Objective To evaluate the value of plasma soluble urokinase?type plasminogen activator receptor (suPAR)and D?dimer for assessing disease severity and prognosis in patients with traumatic brain injury(TBI). Methods A serial of 112 patients with traumatic brain injury admired to our hospital were divided into mild TBI (GCS score 13~15),moderate TBI(GCS score 9~12)and severe TBI(GCS score 3~8). The levels of plasma suPAR and D?dimer were monitored within 24 h after patient admission. Results The levels of suPAR and D?di?mer in TBI group were obviously higher than those in the control group(15.86±7.33 vs 2.79 ± 0.69,P<0.01;3.50 ± 2.78 vs 24 ± 0.15,P<0.01). The levels of suPAR and D?dimer in the severe TBI group were also obviously high?er than those in the moderate TBI group(P<0.05). Plasma suPAR levels and GCS score had significant negative correlation(r =- 0.854,P < 0.01). D?dimer levels and GCS score showed a negative correlation(r =- 0.738, P < 0.01). Plasma suPAR and D ? dimer was positively correlated(r = 0.753,P < 0.01). The area under the curve of D?dimer(AUC)was larger,0.854,95%CI 0.763~0.945;the AUC of suPAR was 0.801,95%CI 0.698~0.903. Conclusion Higher levels of suPAR and D?dimer in TBI patients is not only relevant to the injury sever?ity ,but also closely to the prognosis.

Objective To establish a rat model of peritoneal bacterial infection after liver transplantation.Methods To construct a dark Agouti rat-to-Lewis(DA-to-LEW) rat model of liver transplantation.Peritoneal bacterial infection in the rats was induced by intraperitoneal injection of bacterial suspension.The liver function,blood gas,blood cell count and other indicators of the rat models were detected.Results There was a high mortality rate in rats with bacterial injection at day 5 after liver transplantation,therefore unfavorable for the following study.It waft better to inject the bacteria in an amount of 5×10~5 cfu/mL at day 3 after liver transplantation.The cumulative 7-day survival rate of those rats after infection reached up to 37.5%.The infection became increasingly severe,the general conditions were worsening,the rectal temperature was rising,the WBC count was increased,the pH was decreased,liver dysfunction was progressively increased,and metabolic acidosis occurred in the rats.Liver parenchymal damage was more pronounced than that of bile ductal injuries,and the rats died one after another at about 5 days after infection.Pathological examination of multiple organs showed that the main cause of death of the rats was liver damage,without accompanying lung and kidney damages.Conclusion The results of this study suggest that it is a successful method to establish a rat model of peritoneal bacterial infection after liver transplantation,and this model can be used in related experimental researches.

90% in 20 min and more higher than the control tablets or capsule. CONCLUSION: The optimum formulation suits to slightly soluble drugs with different o/w distribution coefficient.It can provide reference for application of the SMEDDS the practical cases.

Objective To investigate the changes of immune state and the impact on immunological rejection elicited by abdominal cavity bacterial infection after DA-Lewis rat liver transplantation.Methods Orthotopic liver transplant model was established by modified Kamada two-cuff technique.The animals were divided randomly into Group 1,isotonic Na chloride injected into abdominal cavity 3 days after operation;Group 2,mixed Bacillus coli liquid injected instead of saline;Group 3,immunosuppressive drug CsA administered routinely after operation(3 mg?kg-1?d-1).All the animals were sacrificed 7 days after infection.The blood and graft samples were collected for cell-subpopulation,mixed lymphocyte culture,IL-4,IFN-? mRNA detection and histological evaluation.Results Seven days after infection,the lympholeukocyte population,CD4/CD8(G1=1.753?0.181,G2=1.384?0.073,G3=0.997?0.025)and lympholeukocyte function(SI:G1=67.59?3.40,G2=37.14?0.90,G3=15.87?0.51)declined in Group 2 as compared with other groups and cellular differentiation drifted to Th2.There was significant difference between Group 2 and Group 1 or 3.Conclusion Abdominal cavity bacterial infection after rat liver transplantation will promote the differentiation of T cells into Th2,down-regulate CD4/CD8 ratio and immune function of lymphocytes and accordingly alleviate partly the acute rejection following liver transplantation.

Adult ; Chemical and Drug Induced Liver Injury, Chronic ; Dimethylformamide ; poisoning ; Female ; Humans

Adult ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Tracheal Neoplasms ; surgery ; Young Adult

Objective To explore the effects of high-dose ambroxol hydrochloride (Mucosolvan) on pulmonary protection and anti-inflammatory in traumatic brain injury patients treated by mild hypothermia.Methods From June 2008 to June 2012,40 elderly traumatic brain injury patients aged 60-70 years treated by mild hypothermia in our hospital were selected.Patients were randomly divided into two groups:low-dose ambroxol hydrochloride group and high dose ambroxol hydrochloride (n=20,each).Patients in low-dose ambroxol hydrochloride group were treated with ambroxol 30 mg plus saline infusion,3 times/day; while patients in high-dose ambroxol hydrochloride group were treated with ambroxol 300mg plus saline infusion,3 times/day; both groups were treated for 7 days.The changes of characteristic and quantity of sputum,PaO2and PaO2/FiO2,and serum TNF α level were analyzed at day 1,3,7.Duration of mechanical ventilation,tracheotomy proportion,and mortality were compared between the two groups 3 months after treatment.Results At day 3-7 after the intervention,the sputum got thinner and less,and more easy to suck in highdose group than in low-dose group (thin sputum proportion:75％ vs.40％,P =0.025; clean proportion by once suction:65％ vs.25％,P=0.011).The improvement of PaO2,PaO2/FiO2 were more significant in high dose group than in low dose group (PaO2 ∶ 3d,(92.3±12.3) mm Hg vs.(83.3±15.2) mm Hg,P=0.046;7d,(95.9±12.5) mm Hgvs.(87.1±11.7) mm Hg,P=0.028;PaO2/FiO2∶3d,(290.8± 15.8) mmHgvs.(221.8± 16.4) mm Hg,P=0.000;7d,(296.3±16.9)mm Hg vs.(238.4±15.0) mm Hg,P=0.000).Serum concentrations of TNF α was lower in highdose group than in low dose group [3d,(54.1± 4.9) ng/L vs.(71.4± 5.6) ng/L,P=0.000;7d,(35.1± 2.7) ng/L vs.(63.3±4.3) ng/L,P 0.000].Duration of mechanical ventilation was shorter and tracheotomy proportion was lower in high dose group than in low dose group [(116.8±18.7) hrsvs.(178.4±35.5) hrs,P=0.000; 25％ vs.60％,P=0.025].There was no significant difference in mortality between groups 3 months after treatment.Conclusions The application of high dose ambroxol can improve respiratory function,decrease duration of mechanical ventilation and tracheostomy proportion,and reduce the systemic inflammatory response in elderly traumatic brain injury patients treated by mild hypothermia,but without long-term survival benefit.

Objective To explore the anatomical basis for the flexor pollicis brevis branch of median nerve transfer to the deep branch of ulnar nerve.Methods Eight fresh upper limb were dissected and observed.The specimen were dissected under the loup.Observed the number of the flexor pollicis brevis branch and measured the distances from pisiform bone to the flexor pollicis brevis branch.Then the transfer operation on the cadaver were imitated.After the anastomosis was completed,the stumps of the nerves were sectioned and stained with HE.The crossing-sectional area and the density of nerve fiber were obtained by Image-Pro Plus version 6.0,then the number of the nerve fiber were calculated.The data analyzed by SPSS 17.0.Results The flexor pollicis brevis branch constantly appear,there were two branches in 2 specimens,one branch in 6 specimens.The flexor pollicis brevis branch could transfer to the deep branch of ulnar nerve by end-to-end surture without tension.The regeneration distances was (37.3 ± 5.76) mm.The crossing-sectional area were (0.0575 ± 0.0086)mm2 and (0.2039 ± 0.0396)mm2,the number were (492.50± 62.62) and (1651.13± 79.01),the density were (8781.4246 ± 1676.2894)/mm2 and (8371.1592 ± 1677.6509)/mm2 in the flexor pollicis brevis branch and the deep branch of ulnar nerve,respectively.There were no significant differences in the density of the nerve fiber between the donor and recipient nerve (P ＜0.05).But there were differences in the crossing-sectional area and number of the nerve fiber(P ＜ 0.05).Conclusion The flexor pollicis brevis branch transfer to the deep branch of ulnar nerve can provide a short regenerating distance,but can supply a part of recipient nerve to reinnervate.

BACKGROUND:Ti6Al4V is a titanium aloy that is widely used in human joint replacement, but its modulus of elasticity is greater than human bone, resulting in the bad stability of the prosthesis. Ti35Nb3Zr2Ta, a new βtitanium aloy, has a lower modulus of elasticity, and maybe becomes a new-generation human joint prosthesis material that has a better biocompatibility. OBJECTIVE:To study the biocompatibility of Ti35Nb3Zr2Ta in prosthesis. METHODS:Wanfang, CNKI and PubMed databases were retrieved using a computer with “new β titanium;prosthesis; biocompatible” as keywords, and the retrieval time ranged from 2010 to 2015. Articles focusing on current application status for medical prosthesis materials and the biocompatibility of Ti35Nb3Zr2Ta in prosthesis were selected. RESULTS AND CONCLUSION:Compared with Ti6Al4V, Ti35Nb3Zr2Ta has higher surface roughness and smaler surface contact angle; the alkaline phosphatase activity and amount of calcium deposits in osteoblasts cultured at Ti35Nb3Zr2Ta is significantly higher than that at Ti6Al4V. Ti35Nb3Zr2Ta has good biocompatibility, and can be considered to be widely used as joint prosthesis material further.

Objective To evaluate the effects of modified early goal directed therapy (EGDT )on the prognosis of patients with septic shock .Methods Clinical data of 116 patients with septic shock admitted to ICU during January 2011 to March 2013 were retrospectively analyzed .Patients were divided into modified early goal‐directed therapy group (n=57) and traditional early goal‐di‐rected therapy group (n=59) according to different methods of treatment ,the patients′28‐day survival rates of these 2 groups were compared .Modified early goal‐directed therapy are divided into survival group (n=46) and non‐survival group (n=11) according to 28‐day prognosis .Acute physiology and chronic health evaluation Ⅱ (APACHEⅡ ) score ,sequential organ failure assessment (SOFA) ,multiple organ dysfunction syndrome (MODS) score and other relevant indicators of survival group and non‐survival group were compared .Results The 28‐day survival rate in modified early goal‐directed therapy group had increased approximately 18 .9% higher than that of the traditional early goal‐directed therapy group(P< 0 .05) .The APACH Ⅱ score ,SOFA score and MODS score in non‐survivors were significantly higher than those of survivors in modified EGDT group ,which were[(29 .36 ± 1 .57)d vs .(24 .30 ± 3 .27)d] ,[(13 .45 ± 0 .52)d vs .(12 .78 ± 1 .33)d] ,[(9 .00 ± 0 .00)d vs .(4 .04 ± 1 .94)d]separately .And vaso‐pressors time and mechanical ventilation time was significantly longer in non‐survivors than survivors(P<0 .05) .Conclusion Mod‐ified early goal directed therapy could improve 28‐day survival rate ,and it show s beneficial effects on outcome of critical patients w ith septic shock .