Objective To analyze the expression of glial fibrillary acidic protein(GFAP) in hippocampal of rats with hypoxic-ischemic brain damage(HIBD) after injection of bone marrow stromal cells(BMSCs) supernatant into the lateral ventricle of the neonate rats,assess the ability of learning and memory,and explore the mechanism.Methods 7-day-old SD rats were randomly divided into sham operation group,model group,cells and supernatant group,with 20 rats in each group.The HIBD model was established via the ligation of left carotid arteries followed by 2-hour hypoxia.One week later,rats in control group were injected with 0.01 mol/L PBS 2 μl via the left ventricle.Meanwhile,the cell and the supernatant groups were injected with BMSCs and supernatant harvested from BMSC culture,respectively,via the same route.In the sham operation group,the left carotid arteries were separated but not ligated,and no hypoxia treatment was imposed on this group.They also received 0.01 mol/L PBS injection 2 μl per weak post surgery.8 weeks later,Morris water maze test was performed to assess the learning and memory,and the expression of GFAP in the dentate gyrus of rats was measured by immunohistochemistry.Results Morris water maze showed that the searching time of the probe trail(T1:(15.40±2.80) s) and reversal probe trail (T2:(16.45± 1.16) s) of the model group was shorter than that of the sham operation group (T1:(19.96±2.57) s,T2:(2:25.32±2.54)s,P＜0.05),while the searching time of the cell group(T1:(17.54± 1.80)s,T2:(18.99± 1.47) s) and supernatant group (T1:(17.40±2.37) s,T2:(17.96± 1.09) s) was prolonged compared with that of the model group (P＜0.05).No significant difference between the cell group and the supernatant group (P＞0.05).The integral optical density (IOD) value of GFAP positive cells was higher in the model group than that in the sham operation group(15.26±1.49 vs 12.82±2.56,P＜0.05),while the IOD of cell group(18.13±1.97) and that of the supernatant group(17.38± 1.64) were higher than that of the model group (P＜0.05).However,there was no significant difference between the cell group and the supernatant group (9＞0.05).Conclusion BMSC supernatant injected through lateral ventricle can improve the HIBD rats' abilities of learning and memory.The mechanism might be that MSCs secrete some cytokines to promote central nervous system repair.

Objective To evaluate the effects of pulmonary recruitment (RM) in severe acute respiratory distress syndrome (ARDS) with different body position and positive end-expiratory pressure (PEEP) mode in stage of mechanical ventilation. Methods From June 2013 to June 2016, 80 cases of ICU hospitalized patients with clinical data were enrolled, and they lay in the prone or supine position (prone position group and supine position group, each of 40 cases). The hemodynamic parameters including heart rate (HR), central venous pressure (CVP) and peripheral arterial pressure, respiratory mechanics index including respiratory rate (RR), respiratory system compliance (Crs) and platform pressure (Pplate), and the changes of blood gas analysis index were monitored to observe the effects of RM in different positions with positive end expiratory pressure increasing method. Results The levels of oxygenation index and arterial partial pressure of oxygen (PaO2) were improved 3, 5 and 7 d after treatment compared with those 1 d after treatment (P<0.05), and they were improved significantly in prone position group than those in supine position group 3 and 5 d after treatment (P<0.05). The levels of RR, Crs and Pplate 15 min, 30 min, 1 h, 6 h, 12 h and 24 h after RM had significant differences compared with those before RM (P<0.01). The levels of HR, CVP, peripheral arterial pressure 15 min, 30 min, 1 h, 6 h, 12 h and 24 h after RM had no significant differences compared with those before RM (P>0.05). Conclusions For patients with severe ARDS, early implementation of prone position ventilation combined with PEEP increasing method re-expansion treatment is safe and reliable. It can effectively improve oxygenation level and help to improve the survival rate.

Objective To construct the murine allogeneic acute GVHD model.Methods C57BL/6 (H-2b) mice were used as the donors and Balb/c (H-2d) mice as the recipients in allogeneic bone marrow transplantation (BMT).Groups were set as total body radiation (TBI) control group (n =4),GVHD group (n =10),simple BM transplantation group (n =10) and normal control group (n =4).For TBI control group,mice were subjected to TBI but did not receive BMT after radiation.For GVHD group,5 days before TBI,gentamycin (320 mg/L) and erythromycin (250 mg/L) were added into the drinking water,and on the day of transplantation,mice received one total dose of 8.0 Gy 60Coγ TBI,and within 5 h,2 × 106 C57BL/6 BM cells and 1 × 107 C57BL/6 spleen cells were transfused per mouse via the tail vein.For simple BMT group,the pretreatment was the same as GVHD group,and mice received only 2 × 106 C57BL/6 BM cells per mouse via the tail vein.The mental status,activity,posture,fur,weight,and stool were observed after transplantation.Survival time of each mouse was recorded,survival rate was calculated,and survival curve was drawn.Pathological examination was done for the liver,skin,small intestine and BM on the brink of death.Results The median survival time (MST) in TBI control group,GVHD group and BMT group was (9.0 ± 0.7),(32.0 ± 3.2) and ( 17.5 ± 1.6) days respectively,and there was significant difference between every two groups (P ＜ 0.01 ).Pathological examination in TBI control group showedhematopoiesis exhaustion.GVHD group showed acute GVHD symptoms 10-13 days after allo-BMT,and the pathological changes of the skin,liver and small intestine corresponded to those of Ⅰ to Ⅱ degree of GVHD.Simple BMT group also showed acute GVHD symptoms 10-13 days after alloBMT,but their GVHD manifestation and histological changes were less serious and only 0 to Ⅰ degree of GVHD could be seen.ConclusionStable acute GVHD model can be constructed by transfusion of allogeneic BM cells and spleen cells into Balb/c mice after lethal TBI.

The graft-versus-tumor (GVT) effect of T cells induced by tumor antigen-pulsed CD8α(+) dendritic cells (DCs) in vitro was investigated in this study. Immature CD8α(+) DCs were prepared from C57BL/6 (H-2(b)) bone marrow cells by using a cytokine cocktail. On the 3rd day of culture, CD8α(+) DCs were pulsed by allogeneic (Balb/c, H-2(d)) EL9611 leukemia antigen, or RM-1 syngeneic prostate cancer antigen, with the concentration series of 0, 2.5, 5.0, 10.0, 20.0 μg/mL, respectively, then antigen-loaded immature CD8α(+) DCs were co-cultured with syngeneic T cells according to the DC/T ratio of 1:1, 2:1 and 4:1. T cell proliferation was measured by MTT assay. Cytokines including interferon gamma (IFN-γ) and interleukin-10 (IL-10) in CD8α(+) DCs and T co-culture supernatant were detected by using ELISA. Cytotoxic effect of antigen-specific T cells was tested by LDH release assay. Conventional mature DCs (mDCs) induced from C57BL/6 (H-2(b)) bone marrow cells by using granulocyte-macrophage colony stimulating factor (GM-CSF) and interleukin-4 (IL-4) served as a control. The results showed that the proliferative activity of T cells stimulated by CD8α(+) DCs loaded with allogeneic or syngeneic tumor antigen was augmented with the CD8α(+) DC/T ratio increased (P<0.05). When antigen concentration ≤ 5 μg/mL and CD8α(+) DC/T ratio ≤ 2:1, the ability of CD8α(+) DCs to stimulate T cell proliferation was higher than mDC control in allogeneic tumor antigen-pulsed groups (P<0.05), but not in syngeneic tumor antigen-pulsed groups (P>0.05). The level of IFN-γ and IL-10 in CD8α(+) DCs and T cell co-culture supernatant were increased in both allogeneic and syngeneic antigen-pulsed groups (P<0.05), and the cytokine level was higher in allogeneic antigen-pulsed groups than in syngeneic antigen groups when the CD8α(+) DC/T was 1:1 or 2:1 (P<0.05). There existed a negative correlation between the level of IL-10 and T cell proliferation. T cell cytotoxicity assay showed that when CD8α(+) DCs were pulsed with allogeneic tumor antigen, the maximal T cell killing efficiency could reach (100±7.7)%, whereas syngeneic tumor antigen-pulsed group had only (65.0±3.4)%. It was concluded that syngeneic and allogeneic tumor antigen-pulsed immature CD8α(+) DCs could stimulate T cells to exert the GVT effect in vitro, and the GVT effect was more obvious with allogeneic tumor antigen than with syngeneic tumor antigen. The optimal condition was low allogeneic tumor antigen pulsation (≤ 5 μg/mL) and low CD8α(+) DC/T ratio (1:1 and 2:1).

Objective:To investigate the effect of segmental Le FortⅠosteotomy and bilateral sagittal split ramus osteotomy ( BSSRO ) on the condyle position in skeletal class Ⅲ malocclusion patients . Methods:In this retrospective study , 19 patients with skeletal class Ⅲmalocclusion who met the inclu-sion criteria were enrolled .All the patients underwent the segmental Le FortⅠ osteotomy and BSSRO . Cone beam computed tomography ( CBCT) scans were performed in the following phases:T1:within one week before the surgeries;T2:within one week post-surgery;T3:three months post-surgery;T4:6 to 14 months post-surgery .The posterior spaces , anterior spaces and the superior spaces of the bilateral tem-poromandibular joints were measured according to the Kamelchuk method respectively .The fossa ratios of the condyle and the distribution of the condyle positions related to the glenoid fossa ( anterior , concentric and posterior position ) were calculated .The results were analyzed statistically .Results:The posterior space , the anterior space and the superior space of bilateral temporomandibular joints in T 2 phase [ right:(2.78 ±1.23) mm, (2.47 ±0.89) mm, (3.07 ±0.85) mm; left: (2.93 ±0.83) mm, (2.69 ± 1.14) mm, (3.44 ±1.16) mm] showed significantly larger spaces than those in T 1 phase [right:(1.81 ±0.95) mm, (1.65 ±0.55) mm, (2.13 ±0.52) mm;left:(2.12 ±1.05) mm, (1.79 ±0.59) mm, (2.15 ±0.93) mm],in T3 phase [right:(2.08 ±1.25) mm, (1.79 ±0.68) mm, (1.80 ±0.76) mm;left: (2.05 ±0.75) mm, (1.99 ±0.94) mm, (2.14 ±0.71) mm] and in T4 phase [right:(1.94 ±0.77) mm, (1.81 ±0.69) mm, (2.05 ±0.69) mm;left:(1.89 ±0.69) mm, (1.80 ±0.61) mm, (2.19 ±0.75) mm], P<0.05.No significant differences were observed among T 1,T3 and T4 pha-ses in the terms of the joint spaces of both sides ( P >0.05).The fossa ratio and the condyle position related to the glenoid fossa had no significant difference in all the four phases (P>0.05).The results suggested that the condyle moved downward in T 2 phase and changed to the original pre-surgery position in T3 phase, then keot stable in T4 phase.Conclusion:Segmental Le FortⅠ osteotomy and BSSRO caused significant and transient changes of the condyle position in skeletal class Ⅲmalocclusion patients . However , the condyle tended to move back to the original pre-surgery position and might keep stable .

Objective To analyze the expression of synaptophysin (SY) in hippocampal dentate gyrus of rats with hypoxic-ischemic brain damage(HIBD) after the injection of bone marrow stromal cells(BMSCs) and its supernatant into the lateral ventricle and to explore the mechanism of potential effects. Methods Eighty 7-day-old sprague-dawley(SD) rats were randomly divided into sham group, control group, cell group and supernatant group, with 20 rats in each group. The HIBD model was established via the ligation of left carotid arteries followed by 2-hour hypoxia. One week later, control group was injected with 0.01 mol/L PBS via the left ventricle. Meanwhile, cell and supernatant group were injected with BMSCs and supernatant harvested from BMSC culture, respectively, via the same route. For spam group, the left carotid arteries were separated but not ligated, and no hypoxia treatment was imposed on this group. They also received 0.01mol/L PBS injection one week post surgery. After 8 weeks, the expression of SY in the dentate gyrus of rats was measured. Results Compared with sham group, model group showed significantly lower IOD (integral optical density) of SY positive material in the dentate gyrus(P < 0.05). Compared with model group, supernatant group and cell group exhibited significantly increased IOD values (P < 0.05), but there was no significant difference between cell group and supernatant group (P > 0.05). Conclusions BMSCs and supernatant injected via the lateral cerebral ventricle can increase SY expression in the hippocampal dentate gyrus of HIBD rats and promote synapse formation. The mechanism of this effect may be related to cytokine secretion by BMSCs which promotes synapse formation.

Objective To evaluate the efficacy and safety of the TVT-Secur procedure for female stress urinary incontinence (SUI). Methods Analyze retrospectively the preoperative, intraoperative and postoperative complications and follow-up data of 27 SUI patients from October 2008 to May 2010. 20 cases were simple SUI, and 7 cases were mixed SUI. The average age was 56.1 ± 10.7 years (range, 35-77), the average parity was 2.8-±- 1.4 (range, 1-6), the average body mass index was 25.6±2.5, and the average course of the disease was 6.8±7.2 yeas (range, 1-30). Two cases had past history of pelvic surgery without any anti-incontinence surgery. Mashall-marchett test was positive in all patients, with an average abdominal leak point pressure (ALPP) of 60.9±27.5 cm H2O (range, 27- 120 cm H2O). The mean International Consultation on Incontinence-Short Form (ICIQ-SF) score was 11.2 ± 1.8 (range, 7- 14) before surgery. Results 27 patients underwent TVT-Secur procedure, of which 19 cases underwent "U" procedure, and 8 cases underwent "H" procedure. The mean operation time was 15.3±1.4min (range, 13- 19 min). There were no intraoperative bladder or urethral injury, and no obturator vessel or nerve damage. The blood loss was 10 to 50 ml, and the maximum urinary flow rate was 25. 4±13. 1 ml (range, 4-50 ml). Three eases had mild dysuria(11. 1%), and 3 cases had wound effusion(11. 1%). Followed up for 12. 6 ±6. 7 months (range, 3-21 months). 10 cases complained of bladder overactivity symptoms such as frequency, urgency, and urge incontinence, and no case had vaginal erosion. Therapeutic efficacy: 15 cases were cured (56%), 8 cases were improved (30%), and 4 cases were ineffective (15%). Conclusions TVT-Secur procedure is a simple, safe and minimally invasive surgery, while the cure rate is low. The long-term efficacy needs great amount of clinical data and long-term follow-up to prove.

Objective To study the clinical efficacy and operative skill of multi-endoscopic technique in treatment of post-traumatic urethrostenosis in male patients.Methods A retrospective analysis was done on clinical data of 47 male patients with post-traumatic urethrostenosis treated with direct visional incision urethrotomy combined with transurethral resection of scar tissue and ureteroscopic incision.There were 29 patients with anterior urethral strictures and 18 with posterior urethral strictures.Results Of all,43 patients underwent successful endoscopic surgeries at the first time but one underwent secondary surgery because of unsuccessful endoscopic incision.These patients achieved satisfactory results without urinary incontinence,fistula or reoperation.The left three patients underwent open surgeries because of unsuccessful endoscopic incision,in which one patient could micturate at maximal flow rate of 9-12 ml/s,without therapeutic urethral dilation,one could micturate under regular therapeutic dilation and the other one could not micturate.Conclusions With the advantages of safety,high success rate and good long-term efficiency,multi-endoscopic technique can be used as an initial treatment for male patients with post-traumatic urethrostenosis and is worthy to be popularized.

Objective To assess the clinical value of intravesical prostatic protrusion (IPP) measured by transabdominal uhrasonography in judgement of benign prostatic obstruction (BPO). Methods According to pressure-flow study, 109 patients with benign prostatic hyperplasia were di-vided into 3 groups (non-obstruction, equivocal obstruction and obstruction). IPP was measured by transabdominal ultrasonography in all patients. The difference of IPP between different groups was studied and the correlation between IPP and the parameters reflecting BPO was analyzed. Results IPP value of the non-obstruction group, equivocal obstruction group and obstruction group was 2.7 ±1.2 mm, 2.9±1.4 mm and 15.4±6.5 mm. There was significant difference in IPP between the non-obstruction group, equivocal obstruction group and obstruction group (P<0.01). IPP was correlated with the parameters including Pdet. Qbeg, Pdet. Qmax, Pdet. Qend, Qmax and A-G number, Spearman's ratio was 0. 628, 0. 714, 0. 591, -0. 450 and 0. 729(P<0.01), respectively. The sensi-tivity and specificity of judging BPO were 89.9% and 97.5% if the cut-off was IPP≥10 mm. Con-clasion IPP measured by transabdominal ultrasonography could be a convenient and accurate method in diagnosis of BPO.

Objective:To investigate the effect of ultrasound-guided transversus abdominis plane block on intraoperative and postoper-ative analgesia in laparoscopic abdominal surgery.Methods:Sixty ASAⅠ-Ⅱpatients with abdominal tumor,undergoing laparoscopic/robotic surgery were randomly assigned into two groups:one group undergoing general anesthesia(G group)and the other undergo-ing general anesthesia combined with transversus abdominis plane block(G+T group).After induction of general anesthesia in the G+T group,the patients received transversus abdominis plane block with injection of 15 Ml of 0.25% ropivacaine on each side,guided by ultrasound.The operation time,resuscitation time,orientation recovery time,and the dosage of remifentanyl were recorded and com-pared.During surgery,the MAP and HR at different time points(5 min before,after surgical incision;30 min after the surgery begin-ning;surgery finished)between the two groups were recorded and compared.Additionally,the VAS scores at different postoperative time points were compared between the two groups.Results:Compared to the G group,the resuscitation time,orientation recovery time and the dosage of remifentanyl in the G+T group were significantly decreased(P<0.05).In G group,compared to the basic value, the MAP and HR at 5 min and 30 min after surgical incision were significantly increased(P<0.05);whereas in the G+T group,the MAP and HR remained stable at different time points(P>0.05).Moreover,compared to the G group,the VAS score in the G+T group was sig-nificantly lower at 2,6,and 12 hours postoperatively(P<0.05).Conclusions:General anesthesia combined with transversus abdominis plane block in patients undergoing laparoscopic abdominal surgery reduces the intraoperative and postoperative remifentanil con-sumption,improves the efficacy of perioperative analgesia,and enhances the patient's recovery after surgery.