Objective Acute renal failure (ARF) requiring renal replacement therapy (RRT) was reported in 0.33％to 9.5％ patients after cardiac surgery.This study was designed to assess the clinical usefulness and accuracy of 3 clinical tools for the prediction of ARF after cardiac surgery in Chinese patients.Methods Five hundred and four eligible patients with complete clinical data in our institution received prospective assessment for RRT and acute kidney injury (AKI) between June,2009 and November,2010.The clinical tools used were Cleveland ARF Score,acute kidney injury prediction following elective cardiac surgery(AKICS) and Simplified Renal Index(SRI).Hosmer—Lemeshow goodness-of-fit test was used to estimate the calibration.Discrimination was determined with receiver operating characteristic (ROC) curves and area under a ROC curve (AUC).Results Follow-up was completed in all 504 patients.The overall incidence of postoperative RRT was 3.17％(16/504) with a mortality of 37.5％,and the incidence of AKI was 5.36％ ( 27/504 ).Discrimination for the prediction of RRT and AKI was good for SRI measured with AUROCs:0.759 (95％ CI,0.643-0.874) for RRT and 0.773 (95％ CI,0.677-0.868 ) for AKI.SRI score performed better in terms of discrimination than Cleveland ARF score and AKICS in our study,which did not consist with results reported by other centers.Conclusion SRI scoring system is the most useful among three tools for predicting postoperative RRT and should be the first choice in Chinese patients for whom a cardiac surgery is planned.It can also be used in predicting the composite end point of AKI with an extended application in patients at risk for postoperative kidney dysfunction.

Cerebral venous thrombosis, as a rare extraintestinal manifestation of inflammatory bowel disease, is often neglected in the course of clinical diagnosis and treatment. This article reviews the advances in the treatment of inflammatory bowel disease related cerebral venous thrombosis.

Objective To explore the safety of Habib VesOpen bipolar radiofrequency ablation (RFA) catheter used in the treatment of portal vein tumor thrombus (PVTT). Methods A total of 10 miniature pigs were randomly divided into 3 groups. Group A(n=6):RFA of normal portal vein was directly performed;group B (n=2): balloon obstruction of the portal vein was performed first, which was followed by RFA for the fresh thrombus in the portal vein; group C (n=2): PVTT model was established first, and RFA of the portal vein was carried out when the portal thrombus became organized. MRI examination was employed at one, 3 and 4 weeks after RFA; the animals were sacrificed 4 weeks after RFA and pathological examination of portal vein was performed. Results Pigs of group A received portal vein RFA under the condition of 5 W power for 0.6-3.6 min. No obvious abnormality was detected by MRI and pathological examination , which were performed one month after the treatment. In the pigs of group B , MRI performed after RFA showed that the damage of portal vein area was more serious than that in the pigs of group A;abdominal MRI examination performed at one, 3 and 4 weeks after RFA showed that the portal venous edema was gradually decreased;pathological examination at one month after RFA demonstrated serious injury of adjacent liver tissue. Pigs of group C received portal vein RFA under the condition of 7 W power for 1.5 min; no obvious edema of the ablated area was observed on MRI performed after RFA , and pathological examination revealed organized thrombus necrosis and va scular endothelial cell damage. Conclusion When Habib VesOpen bipolar RFA catheter is used for the treatment of PVTT, the RFA power and time should be properly selected according to the severity of PVTT. In order to ensure a safer procedure, high power and short ablation time should be used when the severity of PVTT is mild, while low power and longer ablation time are recommended when the PVTT is more severe.

Antibiotics, Antineoplastic ; administration & dosage ; Carcinoma, Hepatocellular ; therapy ; Chemoembolization, Therapeutic ; methods ; Doxorubicin ; administration & dosage ; Drug Carriers ; Follow-Up Studies ; Humans ; Liver Neoplasms ; therapy ; Male ; Microspheres ; Treatment Outcome

OBJECTIVE Bergapten (BG), is a furanocoumarin derived from herbal and citrus extracts can act as antioxidant and selective anticancer agents.The current study aimed to investigate whether bergapten would attenuate immunosenescence and to exploreits immunomodulatory effects on immune responses in D-galactose-induced aging BALB/c mice.METHODS Firstly,mice were given D-galactose(180 mg·kg-1)subcutaneous injections for 30 d.To evaluate the establishment of the aging-related effect in mice, serum samples of BALB/c mice were collected from tail vein. Aging BALB/c mice were freely divided into three groups: negative control group received 1% Tween 80 solution only, named D-gal group. Positive groups were received BG administration at the dose of 20 and 100 mg·kg-1, named D-gal+BG(20)group and D-gal+BG(100)group,respectively.Effects of bergapten on T lympho-cyte proliferation and flow cytometry were assessed by using the splenic cell suspension. Enzyme linked immunospot kits were used to quantitatively determine interferon-γ(IFN-γ)and interleukin-4(IL-4) levels of the isolated serum. Immunophenotype was determined by using mixture of antibodies includ-ing anti-CD3,anti-CD4,and anti-CD8.RESULTS Bergapten(20 mg·kg-1)therapy can modulate immu-nity against viral epidemics and attenuate aging-induced immune deficiency(P<0.01),which was correlat-ed with the decline in the activation of the Th and Tc responses in D-galactose induced aging BALB/c mice.According to the in vivo results,bergapten exposure up-regulated the secretion of IFN-γ and IL-4 in T-helper 1(Th1)and T helper 2(Th2)cells(P<0.05,P<0.01).Additionally,BG(20 mg·kg-1)restored antigen-specific CD4+and CD8+T cells in aging models (P<0.05, P<0.01), which may help to curing chronic infections. CONCLUSION The beneficial effect of bergapten in D-galactose induced aging BALB/c mice may be due to the Th and Tc responses activation.

Objectives: The FOURIER trial reported that inhibition of PCSK9 with evolocumab on a background of statin therapy lowered low-density lipoprotein (LDL) cholesterol levels to a median of 30 mg per deciliter (0.78 mmol per liter) and reduced the risk of cardiovascular events. Here, we report data from a single center focusing on the effect of a PCSK9 inhibitor antibody on hyperlipidemia. Methods: We enrolled 29 hypercholesterolemia patients who had LDL cholesterol levels ≥ 70 mg per deciliter or nonHDL cholesterol ≥ 100 mg per deciliter and were divided into two groups (placebo n = 14, evolocumab n = 15), and participated in a 72 - 96 week, randomized, double-blind, placebo-controlled trial with statin therapy. Patients were randomly assigned to receive evolocumab (140 mg every 2 weeks or 420 mg monthly) or matched placebo via subcutaneous injection. Lipid changes during follow-up were analyzed. Results: The median LDL cholesterol level at baseline was 88 mg per deciliter, and the average LDL cholesterol level was 101.8 ± 20.0 mg per deciliter. At 4 weeks, the median LDL cholesterol level was 39 mg per deciliter, and the average LDL cholesterol level was 34.8 ± 51.8 mg per deciliter. Compared to placebo group, the LDL cholesterol levels were significantly reduced after treatment (P < 0.001), as well as total cholesterol, ApoB, and ApoB / ApoA1 levels. During follow-up, no discomfort was reported at local injection sites, and no cases of abnormal liver function were observed. Conclusions Evolocumab significantly reduced LDL cholesterol levels and was well tolerated.

Objectives: The FOURIER trial reported that inhibition of PCSK9 with evolocumab on a background of statin therapy lowered low-density lipoprotein (LDL) cholesterol levels to a median of 30 mg per deciliter (0.78 mmol per liter) and reduced the risk of cardiovascular events. Here, we report data from a single center focusing on the effect of a PCSK9 inhibitor antibody on hyperlipidemia. Methods: We enrolled 29 hypercholesterolemia patients who had LDL cholesterol levels ≥ 70 mg per deciliter or nonHDL cholesterol ≥ 100 mg per deciliter and were divided into two groups (placebo n = 14, evolocumab n = 15), and participated in a 72 - 96 week, randomized, double-blind, placebo-controlled trial with statin therapy. Patients were randomly assigned to receive evolocumab (140 mg every 2 weeks or 420 mg monthly) or matched placebo via subcutaneous injection. Lipid changes during follow-up were analyzed. Results: The median LDL cholesterol level at baseline was 88 mg per deciliter, and the average LDL cholesterol level was 101.8 ± 20.0 mg per deciliter. At 4 weeks, the median LDL cholesterol level was 39 mg per deciliter, and the average LDL cholesterol level was 34.8 ± 51.8 mg per deciliter. Compared to placebo group, the LDL cholesterol levels were significantly reduced after treatment (P < 0.001), as well as total cholesterol, ApoB, and ApoB / ApoA1 levels. During follow-up, no discomfort was reported at local injection sites, and no cases of abnormal liver function were observed. Conclusions Evolocumab significantly reduced LDL cholesterol levels and was well tolerated.

OBJECTIVETemporomandibular joint sideways and rotational disc displacement was assessed by arthrography with dental volumetric computerized tomography.

METHODSThe study was conducted retrospectively on 119 joints of 109 patients (87 females, 22 males, mean age 31.1 years), who had undergone arthrography with dental volumetric CT in the sagittal and coronal planes. The disc displacements were subdivided into 5 types; condylar abnormalities were subdivided into 4 types.

RESULTSComplete anterior disc displacement was the commonest (70.6%) and medial the rarest (0.8%); anterolateral and anteromedial displacements were 18.5% and 10.1% respectively. The types of disc displacements were not correlated with bone lesions. A higher prevalences of bone lesions were found in the lateral poles of condyles.

CONCLUSIONSArthrography using dental volume CT can be taken in the sagittal and coronal planes, so the sideways and rotational disc displacements, perforations and bone lesions can be evaluated. It's superior to conventional arthrography.

Adolescent ; Adult ; Aged ; Arthrography ; Female ; Humans ; Male ; Middle Aged ; Temporomandibular Joint Disc ; diagnostic imaging ; Temporomandibular Joint Disorders ; diagnostic imaging ; Tomography, X-Ray Computed

OBJECTIVETo investigate luciferase gene expression and pathological changes of submandibular glands (SMG) of rats after adenovirus-mediated gene transfer.

METHODSAdenovirus-mediated luciferase gene (AdCMVLuc, 10(8) pfu in 50 microl) was injected in to SMG of forty wistar rats. The SMGs were harvested for gene expression measurement and pathological study after 3 days, 1,2,4 and 8 weeks.

RESULTSPeak expression was observed in three days following administration of the vector however, gene expression in submandibular glands decreased rapidly. the pathological changes induced by retrograde injection of AdCMVLuc included: after 3 days to one week, compression of acini, dilation of terminal ducts; after two weeks, slight atrophy of a part of acini, increase of iteracinar distance and focal lymphocyte infiltration in lobules and interlobular ducts; after 4 weeks, recovery evidence was found in acini; after 8 weeks, normal acini and ducts were found. The ultrastructural changes included: 3 days, much more rough endoplasmic reticulum was found both in acini and duct epithelial cell; a lot of mucus drops were found in acini; after 1 week, microvillus decreased in duct epithelial cells, mitochondria increased significantly in acini; intercellular space was enlarged.

CONCLUSIONSAdenovirus-mediated gene transfer can produce biological proteins and induce marked inflammatory changes in rat SMG. The ultrastructural changes suggest high protein synthesis activity in the acinar cells after gene transfer.

Adenoviridae ; enzymology ; genetics ; Animals ; Gene Expression ; Gene Transfer Techniques ; Luciferases ; genetics ; Male ; Random Allocation ; Rats ; Rats, Wistar ; Submandibular Gland ; pathology ; virology

OBJECTIVETo study a new method for repair of facial depression and facial nerve defect after parotid carcinoma resection.

METHODS12 patients with parotid carcinoma and peripheral bone invasion were treated using facial nerve canal dissection and radical resection of the tumor, the parotid gland and the involved facial nerve and bone, including the mastoid, stylomastoid foramen, styloid process and the rear part of the mandible. A sternocleidomastoid muscle flap was elevated and transferred to repair the facial depression. The great annular nerve in the flap was anastomosed with the severed end of the facial nerve in the canal.

RESULTSThe depressed deformity of the parotid area was well corrected in 9 patients. The aesthetic results were compromised in 2 patients because of tumor recurrence and reoperation. The depressed deformity was not corrected in 1 patient because of infection. Postoperatively, the function of the facial nerve recovered to a normal level. The recovery time ranged from 12 to 20 weeks ,with an average of 16.3 weeks. The local control rate of tumor was improved.

CONCLUSIONSImmediate transplantation of the sternocleidomastoid muscle-great auricular nerve flap and facial nerve canal dissection in radical parotidectomy can repair the depressed deformity of the parotid area, restore facial nerve function,and decrease tumor recurrence. The method is an ideal operation with functional recovery.

Adult ; Cervical Plexus ; Facial Nerve ; transplantation ; Female ; Humans ; Male ; Middle Aged ; Neck Muscles ; transplantation ; Parotid Neoplasms ; surgery ; Surgical Flaps ; innervation ; Treatment Outcome