Objective To establish animal model of guinea pig anaphylactic shock ,explore the expression of IL‐4 and IL‐10 in guinea pig serum ,provide scientific and objective evidence for medicolegal and clinical diagnosis of anaphylactic shock as well .Meth‐ods After 40 guinea pigs were classified into the experimental and the control groups ,in which the experimental group was 30 and the control group was 10 ,Elisa method was used to detect IL‐4 and IL‐10 by extracting serum of guinea pigs in the experiment group and the control group .Results The IL‐4 levels of serum in experimental group was higher than that in control group (P<0 .01);the IL‐10 levels of serum in experimental group was higher than that in control group (P<0 .01) .Conclusion The level of serum IL‐4 and IL‐10 in the experiment group are obviously higher than that of the control group .This provides an evidence for an‐aphylactic shock forensic identification and clinical diagnosis .

Primary light-chain (AL) amyloidosis is a rare, fatal and clonal plasma cell dyscrasia. The bortezomib-based treatment has improved the survival of AL amyloidosis patients, but the prognosis of advanced patients is still poor. More effective novel agents are urgently needed. At the 62nd American Society of Hematology (ASH) Annual Meeting, the clinical data of a variety of new drugs (such as anti-CD38 monoclonal antibody, bcl-2 inhibitor combined with statins and CAEL-101, etc.) were reported.

Objective To investigate the characteristics and cytocomptibility of porcine aorta fixed with genipin in vitro and to provide the proper biomaterials for fabrication of esophageal prosthesis. Methods The porcine aortas were treated by genipin for 7min to 7days, were then examined with naked-eye and light microscope. Subsequently, the fixation index determination and the biomechanics test were also performed. The cytotoxicity of the genipin-fixed materials was evaluated in vitro by MTT assay using a mouse -derived established cell line of L-929 fibroblasts as test cells. Results The experimental results indicated that the antigenicity of porcine aorta tissues could be diminished by genipin through getting rid of cell in the porcine aorta tissues and reducing the level of free amino groups in the porcine aorta tissues. The structural integrity of porcine aorta tissues can be preserved after treating with genipin. It was also found that the genipin-fixed porcine aorta tissues appeared more toughness and visco-elasticity. The RGR of genipin-fixed porcine aorta tissues was high which presumed a low cytotoxicity of this material. Conclusion The Genipin-fixed porcine aorta should be a promising material for fabricating esophageal prosthesis or fabricating scaffold of tissue-engineered esophagus.

Objective:To investigate the mechanism responsible for lost sensibility of tyrosine aminotransferase(TAT)to dexam- ethasone(Dex)in human hepatoma cell line SMMC-7721 through examining the cDNA sequence of TAT and the status of glucocorticoid receptor(GR)pathway.Methods:The TAT cDNA fragment containing the full length of coding sequence was amplified by reverse transcription-polymerase chain reaction(RT-PCR)and was sequenced.The expression of TAT mRNA was determined by real-time quantitative PCR to observe the influence of Dex on expression of TAT mRNA in SMMC-7721 cells.The experiement with HepG2 cells was performed as the control.Reporter genes(GRE-tk-LUC and GRE-MMTV-CAT)were transiently transfected into SMMC-7721 cells by electroporation.The induction efficiencies of LUC and CAT genes expression by Dex were examined and compared between SMMC-7721 cells and HepG2 cells.Results:The results showed that there was a same-sense mutation(Gln576Gln)in TAT cDNA se- quence.TAT mRNA could be induced by Dex,with the maximal induction level being 2.22-folds in SMMC-7721 cells,which was signifi- cantly lower than that in HepG2 cells(15.1-fold increase,P

Objective To investigate the effects of dexmedetomidine preconditioning on nitric oxide (NO)/endothelin (ET)-1 imbalance and remote lung injury induced by lower limb ischemia-reperfusion (LIR). Methods Sixty patients who scheduled for unilateral lower extremity surgery matched American Society of Anesthesiologists (ASA) Ⅰ-Ⅱ, were randomized into two groups:control group (R group, n=30) and dexmedetomidine preconditioning group (PD group, n=30). Lumbar plexus combined with sciatic nerve block was performed guided by a nerve stimulator in both groups. In group PD, dexmedetomidine intravenous infusion was started at a dose of 0.125 mL/kg (4 mg/L) for 10 minutes before using tourniquet, whereas group R received an equivalent volume of normal saline. Artery blood gas analysis, respiratory index and oxygenation index were measured, and NO, ET-1, interleukin-8 (IL-8) and malondialdehyde (MDA) concentrations were determined from plasma samples 10 minutes before tourniquet inflation (T0), 15 minutes (T1), 2 h (T2), 6 h (T3) and 24 h (T4) after tourniquet deflation. Results Compared with T0, RI was higher at T3 in group R and OI was lower at T2-4 (P＜0.01). There were no significant differences in RI and OI of group PD between different time points (P＞0.05). In R and PD groups, ET-1, IL-8 and MDA concentrations were increased, while NO level and NO/ET-1 ratio were significantly decreased after tourniquet deflation (P＜0.05). Compared with group R, RI was lower and OI was higher at T3 in group PD (P＜0.01). The levels of ET-1, IL-8, MDA, NO and NO/ET-1 ratio were significantly different after tourniquet deflation between group PD and group R (P＜0.05). In group R, there was positive correlation between ET-1 and IL-8 levels with RI, and negative correlation between ET-1 and IL-8 levels with OI (P＜0.01). There was positive correlation between NO level, NO/ET-1 ratio and RI level (P＜0.01). Conclusion Lung function impairment induced by tourniquet application could be attenuated by dexmedetomidine preconditioning based on protecting endothelial cells and inhibiting lipid peroxidation.

ObjectiveTo prospectively evaluate the therapeutic effect of Alvenor on symptoms and signs of chronic venous insufficiency of lower extremities.MethodAccording to preset criteria, 133 patients from 8 hospitals in Hangzhou, Beijing, Guanzhou and Shanghai were recruited into this study including 78 males (58.6%) and 55 females (41.4%). The average age was 23～77 (55?13) years. The illness course was from 1～50 years with a mean of (11?11) yrs. Other therapeutic modalities were adopted in 34 before inclusion into this study and 38 cases (28.8% ) had suffered from certain complications. Classification was first defined when the patient was enrolled and clinical symptoms and signs were evaluated. Alvenor was given 500?mg, twice a day orally. Reevaluation and record by the same criteria was carried out 15, 30, and 60 days after treatment, and statistical analysis was conducted. ResultsSwelling, heaviness, spasm, and pain, etc, were statistically improved. ConclusionsAlvenor is effective in the treatment of symptoms and signs of chronic venous insufficiency of the lower extremities.

Objective:To analyze the therapeutical effect of Irbesartan for coronary atherosclerosis mice ( ApoE-/-) and its possible mechanisms. Methods: A total of 16 male ApoE-/- mice were randomly divided into control group and Treatment group [Irbesartan,50 mg/(kg·d),4 weeks]. HE,immunofluorescence,Western blot and ELISA were performed to analyze the effect of Irbesartan on ApoE-/- and the changes of related signaling pathways. Results: Compared with control group,the treatment group had lower atheroma macular areas and inflammatory cytokines in blood vessel (P<0. 05). Treatment group had lower levels of leptin,but higher levels of PPAR-γ and adiponectin in perivascular adipose tissues ( PVAT ) than these of control group, the difference were statistically significant ( P<0. 05 ) . Western blot and immunofluorescence analysis shown that Irbesartan treatment significantly depressed the expression of p-p65 and p-IKK in PVAT when compared with these of control group (P<0. 05). Conclusion:Irbesartan has significantly therapeutic effect on ApoE-/-mice,the possible mechanisms including anti-inflammatory effects in PVAT,improved the adipose tissue function and regulated the PPAR-γ-NF-κB signaling pathways.

Objective To investigate the clinical efficacy of endovascular treatment for iliac vein compression syndrome (IVCS) in 112 cases. Methods From September 2011 to June 2015, 112 cases of IVCS (Cockett syndrome) were treated in our hospital with endovascular methods .The case numbers of different CEAP ( clinical etiological anatomical pathophysical ) classifications were C2 (45 cases), C3 (23 cases), C4 (19 cases), C5 (11 cases) and C6 (14 cases).All the cases were diagnosed by venography .The operations started from puncturing the ipsilateral veins .The stenotic degree and compressed intensity of iliac vein were evaluated by the minimum diameter with low pressure balloon .And then a stent was placed into after percutaneous transluminal angioplasty ( PTA) when residual stenosis was more than 50%.The occlusive segment was dilated by 8 mm diameter balloon firstly , and catheter directed thrombolysis treatment was applied if thrombus was detected .The PTA and stenting were performed when the thrombus was completely removed .The improvement of clinical symptoms was observed after operation and the patients were followed up by ultrasound and venograghy . Results Nine cases were given PTA only , and the other 103 cases underwent stent placement . Postoperative venography showed collateral vessels were disappeared in 22 cases, obviously decreased in 56 cases and mildly decreased in 34 cases.The average difference of swelling leg ’s circle was diminished from (2.56 ±0.88) cm pre-operation to (0.93 ±0.71) cm post-operation, while the average area of skin ulcer was diminished from (6.34 ±3.78) cm2 pre-operation to (2.13 ±1.88) cm2 post-operation, all of which were statistically significant (t =20.24 and 7.19,P=0.000).A total of 86 cases were successfully followed up during a period from 2 months to 45 months (average, 19.2 months).The patency rate of treated iliac vein 12 months after operation was 76.2%in the PTA group, and in the PTA with stenting group was 96.7%, 88.6%, and 86.1%, respectively, at 12, 24, and 36 months after operation, in which a statistical significance was detected (log-rank χ2 =30.32, P=0.000).The patency rate in diameter ≥16 mm group was 95.2%and 95.2%, respectively, at 12 and 24 months after operation, while in diameter <16 mm group was 97.0%and 93.3%, respectively, in which no statistical significance was detected (log-rankχ2 =0.39, P=0.532).Thrombotic complication was found in 2 cases during the follow-up period , including 1 case of iliac vein thrombosis at 1 month and 1 case of thrombus in contralateral leg 8 months later .According to the results of venography in 78 cases at 12 months after operation , restenosis was found in 5 out of 6 cases in the PTA group, and the patency rate in the stent placement group was 95.8%(69/72).No stent migration was found . Conclusion Comfortable clinical results were obtained after endovascular therapy for iliac vein compression syndrome , and the application of stenting could increase the middle and long term patency rate of treated vessels .

Objective To investigate the clinical manifestations and diagnosis and treatment of aortic dissection(AD).Methods The clinical data of 20 patients with aortic dissection were analyzed retrospectively.Results 20 patients were diagnosed by CT, MRI and colour ultrasonography (5,5,10 cases, respectively). According to DeBakey typing, this group of patients was composed of type I(11 cases, 55%), type II(2 cases, 10%)and type III (7 cases, 35%). All patients were treated with internal medicine ,average time in hospital stay was(29 8?25 5)days. The patients' conditions were improved in 19 person-times (76%). 4 patients died (20%) and 2 patients abandoned treatment (8%).Conclusions The accurate diagnosis as early as possible and active therapy was a key of improvment of prognosis in patients with aortic dissection.

Objective Toinvestigate the relationship between red blood cell volume distribution width (RDW) and acute coronary syndrome (ACS),and the correlation between RDW and degree of coronary artery stenosis. Methods A total of 221patients accepting coronary angiography were involved as ACS group and another 50 patients also accepting coronary angiography as normal control group. ACS group wasfurther divided into unstable angina (UA) group of 77 cases and acute myocardial infarction (AMI) group of 144 cases ,then their level of RDW was detected. According to Gensini score ,we divided the 221 positive cases of coronary angiography into ≤ 30 point group ,31-60 point group and > 60 point group and their level of RDW was detected. Results The level of RDW in ACS group(13.02 ± 0.68)was significantly higher than that innormal control group(12.62 ± 0.38),and the difference was statisticallysignificant(P < 0.05). And the difference between UA group(12.84 ± 0.68)and AMI group(13.12 ± 0.66)also showed statistical significance(P < 0.05). With the increase of Gensini score ,the level of RDW was also increased ,and the difference between each two groups was statistically significant (P < 0.05) except that between control group and ≤ 30 point group. Conclusions The level of RDW in ACS group and AMI group is significantly higher ,suggesting that RDW may be involved in the pathogenesis of acute coronary syndrome ,and the RDW level could be a potential indicator of ACS. RDW level is closely related to the severity of coronary stenosis and could be one of its predictors.