Objective To study the change of intestinal permeability in patients with acute pancreatitis (AP) to investigate the indication of early operation in AP patients. Methods Serum concentrations of glutamine, endotoxin and urine lactulose/mannito (L/M) ratio were measured and compared at different time in 18 AP patients received non-operative treatment and 7 underwent operation . Results Serum concentrations of glutamine, endotoxin and urine lactulose mannito (L/M) ratio were significantly higher in operation treatment AP patients than those in non-operation treatment AP patients. Conclusion In the early course of AP, continued increased intestinal permeability and serum concentration of endotoxin is the indications of operation.

The perioperative total serum CK and CK-MB activities were determined in 38 patients with carcinoma of the esophagus and cardia of the stomach with fluorometric and cylinder layer chromatography. The data were compared with those obtained from 18 patients undergoing pulmonary operation and 20 normal subjects. The results suggest that: (1) carcinoma of the esophagus and cardia of the stomach could not induce variation of the total serum CK and CK-MB; (2) the elevation of the total serum CK after esophagogas-trostomy might probably be due to the trauma of the skeletal muscles of the chest wall;(3)the total serum CK is non-specific for the diagnosis of AMI in the perioperation period,but CK-MB might be considered as a specific enzyme criteria.

Objective To study the reliability and validity of using sacral markers in evaluating the balance function in standing and walking of stroke patients with hemiplegia.Methods Twenty-one hemiplegic stroke patients were recruited and their baseline mean sway amplitude (MSA) and mean sway velocity (MSV) were measured using sacral markers and center of gravity analysis assuming a segmented body,thegold standard for such analysis.The data were analyzed using Bland-Altman plots to obtain the 95％ limits of agreement (LOA).Results ①Test-retest reliability:The 95％ LOA of the MSA in standing was (-4.42,5.14) on the X axis,(-6.04,4.52)on the Y axis,and (-1.75,1.31) on the Z axis.The MSV in standing was (-0.08,0.09) on the X axis,(-0.10,0.08) on the Y axis and (-0.03,0.02) on the Z axis.The 95％ LOA of the MSA in walking was (-185.74,105.53) on the X axis,(-22.57,2.76) on the Y axis and (4.43,2.76) on the Z axis.The MSV in walking was (-3.10,1.76) on the X axis,(-0.38,0.54) on the Y axis and (-0.07,0.02) on the Z axis.②Validity:The 95％ LOA of the MSA in standing was (-3.62,2.55) on the X axis,(-3.95,3.94) on the Y axis and (-7.35,19.43) on the Z axis.For the MSV in standing it was (-0.06,0.04) on the X axis,(-0.07,0.07) on the Y axis and (-0.12,0.32) on the Z axis.The 95％ LOA of the MSA in walking was (-4.40,4.74) on the X axis,(-17.35,4.14) on the Y axis and (-17.35,4.14) on theZ axis.For the MSV in walking itwas (-0.07,0.08) on the X axis,(-0.29,0.07) on the Y axis and (-0.12,0.18) on the Z axis.The 95％ LOAs of the variables representing their reliability and validity are small enough to be acceptable in clinical application.Conclusions The sacral marker method can be used in assessing the balance of stroke patients.

Objective To investigate the clinical value of a three-dimensional motion analysis system by using the body segmental method for testing the balance of hemiplegic stroke patients.Methods Twenty stroke patients with hemiplegia were measured using the lower extremity Fugl-Meyer motor assessment (FMA-L),the Brunel balance assessment (BBA),the Berg balance sale (BBS) and a 5 m timed up-and-go test (5m-TUGT).The three-dimensional motion analysis system using the body segmental method was applied in three positions-sitting,standing and walking.Spearman's rank correlation coefficient was used to determine the extent of correlation between the values measured by the three-dimensional motion analysis system and the FMA-L,BBA,BBS and 5m-TUGT results.Results Some motion analysis variables (MSAx,MSVx,MSAy,MSVy and SPxy,SP3-D) are recorded in sitting and standing,while the center of gravity (COG) swing in the horizontal plane and some other variables (MSAx,MSVx and SPxy and SP3-D) are measured while walking.Anterior-posterior COG swing had a high negative correlation with the FMA-L,BBA and BBS scores and a high positive correlations with 5m-TUGT times.But except in sitting,MSAz and MSVz were both uncorrelated with FMA-L,BBA or BBS scores or with 5m-TUGT times.COG swing in the horizontal plane in sitting and standing apparently correlates with lower extremity motor function,balance,and walking ability.However,only the X axis swing parameters of the COG while walking correlated with lower extremity motor function,balance or walking ability.Conclusions A three-dimensional motion analysis system using the body segmental method can be used clinically to monitor patients' balance in real time and dynamically in different positions and activities,and it can be used to predict motor function and balance control in hemiplegic stroke patients.

OBJECTIVE To explore the role of gecko crude peptides (GCPs) in the proliferation, apoptosis, migration and lymphangiogenesis of human hepatocellular carcinoma cells (HepG2) and human lymphaticendothelial cells (HLECs) in vitro. METHODS The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay was used to evaluate the anti- proliferative effect of GCPs and siRNA-VEGF-C on HepG2 cells, Hoechst 33258 staining and flow cytometry were performed to analyze cycle and apoptosis. The migration and invasion ability of cells were assayed by transwell chamber experiment and wound-healing assay. The protein and mRNA expressions of vascular endo?thelial growth factor-C (VEGF-C) and CXC chemokine receptor-4 (CXCR4) were detected by q-PCR, immunofluorescence, Western blot. The protein expressions of the extracellular signal regulated kinase (ERKI/2), c-Jun N-terminal kinase (JNK), p38-mitogen activated protein kinases (p38 MAPK), serine/threonine kinase (Akt) and phosphatidylinositol- 3- kinase (PI3K) were detected by western blot. The anti-lymphangiogenesis effect of GCPs on the HLECs was analyzed using an in vitro tube-formation assay. The protein and mRNA expressions of vascular endothelial growth factor receptor-3 (VEGFR-3) and stromal cell-derived factor-1 (SDF-1) were detected by q-PCR, Western blot. RESULTS GCPs and siRNA-VEGF-C inhibited HepG2 proliferation, invasion and migration, and the most obvious inhibitory effect was both synergistic effects. Thus, GCPs suppressed HLECs proliferation, migration and tube-like structure formationin a dose- dependent manner, and had inhibitory effect of tumor- induced lymphangiogenesis in vitro. Additionally, we found that GCPs and siRNA- VEGF- C decreased the expressions of MMP-2, MMP-9, VEGF-C, CXCR4, phospho-ERK1/2, phospho-P38, phospho-JNK and PI3K in HepG2 cells. Moreover, GCPs had a dose-dependent depressive effecton the expressions of VEGFR- 3, SDF- 1 in HLECs. CONCLUSION The low expression of VEGF- C mediated by siRNA-VEGF-C and GCPs inhibit tumor proliferation, invasion and migrationby suppressing the MAPK signaling pathway through reduced levels of VEGF-C, and GCPs inhibit tumor lymphangiogenesis by suppressing the CXCR4/SDF-1 signaling pathway through suppressed VEGF-C/VEGFR-3.

OBJECTIVETo evaluate clinical outcomes of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) reconstruction under arthroscopy and repair of the injured posteromedial complex structure of the knee joint in the treatment of posterolateral knee dislocation with multiple ligament injuries.

METHODSFrom March 2008 to August 2012,22 patients (16 males and 6 females, ranging in age from 20 to 53 years old, with an average of 30.5 years old) with posterolateral dislocation of the knee were treated with primary reconstruction of ACL and PCL, combined with the repair of injuries in the posteromedial complex and soft-tissue. Eight patients had injuries caused by sports,5 patients road accidents and 9 patients falling down. The ACL was reconstructed using the gracilis and semitendinosus tendons. The PCL was reconstructed using LARS artificial ligaments (14 cases), or gracilis and semitendinosus tendons (8 cases). Suture repair was performed in 17 patients with posteromedial ligament injuries,and self-semitendinosus strengthening operations were performed in 5 patients. Continuouspassive montion (CPM) and active exercises were executed after operation at early stage. The IKDC and Lysholm system were used to evaluate therapeutic effects.

RESULTSAll the patients were regularly followed up, and the duration ranged from 11 to 56 months (averaged, 39 months). According to the IKDC scale,9 patients got a grade A result, 10 got a grade B result, and 3 got a grade C result. The IKDC subject score was 89.6±3.1 and the Lysholm scores was 90.7±1.8 at the latest follow-up, which were both better than those before operation.

CONCLUSIONReconstructing the ACL and PCL and repairing injured posteromedial complex of the knee followed by an active rehabilitation is an effective method to treat posterolateral knee dislocation.

Adult ; Anterior Cruciate Ligament ; surgery ; Anterior Cruciate Ligament Injuries ; Arthroscopy ; methods ; Female ; Humans ; Knee Dislocation ; surgery ; Male ; Middle Aged ; Posterior Cruciate Ligament ; injuries ; surgery ; Reconstructive Surgical Procedures ; methods

Objective:Investigating the expression of HIV-1 co-receptors CXCR4,CCR5 and chemoking SDF-1 in human placentae and trophoblasts is to explore the mechanism of in-utero transmission of human immunodeficiency virus type 1(HIV-1).Methods:Using semi-quantitative reverse transcriptase-polymerase chain reaction,detected the transcripts of CXCR4,CCR5 in placenta tissues and trophoblasts.Immunocytochemistry and immunohistochemistry analysis revealed the expression of CXCR4,CCR5 in primary cultured first trimester trophoblasts and villous tissue.Also the expression of SDF-1 in villi of first trimester,and the presence of SDF-1 in the culture of isolated trophoblasts were examined by in situ hybridization,immunohistochemistry and enzyme-linked immunosorbent assay.Results:CXCR4 and CCR5 mRNA were detected in placentae of various gestational phases and in first trimester trophoblasts.However,primary cultured trophoblasts were found to be reactive only with antibodies against CXCR4.In the villous tissue sections,CXCR4 was found in trophoblasts,while CCR5 in stromal cell and/or Hofbauer cell.First trimester trophoblasts expressed SDF-1 strongly and secreted SDF-1 in vitro.Conclusion:CXCR4 and CCR5 were expressed in placentae.Hence,they maybe involved in in-utero transmission of HIV-1 as co-receptors.However,SDF-1 expressed in trophoblasts may protect fetus from being invaded by X4-HIV-1.R5-HIV-1 may infect CCR5+ stromal cells and/or Hofbauer cells through placental disruptions.

Aconitum ; poisoning ; Animals ; Disease Models, Animal ; Female ; Hemoperfusion ; methods ; Male ; Plant Poisoning ; therapy ; Rabbits

Objective To observe the efficacy of single Nd-YAG laser treatment for the sub-inner limiting membrane(sub-ILM) haemorrhages in the macular region.Methods This is an uncontrolled case series retrospective study.Nd-YAG laser was performed for 6 patients (6 eyes) with premacular sub-ILM haemorrhages.The best corrected visual acuity(BCVA) and optical coherence tomography(OCT) in macular were observed at 1 day,1 week,1 month and 3 months after operation.The conditation of hematopoietic drainage and complications of macular retina were recorded.Results Sub-ILM haemorrhages were clinically confirmed in 6 patients (aged from 23 to 60 years old),including 4 cases of paroxysm associated with cough,1 case of hypertension,and 1 case of diabetic retinopathy.Funduscopic examination showed sub-inner limiting membrane hemorrhage in the macular region,BCVA count finger (CF) was 0.05 (averagely 0.03).The onset time was from 5 hours to 12 days.All the patients were treated with Nd-YAG laser treatment once,and all of them resulted in excellent partial visual recovery immediately.The average hemorrhage absorption time was 2 weeks.OCT examination showed macular retinal inner limiting membrane calm and foveal shape recovery at 3 month after laser treatment.However,the two patients with hypertension and diabetes recieved vitrectomy at 2 weeks and 1 month after laser surgery respectively because of serious vitreous hemorrhage.Conclusion Single Nd-YAG laser is a safe and effective method in the treatment of simplicity sub-ILM haemorrhages.

Objective To investigate the reliability and sensitivity of a three dimensional motion analysis system by using the segmental method.Methods Ten healthy young men participated in this study.They were asked to stand with one leg and with their eyes open and closed,respectively,each lasted for 30 seconds and was re- peated twice.According to the 12-segment rigid body model of the human body,twenty-one infrared light emitting di- ode(1RED)markers were placed over the bony prominences on the proximal and distal ends of each segment,the motion track of the IRED markers was recorded by the three dimensional motion analysis system.The mean sway am- plitude( MSA )and the sway path(SP)of the center of gravity(COG)were calculated.Correlation analysis was used to determine the reliability between the two repetitions.Paired sample t-test was used to determine the sensitivity be- tween the eyes open and closed conditions.Results The correlation coefficients of the MSA of the COG in the eyes open and closed conditions were 0.623 and 0.018,respectively,and the correlation coefficients of the SP of the COG were 0.936 and 0.654,respectively.It was also shown that significant differences existed among the three directions of the MSA of the COG and the SP of the COG.Conclusion Besides the weak reliability of the MSA of COG in the eyes closed condition,the high reliability and sensitivity of the MSA and SP of the COG are found.The segmental method can be used in the scientific study of human balance control.