEGF), transforming growth factor-beta1 (TGFβ1) mRNA expression and bcl-2, Bax protein expression levels of intervention and explore the mechanism of the Aralia chinesis anti-hepatic fibrosis. Sixty male Sprague-Dawlley (SD) rats were randomly divided into six groups: nomal group, model group, high-dose (10 mL x kg(-1)), medium-dose (7.5 mL x kg(-1)), low-dose (5.0 mL x kg(-1)) of A. chinesis treated group and colchicine treated group. The change of liver histopathology was observed by HE and Masson staining. The mRNA of VEGF, TGF-β1 were detected by RT-PCR. The protein of Bcl-2 and Bax were detected by Western blot. In the model group liver cell obvious degeneration, necrosis, a large number of collagen fibers of the cable hyperplasia, part visible pseudolobule formation. A. chinesis large, medium, low-dose group and colchicine group liver cell degeneration and necrosis reduced A. chinesis small, medium, and high-dose group was gradually reduced trend and A. chinesis large, middle dose group degree of reduction is particularly significant. Compared with model group, A. chinesis of large, medium and small dose group and colchicine group VEGF mRNA expression, A. chinesis of large, medium-dose group TGF-β1 mRNA expression reduce (P < 0.05); compared with colchicine group, A. chinesis of large, middle dose group of VEGF mRNA expression decreased (P < 0.05); A. chinesis of large, middle dose group of TGF-β1 mRNA expression decreased (P < 0.01), and compared with colchicine group, large dose group of of TGF-β1 mRNA expression decreased (P < 0.05). Compared with model group, A. chinesis of large, medium and small dose group and colchicine group Bcl-2 protein expression reduce (all is P < 0.05). But A. chinesis of large, medium and small dose group and colchicine group of Bax protein expression were increased (P < 0.05). A. chinesis regulation of VEGF, TGF-β1 may prevent the activation of hepatic stellate cells, liver tissue by up regulating the anti-apoptotic protein Bax and down pro-apoptotic protein Bcl-2 expression, thereby to improve the degree of liver fibrosis.
Animals ; Apoptosis ; drug effects ; Aralia ; chemistry ; Drugs, Chinese Herbal ; administration & dosage ; Hepatic Stellate Cells ; drug effects ; metabolism ; Humans ; Liver Cirrhosis ; drug therapy ; genetics ; metabolism ; Male ; Proto-Oncogene Proteins c-bcl-2 ; genetics ; metabolism ; Rats ; Rats, Sprague-Dawley ; Transforming Growth Factor beta1 ; genetics ; metabolism ; Vascular Endothelial Growth Factor A ; genetics ; metabolism ; bcl-2-Associated X Protein ; genetics ; metabolism

To compare the efficacy of interferon and thymosin alpha-1 combination therapy with interferon monotherapy for HBeAg positive chronic hepatitis B. The relevant randomized controlled trials were searched throughout PubMed, EBSCO, Cochrane Library, CBMdisc, VIP, WanFang since Janurary 1990. Studies were included if patients were followed up for at least 6 months after cessation of treatment. Meta-analysis was carried out with RevMan5.0 software. Subgroup analyses were used at different time of observation. Seven randomized controlled trials were included(535 patients in total). According to the results of meta-analysis, the combination therapy was remarkably more effective than monotherapy both at the end of the treatment and the follow-up in terms of HBV-DNA negative rate (54.9% vs 36.3%, OR=2.39, 95% CI=1.64-3.49, P value is less than 0.01; 58.6% vs 30.7%, OR=3.68, 95% CI=2.51-5.41, P value is less than 0.01, respectively), ALT normalization rate (74.5% vs 60.9%, OR=1.94, 95% CI=1.26-3.00, P value is less than 0.01; 74.0% vs 55.6%, OR=2.36, 95% CI=1.54-3.62, P value is less than 0.01, respectively), HBeAg loss rate (56.9% vs 36.7%, OR=2.38, 95% CI=1.61-3.51, P value is less than 0.01; 62.2% vs 33.2%, OR=3.42, 95% CI=2.31-5.06, P value is less than 0.01, respectively) , and HBeAg seroconversion rate (40.1% vs 29.0%, OR=1.65, 95% CI=1.10-2.47, P value is less than 0.05; 47.0% vs 29.5%, OR=2.13, 95% CI=1.43-3.16, P value is less than 0.01, respectively); the HBsAg loss rate of the combination therapy group was significantly higher than that of the monotherapy group only at the end of the follow-up (9.8% vs 3.7%, OR=2.92, 95% CI=1.09-7.76, P value is less than 0.05). Interferon and thymosin alpha-1 combination therapy achieves superior effect with no increase in the adverse effects as compared to interferon monotherapy for HBeAg positive chronic hepatitis B.
Antiviral Agents ; therapeutic use ; Drug Therapy, Combination ; Hepatitis B e Antigens ; blood ; Hepatitis B, Chronic ; blood ; drug therapy ; Humans ; Interferons ; therapeutic use ; Randomized Controlled Trials as Topic ; Thymosin ; analogs & derivatives ; therapeutic use ; Treatment Outcome

Objective To observe the expression of matrix metalloproteinases(MMP)-1,MMP-3 and iNOS in cartilage of experimental rabbit osteoarthritis at different time intervals after anterior cruciate ligament transection(ACLT)operation.The aim of this study is to provide the theoritical evidence for using ACLT rabbit model in Osteoarthritis(OA)research.Methods Unilateral ACLT was performed on 27 randomly selected while rabbits and underwent unilateral arthrotomy was performed on the other 9 white rabbits as the control group.Nine randomly selected white rabbits in experimental group were killed and 3 white rabbits in the control group at 4th,8th and 12th week respectively.Cartilage degradation of femoral condyles was evaluated macr-oscopically,mRNA expression level and protein expression level of MMP-1,MMP-3 and iNOS was measured by reverse transcription-polymerase chain reaction(RT-PCR)and immunohistochemistry respectively.Results Forepart OA cartilage degradation was observed at the 4th week and became more severe at the 8th week after ACLF.Afterpart cartilage degradation was evident at the 12th week after ACLT while cartilage still remained normal in the control group,mRNA expression level and protein expression level of MMP-1.MMP-3 and iNOS were increased at the 4th week and became higher gradually at the 8th,12th week after ACLT compared with the control group.Expression distribution of MMP-1,MMP-3 and iNOS bad different patterns respectively.Conclusion It is suggested that the process of OA cartilage degradation can be simulated by ACLT model and MMP-1,MMP-3 and iNOS may be good markers in therapeutical research of OA.

Objective To study the gene mutation of a Chinese family with Alport syndrome and to perform preimplantation genetic diagnosis before embryo implantation.Methods Next generation sequence analysis was done for checking COL4A3,COL4A4 and COL4A5 genes in the Alport syndrome family members.Array comparative genomic hybridization(CGH) was used to detect the embryos.Results A mutation c.2605G ＞ A was found and identified in COL4A5 gene of all of the Alport syndrome patients in the family,but COL4A3 and COL4A3 genes were normal in all of the detected people.After searching for the mutation database,the mutation c.2605G ＞ A of COL4A5 gene was related to the X-linked dominant Alport syndrome.Three embryos were detected by using the preimplantation genetic diagnosis.Among these embryos,there were two male and one female.One of the male embryos was chromosomal aneuploidy,which was 45,XY,-16 and the other was normal.This normal embryo was implanted,and after 20 weeks the prenatal amniocentesis diagnosis approved that the fetus was normal.Conclusions The mutation of COL4A5 gene (c.2605 G ＞ A) is the cause of Alport syndrome in this family,which indicates that next generation sequence analysis proves to be an accurate and rapid method to detect Alport syndrome disease.Meanwhile array CGH can be used to reduce birth rates as a useful preimplantation genetic diagnosis method.

OBJECTIVETo study the protective effect of alcohol extract of Plumula Nelumbini (AEPN) on carbon tetrachloride (CCl4) induced hepatic fibrosis rats and to explore its possible mechanism.

METHODSTotally 32 male SD rats were randomly divided into four groups, i.e., the normal control group, the model group, the high dose AEPN group, and the low dose AEPN group, 8 in each group. 1,000 mg/kg AEPN was given to rats in the high dose AEPN group by gastrogavage at 10 mL/kg, once daily, while 500 mg/kg AEPN was given to rats in the low dose AEPN group by gastrogavage at 10 mL/kg, once daily. Hepatic fibrosis was induced by intraperitoneal injection of CCl4. Serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and albumin (ALB) were examined using automatic biochemical analyzer. Activities of superoxide dismutase (SOD), contents of malondialdehyde (MDA) and hydroxyproline (Hyp) in the hepatic tissue were determined using colorimetry. The degree of liver fibrosis was observed by HE staining and Masson staining. The expression of α-smooth muscle actin (α-SMA) was detected using immunohistochemistry.

RESULTS(1) Compared with the normal control group, serum levels of ALT and AST obviously increased and the serum ALB level obviously decreased in the model group (all P < 0.05). After treated by AEPN, serum levels of ALT and AST were lowered. and the serum ALB level was higher (all P < 0.05). (2) Compared with the normal control group, collagen deposition was obviously seen in rats' livers of the model group, and pseudolobule had formed; inflammatory activities and fibrosis degrees were serious; contents of Hyp also increased (P < 0.05).After treated by AEPN, collagen deposition was obviously reduced with no obvious pseudolobule; inflammatory activities and fibrosis degrees were alleviated; contents of Hyp were also lowered (P < 0.05). (3) Compared with the normal control group, contents of MDA in the liver tissue obviously increased, while activities of SOD obviously decreased (P < 0.05) in the model group. After treated by AEPN, contents of MDA in the liver tissue decreased and the serum SOD level significantly increased (all P < 0.05). (4) Compared with the normal control group, the expression of α-SMA was obviously elevated in the model group (P < 0.05). After treated by AEPN, its expression was obviously lowered (P < 0.05).

CONCLUSIONSAEPN could fight against CCl4 induced liver fibrosis in rats. Fighting against lipid peroxidation and inhibi- ting activation and proliferation of hepatic stellate cells might be possibly main mechanism.

Alanine Transaminase ; metabolism ; Animals ; Carbon Tetrachloride ; Collagen ; Drugs, Chinese Herbal ; pharmacology ; Ethanol ; Hepatic Stellate Cells ; Hydroxyproline ; metabolism ; Lipid Peroxidation ; Liver Cirrhosis, Experimental ; drug therapy ; Male ; Malondialdehyde ; metabolism ; Rats ; Superoxide Dismutase ; metabolism