[Objective]To evaluate the two-dimensional shear wave elastography(2D SWE)in predicting the prognosis of the patients with acute-on-chronic hepatitis B liver failure(ACLF-HBV).[Methods]312 patients diagnosed with ACLF-HBV at the De-partment of Infectious Diseases in the Third Affiliated Hospital of Sun Yat-sen University from October 1st 2013 to December 31th 2015 were recruited. The baseline data of all patients,including 2D SWE,laboratory data,ultrasonographic data,Model for End-stage Liver Disease score(MELD),Child-Turcotte-Pugh score(CTP),and King′s College Hospital score(KCH),were collected when enrolled. All patients were followed up for at least 90 days and their clinical outcomes(recovering or worsening)were recorded. 2D SWE values of all patients were dynamically collected every 2~4 weeks during the follow-up until death,liver transplantation, or discharging from hospital.[Results]The worsening patients showed higher 2D SWE values than the recovering ones[(44.0 ± 7.5) kPa vs(36.8 ± 10.3)kPa,t=-6.5,P=0.000],2D SWE value less than 39.2 kPa could be a prediction of the patient′s recovery in 90 days.The predictive value of 2D SWE(AUROC=0.73)was higher than that of KCH(AUROC:0.65,z=2.1,P=0.033). Among all the dynamically measured patients,2D SWE rose from(42.1 ± 8.0)kPa to(47.5 ± 9.3)kPa in the worsening group during the 90-day follow-up,while nearly stable in the recovery group.[Conclusion]Noninvasive liver stiffness measurement by 2D SWE is a use-ful method in evaluating the prognosis of ACLF-HBV patients. Taking a cutoff of 39.2 kPa,patients with higher 2D SWE values could have worse clinical outcomes ,otherwise better. It seems that dynamically measuring 2D SWE values could also be helpful ,but more research in the future should be needed.

Objective To evaluate the role of mammalian target of rapamycin (mTOR ) in reduction of oxygen-glucose deprivation and restoration (OGD/R )-induced injury to isolated cardiomyocytes by hypoxic preconditioning (HPC) in neonatal rats .Methods Primary cardiomyocytes were obtained from neonatal Sprague-Dawley rats (1-3 days after birth ) ,and seeded in 96-well plates at the density of 1 × 105 cells/ml (200μl/well ) . The cells were randomly divided into 6 groups ( n=6 each ) using a random number table:control group (group C) ,rapamycin group (group R) ,group OGD/R ,rapamycin+OGD/R group (group R+OGD/R);group HPC+OGD/R ,and rapamycin+HPC+OGD/R group (group R+HPC+OGD/R) .Rapamycin (final concentration 20 nmol/L) was added to the culture media and the cells were then incubated for 1 h in group R .In R+OGD/R group ,rapamycin (final concentration 20 nmol/L ) was added to the culture media ,the cells were then incubated for 1 h ,and then OGD/R was performed .In HPC+OGD/R group ,OGD/R was performed immediately after HPC was completed .In R+HPC+OGD/R group ,rapamycin (final concentration 20 nmol/L) was added to the culture media ,the cells were then incubated for 1 h , and then HPC and OGD/R were performed . All the cells were subjected to OGD for 2 h followed by restoration of O2-glucose supply for 3 h to induce OGD/R .HPC was induced by 3 cycles of 10 min hypoxia followed by 30 min reoxygenation .The cell viability (using MTT assay ) and lactic dehydrogenase (LDH) activity in the culture medium were determined .Results Compared with group C ,the cell viability was significantly decreased , and LDH activities in the culture medium were increased in OGD/R , R+OGD/R ,HPC+OGD/R and R+ HPC+OGD/R groups ( P<0.05 ) ,while no significant change was found in the cell viability and LDH activities in R group ( P>0.05) .The cell viability was significantly higher ,and LDH activity in the culture medium were lower in HPC+OGD/R group than in OGD/R group ,and in R+HPC+OGD/R group than in HPC + OGD/R group ( P< 0.05 ) .Conclusion mTOR is involved in HPC-induced attenuation of OGD/R injury to isolated cardiomyocytes in neonatal rats .

Objective To assess the effect of peroxisome proliferator-activated receptor γ (PPARγ) agonist on prostate epithelial cells in vitro.Methods The expression of peroxisome proliferator-activated receptor γ(PPARγ) was studied by immunocytochemistry and immunofluorescence study.The RWPE-1 human prostate epithelial cell line was treated with PPARγ agonist rosiglitazone 100 μmol/L for 48 h.Analysis of apoptosis was performed by Caspase 3/7 activity assay.Mitochondria depolarization was measured by using the potential-sensitive color,JC-1.The expression of apoptosis-related proteins-Bax was investigated by immunohistochemistry.Results PPARγ mainly located in nucleus and perinucleus.RWPE-1 cell line treated with PPARγ agonist rosiglitazone showed higher Caspase 3/7 activity (10636±1032 RLU) than in control (5936±620 RLU),P＜0.01 and significantly upregulated Bax level (8250±694 vs.6017±563)than in control group,P＜0.01.In addition,mitochondrial membrane potential was depolarized in rosiglitazone treated cells.Conclusions PPARmay play important roles in the pathophysiology of BPH.The mechanism might be that PPARγ regulates cell apoptosis.It is suggested that the mitochondrial and Bax pathway might be involved in signaling PPARγ induced cell apoptosis.

Objective To explore the expression and the role of Toll-like receptor(TLR3 and TLR4) in rats with nephrotic syndrome induced by respiratory syncytial virus(RSV).Methods SD rats were inoculated intranasally and intraperitoneally with 6?106 plaque for-ming unit(PFU) RSV to construct RSV-induced nephropathy in rat model.Rats were anesthetized and blood was withdrawn from cardiac on day 4,14,30,60 after inoculation.The normal ones without intervention were set as control group.The renal histology was observed by light microscope and electron microscope.The urinary protein collected in 24 hours were measured.Meanwhile,the expressions of TLR3 and TLR4 were detected by indirect immunofluorescence staining and flow cytometry in peripheral blood mononuclear cells of rats.The results were analyzed by SPSS 13.0 softwore.Results After inoculation,the proteinuria increased and under the electron microscope the foot processes of glomerular epithelial cells were fused which resembled human minimal change nephrotic syndrome.Proteinuria reached the peak and the fusion of foot processes were most extensive in rats of RSV at 60 d.The expressions of TLR3 and TLR4 in each group of RSV-induced nephropathy in rat models were significantly higher than those in normal control group(Pa0.05).Conclusions TLR3 and TLR4 in peripheral blood mononuclear cells of RSV-induced nephropathy rat mo-dels had being significantly activated until 60 d after RSV inoculation.TLR signaling pathway may play an important role in nephrotic syndrome of rats induced by RSV.

A systematic method of isolating and culturing human bone mesenchymal stem cells (hMSCs), and inducing them to differentiate into neuron-like cells in vitro was established. The hMSCs were isolated from bone marrow with the lymphocyte-separating medium, cultured and expanded in vitro, and induced after addition of compound neuro-revulsants. The morphological changes of hMSCs were observed, and the expression of surface markers in induced hMSCs was immunocytochemically identified during induction period. The hMSCs could be separated, cultured and expanded in vitro. After induction by compound neuro-revulsants for 48 h, the changes of neuron-like cells, such as cellular shrinkage and neurite growth, were observed in some cells. The immunochemical staining revealed nestin (+) or NF (+), and GFAP (-). It was concluded that hMSCs were successfully cultured and induced to differentiate into neuron-like cells.
Bone Marrow Cells/*cytology ; Cell Culture Techniques ; Cell Differentiation/*physiology ; Cells, Cultured ; Mesenchymal Stem Cells/*cytology ; Neurons/*cytology

Animals ; Animals, Newborn ; Apoptosis ; drug effects ; Brain ; drug effects ; pathology ; Disease Models, Animal ; Estrogens ; pharmacology ; Female ; Hypoxia-Ischemia, Brain ; drug therapy ; In Situ Nick-End Labeling ; Male ; Rats ; Rats, Wistar

The aim of this study was to develop the data element standard directory of traditional Chinese medicine (TCM) clinical pharmacy information, to provide application standards and models of TCM clinical pharmacy for the electronic medical record (EMR). The developed line of work is as follows: initially establish research through four forms: literature analysis, questionnaires, discussion groups, expert advice. The research range from the Chinese herbal medicine research, herbal origin, harvesting, processing, identification of traits, physical and chemical identification, modern research, character, taste, Indications, clinical application, processing, dispensing medicine, Chinese medicine specifications, usage, dosage, caution, efficacy indications to small packaging applications, drug research, management and other related issues, including traditional Chinese medicine theory, application and hospital management information; according to the general and part 16 content of the national "Health Information Data Element Standards", and the basic method of extracting data element to study and develop the data element of TCM clinical pharmacy information from the defining content. Correspondingly propose the ideas and methods of construction of the "Data Element Standard Directory of TCM Clinical Pharmacy Information", sort out medicine clinical information data element standard catalog, divided into basic categories, clinical application class, management class three parts, and set norms and standards of identifying data elements, definitions, allowable value of traditional Chinese medicine clinical information, and discuss the sources and standards of information collection, leaving the interface, standardized and scientific terminology, docking with the existing standards, maintenance and management program and oter issues.
China ; Data Mining ; methods ; statistics & numerical data ; Database Management Systems ; standards ; statistics & numerical data ; Electronic Health Records ; standards ; statistics & numerical data ; Evidence-Based Medicine ; methods ; statistics & numerical data ; Humans ; Information Dissemination ; methods ; Medicine, Chinese Traditional ; methods ; Phytotherapy ; methods ; statistics & numerical data

OBJECTIVETo explore the reason, key diagnosic point and therapeutic method of the incisions fat colliquation or infections at early stage after operation of lumbar disc herniation.

METHODSFrom July 2007 to May 2012, clinical data of 11 patients with incision fat liquefaction or early infection after lumbar discectomy were retrospectively analyzed. There were 5 males and 6 females with an average age of 43.1 years, and the mean time of incisions fat colliquation or infection was 5 days and a half after operation. The main clinical features included local wound pain aggravating, fervescence, fresh seepage in the wound, and blood inflammatory index increased, etc. The wound could heal at the first treatment stage or not was an evaluation standard of curative effect.

RESULTSAll patients were followed up with an average period of 21 months. The wounds of 10 cases healed at the first stage without recurrence and complications. In 1 case infected by staphylococcus aureus, distal part of the wound present local red, swelling and with wave motion at 2 months after operation, staphylococcus aureus infection was confirmed after puncture and bacterial culture, and 1 thrum was found after local incision. The wound healed after change dressings for 1 week, without recurrence after followed up for 13 months.

CONCLUSIONPreventing the risk factors before operation, minimizing invasive technique during operation reasonable antibiotics application for the lumbar operation reguiring placement objects, and correctly handling with wound after operation could prevent and reduce the incidence of incisions fat liquefaction or infection after operation of lumbar disc herniation. For incision fat liquefaction or infection, early diagnosis, debridement, VSD negative pressure irrigation and drainage, to choosing sensitive antibiotics according to the results of drug sensitivity, may contribute to wound early healing and decrease complication.

Adipose Tissue ; pathology ; Adult ; Aged ; Female ; Humans ; Intervertebral Disc Displacement ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Staphylococcal Infections ; pathology ; therapy ; Surgical Wound Infection ; pathology ; therapy ; Time Factors

Objective:To improve the therapeutic gain ratio from 125I seed implants by investigating the QA/QC strategies used in brachytherapy treatment of lung cancer. Methods:A total of 287 lung cancer and pulmonary metastases cases were studied. Among which, 184 are male and 103 are female with a mean age of 61.9 years. The NOA-NSCLC subgroup and pulmonary metastases were targeted on conventional CT positioning. Considering that COA-NSCL subgroup on the tumor target area is difficult to determine with CT, the coincidence circuit SPECT was used to assist in positioning. A dose-volume histogram was constructed to evaluate the quality of the TPS and optimization. Corrections on real-time positioning are necessary when using an image-guided implantation. The C-LC should be aligned with the FFB for CT-guided percutaneous puncture implantation. After implantation, dosimetry verification was con-ducted. Results:The NOA-NSCLC subgroup, comprising the risk organs such as heart, lung, and spinal column, received an average dose of 137, which was significantly lower than that of normal tissue dose tolerance. The NOA-NSCLC subgroup and lung metastases have matched peripheral dosages of 92.1 and 106.2 Gy with local-control efficiency rates of 91.97% (126/137) and 96.0% (48/50), 1-year survival rates of 91.24%and 83.4%(42/50), and 2-year survival rates of 50.36%(69/137) and 52.3%(26/50), respectively. The 35 COA-NSCL subgroup and 65 lung cancer group have local control efficiency rates of 91.43%(32/35) and 92.3%(60/65) and 1-year survival rates of 88.57%(31/35) and 80.30%(53/66), respectively. Conclusion:Proper radiation dosimetry as a QA/QC strategy was found to improve particle-implantation therapy gain and greatly reduce the risks of radiation pneumonia and pulmonary fibrosis.

Objective To evaluate the efficacy and tolerance of monochromatic excimer light (MEL) 308 nm in the treatment of vitiligo. Methods Seventy-seven patients were enrolled in the prospective and open clinical study. Two-hundred and one lesions were subjected to local phototherapy of MEL 308-nm once a week for 3 to 6 months. Results Of these lesions, 86.6% obtained repigmentation at different degrees. The repigmentation was more obvious in lesions on the head, face, neck and trunk than in those on the limbs or extremities. Moreover, patients with generalized and segmental vitiligo got a better improvement than patients with other types of vitiligo. Conclusion MEL 308-nm is effective in the treatment of vitiligo without obvious adverse effects.