Objective To study some sensitive electrophysiological parameters in surveillance of allograft rejection.Methods Forty rats underwent heterotopic heart transplantations.IMEG was re- corded by an epicardiac unipolar pacing lead fixed at the right ventricular outflow tract.QRS amplitude and heart rate were determed daily in 10 syngeneic and 30 allogeneic transplants.Syngeneic transplants were killed at 7 th postoperative day,and allogeneic transplants killed at 3 rd,5 th and 7 th postopera- tive day.Histopathologie studies were performed at every transplanted heart.Results In syngeneic group,QRS amplitude kept constant after the transplantation while no significant differences were ob- served at the 3 rd,5 th and 7 th postoperative day.QRS amplitude was dropped obviously in allogeneic group after the first two postoperative days whereas significant differences were observed at the rejec- ting and non-rejecting hearts.Conclusions IMEG is a valid method to monitor acute allograft rejec- tion.QRS amplitude is a more sensitive electrophysiological parameter to diagnose severe rejections than heart rate,while mild rejections were not detected by this method.

Objective To observe the effect of restrictive transfusion in colon cancer surgery in elderly patients on postoperative VAP (ventilator-associated pneumonia). Methods Forty cases of elderly patients with colon cancer intending to undertake surgery were randomly divided into restrictive transfusion group (group R) and standard transfusion group (group S) with 20 cases in each group. In group R, patients were administered one third of accumulative fluid loss in the first 60 minute, then the infusion rate were 4 mL/(kg·h) and central venous pressure was maintained at 5 ~ 7 cmH2O. In group S, rate of fluid administration = CVE + deficit +maintenance + loss + third space. Blood gas index including lactic acid and volumes of fluid administered, blood loss, urine volume and thoracic fluid count (TFC) were recorded in the operation. Clinical pulmonary infection score(CPIS) was recorded respectively before operation, 1 day, 3 day, 7 day after operation to evaluate the risk of VAP. Results Compare with those in group S, there were significantly less TFC and intraoperative volumes of fluid administration in group R. The CPIS was significant lower at day1, day3, day7 after operation in group R. There was no significant difference in MAP, HR, CO and urine volume between two groups. Conclusions In colon cancer surgery for elderly patients, restrictive transfusion can maintain hemodynamic stability, ensure the tissue oxygenation, reduce conjunction edema, shorten the recovery and hospital stay and reduce the incidence of VAP.

The clinical characteristics, therapeutic effects and complications of 32 incipient patients with acute Vogt-Koyanagi-Harada ( VKH) syndrome admitted in Wuxi Second Hospital during October 2010 to September 2013 were retrospectively analyzed.There were 15 males and 17 females with a mean age of (41.3 ±14.1) years (22 -71 years), the time from the disease onset to treatment ranged from 3 to 20 days.Among 32 cases, 30 ( 94%) had premonitory symptoms. The multifocal bullous neurosensory detachment, optic disk hyperemia and edema in posterior pole of fundus were found in all cases, and exudative retinal detachment was found in 4 cases (6 eyes).The results of optical coherence tomography ( OCT) showed the macula neurosensory detachment, thick retinal neuroepithelial layer and wavy RPE layer in all patients.Fundus fluorescein angiography ( FFA) showed that scattered hyperfluorescence dots and cystic fluorescein reservoir was observed in early phase and later period respectively.Patients received intravenous methylprednisolone with the onset dose of 80 mg per day for 3-7 days and oral administration followed, which would gradually decrease later;the average treatment duration was (52.9 ±14.6) weeks. The visual acuity of 40 eyes (22 cases) was recovered to more than 0.8, and no blindness occurred after the treatment.During the treatment hair loss, depigmentation of skin and hair were found in 12 cases (38%) , and 2 cases showed short-term elevated intraocular pressure.These symptoms disappeared after drug therapy ceased.And no recurrence was found during the follow-up of 6 months.However, sunset glow fundus was found in 13 patients (26 eyes).The study shows that the diagnosis of VKH syndrome is based on the typical signs of the fundus presented on OCT and FFA.Early and systemic administration of glucocorticoids is important treatment for patients with VHK syndrome, which could decrease systemic and local complications effectively.

Objective To investigate the capabilities of Plasmodium microscopic examinations of professional staff in medi-cal institutions in Wuxi City,so as to provide evidences for improving malaria control and elimination work in the future. Meth-ods The data of questionnaires for laboratorial staff in charge of Plasmodium microscopic examinations were collected and ana-lyzed in the medical institutions in Wuxi City in 2016,and the influencing factors related to the capabilities of Plasmodium mi-croscopic examinations were analyzed by the method of logistic regression. Results Totally 54 laboratorial workers in 54 medi-cal institutions in Wuxi City were investigated,16 of them were male,and 38 were female,and the ratio of male to female was 0.42:1. Among the 54 laboratorial workers,12 persons(22.22％)had the experience of detecting Plasmodium in the work. The multivariable analysis showed the ability to detect Plasmodium was associated with male laboratorial workers(adjusted OR =0.11,95％CI:0.02-0.53),laboratorial workers with intermediate or higher professional titles(adjusted OR=5.31,95％CI:1.04-27.19)and laboratorial workers from county and township medical institutions(adjusted OR=0.04,95％CI:0.01-0.98). Conclusions All of the medical institutions in Wuxi City have the capability of microscopic examinations of Plasmodium. How-ever,the ability of laboratorial staff in primary hospitals still should be improved.

The tumor metastasis is the major cause of the death of cancer patients.S-100A4 is a member of the S100 family of calcium-binding proteins and has been categorized as a metastasis-associated protein.S-100A4 is a candidate as a molecular marker for metastatic potential with high prognostic significance.An increase in S-100A4 protein expression has been correlated with poor prognosis of patients with breast,colorectal,gallbladder,bladder,esophageal,nonsmall-cell lung,gastric,medulloblastoma,pancreatic and hepatocellular cancers.The overexpression of S-100A4 protein can induce the increase of invasion and mobility of the tumor cells.It has been considered that S-100A4 is secreted by the tumor and stroma cells as a regulator of tumor metastasis.S-100A4 can regulate the progress of cell cycle,change cell adhesion,cell mobility and increase the survival ability of the tumor cells.

Objective To investigate the effects of rapid colloid and crystalloid infusions on the plasma concentration of propofol( Cp) during target-controlled infusion.Methods Thirty-six patients were randomly assigned to three interventions(12 patients per group).At least 30 min after the start of propofol infusion,the hydroxyethyl starch solution group(HES)received HES of 24 mL/(kg· h),on the former 20 min,the sodium acetate Ringer’s injection group(AR)received AR of 24 mL/(kg· h),while HES group and AR group of later 20 min and the control group of whole course received AR of 2 mL/(kg· h).The plasma concentrations of propofol were recorded per 2 min and a half.The cardiac outputting,blood volume and clearance of indocyanine green were measured by pulsed dye density analyzer,the effective hepatic blood flow( EHBF) were obtained.Results The varying of Cp with time showed a significant treatment factor(F[2,33] =14.14,P<0.001)and time factor(F[16,528] =10.37,P<0.001)and interaction between the above factors(F[32,528] =2.82,P <0.001) by ANOVA for repeated measurement;the difference of Cp among each group,Cp in HES group was significantly lower than AR group(5-40 min)or control group(10-40 min),with significant difference(P<0.05).The varying of EHBF with time showed a significant treatment factor(F[2,28] =3.68,P=0.038)and time factor(F[2,56] =5.37,P=0.007)and interaction between the above factors(F [4,56] =3.67,P=0.010);while there was no significant difference in other groups.Conclusion Rapid HES infusion increases the effective hepatic blood flow,resulting in a decrease of propofol concentration during target-controlled infusion.Rapid HES infusion should be used cautiously as it may decrease the depth of anesthesia.

Adenocarcinoma, Mucinous ; pathology ; Breast Neoplasms ; pathology ; Carcinoma, Ductal, Breast ; pathology ; Carcinoma, Renal Cell ; pathology ; Carcinoma, Squamous Cell ; pathology ; Cystadenocarcinoma, Mucinous ; pathology ; Cystadenoma, Mucinous ; pathology ; Female ; Giant Cells ; pathology ; Humans ; Osteoclasts ; pathology ; Ovarian Neoplasms ; pathology ; Pancreatic Neoplasms ; pathology ; Thyroid Carcinoma, Anaplastic ; Thyroid Neoplasms ; pathology ; Tongue Neoplasms ; pathology ; Urologic Neoplasms ; pathology

ObjectiveTo investigate the effect of transforming growth factor-β1 (TGF-β1) antibody on peripheral neural fibrosis after chronic entrapment.MethodsA total of 75 rats were randomly divided into three groups, ie, Group A (sham operation, only the sciatic nerve exposed), Group B (compression only, treated with sciatic nerve entrapment) and Group C (compression plus antibody injection).Electron microscopy, immunohistoehemistry, RT-PCR and Western blot were performed to observe the morphological changes of the compressed nerve tissue and to determine the level of TGF-β1 , collagen Ⅰ and collagen Ⅲ at 2, 4, 6, 8, 10 weeks after sciatic nerve compression, respectively.Results The levels of TGF-β1 , types Ⅰ and Ⅲ collagen protein were increased significantly in the Group B compared with that in the Group A, when the expression of TGF-β1 was increased in the early phase of the compression, reached the peak at the 4th week, and then decreased slowly.The expressions of collagenⅠand collagen Ⅲ were increased after compression, reached a peak at the 6th week and then maintained a relatively high level.The number of the fibrous tissues was decreased significantly and the content of types Ⅰ and Ⅲ collagen protein declined in the Group C, with statistical difference compared with the Group B (P ＜ 0.05).ConclusionsPeripheral nerve fibrosis can be caused by chronic nerve compression.TGF-β1 plays an important role in effectively inhibiting the collagen synthesis and ameliorating the nervous fibrosis of the protein following peripheral nervous entrapment.

Objective To investigate the effects of pretreatment with remifentanil on hemorrhagic shock (HS)-induced acute liver injury in rabbits.Methods Thirty-two New Zealand white rabbits,weighing 2.0-2.5 kg,were randomly divided into 4 groups (n=8 each): sham operation group (group S) ; group HS,low-dose remifentanil group (group RL) ; high-dose remifentanil group (group RH).Remifentanil was infused at 0.66 and 1.32 μg· kg-1 · min-1 for 145 min in groups RL and RH respectively,while the equal volume of normal saline was infused in group C.HS was induced by withdrawing blood from the left femoral artery at 15 min after continuous infusion of normal saline or remifentanil and mean arterial pressure (MAP) was reduced to 40 mm Hg.MAP was reduced to 35-45 mm Hg and maintained at this level for 120 min in groups HS,RL and RH.Blood samples were taken for determination of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities before administration (T0),immediately before blood letting (T1),and at 10,30,60 and 90 min after blood letting (T3-6).The animals were then sacrificed and the livers were immediately removed for microscopic examination.Results Compared with group S,the serum ALT activity at T5 and T6 and serum AST activity at T4-T6 were significantly increased in the other three groups (P ＜ 0.05).Compared with group HS,the serum ALT activity at T5 and T6,and serum AST activity at T4-T6 were significantly decreased in group RH,and no significant change was found in group RL (P ＞ 0.05).Compared with group RL,the serum ALT activity at T5 and T6,and serum AST activity at T4-T6 were significantly decreased in group RH (P ＜ 0.05).The serum ALT activity at T5 and T6 and serum AST activity at T4-T6 were significantly increased in groups HS,R and RH than those at T0 (P ＜ 0.05 or 0.01).The patho1ogical injury was attenuated in group RH compared with groups HS and RL.Conclusion Remifentanil pretreatment can attenuate HS-induced acute liver injury in rabbits,and the effect is related to the dose.

Objective To assess the correlation between the subclasses of antibodies against desmoglein (Dsg) 1 and Dsg3 and disease activity in patients with pemphigus. Methods Sera were collected from 47 patients with pemphigus, and ELISA was performed to determine the titers and subclasses of antibodies against Dsg1 and Dsg3. The correlation of antibody titers and subclasses with disease activity was assessed.Results Clinical phenotype was associated with antibody profiles in these patients with pemphigus. Of 17 patients with mucocutaneous involvement, 14 (82.4%) had both anti-Dsg3 and anti-Dsg1 antibodies; of 16 patients with cutaneous involvement, 15 (93.7%) had anti-Dsg1 antibody, only 1 (6.3%) developed anti-Dsg3 antibody; of 6 patients with mucosal involvement, all ( 100% ) had only anti-Dsg3 antibody. The serum levels of antibodies against Dsg1 and Dsg3 were increased, but not in parallel with the disease severity in these patients.Moreover, the subclasses of antibodies were correlated with disease severity. IgG4 subclass antibodies against Dsg1 and Dsg3 predominated in patients with pemphigus at active stage, whereas IgG1 subclass in those at remission stage. The serum levels (expressed as absorbance value) of IgG4 and IgG1 subclass antibodies were 1.92 ± 1.21 and 0.60 ± 0.61 respectively, with the ratio of IgG4 to IgG1 more than 1, in patients with antiDsg1 antibodies at active stage, 0.03 ± 0.02 and 0.22 ± 0.11 respectively with the ratio of IgG4 to IgG1 less than 1, in those at remission stage, 2.35 ± 2.17 and 1.84 ± 1.16 respectively with the ratio of IgG4 to IgG1 more than 1 in patients with anti-Dsg3 antibodies at active stage, 0.15 ± 0.16 and 1.05 ± 0.77 respectively with the ratio of IgG4 to IgG1 less than 1 in those at remission stage. Conclusions The subclasses of pemphigus-specific antibodies are closely correlated with the disease severity in patients with pemphigus. The detection of subclasses and titers of anti-Dsg1 and anti-Dsg3 antibodies may aid in the diagnosis of and monitoring of disease severity in pemphigus.