Objective: To investigate the correlation between FIB-4 and the clinicopathological characteristics and prognosis of patients with hepatocellular carcinoma (HCC) after curative resection. Methods: From January 2009 to December 2012, the clinicopathological and follow-up data of 245 patients with HCC after curative resection were retrospectively studied. Their survival was calculated using the Kaplan-Meier method. The Cox proportional hazard regression model was used for the multivariate analysis. Results: According to FIB-4 index, patients were divided into two subgroups: FIB-4Ⅰ(≤3.25) and FIB-4Ⅱ(>3.25). FIB-4 could predict liver cirrhosis severity (Ishak grade, Grade 1-5 vs. Grad 6, r=0.681, P<0.001). It was associated with liver function such as:aspartate transaminase (P<0.001)、total bilirubin (P=0.009)、albumin (P=0.001) and platelet count (P<0.001) other than tumor clinicopathologic features. Both univariate and multivariate analysis showed FIB-4 could predict the prognosis of HCC patients (Overall survival: P=0.037 and 0.011; Recurrencefree survival: P=0.027 and P=0.043, respectively). Conclusion: The preoperative FIB-4 index could be used as a prognostic marker for the prognosis of HCC after curative hepatectomy.

Objective To assess the effect of leukocyte fihration on systemic inflammatory response to cardiopulmonary bypass.Methods Twelve mongrel dogs weighing 25-30 kg were randomly divided into 2 groups (n=6 each):control group(C)and leukocyte depletion group(LD).The dogs were anesthetized with intraperitoneal pentobarbital 25 mg?kg~(-1).The trachea was intubated.The arterial line of CPB was connected with aortic cannula and the venous line with a cannula inserted into right atrium.The leukocyte-depletion filter LD-1 was positioned in the venous line of CPB circuit.Aorta was clamped at 10 min of CPB and St.Thomas cardioplegic solution 20 ml?kg~(-1) was injected into the root of aorta.The filter was used for 5 min starting from 2 min of CPB. Aorta was clamped for 60 min.Blood samples were taken from femoral vein before CPB(T_0,baseline), immediately after aortic clamping(T_1)at 30 min of aortic clamping(T_2)5 min after aortic unclamping(T_3)at the termination of CPB(T_4)and 2 h after termination of CPB(T_5)for leukocyte count and determination of plasma L-selectin,IL-6 and IL-8 concentrations and MPO activity.The IL-6 and IL-8 concentrations in the filter LD-1 were measured at 30,60 and 90 rain after leukocyte filtration.The membrane of filter LD-1 was taken at 90 min after filtration for microscopic examination.Results The leukocyte count was significantly lower at T_1 in LD group than in C group.The plasma L-selectin,IL-6,IL-8 concentrations and MPO activity were significantly increased during CPB as compared to the baseline at T_0 in both groups but were lower at T_5 in LD group than in C group.The IL-6 and IL-8 concentrations in LD-1 filter were increased at 60 and 90 min after filtration as compared to those at 30 min.The filter membrane was covered with enormous number of leukocytes.Conclusion Leukocyte filtration can decrease systemic inflammatory response to CPB in dogs.

Objective To evaluate the efficacy of a sustained releasing mosquito larvicide package against larval breeding and its impact on water and plant,in order to provide a scientific evidence for its application in control and prevention of Dengue.Methods Guangzhou Center for Disease Control and Prevention was chosen as the test place.Twenty test sites were set up,2 bags of sustained releasing larvicides package,1 bag of sustained releasing larvicides package,3 g 1％ temephos granules and nothing were put into 4 glass bottles for each test site from July to December in 2014,respectively.The 4 glass bottles were called high dose (H) group,low dose (L)group,positive control (P) group and blank control (B) group,respectively.The 4 groups were observed at intervals of 10 days for 19 times.Environmental air temperature,turbidity of water,number of larvae and damage of plant were recorded.And 5 test sites were selected to collect water specimen.The chemical oxygen demand,ammonia nitrogen concentration and temephos concentration of water specimen were detected.Results The larval breeding rates were 0 (0/380),1.1％ (4/380),0.8％ (3/380) and 63.4％ (241/380),damage rates of plant were 5.0％ (19/380),5.5％ (21/380),4.7％ (18/380),4.7％ (18/380) and turbidty rates of water were 24.5％ (93/380),19.7％ (75/380),33.4％ (127/380) and 20.3％ (77/380) in H,L,P and B groups,respectively.Statistically significant differences were seen in larval breeding rate and turbidity rate of water between different groups (x2 =823.565,24.715,all P ＜ 0.05),but they were not seen in damage rate of plant (x2 =0.332,P ＞ 0.05).The temephos concentrations were 1.24,0.78 and 2.33 mg/L in H,L and P groups,respectively.Statistically significant differences were seen in temephos concentration between different groups (H =35.426,P ＜ 0.01),but they were not seen in chemical oxygen demand and ammonia nitrogen concentration (H =0.239,0.013,all P ＞ 0.05).Conclusions The sustained releasing package of mosquito larvicide makes less pollution to water and has no impact on water turbidity.Moreover,it doesn't damage the aquatic plant.The efficacy of the sustained releasing package of mosquito larvicide could effectively prevent mosquito larval breeding in Dengue epidemic period.

AIM: To determine the effect of hydrogen peroxide(H_2O_2) on voltage-gated potassium channel currents(IKv) in pulmonary vascular smooth muscle cells(PASMCs).METHODS: Using whole cell patch-clamp technique,IKv was recorded in freshly isolated rat PASMCs with acute enzymatic digestion method.The effect of hydrogen peroxide on IKv in PASMCs was investigated in normoxia.RESULTS: IKv in PASMCs was increased significantly by H_2O_2 and the increase depended on the concentration in normoxia.Current-voltage relationship curve shifted to the left.CONCLUSION: Hydrogen peroxide is an important K~+ channel opener.

The effects of adrenomedullin (ADM) on the L-type calcium currents (I(Ca,L)) and the mechanism of the signal transduction process were studied. Enzymatically isolated guinea-pig ventricular myocytes were used to measure ICa,L with whole-cell patch-clamp techniques. ADM at the concentrations of 1-100 nmol/L decreased ICa,L in a dose-dependent manner (P<0.05). ADM22-52) (100 nmol/L), a specific ADM-receptor antagonist, completely abolished the ADM-induced inhibition of ICa,L. Pretreatment of the cells with H-89 (10 micromol/L), a specific PKA inhibitor, did not attenuate the effects of ADM. Intracellular application of 10 micromol/L PKC19-36), a specific PKC inhibitor, prevented the ADM-induced inhibition of the ICa,L, while the specific PKC activator PMA could mimic the effects of ADM on the ICa,L. PMA (1 micromol/L) decreased the ICa,L by 32.26+/-4.20%(P<0.05). These findings indicate that ADM can inhibit the ICa,L in guinea-pig ventricular myocytes, and the inhibition is mediated by the specific ADM-receptor and an activation of protein kinase C.
Adrenomedullin ; pharmacology ; Animals ; Calcium Channels, L-Type ; metabolism ; Guinea Pigs ; Heart Ventricles ; cytology ; Myocytes, Cardiac ; drug effects ; metabolism ; Patch-Clamp Techniques ; Protein Kinase C ; metabolism

BACKGROUNDMinimally invasive techniques are gaining wide-spread application in lumbar fusion surgery, because they may have advantage over conventional open surgery in approach-related morbidity. This research was aimed to evaluate the safety and accuracy of the techniques of minimally invasive transforaminal lumbar interbody fusion by using a computer-assisted spinal navigation system combined with electromyography monitoring.

METHODSSixteen patients underwent minimally invasive transforaminal lumbar interbody fusion. A computer-assisted spinal navigation system and electromyography were used for guiding pedicle screw placement. The operative duration, blood loss, complications, and fluoroscopic time were recorded. Clinical outcome was assessed by Visual Analog Scale and Oswestry Disability Index. Radiographic images were obtained to evaluate the accuracy of pedicle screw placement and fusion rates.

RESULTSThe Visual Analog Scale and Oswestry Disability Index scores were vastly improved postoperatively. A total of 64 pedicle screws were implanted and three were regarded as misplacement by post-operative CT scan. Three screw trajectories were adjusted according to intra-operative stimulus-evoked electromyography monitoring. The average fluoroscopy time in each patient was 31.8 seconds, which equals to 7.9 seconds per pedicle screw. No patients had instrument related neurological complications, infection, implant failure or revision. Successful fusion was found in all patients.

CONCLUSIONSThe combination of navigation system and real-time electromyography monitoring can make the minimally invasive operation more safe and accurate while decreasing radiation exposure time of the medical staff and patient and minimizing the chance and the degree of the pedicle screw misplacement.

Adult ; Aged ; Bone Screws ; Electromyography ; methods ; Humans ; Lumbar Vertebrae ; surgery ; Middle Aged ; Monitoring, Intraoperative ; methods ; Spinal Fusion ; methods ; Spine

OBJECTIVETo evaluate in vivo gene delivery of Bio-Oss coated with adeno-associated virus-mediated human bone morphogenetic protein 7 (rAAV-BMP7/Bio-Oss) for bone regeneration around dental implants.

METHODSIn vitro rAAV-BMP7 were constructed and compounded with Bio-Oss. In 6 male New Zealand rabbits, two hydroxyapatite (HA) coated titanium dental implants were placed respectively to each animal in the bilateral tibia metaphysis. Before implantation, a standardized gap (8 mm in width, 4 mm in depth) was created between the implant surface and the surrounding bone walls. Rabbits were randomly divided into three groups (group A, B, C). Gaps of group A were filled with rAAV-BMP7/Bio-Oss (n = 4), gaps of group B were filled with Bio-Oss alone (n = 4), and gaps of group C were filled with nothing (n = 4). The rabbits were sacrificed at 4 and 8 weeks respectively, and the sclerous tissue slices obtained, then histology and histomorphometric analysis were conducted.

RESULTSHistological and histomorphometric analysis revealed an enlarged bone-forming area in the bone defects of group A and B at 4 and 8 weeks after implantation. Greater bone-implant contact was achieved with rAAV-BMP7/Bio-Oss than with Bio-Oss alone and this difference was statistically significant (P < 0.05).

CONCLUSIONrAAV-BMP7/Bio-Oss can induce a stronger peri-implant bone reaction and larger new bone formation than Bio-Oss alone in the treatment of bone defects adjacent to titanium dental implants.

Animals ; Bone Morphogenetic Protein 7 ; Bone Regeneration ; Bone Substitutes ; Bone and Bones ; Dental Implantation, Endosseous ; Dental Implants ; Durapatite ; Humans ; Male ; Minerals ; Rabbits ; Titanium

OBJECTIVETo explore the relationship between blood pressure variability (BPV) and combined cardiovascular events in 5-10 years in patients with hypertension.

METHODSA total of 367 hypertensive patients treated in our hospital from January, 2000 to January, 2005 were analyzed, and their BPV was assessed in comparison with 145 normotensive individuals. The hypertensive patients were classified into high BPV group and low BPV group, and the general clinical data and biochemical profiles were compared. The relationship between BPV and combined cardiovascular events of the patients within 5-10 years were explored.

RESULTSCompared with the normotensive individuals, the hypertensive patients showed significantly increased standard deviation and coefficient of variation of 24-h systolic blood pressure (SBP), 24-h diastolic blood pressrue (DBP), daytime SBP, daytime DBP, night-time SBP and night-time DBP (P<0.01). The percentages of drinking, smoking, diabetes and coronary heart disease were significantly higher in patients with high BPV than those with lower BPV (P<0.01 or 0.05); uric acid, homocysteine, urinary protein/creatinine ratio and urinary microalbumin increased more significantly in patients with high BPV (P<0.01 or 0.05). In addition, the combined cardiovascular events in 5-10 years were significantly higher in the patients with higher BPV than those with lower BPV (P<0.01 or 0.05). Logistic multivariate logistic regression analysis showed that alcohol, diabetes, coronary heart disease, uric acid and homocysteine were independent risk factors for cardiovascular events in hypertensive patients (P<0.01 or 0.05).

CONCLUSIONIn hypertensive patients, BPV is closely correlated with the long-term combined cardiovascular events, and a high BPV is associated with a greater likeliness of combined cardiovascular events.

Objective To improve clinically the recognition of fungal infection associated with hemophagocytic lymphohistiocytosis (HLH) in children. Methods Clinical data of 3 children with fungal infection complicated with HLH in our hospital was retrospectively analyzed. Results All the 3 cases complained of recurrent fever, 2 cases with cough and one case with vomiting. Hepatosplenomagaly and lymphadenectasis were found in the medical examination. The time of diagnosis of fungal infection through etiological examination was 5 days after admission. It was further diagnosed as hemophagocytic lymphohistiocytosis after failure of effective antifungal therapy. Routine blood test showed the counts of leukocytes were increased in early stage, while the number of platelets and hemoglobin decreased in different degrees. The recovery is not satisfactory using antifungal therapy alone, and 2 of them are gradually aggravated and treated with mechanical ventilation. On the basis of antifungal therapy, 2 cases were treated under HLH-2004 regimen, 1 received dexamethasone treatment. All the 3 cases received intravenous immune globulin, and showed improvement. Conclusions Fungal infection complicated with HLH in childhood is rare. The effect of simple antifungal therapy on the progression is limited. However, increasing immunosuppressive therapy based on effective antifungal therapy can improve the prognosis.