Objective To observe the effects of shenfu injection (SFI) on the awakening quality of the patients with hepatitis B cirrhosis undergoing splenectomy under general anethesia. Methods Forty patients with hepatitis B cirrhosis and hepatic insufficiency (ASA classⅡ~Ⅲ) underwent splenectomy by general anesthesia. Patients were all sent into the post-anesthesia care unit (PACU) shortly after the operation with unconscious and no spontaneously breathing. They were randomly divided into two groups: SFI treatment group (Group SFI, n =20) and normal saline controlled group (Group NSC, n = 20). SFI group were treated with SFI (1 mL/kg, i. v.) in 10 minutes, and NSC group were treated with normal saline (1 mL/kg,i.v.). The time of eyes opening, extubation of tracheal catheter and the detention time of PACU were recorded. The heart rate (HR) and the average artery presses (MAP) were monitored at 4 time points: before SFI and normal saline administration, 5 min, 15 min, and 45 min after administration. The incidence of restlessness during the patients awakening period was also recorded. Results The time of eyes opening, extubation and the detention time of PACU of SFI group show no significant difference compared with the NSC group (P > 0.05). SFI and normal saline intravenous injection did not cause significant changes on HR and MAP at the time of 5 min , 15 min and 45 min compared to the time of before administration (P > 0.05). The incidence of restlessness during the patients resuscitation period in SFI group were lower than in NSC group (P < 0.05). Conclusion Shenfu injection can effectively improve the awakening quality and decrease the incidence of restlessness of the patients with hepatitis B cirrhosis undergoing splenectomy under general anesthesia during the awakening period in PACU.

Objective To assess the clinical value of transcatheter arterial chemoembolization (TACE) together with radiofrequency ablation (RFA) and sorafenib in treating recurrent hepatocellular carcinoma (HCC) after surgery.Methods A total of 40 patients with recurrent HCC after surgery, who were encountered at authors' hospital during the period from December 2009 to May 2014, were collected. The patients were divided into the study group (n=20) receiving TACE combined with RFA and sorafenib and the control group (n=20) receiving TACE plus RFA. Within 7-10 days after TACE, RFA was carried out. In the study group, oral sorafenib therapy (400 mg, two times everyday) started at 4 days after TACE. Withdrawal of sorafenib would be ordered if drug resistance occurred. Each patient underwent TACE combined with RFA not less than two times. Results The median survival time of the study group and the control group was 31.0 months and 24.8 months respectively, and statistically significant difference existed between the two groups (P<0.05). The one-year, 2-year and 3-year survival rates of the study group were 85%, 70% and 50%respectively, while the one-year, 2-year and 3-year survival rates of the control group were 80%, 55% and 30% respectively; the differences between the two groups were not statistically significant (P>0.05). The progression free survival (PFS) time of the study group and the control group was 6.8 months and 5.7 months respectively, the difference between the two groups was statistically significant (P<0.05). Conclusion TACE combined with RFA and sorafenib can prolong the overall survival time and the progression free survival time of patients with recurrent HCC after surgery.

Objective To investigate the role of three-dimensional scaffolds seeded with NeuroD1-modified neural stem cells (NSCs) for repair of spinal cord injury in rats.Methods A new three-dimensional bio-printer was used to make bionic spinal cord scaffolds.NSCs are transduced with retrovirus vectors encoding NeuroD1 to express transgenes in high levels.Forty healthy female SD rats were divided into control group,scaffold group,scaffold + NSCs-green fluorescent protein (GFP) group and scaffold + NSCs-NeuroD1 group with 10 rats per group,according to the random number table.Spinal cord injury in rats was induced using the electric controlled cortical impactor.A week later,the control group was excised 3 mm spinal cord at the injury site under microscope.RT-PCR was used to confirm the construction of NeuroD1 overexpressing NSCs.Survival and differentiation of transplanted NSCs were detected with fluorescent staining.Rat neurological motor function was evaluated with BBB score at postoperative 1,2,4,6 and 8 weeks.Rat electrophysiological changes were observed by monitoring motion evoked potential and sensory evoked potential at 8 weeks.Results RT-PCR results confirmed the successful reconstruction of NeuroD1-overexpressing NSCs.BBB score in scaffold + NSCs-NeuroD1 group was the highest and had significant differences compared to other three groups (P ＜ 0.05).Electrophysiological results showed the motor and sensory in scaffold + NSCs-NeuroD1 group had the shortest latencies and highest amplitudes,which revealed significant differences compared to other three groups (P ＜0.05).Immunofluorescence staining showed GFP cells in scaffold + NSCs-NeuroD1 group at 8 weeks,which differentiated into neurons and astrocytes.GAP-43 was positively stained,and myelin formation was detected.Conclusion Three-dimensional scaffolds seeded with NeuroD1-modified NSCs can promote nerve loop reconstruction in spinal cord injury rats,and accelerate recovery of motor and sensory function.

Objective To investigate the effect of temperature sensitive umbilical cord mesenchymal stem cells (tsUCMSCs) transplantation under mild hypothermia environment on cognitive function of rats after severe traumatic brain injury (TBI).Methods Thirty-six male SD rats weighing (300 ± 20)g were subjected to severe TBI by fluid percussion device (2.5 atm) and managed with tsUCMSCs combined with mild hypothermia.Rats were divided into three groups:sham operation group,TBI group,and TBI + tsUCMSCs + mild hypothermia group (TBI + intervention group) according the random number table,with 12 rats per group.Latency to the platform and the time in targeted quadrant were recorded to evaluate the learning and memory with Morris water maze.Population spike (PS) and excitatory postsynaptic potential (EPSP) of long-term potential (LTP) were examined to evaluate synaptic plasticity of hippocampus.Phosphorylated Tau at Thr231 and phosphorylated GSK3 at Ser9 were detected by Western blot.Results Latency to the platform [(15.9 ±3.2) s vs (8.08 ±2.69) s,P＜0.01]was prolonged and time in targeted quadrant [(14.4 ± 3.0) s vs (36.3 ± 5.7) s,P ＜ 0.01] was shortened in TBI group at day 28 compared with sham operation group.Whereas,latency to the platform [(10.7 ± 2.8) s,at Ser9 were detected by Western blot.Results Latency to the platform [(15.9 ± 3.2) s vs (8.08 ± 2.69) s,P ＜ 0.01] was prolonged and time in targeted quadrant [(14.4 ± 3.0) svs (36.3 ± 5.7) s,P ＜0.01] was shortened in TBI group at day 28 compared with sham operation group.Whereas,latency to the platform [(10.7 ± 2.8) s,P ＜ 0.01] and time in targeted quadrant [(29.4 ± 4.4) s,P ＜ 0.05 |were reversed in TBI + intervention group.PS and EPSP of LTP were elevated in TBI group,but the elevation was suppressed in TBI + intervention group.Meanwhile,Tau hyperphosphorylation (0.80 ± 1.00vs 1.24 ±0.13,P＜0.05) and GSK3 deactivation (3.01 ±0.41 vs 1.27 ±0.22,P ＜0.01) were significantly reversed in TBI + intervention group compared with TBI group.Conclusion Combination of tsUCMSCs and mild hypothermia therapy can improve the TBI-induced cognitive deficit.

Objective To evaluate the short-term efficacy, safety and effectiveness of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) combined with radioactive 125I seed implantation in treating advanced non-small-cell lung cancer (NSCLC). Methods A total of 48 patients with inoperable and EGFR mutation-positive advance NSCLC were included in this study. The patients were divided into study group (n = 26) and control group (n = 22). Patients in the study group were treated with EGFR-TKIs combined with radioactive 125I seed implantation; while patients in the control group only received EGFR-TKIs treatment, which was kept on until the disease progressed. The clinical efficacy, and the incidence of side effect as well as the survival rate were determined, and the results were compared between the two groups. Results Local disease control rate of the study group and the control group was 92.3% and 68.2%respectively, the difference was statistically significant (P= 0.033), while the effective rate was 76.9% and 54.5%respectively, the difference was not significant (P=0.101). Progression-free survival (PFS) time of the study group and the control group was 14.1 months and 9.7 months respectively (P< 0.05). The one-year survival rate of the study group and the control group was 80.8%and 63.6%respectively (P<0.05), and the median survival time was 26.9 months and 17.1 months respectively (P < 0.05). The major complication caused by radioactive 125I seed implantation was pneumothorax. Conclusion For EGFR mutation-positive advance NSCLC, EGFR-TKIs together with radioactive 125I seed implantation is a safe and effective treatment.Its short-term efficacy is superior to pure EGFR-TKIs therapy. At present, this combination therapy is a new alternative for the treatment of EGFR mutation-positive advance NSCLC.

Objective To estimate whether the ligation of bilateral internal carotid artery in combination with one vertebral artery can lead to chronic cerebral hypoperfusion. Methods The sham operation, 2?VO and 3?VO rat models were subjected to the matching operation. Four weeks after operation,the cortical blood flow was determined. The learning and memory abilities were measured with Morris water maze test eight weeks later,then the rats were sacrificed to observe the morphological change of hippocampal CA1 region. Results Compared with the sham operation group((47±8.797)ml·min-1·100 g-1),the cerebral blood flow of 2?VO((24.30±8.999)ml ·min-1·100 g-1) and 3?VO((9.870±2.208)ml·min-1·100 g-1) were significantly decreased (P<0.01). Compared with the sham operation group((8.33±4.88)s),escape latencies of Morris water maze of 2?VO group ((14.78±7.84)s) and 3?VO group((14.86±7.96)s) in the fifth days also presented significantly increased (P<0.01),but rare difference between the two groups. Compared with the sham operation group[ (37.20±9.21) s, (10.01.±2.91)times],the target quadrant swimming time and crossing times of 2?VO group((20.13±5.80)s, (6.60±3.19)times) and 3?VO group((20.05±5.76)s,(6.55±2.59)times) in the fifth days also presented signifi?cantly decreased (P<0.01). There were distinct pathomorphology changes in hippocampal CA1 region of the two groups. Conclusion The ligation of bilateral internal carotid artery in combination with one vertebral artery can lead to chronic cerebral hypoperfusion,and can make the similar ethology representation with the 2?VO models.

Objective To investigate the effect of silence regulatory protein 1 (Sirt1) on axonal outgrowth. Methods The hippocampal neurons was first isolated in vitro from rat embryos. The distribution and expression of Sirt1 were then detected 72 h later. The down-regulation of Sirt1 was induced by RNAi technology and up-regulation of Sirt1 was in-duced by overexpression of Sirt1 and resveratrol (RES). Immunofluorescence staining was used to examine the axon length. Results Immunofluorescence staining showed that Sirt 1 was located in neuronal cell body and neurite, especially in the distal axons. Down-regulation of Sirt1 significantly decreased axonal length compared with siRNA control group [(178.3 ± 3.2) μm vs. (110.2 ± 18.30) μm, P< 0.01 ]; Overexpression of Sirt1 significantly increased axonal length com-pared with eGFP control group [(178.3±3.2)μm vs (310.6±39.5)μm, P<0.01 ];Activation of Sirt1 by RES treatment al-so significantly increased axonal length compared with vehicle control group (DMSO treated group) [(291.7±13.2)μm vs. (525.1±49.1)μm, P<0.01 ]. Conclusions Sirt1 plays a key role in axonal growth which may be used as a potential thera-peutic target of axon regeneration.

Objective:To study the diuretic effect of micronized powder of Panax notoginseng (Burk.) F.H.Chen on rats.Methods:The metabolic cage method and weighing method were used in this experiment;The indictor of urine excretion in 6 h was used to study the diuretic effect of powder ofPanax notoginseng (Burk.) F.H.Chen in the water loaded rats;the output of Na +,K +,C1-in urine were measured to elucidate the related mechanization.Results:Powder of Panax notoginseng (Burk.) F.H.Chen under high dose after administration of 2h to 5h can significantly increase the urine volume of rat compared with the blank control group (P＜0.01,P＜0.05),but no diuretic effect after administration of 6h.powder of Panax notoginseng (Burk.) F.H.Chen under high dose could increase the urine Na+,Cl-(P ＜0.01) but reduce the K+ excretion,inhibitting the Na+ reabsorption and K+ excretion of renal tubule.It could significantly increase rat urine pH value (P＜0.01),the effect ofpH value by which is similar with the effect of hydrochlorothiazide and the effect of Jinqiancao granules.Conclusion:For the first time,this study investigated the diuretic effect of powder of Panax notoginseng (Burk.) F.H.Chen,The relevant mechanism is that powder of Panax notoginseng (Burk.) F.H.Chen have an impact on inhibitting the Na+ reabsorption and K+ excretion of renal tubule.

Objective To evaluate the feasibility, safety, and efficacy of Y-shaped jogged stent in patients with malignant hilar biliary obstruction. Methods During the period of January 2010 to June 2015,We retrospectively reviewed 98 cases of malignant hilar biliary obstruction who were received implantation of biliary tract stent. 17 consecutive patients who were treated with Y-shaped jogged stent were identified (group A) during January 2012 to June 2015. Group A was carefully matched according to patients' age, sex, type of tumor, stage, type of biliary obstruction, level of bilirubin at diagnosis, presence of metastasis and treatment, and 17 patients who were underwent unilateral stent placement alone with PTCD were chosen as control group (group B). Patients' baseline characteristics, stenting strategy, complications, stent patency time and survival rates were analyzed, and continuous variables of the two groups were compared using Student's t-test. Categorical variables were analyzed using the Fisher exact test. Results Y-shaped jogged stent implantation group and control groups were closely matched in terms of patients' age, sex, type of tumor, stage, type of biliary obstruction, level of bilirubin at diagnosis, presence of metastasis and treatment ( P>0.05). The bilirubin decreased rate in the two groups was 88.2%and 53.0%respectively (P<0.05). The median time of stent patency after stent implantation was(7.3 ± 1.0)months and(5.7 ± 0.9) months respectively (χ2=4.04,P=0.044), and the median survival time was(9.1 ± 1.5)months and(7.2 ± 1.1)months (χ2=4.60,P=0.032), with significant difference according to Kaplan-Meier analysis. There were no severe complications such as massive hemorrhage, perforation, biliary fistula and severe pancreatitis, which were associated with stent implantation. Conclusions The application of Y-shaped jogged stent is safe, feasible and effective in patients with malignant hilar biliary obstruction. It can relieve the clinical symptoms of biliary obstruction effectively with prolongation of stent patency time and survival rate significantly.