Objective To explore the correlation between arterial iodine fraction ( AIF) obtained with energy spectrum CT and Child-Pugh staging of liver cirrhosis.Methods Retrospectively analyzed the Child-Turcotte-Pugh of hospitalized 80 patients diagnosed as liver cirrhosis (15 cases of Child -A,40 cases of Child -B,and 25 cases of Child-C) and CT examination results.HD750 spectral three-stage CT scanning was conducted in all patients.AIF was calculated with energy spectrum analysis software,and the correlation between AIF and Child-Pugh staging of liver cirrhosis was explored.Results There was no statistically significant difference in the iodine content of hepatic artery and portal vein among different groups(t=1.786,P>0.05).The hepatic artery iodine score pair-wise analysis among different groups showed that the differences were statistically significant(F=30.45,P<0.05). The hepatic artery iodine score was highest in Child-Pugh C group,secondary in Child-Pugh B group and lowest in Child-Pugh A group.AIF and Child-Pugh staging of liver cirrhosis was significantly correlated.Conclusion AIF of liver cirrhosis reveals the state of liver function and is correlated with Child-Pugh staging,thus can be adopted as a supplement in clinical Child-Pugh staging.

Objective To investigate the role of IL-6 in the co-cultivation system of porcine hepatocytes with bone marrow mesenchymal stem cells (MSCs) in vitro.Methods Mononuclear cells were isolated from bone marrow aspirate of swines (n = 3) by 1.077 g/ml density gradient centrifugation.MSCs of passage 3 and primary hepatocytes harvested by a two-step in situ collagenase perfusion technique were inoculated in Millicell culture inserts at a seeding ratio of 1:2,and functional changes of heterotypic interactions were characterized.Levels of IL-6,TNF-α,and TGF-α were measured respectively.Results Hepatocyte viability was greater than 95%.Hepatocyte performance levels such as albumin secretion and urea synthesis were all significantly enhanced in co-culture group compared with hepatocyte homo-culture (P＜0.05).The IL-6 level also significantly increased in co-culture group (P ＜ 0.01).A significant decrease of hepatic functions was observed upon neutralization of IL-6 in co-culture.Conclusion MSC-derived IL-6 plays a key role in the up-regulation of hepatocyte functions in this co-culture.

Objective To establish porcine hepatocyte co-culture system with bone marrow mes-enchymal stem cells (MSCs) in vitro for the ideal cell source of bioartificial liver. Methods Mononu-clear cells were isolated from bone marrow aspirate extracted from the anterior superior lilac spine of swines (n=3) by 1.077 g/ml density gradient centrifugation. MSCs of passage 3 and primary hepato-cytes harvested by a two-step in situ collagenase perfusion technique were randomly distributed, and the morphological and functional changes of heterotypic interactions were characterized. Results The purity of the third passage MSCs and primary hepatoeytes was more than 90 % and 99%, respectively.Hepatocyte viability was greater than 95 %. A rapid attachment and self-organization of three-dimen-sional hepatocyte spheroids were encouraged in co-culture. Heterotypic junctions remained similar to that of hepatocytes in vivo. Hepatocyte performance levels such as albumin secretion and urea synthe-sis were all significantly enhanced in co-culture group compared with hepatocyte homo-culture (P<0.05). The best hepatic function levels were achieved on day 2 and moderately decreased in the following co-culture days. Conclusion Co-cultivation of porcine hepatocytes and MSCs may preserve hepatocyte morphology and function, which could contribute to the functional bioartificial liver.

Objective As an effective means of liver function support for acute liver failure, bioartificial liver has seen great progress in recent years. However, the development of this type of device is currently hindered by limited oxygen transport to cultured hepatocytes. In this study we try to resolve this problem by supplementing the circulating medium of the bioreactor with red blood cells.Methods Freshly isolated primary porcine hepatocytes were inoculated into our newly designed bioreactor and were divided into two groups: RPMI1640 was circulated in the control group and porcine red blood cells were added into the culture medium in the experimental group. The culture media in both groups were oxygenated through extra-corporeal membrane oxygenation, and the oxygen consumption rate (OCR) in the bioreactor was measured by a blood gas analyzer. Liver-specific functions and glucose consumption were also determined. Results The OCR of the experimental group was 1.5 fold that of the control group, and the glucose consumption rate was twice that of the control group. The liver-specific functions of the experimental group were significantly higher than those of the control group in terrns of albumin secretion and urea synthesis. Conclusion Supplementing the circulating medium of the bioreactor with red blood cells can significantly improve the oxygen supply in the bioreactor, thereby enhancing the glucose consumption and liver-specific functions of hepatocytes. This method is convenient and effective, and is expected to be an effective means to resolve the problems of oxygen supply in the bioreactor.

ObjectiveTo study the effects of membrane molecular weight cut off on a novel bioartificial liver(BAL) system.MethodsHealthy beagles underwent 6-hour treatment with a BAL containing membrane with 200 kDa retention rating or 1200 kDa retention rating.The functional changes and cell viability were characterized.ResultsHepatocyte performance levels such as albumin secretion,urea synthesis and viability were significantly higher in the 200 kDa retention rating group when compared with the 1200 kDa retention rating group (P＜0.05).Significant levels of canine proteins were detected in the BAL medium from the 1200 kDa retention rating group.Fluorescence microscopy further verified that heavy deposition of canine IgG,IgM and complement (C3) on co-culture cells were obtained after BAL treatment in the 1200 kDa retention rating group.ConclusionsSmall membrane molecular weight cut off of BAL could reduce the transfer of xenoreactive antibodies into the BAL medium and improved the performance of the BAL.

Objective To investigate the influence of membrane molecular weight cut off in our bioartificial liver(BAL)system.Methods Beagle dogs were used for a model of acute liver failure through D-galactosamine administration.The acute liver failure Beagles were divided into two groups by the membrane molecular weight cut off.Group A was treated with BAL containing 200 kDa retention rating membrane.Group B was treated with BAL containing 1200 kDa retention rating membrane.Each group underwent two six-hour BAL treatments that were performed on day 1 and day 21.BAL medium were examined and levels of IgG,IgM,and complement hemolytic unit of 50％(CH50)antibodies were measured in all Beagles and.Results BAL treatment was associated with a significant decline in levels of CH50.1200 kDa group experienced a significant increase in levels of IgG and IgM after two BAL treatments.Significant levels of canine proteins were detected in BAL medium from 1200 kDa group.Conclusions Xenogeneic immune response in the BAL system was influenced by membrane molecular weight cut off.

Objective To explore the correlation between moderate to severe bronchopulmonary dysplasia(BPD)and early breastfeeding in preterm infants with a gestational age of ≤32 weeks.Methods A retrospective analysis was conducted on the clinical data of 220 preterm infants with a gestational age of ≤ 32 weeks.The preterm infants were dividedinto moderate to severe BPD group(37 cases)and control group(183 cases)based on whether moderate to severe BPD occurred or not.The clinical characteristics,breastfeeding volume,and mother s own milk(MOM)feeding rate were compared between the two groups,and the relationship between breastfeeding and the occurrence of moderate to severe BPD in preterm infants was analyzed.Results Univariate analysis showed that the moderate to severe BPD group had a higher proportion of infants with birth weight＜1 500 g,ges-tational age＜28 weeks,vaginal delivery,Apgar score≤7 at 1 minute after birth,and mechanical ventilation time ≥ 7 days compared to the control group(P＜0.05).The duration of intravenous nu-trition was longer in the moderate to severe BPD group(P＜0.05).The moderate to severe BPD group had lower breast milk intake from 0 to 7 days after birth,MOM intake,MOM feeding rate,and breast milk intake from 8 to 14 days after birth compared to the control group(P＜0.05).Multivari-ate Logistic regression analysis showed that a high volume of breastfeeding from 0 to 7 days after birth was an independent protective factor for the occurrence of moderate to severe BPD in preterm infants(OR=0.865,95％CI,0.767 to 0.976,P＜0.05).Gestational age＜28 weeks(OR=5.238,95％CI,1.158 to 23.686,P＜0.05),and mechanical ventilation time ≥7 days(OR=22.386,95％CI,6.769 to 74.030,P＜0.05)were independent risk factors for the occurrence of moderate to severe BPD in preterm infants.Conclusion Early breastfeeding after birth can significantly re-duce the risk of moderate to severe BPD in preterm infants with a gestational age of ≤32 weeks,and clinical measures should be actively implemented to promote early breastfeeding.

Unicompartmental knee arthroplasty (UKA) is an effective treatment for end-stage anteromedial osteoarthritis of the knee. Medial tibial plateau fracture or femoral condyle fracture may occur after UKA, and its treatment is very challenging. The causes leading to this complication include: surgical technique errors, such as the weakening of posterior cortical strength of the tibial platform during operation, the reduction of bone mass due to too much tibial osteotomy, and the stress concentration in the bone bed due to bad alignment of the prosthesis, etc. Prosthesis design factors, such as press-fit fixation design of cementless UKA prosthesis, and multiple nail holes fixation for tibial osteotomy guide, etc. And the morphology of tibial plateau, such as tibial platform in Asian people with narrow and small shap and medial overhanging condyles. Correct selection of patients, strict surgical principles and standardized surgical techniques are the keys to prevent periprosthetic fractures during and after medial UKA. After the diagnosis is confirmed, the treatment choice mainly depends on the fracture pattern and the stability of the prosthesis.

Objective To explore the correlation between moderate to severe bronchopulmonary dysplasia(BPD)and early breastfeeding in preterm infants with a gestational age of ≤32 weeks.Methods A retrospective analysis was conducted on the clinical data of 220 preterm infants with a gestational age of ≤ 32 weeks.The preterm infants were dividedinto moderate to severe BPD group(37 cases)and control group(183 cases)based on whether moderate to severe BPD occurred or not.The clinical characteristics,breastfeeding volume,and mother s own milk(MOM)feeding rate were compared between the two groups,and the relationship between breastfeeding and the occurrence of moderate to severe BPD in preterm infants was analyzed.Results Univariate analysis showed that the moderate to severe BPD group had a higher proportion of infants with birth weight＜1 500 g,ges-tational age＜28 weeks,vaginal delivery,Apgar score≤7 at 1 minute after birth,and mechanical ventilation time ≥ 7 days compared to the control group(P＜0.05).The duration of intravenous nu-trition was longer in the moderate to severe BPD group(P＜0.05).The moderate to severe BPD group had lower breast milk intake from 0 to 7 days after birth,MOM intake,MOM feeding rate,and breast milk intake from 8 to 14 days after birth compared to the control group(P＜0.05).Multivari-ate Logistic regression analysis showed that a high volume of breastfeeding from 0 to 7 days after birth was an independent protective factor for the occurrence of moderate to severe BPD in preterm infants(OR=0.865,95％CI,0.767 to 0.976,P＜0.05).Gestational age＜28 weeks(OR=5.238,95％CI,1.158 to 23.686,P＜0.05),and mechanical ventilation time ≥7 days(OR=22.386,95％CI,6.769 to 74.030,P＜0.05)were independent risk factors for the occurrence of moderate to severe BPD in preterm infants.Conclusion Early breastfeeding after birth can significantly re-duce the risk of moderate to severe BPD in preterm infants with a gestational age of ≤32 weeks,and clinical measures should be actively implemented to promote early breastfeeding.

Unicompartmental knee arthroplasty (UKA) is an effective treatment for end-stage anteromedial osteoarthritis of the knee. Medial tibial plateau fracture or femoral condyle fracture may occur after UKA, and its treatment is very challenging. The causes leading to this complication include: surgical technique errors, such as the weakening of posterior cortical strength of the tibial platform during operation, the reduction of bone mass due to too much tibial osteotomy, and the stress concentration in the bone bed due to bad alignment of the prosthesis, etc. Prosthesis design factors, such as press-fit fixation design of cementless UKA prosthesis, and multiple nail holes fixation for tibial osteotomy guide, etc. And the morphology of tibial plateau, such as tibial platform in Asian people with narrow and small shap and medial overhanging condyles. Correct selection of patients, strict surgical principles and standardized surgical techniques are the keys to prevent periprosthetic fractures during and after medial UKA. After the diagnosis is confirmed, the treatment choice mainly depends on the fracture pattern and the stability of the prosthesis.