0.05).Conclusion Peritoneal dialysis may lead to lower inflammatory and oxidative stress state than the non-dialysis uremic.HPD patients may be in higher oxidative stress and inflammatory state than LPD patients.

Objective To research the clinical application effect of thrombela-stogram(TEG) for anticoagulant therapy to prevent deep venous thrombosis(DVT) in perioperative period of Orthopedics Department.Methods Sixty-eight cases of fracture patients treated with surgery in the Orthopedicsin Department of Jiangning Hospital of Nanjing were selected as the research subjects,and 42 healthy volunteers for a physical examination at the same period were selected as the control group.All fracture patients were treated with anticoagulant therapy after surgery,according to the different anticoagulants,the fracture patients were divided into the low molecular weight heparin(LWMH) group and the rivaroxaban group.On the day of the investigation,the control group was detected by TEG,and the TEG test was performed on all the patients during the perioperative period.Results There was no significant difference on the TEG test results between fracture patients and the control group(P>0.05),the TEG test results of fracture patients were normal,and the blood was not in the high coagulation state.On the 7th d of anticoagulant therapy and the end of anticoagulant therapy,the R value in the LWMH group and in the rivaroxaban group were the highest positive rate,were all more than 50%.At the end of the anticoagulant therapy,the abnormal detection rate of α angle,maximum thrombus(MA) and integrated coagulation index(CI) in the rivaroxaban group were 35.29%,32.35%,41.76%,respectively,were significantly higher than those in the LWMH group(8.82%,17.65%,11.76%),the differences were statistically significant(χ2=6.9283,5.7566,7.5556,P<0.05).After the end of the anticoagulant therapy for Doppler ultrasound,9 cases were diagnosed as DVT,and the incidence rate was 14.06%.Compared and founded,at the end of the anti coagulation therapy,the great value of the diagnostic indicators were α angle,MA and CI,the sensitivity was 64.71%,76.47%,73.53% respectively,and the specificity was 79.41%,73.53%,82.35% respectively.Conclusion After fracture surgery,the coagulation function of the patients are changed,using TEG dynamic detection can accurately understand the change of blood state in real time,and it has important reference value for the evaluation of blood coagulation function.With MA was equal to 68.35 mm as a clinical diagnosis of critical point.

Objective To investigate the effects of GMl on inducing adult rat MSCs to the neural progenitor cells and their descendants. Methods Purified MSCs were induced by basic fibroblast growth factor (bFGF) alone, GMl alone or by combination of bFGF and GMl. After 3 days of incubation, fibronectin and collagen I were detected by immunocytochemistry, and nestin by immunofluorescence. Neuron-specific enolase ( NSE) , glial fibrillary acidic protein ( GFAP) and galactose cerebroside ( GalC) were detected by immunocytochemistry after 7 days of incubation. Results After induction by bFGF alone or combination of bFGF and GM1, some MSCs exhibited the phenotypes of neural progenitor cells in 3 days, and then exhibited neurons and astrocytes in 7 days. In these two groups, cells positive for fibronectin and collagen I were decreased markedly after 3 days of induction. At the same time, cells positive for nestin were increased markedly. After 7 days of induction, NSE and GFAP-positive cells were increased significantly (22. 28% ?2. 97% and 26. 65%?3. 17% ). Furthermore, the combination of bFGF and GMl showed a maximal increase (30. 35%?3. 51% and 32. 22%?2. 68% ). But the GMl alone had shown no inductive effects. Conclusion Combination of bFGF and GMl might synergistically improve the neural induction of MSCs, showing a promising route for the application of MSCs.

Objective To evaluate the accuracy of bispectral index (BIS)-guided closed-loop target controlled infusion (TCI) system in comparison with opened-loop manual TCI during anesthesia of biliary tract and pancreas surgeries.Methods Forty adult patients undergoing open surgery of biliary tract or pancreas under total intravenous anesthesia, including 17 males and 23 females, aged 18-75 years, falling into ASA physical status Ⅱ or Ⅲ, were randomly allocated into closed-loop group (group C, n=20) and opened-loop manual group (group M, n=20).In group M, the propofol effect-site concentration was adapted at the discretion of the anesthesiologist to reach and maintain a BIS as close as possible to 42-52.In the closed-loop TCI group, propofol was administered using the closed-loop anesthesia delivery system to reach and maintain atarget BIS of 42-52.The BIS values would be recorded automatically by the system at each second after it began to run.The anesthesia duration, unconsciousness time, endotracheal intubation time, recovery time and endotracheal extubation time were recorded.The total usage of propfol and remifentanil were calculated.The incidence rates of emergence agitation, postoperative nausea and vomiting and intraoperative awareness were recorded.The frequencies of vasoactive drug were recorded.MDAPE, Wobble, GS through BIS values were calculated.Results BIS was maintained within ±10% of target (excellent) for significantly longer time in group C (52.1±10.5)% than that in group M (37.6±5.8)% (P<0.05).BIS was maintained within ±(10%-20%) of target (good) for the same time in both groups.MDAPE in group C (10.1±2.2)% were significantly lower than those in group M (15.3±6.4)% (P<0.05).GS in group C (23.1±8.9)% was significantly lower than that in group M (33.5±15.8)%.The usages of propofol in group C ·kg-1·min-1 were similar to those in group M (0.12±0.03) mg·kg-1·min-1, and the usages of remifentanil in group C (0.12±0.03) μg·kg-1·min-1 were similar to those in group M (0.15±0.05) μg·kg-1·min-1.The frequencies of vasoactive drug were similar in both groups.There was one incidence of emergence agitation in groups M.Postoperative nausea and vomiting and intraoperative awareness didn't occur in both groups.Conclusion The depth of the anesthesia is maitained more appropriately and stable in the closed-loop group than that in manual administration group.

BACKGROUND:As a kind of stressor, exercise-induced fatigue surely can lead to the material and functional changes of certain nerve nucleus within brain.It is still uncertain on what kind of nucleus closely relate to exer-cise-induced fatigue and what materials induce the functional or/and structural changes of tired central nerve.OBJECTIVE:To study the relationship between nitric oxide synthase (NOS) in ventromedial hypothalamic nucleus(VMH),dorsomedial hypothalamic nucleus(DMH) and exercise-induced fatigue.DESIGN:Randomized controlled study.MATERIALS:The experiment was completed in the Department of Human Anatomy of North University of China and Shanxi Medical University during October 2003 to January 2004.Twenty male Wister rats of clean class were selected.INTERVENTIONS:The rats were randomly divided into experimental group and control group with each of 10 rats.The rats in experimental group were made exercise-induced fatigue animal model by doing heavy load swimming until they were exhausted for 4 consecutive weeks. After the model was built,ABC immunohistochemical method was used to observe the expression of neuronal NOS (nNOS) in neurons of VMH ,and DMH and image analysis and statistic process were conducted.MAIN OUTCOME MEASURES:Number of nNOS positive cells in per unit visual field; Area and gray of positive substance.RESULTS:The number of nNOS positive cells in VMH of fatigue group was (25.25±7.35)/visual field which was much greater than that of control group (9.70±3.20)/visual field(P＜ 0.001).The area of nNOS positive substance was (3 867.75±1 940.41)μm2/visual field which was greater than that of control group(750.13±579.88)μm2/visual field(P ＜ 0.001). The number of nNOS positive cells in DMH of fatigue group was (30.25±7.87) /visual field which was much greater than that of control group (14.00±4.99) /visual field. And the area of nNOS positive substance was (4 512.06±1 243.93) μm2/visual field that was much greater than that of control group(782.46±711.46)μm2/visual field(P ＜ 0.001).CONCLUSION:The nNOS positive neurons in VMH and DMH neurons are closely related to the occurrence of central exercise-induced fatigue.Nitric oxide may play an important role in regulation of VMH and DMH to stress caused by fatigue.

Objective:To investigate the effect of licochalcone A on osteoarthritis in rats and its relationship with p38-MAPK inflammatory signaling pathway.Methods:A total of 160 male Wistar rats were randomly divided into blank non-intervention, blank intervention, arthritis non- intervention and arthritis intervention groups with 40 rats in each group. Rats in the arthritis groups were subjected to unilateral anterior cruciate ligament transection, while rats in the blank groups were only subjected to skin incision and suture. Rats in the intervention groups were treated by intra-articular injection of 1 mL 10 μmol/L licochalcone A for 8 successive weeks. Eight weeks later, the cartilage of rats in each group was stained with safranin, and osteoarthritis soft tissue was scored according to Osteoarthritis Research Society International guideline under the optical microscope. The cartilage was cultured in low glucose cell culture medium supplemented with 5% fetal bovine serum for 48 hours. The contents of nitric oxide, prostaglandin E 2, sulfated glycosaminoglycan and collagen II in the medium were determined by the chemiluminescence reaction method. The expression levels of p38, phosphorylated p38 (p-p38) and matrix metalloproteinase in cartilage tissue were detected by western blot assay. Results:The progress of osteoarthritis in rats treated with licochalcone A was slow. The Osteoarthritis Research Society International score in the arthritis intervention group was significantly lower than that in the arthritis non-intervention group [(3.8 ± 1.7) points vs. (9.7 ± 1.2) points, P = 0.0064]. The contents of nitric oxide, prostaglandin E 2, sulfated glycosaminoglycan, and collagen II in the arthritis intervention group were (77.84 ± 17.65) μmol/mg and (6.78 ± 1.76) ng/mg, (89.78 ± 9.76) μg/mg, and (1.78 ± 0.76) μg/mg, respectively, which were significantly lower than those in the arthritis non-intervention group [(107.56 ± 18.74) μmol/mg, (10.756 ± 1.87) ng/mg, (125.75 ± 8.87) μg/mg, (3.76 ± 0.88) μg/mg, (NO: P = 0.002; PGE 2: P < 0.001; sGAG: P < 0.001; Collagen II: P < 0.001). Western blot assay results revealed that the relative expression of p38, p-p38, p-p38 to total p38 ratio, matrix metalloproteinase in the arthritis intervention group were (3 454 ± 421), (2 072 ± 175), (0.65 ± 0.14 )and (1 776 ± 765), respectively, which were significantly lower than those in the arthritis non-intervention group (5 322 ± 323), (4 257 ± 184), (0.89 ± 0.11), (3 865 ± 874)( p38: P < 0.001; p-p38: P < 0.001; p-p38/p38: P = 0.002; MMP: P = 0.001). Conclusion:Licochalcone A can delay the progression of osteoarthritis in rats with osteoarthritis through inhibiting inflammatory reaction and cartilage matrix degradation, and p38-MAPK signaling pathway may be involved in the regulation process.

Objective To evaluate the clinical significance of high frequency ultrasonography in the diagnosis of annular pancreas in neonates.Methods Ultrasound results,clinical data,operation results and complicating deformity of 19 neonates were reviewed retrospectively.The digestive tracts of 19 neonates,including stomach,duodenum,jejunoileum and colon,were examined with 8-12 MHz linear transducer before surgery.Results Of 19 neonates with annular pancreas,17 cases were diagnosed with ultrasound,the diagnostic rate was 89％.The pancreas tissue encircling the descending duodenum was directly displayed as a direct sign of ultrasonography and the expansion of the proximal end of the duodenum was presented as an indirect sign of ultrasonography in 17 neonates.There were 3 neonates with annular pancreas complicating intestine malrotation and 2 neonates with annular pancreas complicating duodenal membraneous stenosis.One neonate was misdiagnosised and the other was missed.Conclusions High frequency ultrasonography plays an important role in diagnosing annular pancreas and other digestive deformity in neonates.It can be used as the first choice for the neonatal annular pancreas.

Objective To investigate the immune injury in genital tract of BALB/c mice induced by plasmid protein pORF5 of Chlamydia trachomatis and its possible mechanism.Methods GST(glutathione-S-transferases)-pORF5 fusion protein was expressed and digested with PreScission Protease to obtain the target protein without GST tag.After further purification and endotoxin removal,pORF5 protein was injected into the posterior fornix of BALB/c mice on day 1,3 and 6,while the control groups were injected with PBS or GST protein respectively,and then all the mice were sacrificed on day 7 to evaluate genital tract gross pathology and histopathological characterization.The levels of TNF-α,IL-1β and IL-6 in serum,splenocytes culture supernatant and vaginal douche were detected by ELISA.Results Mice in pORF5 group developed different degrees of swelling in isthmic portion and ampulla of uterine tube,connective tissue adhesion and hydrosalpinx in the genital tract tissues,while the PBS group and the GST group did not show any obvious change.The inflammatory score showed that the genital tract pathology in pORF5 group was much more severe than PBS and GST control groups (P＜0.O1).The levels of TNF-α,IL-1β and IL-6 in vaginal douche and splenocytes culture supernatants in pORF5 group were obviously higher than those of PBS and GST groups (P＜0.05).The levels of TNF-α and IL-1β in serum were also higher than those of GST and PBS groups (P＜0.01).Conclusion pORF5 plasmid protein could induce pathological immune response in the genital tract of BALB/c mice,which may be associated with the increase of the production of the inflammatory cytokines TNF-α,IL-1β and IL-6 in BALB/c mice.

Objective To evaluate the clinical features of in-stent restenosis after drug eluting stent (DES) implantation and investigate the relationship between different patterns of DES restenostic lesions and long-term prognosis.Methods All scoronary heart disease patients who underwent repeated pereutaneous coronary intervention (PCI) for DES in-stent restenosis from September 2006 to December 2009 were enrolled.All patients were divided into focal group and non-focal group according to the pattern of restenosis.All patients were prospectively followed up for major adverse cardiovascular event (MACE) including death,repeat PCI and myocardial infarction.Results Totally 88 patients (40 with focal restenosis,48 with non-focal restenosis) were enrolled.There were no significant differences between two groups in age,gender,risk factors,clinical presentation and medical therapy (P ＞ 0.05).Compared with that in focal group,the patients in non-focal group had a higher portion of in-segment restenosis [58.3％ (28/48) vs.12.5％(5/40),P＜ 0.01],higher stenosis rate [(78.1 ± 10.0)％ vs.(70.0 ± 9.7)％,P ＜ 0.01],more need for another DES[81.2％(39/48) vs.17.5％(7/40),P＜ 0.01],and longer stent implanted [(25.0 ± 7.0) mm vs.(17.4 ±3.4) mm,P ＜0.01].After following up for (2.2 ± 1.0) years,there were no significant differences between two groups in MACE and each component (P ＞ 0.05),however,compared with that in focal group,there was a trend of increase in MACE in non-focal group[22.9％(11/48) vs.10.0％(4/40),P=0.092].Conclusion It suggests that patients with non-focal restenosis have a more severe lesion angiographically,which usually results in another DES implanted,and has a worse long-term prognosis.

Objective To explore the shielding effect that Tween has made on the erythrocyte’ s surface antigen( ABO and D antigen mainly) and the stability of the RBC. Methods Various types red blood cells’ surface antigens were incubated with different concentrations of Tween,then the titers of RBC’ s surface antigen before and after incubation were compared. The erythrocyte’ s function alterations and sta-bility through the morphological obersavation,the osmotic fragility,RBC’ s own hemolysis rate,oxygen saturation( SO2 ) ,routine test of blood as well as the supernatant of free hemoglobin determination were confirmed. Results The masking effect of the Tween-20 on D antigen with the weaken titer keeping above“ +” was better and more stable than that on A,B antigen. The impact on B antigen was a little worse,and A was the worst. The advantaged concentration is about 0. 004%. Besides,the influence of Tween-80’s on B and D antigen was not apparent e-nough. Among all of the concentration,0. 74% and 0. 80% did a relatively better job,which also could keep the weaken titer above “ +”. Conclulsion The shielding effect that Tween has made on the erythrocyte’ s surface antigen( ABO and D antigen mainly) is stable,which keeps above “ +”. The morphology and function of the RBC does not change.