Objective To investigate the effect of protamine(PS)coated polylactic acid(PLA)nanocapsule on the immune response of murine bone marrow-derived dendritic cells(BMDCs).Methods PLA nanocapsules were prepared by W1/O/W2 method.Protamine was used to modify the surface of PLA nanocapsule that encapsulated ovalbumin(OVA),a model anti-gen.The prepared OVA/PLA/PS nanocapsules were used to stimulate BMDCs.Flow cytometry was used to analyze the ex-pression of surface molecules CD80,CD83,CD86,MHCⅠ,and MHC Ⅱ,and the uptake of nanocapsule.The levels of IL-12 p70 secreted by BMDCs were detected by ELISA.Results OVA/PLA/PS nanocapsules could significantly up-regulate the expres-sion of CD80,CD83,MHCⅠ,and MHC Ⅱ in BMDCs,and increase the secretion of IL-12 p70 by BMDCs.Furthermore,OVA/PLA/PS nanocapsules could enhance the uptake efficiency of OVA by BMDCs.Conclusion OVA/PLA/PS nanocapsule can en-hance the immune response of BMDCs,and may become a good drug delivery carrier.

Objective Study the early and midterm results of a technique-total aortic arch replacement without using extracorporeal circulation or aortic bypass for the treatment of aortic aneurismal disease involving the transverse aortic arch and proximal descending aorta. Methods Between April and November 2004, 7 consecutive patients with true (n = 3) or false (n =4) aortic aneurysm underwent this procedure. The mean follow-up was 6. 6 years. The median age at operation was 57years ( range 23 to 75 years). Normothermia general anesthesia and median sternotomy combined with left anterior thoracotomy were administered. A partially occluding clamp was placed on ascending aorta and a longitude aortic incision was made. Anastomosis of a branched graft to ascending aorta in an end-to-side fashion was commenced. The descending aorta distal to the aneurysm was occluded and transected, and anastomosed to the distal end of the branched graft in an end-to-end fashion. Finally,the arch vessels were divided and anastomosed to the branches of the graft and the aneurysm excised. Results The average cross-clamp time of descending aorta, left common carotid artery, and innominate artery was (13.6 ±5.6)min, (5.7 ±0.8)min, and (7.8±2.5) min respectively. The mean intubation time was (12.3 ±4.1) hours. There were no adverse outcomes or neurologic complications in this series. All patients survived and recovered completely. The mean follow-up time was (79.7 ±2.1) months. All patients lead a normal life. There was no late death. CT follow-up study 6 years after surgery reveals no abnormal image. Conclusion Total aortic arch replacement without cardiopulmonary and aortic bypass is a feasible and effective method for the aortic aneurismal disease involving the transverse aortic arch and proximal descending aorta in selected patients.

Adult acquired aortic disease such as aortic dissection,aortic aneurysm,is common,and the treatment is complicated.Furthermore,the specific molecular etiology of this kind of disease is unknown.MicroRNA,which is a short peptide molecule,to some extent,participated in almost every aspect of biological functions.This paper aims to review the role of microRNA in molecular etiology of adult acquired aortic disease.

Objective Postictal language testing can provide useful diagnostic information for seizure lateralization.However no such a study based on non-English language was done previously.We investigated the latency of language recovery in Chinese patients with temporal lobe epilepsy (TLE).Methods Complex partial seizures in patients with TLE were extracted from our video-electroencephalogram (EEG) database.For all patients,consciousness testing started as soon as seizures were detected.When they were alert and cooperative,they were asked to read out a sentence “昨晚他们听到老在电台里讲话”which was printed on a card.When the patients were able to read the sentence correctly,the language function was considered recovered.Results Totally 65 complex partial seizures from 22 cases of TLE (11 left and 11 right) were included.Patients were cooperative to language testing in 54 seizures (83％).The latency for consciousness recovery (CRL) and latency for consciousness language recovery (LRL) were not associated with seizure duration,but the seizure lateralization.The CRL (median,161 s) and LRL (281 s) in the left TLE were statistically significantly longer than that in the right TLE (30 s,54 s respectively).Using 150 s recovery time as bound language recovery ratio was 87％ (27/31) in right TLE and 13％ (3/23) in left TLE.Conclusion Postictal language testing based on ideographic Chinese words helps to establish seizure lateralization in patients with TLE.

Objective To summarize the methods and results of surgical treatment of coarctation of the aorta associated with aortic dissection.Methods Analyzed the clinical data of 10 patients with aortic coarctation associated type B aortic dissection who underwent one-stage surgical repair between 2011 and 2013 in Anzhen Hospital.There were 7 males and 3 females with the age ranged from 23 to 56 years,average at 41.2 years.All patients were diagnosed by UCG and CTA.There are three key points to determine the operation method,diameter of the aortic arch and descending aorta,and the extent of dissection.Descending thoracic aortic replacement with short stented elephant trunk was performed in 3 patients,thoracic and abdominal aortic replacement in 1 patient,ascending-abdominal aorta bypass with arch or descending aortic ligature in 3 patients.Results One hospital death occurred(10％).There was no severe surgical complication.No death or reoperation occurred during follow up period.Conclusion Aortic coarctation associated type B aortic dissection is a rare and complex disease.Surgical treatment is an effective and safe method for the disease.

ObjectiveTo evaluate the value of endoscopy in the diagnosis of biliary tract roundworm disease.Methods32 cases of biliary tract roundworm diseases were diagnosed and treated with fibre (electron) stomach duodenum endoscopy and fibre biliary tract endoscopy under the direct-view.Results32 cases were all clearly diagnosed and the worms were taken out with direct-view endoscopy or direct cholangiography with no complications.ConclusionEndoscopy is effective and accurate for the biliary tract roundworm disease and has the advantage of rapidly dispelling the sufferings of the patients.

Objective To investigate whether emodin(1,3,8-trihydroxy-6-methylanthraquinone) can attenuate inflammatory response in rats' lungs with acute necrotic pancreatitis (ANP). Method Acute necrotic pancreatitis model was induced by injection of 3% sodium taurocholic acid into the subcapsular of pancreas and emodin was administered by intestine perfusion. Plasma amylase of 3, 6 and 12 h with acute necrotic pancreatitis was measured together with the detection of IL-1β, IL-6 and IL-10 mRNA expressions in rats' lungs by semi-quantitative RT-PCR. Immunohistochemistry was detected the expression of IL-1β converting enzyme (ICE) in the rats' lungs. Result Plasma amylase of 3, 6 and 12 h with acute necrotic pancreatitis groups are obviously high as compared with normal group(P＜0.05). Plasma amylase was (1 611.20±218.72)IU/L in normal group. Plasma amylase of 3, 6 and 12 h with acute necrotic pancreatitis groups were (1 981.40±56.81)IU/L, (3 287.40±612.37)IU/L and (4 914.60±746.82)IU/L. Plasma amylase of 3, 6 and 12 h with acute necrotic pancreatitis after treatment with emodin groups were obviously low as compared with acute necrotic pancreatitis groups. The plasma amylase was(1 617.20±136.80)IU/L,(2 323.40±318.19) IU/L and (2 670.20±390.03)IU/L respectively. The study showed that the mRNA expression of pro-inflammatory cytokin IL-1β and the expression of IL-6, as well as the expression of IL-1β converting enzyme(ICE) were decreased and IL-10 was increased. Conclusion The study demonstrates that emodin plays an important role in reducing plasma amylase level. Emodin exerts anti-inflammatory effects in acute necrotic pancreatitis rats' lungs by downregulating the mRNA expression of IL-1β and IL-6 and upregulating the mRNA expression of IL-10.

Objective To evaluate the impact of cerebrospinal fluid drain(CSFD) on the incidence of acute spinal cord injury(SCI) following extensive TAAA repair.Methods From February 2009 to July 2016,153 patients underwent extensive TAAA repairs with a consistent strategy of normal thermia,non-circulatory bypass,sequential aortic cross clamping,aortic-lilac bypass,and intercostal artery reconstruction.The repairs were performed with preoperative CSFD (n =78) or without CSFD (n =75).In the former group,CSFD was inserted after the patient has been anaesthetized and continued for 72 hours after surgery.The target CSF pressure was 10 mmHg or less.Results The mean age of patients was (38 ± 10) years and 108 (70.6％) were male.There were 87 (53.8％) patients with previous aortic surgeries and 33 (22％) with Marfan syndrome.The two groups had similar risk factors for paraplegia.Aortic clamp time,operation time and number of reattached intercostal arteries were similar in both groups.In-hospital mortality rates were 1.3％ (one patient) and 6.7％ (five patients) for CSFD and the group without CSFD,respectively (P =0.086).Ten patients (13.3 ％) in the group without CSFD had paraplegia develop.In contrast,only two patients in the CSFD group(2.6％) had postoperative paraplegia(P =0.013).Stepwise logistic regression analysis identified CSFD had spinal cord protection,P =0.026;OR =0.171;95％ CI:0.036-0.809).No patients occurred CSF catheter related complications.Conclusion This randomized clinical trial showed that preoperative CSFD placement could be an effective strategy in preventing SCI following extensive aortic aneurysm repair.Care should be taken to prevent complications related to overdrainage.

Objective To investigate the pathogenesis,diagnosis,treatment and prognosis of aort-oesophageal fistula(AEF).Methods Retropective analysis was performed on 6 patients presenting with AEF between January 2002 and December 2014,and relative literature was reviewed on its pathogenesis,di-agnosis,prognosis and treatment.Results Five men and 1 woman with a mean age of 49 (range,27-71 years)were recruited to the study.One case of AEF was caused by esophageal foreign body,2 cases were caused by aneurysm while the other 3 patients presented AEF after aortic surgery.All 6 patients showed he-matemesis,among whom 3 presented sentinel hemorrhage,1 presented exsanguination after sentinel hemor-rhage,2 presented sudden exsanguination.Among 4 patients with sentinel hemorrhage,2 accompanied with chest pain,1 with dysphagia and 1 with fever.Two patients had a history of hypertension.Diagnostic rate was nearly 100% by gastroscopy or CT/CTA.Four patients died from hemorrhagic shock and 2 patients re-covered from surgery.Conclusion AEF should be seriously considered for patients with a history of hyper-tension,aortic disease or esophageal foreign body presenting sentinel hemorrhage,chest pain,dysphagia,fa-tal exsanguination followed by symptom-free interval.Prompt examinations and aggressive surgery are of great significance for survival.

Objective To construct eukaryotic expression recombinant plasmid containing human granulysin(GLS) and investigate the effect of GLS expression in macrophage RAW264.7 cells on the bactericidal activity against intracellular Mycobacterium tuberculosis.Methods GLS gene was amplified by nested-polymerase chain reaction(PCR) from human cytotoxicity T lymphocyte(CTL) activated by allogenic antigen,and inserted into pBudCE4.1 vector to construct recombinant plasmid.Subsequently,the plasmid was transfccted into RAW264.7 cells which were infected with Mycobacterium tuberculosis H37Rv.The expression of GLS was detected by nested-PCR and immunocytochemistry method.The RAW264.7 cells were lysed after transfected for 96 h,then acidfast stained,cultivated and colony count were done to determine the intraeellular bactericidal activity of GLS.The data were analyzed by t or t' test.Results The pBudCE4.1/GLS eukaryotic expression recombinant plasmid was successfully constructed.The transcriptional and translational expressions of target gene GLS were detected in RAW264.7 cells which were infected with Mycobacterium tuberculosis H37Rv.The bacterial load in macrophages of phorbol myristate acetate(PMA)+pBudCE4.1/GLS group,PMA+pBudCEA.1 group and non-activated group were 1.44±1.25,3.16±0.20 and 3.59±0.21,respectively.The differences between groups were all significant (t=2.403,t=2.854,both P＜0.05).Conclusion Eukaryotic expression recombinant plasmid carrying human GLS gene expressed in macrophages has strong bactericidal activity against intracellular mycobacteria,which provide information for the further study on therapeutic vaccine against Mycobacterium tuberculosis.