Objective: To investigate the effect of astragalus on the serum levels of hepatocyte growth factor (HGF), renal function and the damage of renal morphology in ischemic acute renal failure (IARF). To study the protective mechanism of astragalus in IARF. Methods: The rats were pretreated with astragalus or vehicle for 3 days. IARF was induced by left renal artery clipping for 60 min, after the right kidney was removed. Biochemical parameters for serum HGF,blood urea nitrogen(BUN),creatinine(Cr) were measured and histological analyses of the kidneys were performed by tubular grading. Results: There have no significant difference between the serum HGF levels of I/R controls and the levels observed in sham-operated group (P > 0.05). Serum HGF levels in astragalus treated group was significantly increased than those of I/R control group(P < 0.01) .After 4 h of I/R, serum levels of BUN and Cr were increased in I/ R control rats compare with Sham-operated rats(P < 0.01). Astragalus treatment reduced the levels elevation(P < 0.05). Simultaneously,. I/R-induced severe damage in renal morphology were significantly ameliorated by astragalus treatment(P < 0.01). Conclusions: Astragalus pretreatment can alleviate the damage of renal function in IARF. It is may be one of the mechanisms of astragalus for protecting renal tissue in IARF that astragalus can induce the expression of HGF.

Objective To know the mastery degree of percutaneous coronary intervention (PCI) preoperative nursing knowledge in nurses who are working in emergency department and cardiac ward. Methods 158 cases of nurses who came from three different class Ⅲ grade hospitals with qualification for emergency PCI surgery of the Guizhou province were surveyed with self-made questionnaire. The survey was conducted in nurses who were working in different departments, and the educational background, age, title, category, the cognitive situation of the PCI preoperative nursing knowledge and necessity of preoperative preparations were investigated in nurses. Results The whole pass rate was 48.10%; high qualification, high education, higher title of nurses for the nursing knowledge of the emergency PCI were better; the emergency PCI preoperative preparations for the necessity of cognitive about nurses were on the low side. Conclusion The cognition of the nursing knowledge and the necessity of emergency PCI in preoperative preparations as whole are on the low level, so specialized training should be strengthened to enhance the ability of specialized nursing.

Objective To explore the changes and clinical significance of levels of serum vascular endothelial growth factor(VEGF)and endostatin in smokers. Methods In a case-control study,levels of serum VEGF and endostatin were determined in 82 smokers with lung cancer,82 pair-matched smokers without lung cancer and 20 healthy non-smokers by enzyme-linked immunoabsent assay(ELISA) or competitive enzyme immunoassay.Results The level of serum VEGF in smokers with lung anncer[(16.1±7.9)ng/ml]was markedly higher than that in the other two groups(both P＜0.01).The level of serum VEGF in smokers without lung cancer was significantly higher than that in healthy non-smokers(P＜0.05).The level of serum endostatin in smokers with lung cancer was significantly higher than that in healthy nonsmokers(P＜0.01),but was not significantly different from that in smokers without lung cancer(P＞0.05),and that in smokers without lung cancer was significantly higher than that in healthy non-smokers (P＜0.05).Notably,the ratio of endostatin to VEGF in smokers with lung cancer(1.3±0.5)was significantly lower than that in the other two groups(both P＜0.01).However.there was no significant difference in it between smokers without lung cancer and healthy non-smokers(P＞0.05).The level of serum VEGF correlated significantly to that of endostatin in smokers both with and without lung cancer(P＜0.01).Conclusions These findings suggest that smoking may result in imbalance of levels of serum endostatin and VEGF leading to tumorigenesis.The ratio of endostatin to VEGF can be used as an early diagnostic indicator for lung cancer in smokers.Periodic determination of levels of serum VEGF and endostatin as well as the ratio of endostatin to VEGF is of clinical importance.

Background The cryptochrom 2 (Cry2)in mammalian retina is a main influential factor of circadian clock.Objective Purpose of this study was to investigate the effect of light exposure rhythm on expression of Cry2 in retina.Methods Thirty clean healthy Sprague Dawley(SD)rats were collected and divided into two groups randomly.The rats of the control group exposed to natural light with the normal rhythm for 30 days,but rats of the experimental group exposed to the artificial light (light: dark =18 hours:6 hours) for 3 months with the light intensity of(533± 16)lx.The histopathological change and ultrastructural alteration of rat retina in both groups were examined under the light microscope and transmission electron microscope at the end of the experiment.Expressions of Cry2 protein and its mRNA were assayed by immunohistochemistry and quantitative PCR(Q-PCR).Results The rat retinal morphology and ultrastructure were clear and order-arranged under the light microscope and transmission electron microscope in the control group.However,atrophy and disorganization of retina were found under the light microscope,and liquefaction and vacuole of outer segments of photoreceptors were observed.The vacuolar degeneration of mitochondria in the inner segments of photoreceptors,cellular nuclear shrinkage,chromatin margination,nuclear notch and destruction were seen in the outer nuclear layer under the transmission electron microscope.Immunohistochemistry showed that the expression of Cry2 protein located in cytoplasm and nuclei membrane of the retinal ganglion cell layer and inner nuclear layer in both normal rats and experimental rats.The scores of Cry2 protein expression were 0.833±0.197 in the experimental group,and 1.700±0.245 in the control group,with a significant difference between them (P=0.009).The quantities of Cry2 mRNA were 0.962 ± 0.125 in the control group and 0.615±0.100 in the experimental group,showing a significant difference between the two groups (P =0.006).Conclusions Long-term light exposure under the 533 lx leads to retinal structural and functional damage probably by down-regulating Cry2 expression in retina.Whether the regulation of Cry2 expression is helpful for stabilizing the biorhythm or not is a worthy question to explore.

Objective To present the initial experience and results of laparoscopic transvaginal radical cystectomy (LATRC) with orthotopic ileal neobladder. Methods Six female patients with muscle invasive bladder carcinoma underwent LATRC with orthotopic ileal neobladder. The mean age was 61 years (range 55 to 73 years) . The LATRC with orthotopic ileal neobladder consisted of 4 major steps, namely laparoscopic cystectomy, operation on vagina, extracorporeal formation of ileal pouch and laparoscopic urethral pouch anastomosis. With 5 trocars, the bilateral pelvic lymphadenectomy was performed first The ureters were dissected just outside the bladder. Assisted by the uterine manipulator and the LigaSure system, total bladder, uterus and appendage were dissected by the laparoscopic approach. In the transvaginal step, the specimen was removed through the incision of the anterior and posterior vaginal fornix apex and the neovagina was created by the visualized suture. A 30-40 cm ileal loop was taken from the abdominal cavity, isolated, de-tubularized and reconfigured into W shaped pouch with running suture. The anti-refluxing ureter implantation was performed by inserting the 1 cm ureter into the pouch and suturing in place. The urethra neobaldder anastomosis was done under the laparoscope. Results The mean duration of surgery was 6.2 h(range from 4 to 8 h). The estimated blood loss was 665 ml (range from 400 to 1200 ml). All patients achieved urine control and had neither obstruction nor reflux proved by the intravenous pyelography 1-3 months after surgery. The mean value of neobladdermaximum capacity was 427 ml. No vesicovaginal fistula or other serious complication occurred The mean follow-up was 16 months (9-30 months). During the follow-up, there was no mortality. One patient with lymph node involvement developed liver metastasis 8 months post-operatively. Conclusions The LATRC is feasible and effective for the female patients with invasive bladder cancer. Using uterine manipulator and the transvaginal procedure makes the laparoscopic manipulation easier and simpler. The visualized incision and suture on vagina is good for recovery and reducing postoperative vesicovaginal fistula.

Objective To study the effect of dynamic stress stimulation on the expression of Sox9 mRNA and protein in metaphyseal chondrocytes in vitro, and to explore the specific mechanism of mechanical signal transduction. Methods The rat metaphyseal chondrocytes separated and cultured for the 3rd generation in vitro were randomly divided into four groups:control group (all interventions were not applied), simple dynamic pressure group (a dynamic pressure stimulus with a size of 90 mmHg and a frequency of 0.1 Hz was applied using an open pressure control culture system), simple calcium antagonist group (the concentration of 10μmol/L nifedipine was given) and dynamic pressure+calcium antagonist group (a dynamic pressure stimulus with a size of 90 mmHg, frequency of 0.1 Hz and concentration of 10 μmol/L nifedipine were given at the same time). The expression of Sox9 mRNA was detected after 24 h intervention by real-time quantitative polymerase chain reaction (RT-PCR) in four groups. The expression of Sox9 protein was detected by Western blot assay. The intracellular free Ca2+ in metaphyseal chondrocytes was labeled with Fluo-3/AM, and the average fluorescence intensity detected by laser scanning confocal scanning microscopy was compared between four groups. Results The expression of Sox9 mRNA was 3.81 times higher in dynamic stress group than that in the control group, and the protein expression level was 2.33 times higher than that of the control group (P<0.05). There were no significant differences in the expression of Sox9 mRNA and protein between the calcium antagonist group and the control group. The expressions of Sox9 mRNA and protein were lower in dynamic pressure+calcium antagonist group than those in the dynamic stress group, but which were higher than those of control group(P<0.05). The results of average fluorescence intensity showed that there was no significant difference in the intracellular free Ca2+ concentration between four groups (P > 0.05). Conclusion Dynamic stress stimulation can increase the expression of Sox9 mRNA and protein in rat metaphyseal chondrocytes. There is calcium channel involvement in the mechanical signal transduction.

Objective: To assess changes of liver function in HIV-positive children with/without HBV/HCV co-infection after 1 year of highly active antiretroviral therapy ( HARRT ) . Methods: Seventy-eight pediatric AIDS patients with HBV/HCV co-infection,19 pediatric AIDS patients with HBV co-infection and 44 pediatric AIDS patients without HBV/HCV co-infection who received HAART at least for 1 year were enrolled .HIV-1 viral load was quantitatively detected using a standardized reverse transcriptase-polymerase chain reaction assay , and blood cells were determined by three-color flow cytometry . Anti-HCV antibody and HBsAg was detected using an enzyme-linked immunosorbent technique , and ALT, AST and TBIL were detected by automatic biochemical analyzer .Results: After 1 year-HAART, the viral load was decreased to the lowest limit of detection in 90 .34% patients ( t=2 .61 , P<0 .01 ) , and CD4 +T cell counts were increased from 170 .187 ±132 .405/μl to 796 .014 ± 158 .491/μl ( t=3 .17 , P<0 .01 ) .The levels of ALT and AST were elevated ( t=2 .02 , P <0 .05 ) , while the ALT and AST levels in patients receiving nevirapine (NVP) based HAART increased from 18.28 ±13.74 U/L and 24.23 ±8.09 U/L to 55.35 ±22.40 U/L and 69.97 ±26.72 U/L, respectively(t=3.80,t=4.11;Ps<0 .01 ) .The increment of ALT and AST in NVP based HAART were significantly higher than that in the efavirenz based HAART (ALT:46.28 ±13.35 U/L vs 37.70 ±15.25 U/L and AST:19.53 ±7.23 U/L vs 1.25 ±0.21 U/L, respectively; t=4.53, t=5 .79;Ps<0 .01 ) , particularly in patients co-infected with HIV/HBV/HCV ( ALT:54 .32 ±22 .85 U/L vs 16 .89 ±14 .42 U/L and AST:41 .71 ±19 .26 U/L vs -3 .44 ±15.59 U/L, respectively; t=3.42, t=2.98, Ps<0.01).Conclusion: HARRT can repress HIV-1 replication effectively , but it also cause the damage of liver function , especially in patients with HBV and/or HCV co-infection.

Translational biomedical informatics is a new discipline integrating bioinformatics,medical informatics with translational medicine.The paper discusses the rise and ecology of the discipline,pointing out that full sharing of data is the foundation,complete genotype-clinical phenotype is the core and precise prediction that solves complicated diseases is the key,and analyzing the connotation of the discipline and development trend against the big data background profoundly.

Objective To report initial experience and the indications of retroperitoneal laparoscop- ic partial nephrectomy.Methods From December 2001 to October 2005,23 patients (including 14 cases of renal cell carcinoma,5 of hamartoma and 4 of duplex kidney) underwent retroperitoneal laparoscopic par- tial nephrectomy.One of the patients had solitary kidney.Results All the operations were successful ex- cept for only 1 requiring conversion to laparoscopic nephrectomy because of bleeding resulting from blocking anterior branch of renal artery.The mean operative time was 121 min (60-240 min),and mean ischemic time was 32 min (20-55 min).The estimated bleeding volume ranged from 100 ml to 300 ml,and no pa- tient needed blood transfusion.Pathology showed negative surgical margins in 14 cases of renal cell carcinoma and confirmed the diagnosis of hamartoma in 5 cases.One patient with duplex kidney required open partial nephrectomy because of renal cystic mass resulting from incomplete resection.Conclusions Retroperito- neal laparoscopic partial nephrectomy offers a new effective and minimally invasive treatment for selected pa- tients with renal mass.The long-term effects of the procedure need further investigation.

Objective To discuss the feasibility, safety and validity of the use of ViabahnTM self-expanding covered stent in endovascular repair of peripheral traumatic pseudoaneurysm (TPA). Methods During the period from June 2012 to April 2014, a total of 8 patients with peripheral TPA were admitted to the Department of Vascular and Endovascular Surgery of Shanghai Changzheng Hospital . The clinical data were retrospective analyzed. The lesions were located at the common carotid artery (n=4), vertebral artery (n=1), subclavian artery (n=1) and superficial femoral artery (n=2). On the basis of acute and chronic TPA classification and different therapeutic principles, endovascular repair with ViabahnTM self-expanding covered stent was employed in 8 patients. Intraoperative angiographic findings, the size and number of the implanted stent, and the immediate angiographic results after stent implantation were recorded. All the patients were followed up to evaluate the improvement of the symptoms, the effectiveness of the repair of TPA cavity, and the occurrence of endoleak or restenosis. Results Successful implantation of ViabahnTM self-expanding covered stent was accomplished in all 8 patients, with a technical success rate of 100%. Angiography performed immediately after stent implantation showed that complete repair of TPA cavity was obtained in all patients, the distal segment of the parent artery was patent, and no endoleak was observed. The sizes of the stent used in the patients were 8×50 mm (n=2) and 9×50 mm (n=2) in common carotid artery, 6×50 mm (n=1) in vertebral artery, 11×100 mm (n=1) in subclavian artery, and 8×100 mm (n=2) in superficial femoral artery. The patients were followed up for 6-30 months (mean of 14.3 months), and the clinical symptoms disappeared in all patients. CT angiography indicated that there was no endoleak or restenosis. Conclusion Based on the different therapeutic principles, the use of ViabahnTM self-expanding covered stent in endovascular repair of peripheral TPA is technically simple and micro-invasive, and clinically feasible with reliable effect and safety. Therefore, this technique can be employed as a first-line therapy option for peripheral TPA.