Objective To investigate the effects of human umbilical cord mesenchymal stem cells (UC-MSCs) on vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6) expression in acute myocardium infarction (AMI) rats. Methods The human UC-MSCs were cultured to the 4th generation for experiment. Sixty male Sprague-Dawley (SD) rats were randomly divided into sham group, AMI model group and UC-MSCs group, with 20 in each group. AMI animal model was produced by ligation of anterior descending coronary artery; in the sham group, the threading vein was gone below without ligation. In UC-MSCs group 2×106 UC-MSCs were infused through the caudal vein at 24 hours after successful model production. The animals were sacrificed after 7 days; the myocardial tissue and coronary artery below the ligation line were harvested. The mRNA and protein expressions of IL-6 in myocardium were detected by reverse transcription-polymerase chain reaction (RT-PCR) and Western Blot. The positive expression of VEGF in coronary artery was observed by immunohistochemisty. Results Compared with the sham group, the mRNA and protein expressions of IL-6 in myocardium in AMI model group were increased significantly (gray value: 0.732±0.131 vs. 0.321±0.080, 0.678±0.191 vs. 0.286±0.061, both P < 0.05). Compared with the AMI model group, the mRNA and protein expressions of IL-6 in myocardium in UC-MSCs group were decreased significantly (gray value: 0.300±0.104 vs. 0.732±0.131, 0.312±0.101 vs. 0.678±0.191, both P < 0.05). Observation under light microscope, the VEGF positive cells in AMI model group was increased significantly compared with the sham group (cells/HP: 21.1±2.2 vs. 7.6±1.3, P < 0.05), the VEGF positive cells in UC-MSCs group were increased significantly compared with the AMI model group (cells/HP: 41.5±3.1 vs. 21.1±2.2, P < 0.05). Conclusion Human UC-MSCs could promote angiogenesis by the improvement of VEGF in coronary artery and inhibit the inflammation by the reduction of IL-6 in rats with AMI.

[ ABSTRACT] AIM:To investigate the mechanism of L-type calcium channel ( L-Ca2+)/calpain signal transduc-tion pathway in verapamil inversing resistance of papillary thyroid carcinoma to doxorubicin .METHODS:Human papillary thyroid carcinoma TPC-1 cells were cultured for 2 d.For determining the appropriate concentrations and treatment time of verapamil and doxorubicin , a compatibility test was conducted to detect the cell viability by CCK-8 assay.The cells were divided into control group , doxorubicin group , verapamil group and doxorubicin +verapamil group .The techniques of whole-cell patch-clamp was used to record L-Ca2+currents.The protein expression levels of calpain 1 and LC3 were detec-ted by Western blot .RESULTS: Compared with control group , the density of L-Ca2+current decreased in doxorubicin group and verapamil group (P<0.05).Compared with verapamil group , the density of L-Ca2+current decreased in doxo-rubicin+verapamil group (P<0.01).Compared with control group, the expression of calpain 1 decreased in doxorubicin group and verapamil group (P<0.05).Compared with doxorubicin group , the expression of calpain 1 decreased in doxo-rubicin+verapamil group (P<0.05).Compared with control group , the expression of LC3 increased in doxorubicin group and verapamil group (P<0.05).Compared with doxorubicin group , the expression of LC3 increased in doxorubicin +ver-apamil group ( P<0.01) .CONCLUSION:The drug resistance of TPC-1 cells to doxorubicin may be related to the in-crease in autophagic activity .Verapamil further increases autophagic activity of TPC-1 cells, resulting in autophagic death and inversing the resistance of TPC-1 cells to doxorubicin .The mechanism may be involved in L-Ca2+/calpain 1 signal transduction pathway of autophagy .

Objective To evaluate the effect of propofol on interleukin-1β (IL-1β)-induced increase in monolayer permeability of human umbilical vein endothelial cells (HUVECs).Methods Primary HUVECs were cultured and purified by immuno-magnetic separation.The expression of VE-cadherin in endothelial cells was determined by immunofluorescence.The HUVEC monolayer permeability was detected by the Transwell system.The cells were seeded on the upper chamber (2 × 105 cells/well) and cultured for 3 days after confluence.The cells were treated in two ways.The cells were randomly divided into 6 groups (n =36 each) and 5 of the 6 groups treated with 1,2,5,10 and 20 ng/ml IL-1β for 24 h except for control group.The cells were also randomly divided into 5 groups (n =30 each) and 4 of the 5 groups were pretreated with 0,10,50 and 100 μmol/L propofol for 30 min,and then treated with 10 ng/ml IL-1β for 24 h except for control group.The cells were radomly divided into 3 groups (n =18 each) and 2 of the 3 groups were pretreated with 50 μmol/L propofol for 30 min,and then treated with 10 ng/ml IL-1β for 24 h or 30 min.The expression of occludin protien,p38 mitogen activiated protienkinase (p38 MAPK) and phosphorylated p38 MAPK (p-p38 MAPK) was determined by Western blot.Results Compared with control group,5,10 and 20 ng/ml IL-1β significantly increased HUVEC monolayer permeability in a concentration-dependent manner (P ＜ 0.05 or 0.01).10,50 and 100 μmol/L propofol inhibited IL-1 β-induced increase in the permeability of HUVEC monolayer permeability in a concentration-dependent manner (P ＜ 0.01).IL-1β could down-regulate HUVEC occludin protein expression,and activate p38MAPK signaling pathway,and propofol inhibited IL-1β-induced down-regulation of HUVEC occludin protein expression and activation of p38 MAPK signaling pathway (P ＜ 0.01).Conclusion Propofol can alleviate IL-1β-induced increase in the permeability of HUVEC monolayer via inhibiting activation of p38 MAPK signaling pathway.

ObjectiveTo evaluate intraoperative cholangiography (IOC) and laparoscopic ultrasonography (LUS) for detection of occult common bile duct stones (CBDS) during laparoscopic cholecystectomy (LC). Methods From Jun. 2000 to Sep. 2001, 98 patients undergoing LUS and IOC during LC were analyzed prospectively.Results[The successful rate of LUS and IOC were 100% and 95% respectively, the time for LUS (7 7?2 1) min was significantly shorter than IOC (11 4?3 5) min ( P 0 05). The visualization of intrapancreatic portion of CBD by LUS was 62% vs 97% by IOC ( P

0 05); Flatus, time to resume early activity and hospital stay in laparoscopic group were 2 24?0 56、 3 94?1 64、 13 94?6 5 days respectively, which was significantly shorter than those in open group ( P 0 05) The mean follow up time of the two groups were 23 15?7 95 and 22 19?7 46 months, respectively Local recurrence rate,metachronous metastases rate and cumulative survival probability at 36 months were similar for the two groups Conclusion These results suggest that laparoscopic right hemicolectomy for colon cancer can be performed safely, effectively and economically with the advantages of minimal invasiveness

Objective To compare the safety and efficiency of laparoscopic transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) procedure for herniorrhaphy. Methods Between Jan 1997 and Jan 2005, 235 patients (274 hernias) underwent laparoscopic inguinal hernia repair with 163 TAPP in 139 patients and 111 TEP procedures in 96 patients. Postoperative patients were followed-up for 6-24 months. Results No conversion was necessary. There were no significant differences between TAPP and TEP when considering operating time, postoperative hospital stay, VAS and time to return to daily activity. The recurrence rate was 1. 8% and 0. 9% respectively in TAPP and TEP( P = 0. 524). The total incidence of postoperative complications were 15. 3% and 10. 8% respectively ( P = 0. 282 ) , with seroma, transient neurapraxia and urinary retention being 5. 5% vs. 4. 5% ( P = 0. 707 ) , 5. 5% vs. 3. 6% ( P = 0.464) and 3. 1% vs. 2.7%(P = 1.000). The inhospital cost was significantly higher in TAPP than in TEP(P=0.000). Conclusion TAPP and TEP are both safe and efficient tension-free technique. Surgeons' experience was more important than choice of approach to laparoscopic repair for groin hernias.

Objective To introduce a novel femoral distractor which is applied in close reduction and internal fixation (CRIF) with antegrade intramedullary nail for femoral shaft fractures.Methods From September 2010 to March 2015,85 patients with femoral shaft fracture were treated by CRIF with antegrade intramedullary nail in which our self-designed novel distractor was used.They were 64 males and 21 females,with an average age of 36.6 years.By AO classification,we had 32 cases of type 32-A,40 cases of type 32-B,and 13 cases of type 32-C.The intervals between injury and surgery averaged 7.5 days (range,from 1 to 16 days).The fracture was located at the upper shaft in 26 cases,at the middle shaft in 57 cases,at the middle shaft and ipsilateral neck in one,and at the lower shaft and ipsilateral intertrochanteric site in one.Their operation time,intraoperative blood loss,intra-and post-operative complications,and fracture union time were recorded and analyzed.Results Successful close reduction was achieved in all the 85 patients with no iatrogenic injury to major vessels or nerves.Operation time averaged 105.5 minutes;time for X-ray exposure averaged 25.8 seconds;intraoperative blood loss averaged 209.2 mL.The 85 patients received follow-ups from 8 to 24 months (mean,16.3 months).Fracture union was achieved in 83 cases after an average duration of 7.8 weeks (range,from 4 to 12 weeks),but nonunion occurred in 2 cases.One-year follow-ups revealed recovery of normal function of the affected knee in all,with no limb shortening ＞ 10 mm,rotational angulation ＞ 15°,or lateral or anteroposterior angulation ＞ 10°.No incision infection,deep vein thrombosis or pulmonary embolism happened during the entire follow-up.Conclusion Our self-designed novel distractor can facilitate CRIF with antegrade intramedullary nail for femoral shaft fractures,and avoid the complications and inconvenience associated with a traction table.

Objective To explore the safer and more reasonable time of withdrawing nucleoside analogues antiviral therapy in women with chronic HBV infection during immune tolerance period. Methods The patients included in this study were 343 pregnant women with chronic HBV infection who received nucleoside antiviral therapy in Obstetrics and Gynecology Center of 302 Military Hospital of China. According to the time of withdrawing antiviral therapy after delivery, the patients were assigned to P0 group, i.e., withdrawal immediately after delivery, and the patients who stopped the drug 6 weeks after delivery were assigned to P6w group. The patients were compared between these two groups in terms of prevalence of ALT abnormality during pregnancy and postpartum, the peak value and occurrence time of postpartum ALT, and mother-to-child vertical transmission. Results The prevalence of postpartum ALT abnormality was 30.2％ in P0 group and 20.7％ in P6w group (χ2=4.129, P=0.046). Specifically, for the patients with abnormal liver function during pregnancy, the prevalence of postpartum ALT abnormality was 88.0％ and 39.4％ in the two groups respectively (χ2=14.043, P=0.001). While for the patients with normal liver function during pregnancy, the prevalence of postpartum ALT abnormality was 19.4％ and 16.6％ respectively (χ2=0.392, P=0.531). Mother-to-infant HBV transmission was blocked successfully in all the patients in spite of the time of withdrawing antiviral therapy. Conclusions For the pregnant women with chronic HBV infection who received oral nucleoside analogue antiviral agents to interrupt motherto-child transmission, the time of withdrawing antiviral agents did not show significant effect on the prevalence of postpartum liver function abnormality and rate of successful blocking mother-toinfant HBV transmission. However, for the patients with abnormal ALT during pregnancy, it is appropriate to continue the nucleoside analogue antiviral therapy after delivery.

Diffusion tensor imaging (DTI), which responds with the diffusion of water molecules in spinal cord white matter, may be used to detect the integrity of the spinal cord fiber bundles and the pathological changes after injury. It is sensitive in acute and chronic spinal cord injury, such as cervical spondylotic myelopathy, multiple sclerosis, brain damage secondary spinal cord injury, spinal nerve root damage, and so on. In basic studies, DTI can reveal the microstructure and pathological changes of the injured spinal, and be correlated with behavioral assessment, which involved mice, monkeys, calves, cats, swines, dogs, and so on.

Objective:To investigate the effect of the Ilizarov technique in the treatment of post-traumatic lower extremity shortening with talipes equinovarus.Methods:Clinical data of patients with post-traumatic lower extremity shortening and talipes equinovarus treated by the Ilizarov technique in the Department of Orthopaedics of Xuzhou Renci Hospital from January 2013 to April 2020 were retrospectively analyzed. The annular external fixator was installed on the affected limb according to the Ilizarov principle of external fixation. 3 days after the operation, the internal and lateral screw rods were adjusted at the speed of 2 mm/d to gradually correct the talipes equinovarus. 7 days after surgery, the lower leg was lengthened at a speed of 1 mm/d. After the foot was corrected, the foot external fixator was continued to be worn for 4 to 6 weeks, and then the fixator was removed and the foot was immobilized with a brace for 6 to 8 weeks. The lower leg fixator was removed after the lower extremity length was restored and the bone mineralization at the extension site was good. The length of both lower extremities, angle of talonavicular joint, angle of plantar flexion and dorsal extension of the ankle, and range of motion of ankle were compared before surgery and at the last follow-up. At the last follow-up, the affected feet were scored and rated using the International Clubfoot Study Group (ICFSG) scoring system, which was divided into four grades: excellent, good, medium, and poor. SPSS 25.0 software was used for statistical analysis, and each measurement index and ICFSG score were expressed in Mean±SD. Paired t-test was used to compare the preoperative and last follow-up data, and P<0.05 was considered statistically significant. Results:A total of 31 patients were enrolled, including 17 males and 14 females. The age was 15-18 years old, with an average of 16.5 years old. There were 16 cases on the right side and 15 cases on the left side. The lower extremity shortening was 45-75 mm, with an average of 65 mm. The fixation time of the external fixator was 4.5-6 months after surgery, with an average of 5 months, and the follow-up time was 22-28 months, with an average of 25.5 months. The length of the affected lower extremity recovered, the shape was basically satisfactory, and the plantar gait was restored. At the last follow-up, compared with the preoperative period, the anteroposterior talocalcaneal angle of the foot (23.0°±2.1° vs. 8.5°±2.6°), from lateral talocalcaneal angle the foot (27.0°±4.3° vs. 11.2°±4.4°), ankle plantar flexion angle (24.5°±6.8° vs. 51.1°±6.5°), ankle dorsiflexion angle (5.8°±3.5° vs. -46.8°±7.0°) and ankle range of motion (30.3°±8.2° vs. 4.2°±1.6°) were statistically significant ( P <0.01). ICFSG score: The points at the last follow-up (8.0 ± 4.2) were significantly lower than that before the operation (41.9 ± 5.3) ( P<0.01), of which 18 were excellent, 9 were good, and 4 were medium. Two cases had recurrent deformities in the later stage, and the results were satisfactory after the fusion of the talonavicular joint and calcaneocuboid joint and the anteposition of the posterior tibial tendon in the second stage. There were 4 cases of toe contracture deformity, which did not recur after the release of the flexor digitorum longus tendon at the toe. Anterior ankle impingement was observed in 5 cases and improved after the arthroscopic osteophyte removal. After the lower extremity extension was in place, the external fixator was replaced by the intramedullary nail for walking in 6 patients. The infection of the nail path occurred in 7 cases, which improved after replacement of fixing pins and dressing change of the nail path. Conclusion:The application of the Ilizarov technique in the treatment of post-traumatic lower extremity shortening with talipes equinovarus has the advantages of small trauma and dynamic control of deformity correction, which can achieve good result.