Objective To establish a off-pump leukocyte depletion method in canines.Methods Twenty-one healthy adult mongrel dogs of both sexes, weighing 10-12 kg, were randomized into 2 groups: control group (group C, n = 9) and leukocyte depletion group (group LD, n = 12) . An extracorporeal leukocyte filtration end was constructed by aseptic puncture of the bilateral external jugular veins via a blood transfusion line and the leukocyte filter for extracorporeal leukocyte depletion. In group LD, blood was filtered with a MP-300 blood line and a SQ40S leucocyte depletion filter one end placed in the right external jugular vein (artery end) and the other end placed in the left external jugular vein (venous end). After heparin anticoagulation, a MP-300 blood line pump was used as the power. Blood was filtered at a rate of 75 ml/min and it was maintained for 60 min. The artery end was then closed, normal saline injected into the closed circuit, the remaining blood pumped into the body, and then the venous end closed. In group C, aseptic puncture of the bilateral external jugular veins was performed. Arterial blood samples were taken immediately before leukodepletion (baseline, T_0 ) , at 10, 20, 30, 40, 50 and 60 min of leukodepletion (T_(1-6) , depletion period), and at 10, 20, 30, 40, 50, 60, 120, 180 and 270 min after leukodepletion (T_(7-15) , recovery period) for determination of blood routine. MAP, HR, RBC.Plt and body temperature were recorded at T_0 , T_6 , T_(12) and T_(15) . Results There were no significant difference in MAP and RBC between the two groups ( P > 0.05 ) . HR, body temperature, and Plt were significantly lower in group LD than in group C (P < 0.05) .The leukocyte concentration was lower during depletion period in group LD than in group C ( P < 0.05) , while there was no significant difference in leukocyte concentration during recovery period between the two groups (P > 0.05 ). Conclusion The off-pump leukocyte depletion method is successfully established and has exact efficacy with less adverse effects in this study.

AIM: To explore the feasibility of direct separat and selective enlargement of the bone marrow-derived liver stem cells (BDLSC) from bone marrow cells with a culture system containing cholestatic serum in vitro . METHODS: Bone marrow cells of rats were cultured with selective media containing 2%, 5%, 7% and 10% cholestatic rat serum, respectively. The BDLSC were then induced to proliferate with the addition of hepatocyte growth factor (HGF) on the firth day. BDLSC were characterized using immunocytochemistry and RT-PCR for lineage markers, glycogen staining and urea synthetic assay for functions 2 weeks later. RESULTS: Bone marrow cells were unble to form colony in the presence of 2% cholestatic serum and apopotosis appeared gradually in 7% or 10% cholestatic serum. The BDLSC survived in the medium containing 5% cholestatic serum while the other types of cells did not. The survival cells proliferated with a high speed during the second week and then formed hepatocyte-like colony-forming units (H-CFU). Cells in the H-CFU expressed the characteristic proteins of fetal hepatocytes. Furthermore, they had glycogen storage and urea synthesis functions, two of the critical features of hepatocytes. CONCLUSION: The selective micro-environment effectively selected BDLSC from the bone marrow cell, and will be a new way to provide an abundant source of donor hepatocytes for clinical cell therapy.

Bc58 is a UV resistant wild type strain that has an ability to produce a sorrel pigment induced by L-tyrosine.The FT-IR spectra and chemical tests of its pigment are similar to that of the standard melanin(Sigma).By bioassay shows that the LC_(50) of a Bt formulation added with the melanin of Bc58 and exposed to UV for 5 h is 16.1?g/mL,which is similar to that of Bt formulation without treated with UV,however,it is almost double higher than that of Bt formulation exposed to UV without the melanin of Bc58.The result of SDS-PAGE indicates that the melanin of Bc58 can protect the insecticidal crystal proteins from degradation.It suggests that an excellent UV protective agent to the insecticidal crystal proteins of Bt formulation.

Animals ; Fatty Liver ; complications ; metabolism ; Hepatitis ; etiology ; metabolism ; Male ; NF-kappa B ; metabolism ; PPAR alpha ; biosynthesis ; Rats ; Rats, Wistar ; Tumor Necrosis Factor-alpha ; blood

Objective To explore the necessity of setting up the course on clinical healthcare-associated infection (HAI) and effectiveness of the case-based teaching method in medical higher education.Methods 198 students who underwent internship in a hospital between July 2015 and July 2016 were selected,according to whether they selected clinical HAI coures,they were divided into course selective group(n =107,adopted case-based teaching method) and unselective group(n =91),questionnaire survey on the knowledge and attitude of HAI was carried out.Results The average score on HAI in selective group was higher than that of unselective group([85.3 ± 1.6] vs [58.3 ± 1.8],t =111.72,P＜0.01).Before and after conducted case-based teaching method,21.49％ and 47.66％ of students actively studied respectively,difference was significant (x2 =16.195,P＜0.01).Conclusion It is necessary to carry out a systematic course on HAI,case-based teaching method can improve the learning enthusiasm of students.

Objective To review the current research and application of root cause analysis (RCA) method in China's hospital management.Methods A retrospective analysis in six aspects was made by means of formulating a retrieval strategy and inclusion criteria, retrieval of databases, and literature review.Results The number of Chinese RCA researches was increasing year by year, mostly from researcher of the eastern coastal areas.These studies focused on the effects of RCA application outcomes and nursing safety.Tools in use were mainly fishbone diagram, brainstorming and 3-why method.72.24% of the root causes as found in literature were system factors, and 27.76% were human factors.Most of the researches made positive comments on RCA.Conclusions RCA is being warmly embraced by China's hospital management as it can positively change the accountability culture towards adverse events.Yet RCA has not been satisfactorily applied, and its future research and application in China's hospital management need more in-depth study and critical analysis.

Objective To discuss the clinical application of percutaneous transhepatic removal of gall-stone technique in treating common bile duct (CBD) stones.Methods Between January 2013 and January 2015,a total of 25 patients with CBD stones underwent lithotomy procedure via percutaneous transhepatic route.First,under ultrasound or fluoroscopy guidance percutaneous transhepatic cholangiography (PTC) was performed with subsequent placement of an 8 F rsheath;then,a balloon of 8-12 mm diameter was employed to dilate the papilla;mechanical lithotripsy was adopted when the stone size exceeded 12 mm;finally,through guide-wire exchange technique the stone-retrieval balloon was used to push the stones into the intestinal tract through the sphincter of duodenal papilla.Results The reasons to receive percutaneous transhepatic removal of gall-stone technique in the 25 patients included previous gastrointestinal surgery (n=18),endoscopic treatment failure (n=3),unwilling to receive endoscopic treatment (n=3),and other reasons (n=1).Successful removal of stones was accomplished in all 25 patients.After the treatment,complications occurred in 3 patients (12％),including fever (n=2) and liver abscess formation (n=1).The patients were followed up for 0.5-3 years;two patients died of tumor recurrence and metastasis,and one patient developed recurrence of common bile duct stones.No reflux cholangitis occurred.Conclusion For the treatment of CBD stones,percutaneous transhepatic removal of gall-stone technique carries higher technical success rate with lower incidence of complications,therefore,this technique can be used for the patients who are not suitable for endoscopic treatment or in whom endoscopic treatment failed.

Objective To determine whether hybrid three dimensional diffusion tensor imaging (3D DTI) contributes incremental value to standard T2WI technique for assessing neurovascular bundles (NVB) around the prostate. Methods This retrospective institutional review board-approved study included 69 consecutive patients with prostate tumor who underwent MRI including conventional T2WI and 3D DTI . DTI data were postprocessed and hybrid 3D DTI and axial T2W images were obtained. Three radiologists with one, five and thirteen years of experience in reading prostate MRI and one urologist with three years of surgical experience in urology who were blinded to patient data independently recorded their levels of preference on a five-point scale of the NVBs around the prostate on the basis of T2WI alone and hybrid 3D DTI and T2WI, respectively. The differences of scores of T2WI and hybrid 3D DTI and T2WI of the four doctors were compared by using nonparametric Wilcoxon rank. Results The average scores of hybrid 3D DTI to T2WI and alone T2WI to assess NVBs for 3 radiologists and one urologist were 4.4±0.6, 4.3±0.8, 4.2± 0.6, 4.9±0.3 and 2.9±0.8, 3.0±1.1, 1.6±0.7, 3.8±0.5, respectively. The hybird 3D DTI to T2WI improved the discrimination abilities of NVBs around the prostate for 3 radiologists and one urologist (Z values were-12.791,-9.737,-14.538,-14.901, P<0.01 respectively).The added value of hybrid DTI to T2WI for urologist is the highest, and experienced radiologist is the smallest. Conclusion The hybrid 3D DTI
contributes significant incremental value to the standard T2WI technique for assessing NVB around the prostate.

U-shaped sacral fractures are rare and often difficult to diagnose primarily due to the difficulty in obtaining adequate imaging and the severe associated injuries.These fractures are highly unstable and frequently cause neurological deficits.The majority of surgeons have limited experience in management of U-shaped sacral fractures.No standard treatment protocol for U-shaped sacral fractures has been available till now.This study aimed to examine the management of U-shaped sacral fractures and the early outcomes.Clinical data of 15 consecutive patients with U-shaped sacral fracture who were admitted to our trauma center between 2009 and 2014 were retrospectively analyzed.Demographics,fracture classification,mechanism of injury and operative treatment and deformity angle were assessed.All the patients were treated with lumbopelvic fixation or (and) sacral decompression.EQ-5d score was applied to evaluate the patients' quality of life.Of the 15 consecutive patients with U-shaped sacral fracture,the mean age was 28.8 years (range:15-55 years) at the time of injury.There were 6 females and 9 males.The mean followup time was 22.7 months (range:9-47 months) and mean full weight-bearing time was 9.9 weeks (range:8-14 weeks).Ten patients received lumbopelvic fixation and sacral decompression,one lombosacral fixation,and 4 merely sacral decompression due to delayed diagnosis or surgery.The post-operation deformity angle (mean 27.87°,and range:8°-90°) of the sacrum was smaller than that pre-operation (mean 35.67;range:15-90) with no significance difference noted.At the latest follow-up,all patients obtained neurological recovery with different extents.Visual analogue score (VAS) was reduced from preoperative 7.07 (range:5-9) to postoperetive 1.93 (range:1-3).All patients could walk without any aid after treatment.Eight patients were able to care for themselves and undertook some daily activities.Five patients had returned to work full time.In conclusion,lumbopelvic fixation is an effective method for stabilization of U-shaped sacral fractures with fewer complications developed.Effective reduction and firm fixation are the prerequisite of early mobilization and neurological recovery.Sacral decompression effectively promotes neurological recovery even in patients with old U-shaped sacral fractures.

OBJECTIVETo investigate the expression of cyclin A protein in childhood acute leukemia (AL) and its significance.

METHODSBy using Western blotting analysis, cyclin A protein in bone marrow mononuclear cells from 47 newly diagnosed AL children and 33 non-hematological malignancy children was detected.

RESULTSThe expression of cyclin A in AL group (0.38 +/- 0.20) was higher than that in control group (0.03 +/- 0.15) (P < 0.01). The expression of cyclin A in high risk acute lymphocyte leukemia (ALL) group (HR-ALL) (0.62 +/- 0.38) was higher than that in standard risk ALL group (SR-ALL) (0.33 +/- 0.33) (P < 0.05). The expression of cyclin A in WBC > or = 50 x 10(9)/L group and in WBC < 50 x 10(9)/L group was (0.64 +/- 0.36) and (0.39 +/- 0.38), respectively (P < 0.05). Eight (44.4%) out of 18 patients with positive cyclin A expression achieved complete remission (CR). The CR rate was lower than that of patients with negative cyclin A expression (100%) (P < 0.01).

CONCLUSIONSThe higher expression of cyclin A may predict a poor prognosis for childhood ALL.

Acute Disease ; Adolescent ; Child ; Child, Preschool ; Cyclin A ; genetics ; metabolism ; Female ; Humans ; Infant ; Leukemia ; metabolism ; Male