A total of 20 patients with massive hemorrhage for pelvic fracture, underwent angiographic embolization with gelfoam sponge embolization agents in 3-8 hours after admitted at the Department of Orthopedics, Changhai Affiliated Hospital of Second Military Medical University of Chinese PLA between January 2001 and August 2003 were selected. The patients aged ranged from 18-70 years (mean 43.4-year-old), including 12 male and 8 female. Conduits were inserted into the internal iliac artery embranchment of 8 cases with method of ultraselection, and gelfoam sponge grain and contrast medium were injected together. Conduits combined with gelfoam sponge grain and contrast medium were inserted into 12 cases’ pathic internal iliac artery bole. The whole 20 cases were performed endovascular embolization, and blood pressures turned to normal level after operation gradually without serious complications of embolization. One case died of deterioration after blood pressure stabilization. The result reveals that anglo-graphic embolization with gelfoam sponge embolization agents is a safe, quick and effective method of controlling the severe hemorrhage caused by pelvic fracture.

Objective To explore the relationship between blood lipids and creatinine clearance (Ccr)in aged patients with coronary heart disease(CHD).Methods According to coronary artery angiography(CAG)and Ccr,784 subjects aged 65 years and over were divided into groups and Their lipid levels were compared.Results With increasing lesion of coronary branches,the level of Ccr was obviously decreased(F=5.35,P＜0.01).The level of apolipoprotein A1(ApoA1)was reduced and apolipoprotein B(ApoB)enhanced in renal function of moderate-severe injury(CCr＜0.83 ml ·s-1 · 1.73m-2)(F=5.31,F=4.91,both P＜0.01).The level of ApoA1 was decreased(F=3.52,P＜0.05)and Apo B increased(F=5.65,P＜0.01)in male renal function of moderate-severe injury.The levels of ApoA1 decreased(F=5.79,P＜0.01),ApoB increased(F=4.56,P＜0.05)and high density lipoprotein-cholesterol reduced(F=3.39,P＜0.05)in CHD with renal group of moderatesevere injury.Multi-logistic regression analysis showed that Ccr,HDL-C,ApoA1 and ApoB were influencing factors of CHD.Conclusions Abnormal blood lipid and renal dysfunction are risk factors of CHD,dyslipidemia may induce renal dysfunction.It is important to control lipids and improve other organ functions in the aged patients with CHD.

Objective To explore the relationship between B-type natriuretic peptide (BNP) and fibrinogen (Fib) in the elderly patients with coronary heart disease (CHD). Methods According to the level of BNP,325 subjects aged more than 65 years were divided into four groups,BNP:≤32.4ng/Lgroup,32.5～62.3 ng/Lgroup,62.4～162.5 ng/Lgroup,＞162.5 ng/L group.The levels of left ventricular ejection fraction (LVEF),left ventricular end-diastole dimension (LVEDD) and Fib were compared among the groups. Results With increasing BNP level,the LVEF was gradually decreased [(63.3±8.2)％,(59.6±7.4)％,(57.9±9.7)％,(55.2±10.6)％] and the level of LVEDD was increased[(50.5±4.7)mm,(51.4±5.4)mm,(52.8±5.7)mm,(54.2±5.9)mm ;F=11.54,6.76,both P＜0.01],the level of Fib was enhanced [(3.4±0.7)g/L,(3.7±0.8)g/L,(3.8±1.1)g/L,(4.2±1.0)g/L; F=8.02,P＜0.01].The level of BNP had positive correlation with Fib (r=0.25,P＜0.01). Multi-linear regression analysis showed that Fib and LVEF were influencing factors of BNP (t =2.92, - 3.15, both P ＜ 0.01 ). Conclusions The BNP level is helpful to diagnose heart failure and assess heart function.There is an association between BNP and Fib level.

Objective To explore the correlation of B-type natriuretic peptide (BNP) with blood lipids and renal function in elderly patients with coronary heart disease (CHD).Methods According to the four quantiles of BNP level,325 subjects aged 65 years and over were divided into four groups:group A (≤32.4 ng/L),group B (32.5 ng/L),group C (62.4 ng/L),group D (＞ 162.5 ng/L).The left ventricular ejection fraction (LVEF),left ventricular end-diastole dimension (LVEDD),levels of blood lipids and renal function were compared among the groups.Results With the increase of BNP level,the LVEF was gradually decreased [(63.3±8.2) ％,(59.6±7.4) ％,(57.9±9.7)％,(55.2±10.6)％,respectively,F=11.54,P＜0.01] and the LVEDD was gradually increased (F=6.76,P＜0.01),the level of triglyceride (TG) was gradually decreased (F=2.73,P ＜0.05) in group A,B,C and D.Creatinine clearance was gradually decreased [(1.24±0.31) ml ·s-1 · 1.73 m-2,(1.21±0.31) ml· s-1 · 1.73 m-2,(1.24±0.29) ml · s-1 · 1.73 m 2,(1.09± 0.33) ml · s-1 · 1.73 m-2,respectively,F=3.62,P＜0.05],and blood urea nitrogen was gradually increased (F=4.43,P＜0.05) in group A,B,C and D.Multi-linear regression analysis showed that levels of total cholesterol,triglyceride,low density lipoprotein-cholesterol,high density lipoproteincholesterol,very low density lipoprotein-cholesterol,creatinine clearance and blood urea nitrogen were influencing factors for BNP (all P＜0.05).Conclusions BNP level can be used as a sensitive indicator for the diagnosis of heart failure and the assessment of its severity.The levels of blood lipids and renal function are associated with BNP.

Background Pulmonary fibrosis currently lacks screening and diagnostic methods in the early stages and effective treatments in the later stages, so there is an urgent need to explore the mechanisms and develop targeted treatments. Objective To screen the expression of differentially expressed circular RNA (circRNA) hsa_circUCK2 under pathological conditions and to explore its effect on pulmonary fibrosis. Methods In the cell-based experiments, hsa_circUCK2 was knocked down in HPF-a cells using small interfering RNA (siRNA), and HPF-a cells were stimulated by TGF-β1. Four groups were set up: si-NC group, si-circUCK2 group, si-NC+TGF-β1-treated group, and si-circUCK2+TGF-β1-treated group. Western blot assay was used to detect the expression of fibronectin (FN1) in HPF-a cells of the four groups, scratch assay was used to detect the migration ability of HPF-a cells, and CCK-8 assay was used to detect the proliferation ability of HPF-a cells in the two groups with TGF-β1 stimulation, the si-NC+TGF-β1-treated group and the si-circUCK2+TGF-β1-treated group. In the animal experiments, forty-eighty healthy SPF-grade male C57BL/6 mice were randomly divided into four groups: saline+si-con group, saline+si-circ_0000115 group, SiO₂+si-con group, and SiO₂+si-circ_0000115 group. Mouse lung circRNA mmu_circ_0000115 (mouse homolog of hsa_circUCK2) was knocked down by tracheal drip injection of siRNA, and a mouse lung fibrosis model was constructed by tracheal drip injection of SiO₂ suspension (0.2 g·kg⁻¹, 50 mg·mL⁻¹) after 48 h. Real-time fluorescence quantitative PCR was used to detect the knockout efficiency in each organ of the mouse, Western blot was applied to detect the expression of type I collagen α2 (COL1A2) in the lung tissues, and Sirius red was used to detect collagen synthesis in the lung tissues. Results In the cell-based experiments, after the knockdown of hsa_circUCK2, the Western blot results showed that the expression level of the FN1 protein in TGF-β1-stimulated HPF-a cells was significantly down-regulated (P <0.05); the CCK-8 assay and cell scratch assay showed that the down-regulation of hsa_circUCK2 gene significantly inhibited the proliferation and migration of HPF-a cells (P<0.01). In the animal experiments, the real-time fluorescence quantitative PCR results showed that among the detected organs, mmu_circ_0000115 was significantly knocked down only in the lung tissues (P<0.0001); the Western blot results showed that knocking down mmu_circ_0000115 significantly reduced the COL1A2 protein expression level when compared with the SiO₂+si-con group (P<0.0001); the Sirius red results showed that knocking down mmu_circ_0000115 significantly reduced collagen production and deposition in lung tissues of mice in the model group. Conclusion Knockdown of hsa_circUCK2 inhibits fibroblast activation and reduces collagen deposition in lung fibrosis model mice. It is suggested that the hsa_circUCK2 is involved in the process of pulmonary fibrosis and may be a potential therapeutic target for pulmonary fibrosis.

BACKGROUND:For autoimmune diseases, it is difficult to effectively solve the lack of immunological tolerance in patients by traditional treatments. Mesenchymal stem cells have the biological functions of tissue and organ regeneration and immune regulation. OBJECTIVE:To explore the effects and mechanisms of human umbilical cord-derived mesenchymal stem cells on the development of thymus in nude mice. METHODS:Human umbilical cord-derived mesenchymal stem cells were intraperitoneal y injected into BABL/c nude mice at a dose of 2×106 per mouse. We analyzed the maturation and distribution of thymic epithelial cells in the thymus rudiment of nude mice and the thymopoiesis of this newly developed thymus rudiment;furthermore, we explored the therapeutic effects of human umbilical cord-derived mesenchymal stem cells. RESULTS AND CONCLUSION:Our data showed wel-organized cortex-medul a structure and an obvious improvement in the maturation of thymic epithelial cells in the rudiment. We further demonstrated the improved thymopoiesis and the enhanced export of mature T cells with the T regulatory cells increase in peripheral blood. Furthermore, we found that human umbilical cord-derived mesenchymal stem cells could be engrafted in the thymus and express many cytokines, especial y keratinocyte growth factor which is essential for the thymus development. These findings indicate that a new mechanism of human umbilical cord-derived mesenchymal stem cells can provide a proper microenvironment for the reconstitution and functional maturation of thymus in nude mice, and elicit another insight in terms of therapeutic efficacy of human umbilical cord-derived mesenchymal stem cells in many autoimmune diseases.

Objective:To investigate the function of CD 59 in LAT induced T lymphocytes'proliferation and activation.Methods:Transfected LAT-GFP recombinant lentiviral vectors into Jurkat cells and established a fusion-protein stable express cell line ( Jurkat-GFP ).Junket-GFP cells were transfected with pSUPER-siCD59 plasmids by electroporetion or stimulated by anti-CD59 antibody.The cellular locations of CD 59 and LAT were observed under fluorescence microscope with the immunofluorescence cytochem -istry.The cells proliferation were measured by MTT assay.Furthermore,Western blot was used to detect the total and phosphorylation levels of several down-stream proteins after T cell activated .Results: Jurkat-GFP cells successfully transfected with pSUPER-siCD59 plasmids showed lower fluorescence staining.CD59 and LAT distributed uniformly on the cell surface before stimulated with anti-CD59 antibody and formed clusters once upon stimulation.Jurkat-GFP cells stimulated with anti-CD59 antibody showed a higher level of pro-liferation and protein phosphorylation ,compared with the others.Conclusion:CD59 contributed to LAT induced signaling transduction of T lymphocytes ,and stimulated CD59 molecule partly promoted T cell activation.

Objective To investigate the clinical effects of transpedicular graft of biological artificial material (BAM) -induced artificial bone and posterior pedicle screw fixation in the treatment of osteoporotic thoracolumbar fractures.Methods A total of 72 patients with osteoporotic thoracolumbar fractures treated by transpedicular reduction by leverage,BMA-induced artificial bone grafting and posterior pedicle screw fixation from 2005 to 2010 were reviewed and followed up.The frontal and lateral X-ray radiograph of the spine was performed before and after operation and during the follow-up.The anterior and posterior height of the injured vertebrae,thoracolumbar kyphotic angle ( Cobb' s angle),ratio of anterior to posterior vertebral height were determined.Also,the America Spinal Injury Association (ASIA) scale was used to evaluate the neurological recovery and the visual analog scale (VAS) was applied to assess the back and waist pain.Results All patients were followed up for a mean period of 18.3 months,ranging from 12 to 28 months.Meanwhile,all the patients obtained bone union,with no rejection of artificial bone graft,breakage or loosening of screws,or obvious loss of both vertebrae height and deformity correction angle.Notable improvement of neurological function was achieved in all patients except for two patients with Frankel A nerve injury.The VAS score descended from pre-operative ( 8.4 ± 2.5 ) points to (2.2 ± 1.6 ) points at latest follow-up,which showed obvious alleviation of back and waist pain.Conclusions Transpedicular bone graft plus internal fixation is an effective,reasonable and easy method for managing osteoporotic thoracolumbar fractures.In addition,the implanted BAM-induced artificial bone is of good biological and mechanical properties.

Objective To retrospectively analyse the anterior and posterior surgical approaches in treatment of unstable burst thoracolumbar fractures and compare radiographic measurement parameters of beth surgical techniques so as to provide references for surgical treatment of such kind of fracture. Methods The study selected 41 patients with unstable thoracolumbar fracture treated with either anterior neurodecomprossion and fixation (n=19) or posterior reposition and internal fixation by pedicle screw (n=22) from January 2003 to December 2005. All patients were followed up for 24-48 months ( mean 38 months) and divided into anterior approach group and posterior approach group. Sagittal alignment was assessed by the Cobb angle depending on lateral radiographs. Results The Cobb angle of the anterior approach group was average 27.3°on admission but 3.1°postoperatively and 4.6° at follow-up; while the Cobb angle of posterior approach was average 26.1° on admission, 3.0°postoperatively and 12.5°at follow-up. There was no statistical difference between Cobb angle on admission and postoperative one (P>0.05) but showed significant differences between them at follow-up ( P<0.01). Conclusion The anterior surgical approach can consistently yield better maintenance of kyphotic correction compared with the posterior surgical approach.

Objective To investigate the carbapenem-resistant mechanism of one strain of Klebsiella pneumoniae( KPN) and one strain of Pseudomonas aeruginosa( PAE) .Methods The identity of the isolates was confirmed by using MALDI-TOF mass spectrometry, 16S rDNA and special gene amplification .The minimum inhibitory concentrations (MICs) of the antimicrobial agents were determined by VITEK 2 Compact System .CarbaNP Antimicrobial susceptibility testing , plasmid extraction, electroporation experiment , PCR amplification, and cloning and sequencing were carried out to analyze the en-coding gene of β-lactamases.Results The types of β-lactamases of the KPN were blaKPC-2 and blaSHV, confirmed by se-quencing of the PCR products , and that of the PAE were blaKPC-2 .Only blaKPC-2 was displayed in both transformants .All of the results of CarbaNP were type A .Conclusion Both strains of KPN and PAE resisting to carbapenem produce a plasmid-mediated carbapenemase blaKPC-2 , which belongs to Bush group 2f, class A β-lactamase.The extended-spectrum β-lacta-mases gene encoding blaSHV of the KPN might be located in the chromosome or not in the plasmid carrying with blaKPC-2 .