Abstract BACKGROUND: Sodium hyaluronate is an effective treatment for osteoarthritis, but the underlying mechanism remains unclear. There is evidence that abnormal expressions of matrix metaloproteinase (MMP)-1, -3 and -9 and tissue inhibitor of metaloproteinase (TIMP)-1 and -2 show great effects on osteoarthritis. OBJECTIVE: To assess the influence of intra-articular injection of sodium hyaluronate on expressions of MMPs-1, 3, 9 and tissue inhibitor of TIMPs-1, 2 in the rabbit cartilage after osteoarthritis. METHODS: Twenty-four mature New Zealand white rabbits were divided into normal control, model, and sodium hyaluronate groups. The model and sodium hyaluronate groups underwent unilateral anterior cruciate ligament transection, and rabbits in the sodium hyaluronate group received 0.3 mL of 1% sodium hyaluronate via intra-articular injection at 4 weeks after modeling, once a week for 5 weeks. At 11 weeks folowing surgery, the rabbits were kiled and the cartilage was harvested to extract total RNA. mRNA expressions of MMPs-1, 3, 9 and TIMPs-1, 2 in the cartilage were analyzed using real-time PCR for each group. RESULTS AND CONCLUSION:Compared with the model group, the range and extent of cartilage damage was reduced in the sodium hyaluronate group (P < 0.01), and Mankin scores were noticeably decreased (P < 0.05). In the cartilage, mRNA expressions of MMPs-1, 3, 9 were enhanced and mRNA expressions of TIMPs-1, 2 were down-regulated in the model group. However, the mRNA expression levels of MMPs-1, 3, 9 and TIMPs-1, 2 in the articular cartilage were not obviously changed in the sodium hyaluronate group. These results suggest that MMPs-1, 3, 9 and TIMPs-1, 2 are involved in the progression of osteoarthritis and the therapeutic mechanism of sodium hyaluronate is not realized through the down-regulation of their expressions during development of osteoarthritis. Sodium hyaluronate for treatment of osteoarthritis is a complex process and the underlying mechanisms require further investigation.

Objective:To observe acid-base and biochemical changes in clinical orthotopic liver transplantation with veno-venous bypass.Method,Seven patients receiving orthotopic liver transplantation, veno-venous bypass was undergone in anheptic phase.The acid-base and biochemical parameters were monitored during operation. Result:Compared to preoperation,pH decreased a little in each phase,BE and SBC slightly decreased 60 min following bypass and during skin closure. Compared to before bypass,pH had no changes during bypass and new liver phases. The serum Ca~(2+) level decreased and serum glucose level elevated in each phase,The temperature gradually decreased during operation. The serum K~+ level was transiently elevated from 3.17mmol/L to 3.53 mmol/L early after the heptic revascularizaton. Conclusion:With the application of the veno-venous bypass technique,the hazard of acid-base and biochemical changes can be reduced during orthotopic heptic transplantation.

BACKGROUND:In recent years, repair of articular cartilage injury has become an important field in basic medical research. Because injured articular cartilage is difficult to repair, the repair of articular cartilage injury has become a difficult hotspot.

BACKGROUND:Mesenchymal stem cels, underin vivo orin vitro specific induction conditions, can differentiate into the cartilage, muscle, tendons and so on. Clinical trials concerning mesenchymal stem cels mainly include tissue repair (such as bone, cartilage and joint repair) and treatment of heart, liver, spinal cord injury and nervous system diseases.
OBJECTIVE:To compare the biological characteristics of mesenchymal stem cels from different sources.
METHODS: PubMed and CNKI databases were retrieved for articles related to sources of mesenchymal stem cels and biological characteristics of mesenchymal stem cels published from 1987 to 2015. The retrieved articles were summarized and analyzed in the folowing aspects: cel surface marker, proliferation, differentiation, migration, and function, so as to explore the merits and demerits of mesenchymal stem cels from different sources.
RESULTS AND CONCLUSION:A difference in the proliferation ability and surface markers is found between different sources of mesenchymal stem cels. Immunological competence of mesenchymal stem cels from different sources may be correlated with their activation status, species differences, tissue sources and culture conditions, resulting the immunological competence of mesenchymal stem cels from different sources is not exact the same. In-depth understanding of the factors and mechanisms by which influence the migration of mesenchymal stem cels from different sources can enhance the migration ability of different sources of mesenchymal stem cels, and increase their efficiency in wound healing, tissue repair and regeneration treatment.

BACKGROUND:Osteoarthritis is a joint disease that primarily affects the cartilage. With the changes of the extracelular matrix, chondrocytes appear to have apoptosis. Vascular endothelial growth factor plays an important role in promoting endothelial cel division and proliferation and inducing angiogenesis. Hypoxia-inducible factor is a celular transcription factor and produces different reactions due to the oxygen content. Vascular endothelial growth factor and hypoxia-inducible factor are focused on inhibiting chondrocyte apoptosis. OBJECTIVE:To elaborate the effects of vascular endothelial growth factor and hypoxia-inducible factors on chondrocyte apoptosis. METHODS: Recent literatures related to chondrocyte apoptosis were summarized and analyzed. During the process of osteoarthritis, changes in vascular endothelial growth factors in chondrocytes and regulatory effects of vascular endothelial growth factor and hypoxia-inducible factor on chondrocyte apoptosis were elaborated.

Objective To observe the incidence of fragmented QRS complex (fQRS)and ST Segment depression fQRS (STD fQRS)during the first 48 hours after non-ST elevation myocardial infarction(NSTE MI)and discuss the value of predicting mortality in patients with NSTE MI .Methods Based on the ECGs ,the patients with NSTE MI were divided into two groups :fQRS and non fQRS group .And then fQRS group was divided into two sub-groups :STD fQRS and non-STD fQRS group .Their mortality was studied during long-term follow-up .Results (1)731 patients with NSTE ACS [the NSTE MI group(n=609) and the UA group(n=122)] were studied .The incidence of fQRS in the NSTE MI group was higher than that of the UA group .(2)All cause mortality in the fQRS group were higher than that in the non-fQRS group ,and all-cause mortality in the STD fQRS group were higher than that in the non-STD fQRS group ,all the above results were not only in the early stages of NSTE MI ,but also in the long term fol-low-up .(3) Multivariate Cox regression analysis revealed that STD fQRS was an independent significant predictor for all cause mortality ,but not of the fQRS .Conclusion The STD fQRS may be an independent predictor of mortality in patients with NSTE MI .

BACKGROUND:Studies have found that vascular endothelial growth factor and hypoxia inducible factor are involved in the development process of osteoarthritis, but their correlation is rarely reported. OBJECTIVE:To observe the expression and correlation of hypoxia inducible factor-2α and vascular endothelial growth factor in chondrocytes of articular cartilages in human osteoarthritis. METHODS: Articular cartilage specimens were colected from 50 patients with knee osteoarthritis undergoing total knee joint replacement. According to the joint Kelgren-Lawrance (K-L) X-ray grouping classification standard, there were 18 cases of K-LIII level and 32 cases of K-LIV level. Besides, articular cartilage specimens from 10 patients undergoing amputation for legs tumor or traffic accident served as control group. Hematoxylin-eosin staining, Safranin O-Fast Green staining and Mankin scoring were performed to observe and evaluate the histological characteristics of articular cartilages of each group, immunohistochemical staining was conducted to detect the expression of hypoxia inducible factor-2α and vascular endothelial growth factor in chondrocytes of articular cartilages, and their correlations were analyzed. RESULTS AND CONCLUSION:The Mankin score of K-LIV group was significantly higher than those of K-LIII group and control group. Immunohistochemical staining revealed that the number of chondrocytes with positive expression of hypoxia inducible factor-2α or vascular endothelial growth factor in K-LIV group was significantly higher than that in K-LIII group and control group (P < 0.05). The expression of hypoxia inducible factor-2α and vascular endothelial growth factor increased in chondrocytes of articular cartilages of osteoarthritis patients, and to up-regulate the expression of vascular endothelial growth factor may be the regulatory mechanism of hypoxia inducible factor-2αinthe pathogenesis of osteoarthritis.

BACKGROUND:Articular cartilage repair has been a difficulty in the clinical setting, which is mainly treated with autologous or al ogeneic osteochondral grafts, and cartilage periosteum or periosteum grafts. However, the limited source, secondary lesion and immunological rejection force some researchers to search for a novel treatment strategy, cartilage tissue engineering, that is of great significance for cartilage regeneration and repair. OBJECTIVE:To investigate the tissue-engineered scaffolds for the repair of articular cartilage defects. METHODS:The first author searched the PubMed and WanFang databases for the articles addressing tissue-engineered cartilage for articular cartilage defects published between 1991 and 2015 using the keywords“articular cartilage defect, scaffold, tissue engineered cartilage”in English and Chinese, respectively. The irrelative and repetitive literatures were excluded. RESULTS AND CONCLUSION:Final y 48 eligible literatures were enrol ed based on the inclusion and exclusion criteria. Cartilage tissue engineering possesses the advantages of control ability, little damage to tissue itself, and biological repair of injured cartilage. Tissue-engineered scaffold material is a critical factor in tissue engineering construction;therefore, it should hold biodegradability and histocompatibility. The commonly used scaffold materials include natural macromolecule materials (col agen, silk fibroin and chitosan), and synthetic polymer materials (polylactic acid and tricalcium phosphate). It is necessary to prepare composite scaffolds with high bioactivity integrate advantages of each material. The tissue engineering is bound to be a hotspot in the field of articular cartilage repair.

Objective To explore the methods and effects of case management model in nursing care of patients with chronic kidney disease ( CKD) , so as to provide effective evidence for the model′s promotion in the clinic and provide the reference for specialist nursing development.Methods Base on consummated health education materials and fully preparation work, we chose experienced nurses, who were selected according to competence and trained as case managers, to take care of forty patients with CKD during January to June 2013 as experimental group.A total of forty CKD patients accepted routine nursing carein the January to June 2012 as control group.We compared the treatment compliance and renal function, other indicators measurement at discharge and 6 months after discharge, and hospital readmission rate between two groups within 6 months were measured and compared.Results After 6 months discharge,patients′treatment compliance in the experimental group (46.5 ±3.8) was better than that of the control group (39.2 ±4.8) (t=-8.912;P<0.01).In the experimental group, BUN,SCr and Cys were (10.37 ±2.73) mmol/L, (362.35 ±65.76)μmol/L and(3.62 ± 0.69)mg/L respectively compared (12.13 ±2.49)mmol/L, (412.90 ±88.43)μmol/L and (4.04 ±0.87)mg/L respectively in the control group, and all these of data in the experimental group were lower than these in the control group (t=-3.685, -3.132, -2.431,respectively;P <0.05), but data between discharge and discharge after six months had no differences (t =1.671, -0.955,0.466,respectively;P >0.05).The readmission rate was 12.5%in the experimental group compared with 37.5%in the control group ( Z=6.667, P<0.05).Conclusions Case management model can improve the patients′treatment compliance, improve disease control, reduce hospital readmission rate, and is an effective nursing model to adapt development of the new period.

Objective To explore the diagnostic value of 18F-FDG PET/CT in biliary obstruction.Methods Totally,28 biliary obstruction patients were divided into benign obstruction group (n =11) and malignant obstruction group (n =17)according to the cause of obstruction.Imaging characteristics of 18F-FDG PET/CT and maximal standard uptake value (SUVmax) were compared between the two groups.Efficacy of PET/CT and MRI in the diagnosis of obstructive jaundice were compared.Results In 28 cases,no or mild dilatation of biliary tract accounted for 53.57％ (15/28),moderate to severe dilatation of biliary tract accounted for 46.42％ (13/28).Among the malignant obstruction group,2 cases of hilar cholangiocarcinoma,5 cases of bile duct carcinoma,6 cases of carcinoma of the head of pancreas,and 4 cases of ampullary carcinoma were included,18F-FDG PET/CT showed proximal high metabolic nodules of the obstruction site in 14 cases.Among the benign obstruction group,7 cases were bile duct inflammatory stricture,of which 4 cases with bile duct stones.18F-FDG PET/CT showed a slight increase with patchy or nodular mild metabolism in 6 cases.There were 4 cases of autoimmune pancreatitis.The imaging 18 F-FDG PET/CT demonstrated multi-segmental or multiple nodular enlargement of the pancreas,with generally increased metabolism.SUVmax of malignant obstruction group (6.88± 2.81) was significantly higher than that of benign obstruction group (4.20± 1.70;t=3.143,P＜0.05).The sensitivity,specificity and accuracy of 18F-FDG PET/CT and MRI in the diagnosis of malignant obstructive jaundice were 94.12％ (16/17) and 58.82％ (10/17;x2=4.086 5,P=0.043),81.82％ (9/11) and 63.64％ (7/11;x2=0.229 2,P=0.632),89.29％ (25/28) and 60.71％ (17/28;x2 =4.666 7,P=0.031),respectively.Conclusion 18F-FDG PET / CT has a great value in the diagnosis of obstructive jaundice,which is of great significance for clinical decision-making.