Coagulopathy is very common in patients in intensive care unit (ICU) and often indicates organ dysfunction or underlying diseases.The application of traditional methods assessing the patients' coagulation status in ICU is limited because they can not reflect the whole process of coagulation.Thromboelastography (TEG),a point-of-care (POC) assay of coagulation,fibrinolysis and platelet function,developed in recent years has been widely used in organ transplant and cardiovascular surgery and so on.However,there is no standard for the use of TEG in ICU.The development and application of TEG in sepsis,multiple trauma,guiding blood transfusion,extracorporeal membrane oxygenation (ECMO),and anticoagulation monitoring were addressed in this review,and its value and application prospect in ICU were analyzed.

BACKGROUND: Wnt signaling pathway is a key regulator of cellular proliferation and differentiation, but its correlation with neural differentiation of bone marrow mesenchymal stem cells (BMSCs) is not very clear. OBJECTIVE: To find out the molecules of the Wnt family which are involved in differentiation of rat BMSCs into neuron-like cells. METHODS: The rat BMSCs were separated and cultured in vitro. The morphology of the BMSCs was observed. Flow cytometry analysis was performed to detect cell phenotype CD44, CD9, CD34 and CD45. Wnt3a and Wnt5a were respectively combined with basic fibroblast growth factor to induce BMSCs differentiation into neuron-like cells, and then were identified by using immunocytochemistry and RT-PCR. RESULTS AND CONCLUSION: The BMSCs were long-spindle. CD9 and CD44 were highly expressed, while CD34 and CD45 were lowly expressed. Nestin and neuron specific enolase were positive but glial fibrillary acidic protein were not obviously expressed when they were cultured with Wnt3a. In Wnt5a group, Nestin expression was weakly positive, while neuron specific enolase and glial fibrillary acidic protein were negative. RT-PCR result revealed Nestin expressed both before and after induction in the Wnt3a induced group, neuron-specific enolase exhibited apparent amplified bands 5 days after the induction, and more apparent at 10 days. A weak amplification band of glial fibrillary acidic protein could be seen at 10 days after the induction. In Wnt5a and control groups, BMSCs induced by 10 days weakly expressed Nestin, while neuron-specific enolase and glial fibrillary acidic protein were almost not expressed. It is indicated that Wnt3a molecule can promote the differentiation of BMSCs cultured in vitro to neuron-like cells.

Objective To study the advantage of magnetic resonance imaging(MRI) in diagnosis of complications following liver transplantation.Methods The MRI appearances were analyzed retrospectively in seventy-eight patients with postoperative complications after liver transplantation which was confirmed by operation,hepatic biopsy,angiography and cholangiography.Results The symptoms of skin and sclera jaundice,fever and belly pain were found in sixty-four patients.Liver function was abnormal in laboratory tests.Fourteen were non-symptom with normal liver function.By analyzing the MRI images,the results were found including hepatic portal vein anastomosis stenosis(n=21),hepatic arterial anastomosis stenosis(n=10),inferior vena cava anastomosis stenosis(n=1),bile duct anastomosis stenosis(n=15),bile duct non-anastomosis stenosis(n=5),transplant rejection(n=17),hepatic carcinoma recurrence(n=9).Conclusion MRI can be revealed hepatic vessels and bile ducts stenosis and dilations;it's the best device in diagnosis of complications after liver transplantation.

In this study, we aimed to investigate the regulatory effect of troglitazone (TGZ) on aromatase activity (AA) in human ovarian granulosa cells. The granulosa cells obtained from women who underwent in vito fertilization were treated with various concentrations of TGZ and/or retinoid X receptor ligand (RXR) LG100268 (LG), for 24h, and then cellular AA and the level of P450arom mRNA were determined. The treatment of the cells with TGZ for 24 h resulted in a dramatic inhibition of AA in a dose dependent manner. While the treatment with LG alone inhibited AA, the combined treatment with both TGZ and LG caused a much more reduction in AA. The changes in AA by TGZ and/or LG were associated with comparable changes in P450arom mRNA assessed by RT PCR. These results suggested that TGZ directly inhibited AA in human granulosa cells probably via nuclear receptor system which was composed of peroxisome proliferator activated receptor ?(PPAR?):RXR heterodimer.

ObjectiveDahl salt-sensitive (Dahl/SS) rats are hereditary salt-sensitive hypertensive rats.Its pathogenesis is similar to that of human primary hypertension,CPB established in Dahl/SS rats provides an animal model for the study of CPB in patients with primary hypertension.MethodsMale 14-16 weeks old Dahl/SS rats weighing 360-390 g were fed with high salt (8％ NaCl) diet for 4 weeks before the experiment.Ten Dahl/SS rats were randomly divided into 2 groups ( n =5 each) according to the CPB time:groups Ⅱ and Ⅲ underwent CPB for 120 and 75 min respectively.Another 7 male 14-16 weeks old ordinary SD rats weighing 410-490 g undergoing CPB for 120 min were used as control group (group Ⅰ ).Anesthesia was induced with isoflurane inhalation.Orotraeheal intubation was performed.The animals were mechanically ventilated.Right jugular vein and tail artery were cannulated for venous drainage and arterial inflow from CPB circuit.Blood was oxygenated with a customized mini-oxygenator.Blood gases were analyzed and blood glucose concentration was determined.MAP was recorded before (baseline) and at 30 and 60 min of CPB and 30 and 90 min after CPB.The rate of changes in MAP and blood glucose concentration and survival rate at 7 d after termination of CPB were recorded.ResultsThere was no significant difference in blood gases among the 3 groups.The rates of change in MAP and blood glucose concentration were significantly higher during and after CPB in Dahl/SS rats than in control SD rats in a duration of CPB dependent manner.The survival rate at 7 d after CPB was 7/7 (in group Ⅰ ),1/5 (in group Ⅱ ) and 4/5 (in group Ⅲ ) respectively.ConclusionA model of 75 min CPB is established successfully in Dahl/SS rats.

Objective To investigate the pulmonary microvascular responsiveness of diabetic animals to sepsis and the potential mechanism of NO system.Methods Sixty-four Wistar rats of clean grade were randomly (random number) divided into 4 groups,namely normal control group (group A,n =16),diabetes group (group B,n =16),sepsis group (group C,n =16),diabetes and sepsis group (group D,n =16).Diabetic mellitus model was made in rats with injection of streptozotocin,STZ (65 mg/kg).Successful model was defined as the blood glucose value≥ 16.67 mmol/L 48 hours after injection of STZ.All animals were fed 4 weeks before initiation of next experiment.The sepsis model was established by intravenous injection of LPS (10 mg/kg) in rats.RT-PCR was used to determine the mRNA expression of Tie-2 in rats'blood.The ratio of dry/wet of lung tissue and the extravasation of Evans blue dye into the lung were detected.Quantitation of NO in lung tissue and serum was measured by using Griess method.RT-PCR was also used for determination of iNOS,eNOS,DDAH2 mRNA expressions in lung tissue.Data were analyzed with ANONA and LSD method for comparison between groups,and P ＜ 0.05 was considered statistically significant.Results Compared with septic group.,the diabetic rats with sepsis group demonstrated higher expression of Tie-2 mRNA in blood (19.72 ± 0.70) vs.(3.99 ± 0.92),P =0.00,lower ratio of dry/wet in lung tissue (0.19 ±0.01) vs.(0.22 ±0.01),P =0.000,higher permeability of Evans blue dye into lung tissue (3.76 ± 0.77) vs.(1.74 ± 0.24),P =0.000.Serum NO level was lower in group D than that in group C (123.13 ±4.24) vs.(188.30 ±5.18),P =0.000,however,NO levels in lung tissue of both group D and group C were higher than that in control group (53.62 ± 6.70),(23.63± 3.92) vs.(10.37 ± 1.29),P =0.00,and NO level in group D was higher in 2 times than that in group C (P =0.00).However,there were no differences in eNOS expression among groups A,B and C,but the difference in eNOS expression was present between group D with lower expression and group A,that lower in group D (0.07 ±0.02) vs.(0.38 ±0.05),P=0.017.Compared with group C,the expression of iNOS was higher in group D (80.23 ±2.49),(32.48±5.37) vs.(1.74±0.23),P=0.00),and the expression of DDAH2 was lower in group D (0.49 ±0.13),(7.26 ±0.50) vs.(11.96 ±0.55).Conclusions Diabetic rats with sepsis enhanced endothelial cell damages.Diabetes deteriorates the regulatory activity of NO system,suggesting the potential mechanism of the worsened damages of EC in diabetic sepsis host.

Objective To investigate the effects and mechanisms of 5-aza-2'-deoxycytidine (5-Aza-CdR) on endometrial cancer cell.Methods In vitro experiments of 5-Aza-CdR were done using human endometrial cancer cell line HEC-1B.Evaluation of cellular proliferation and apoptosis was ascertained respectively using trypan blue exclusion and flow cytometry.RT-PCR and methylation specific PCR(MSP) was done to detect the expression of RASSF1 A mRNA and methylation status of RASSF1 A promoter of HEC-1B cell line.Results (1) The status of cellular growth and apeptosis of HEC-1 B cell line:the growth inhibition effects of 5-Aza-CdR on HEC-1B cell line were both concentration-dependent (P ＜ 0.01) and time-dependent(P ＜0.01),as well as the apoptosis rate of HBC-1-B cell line depended on the dose of 5-Aza-CdR obviously(P ＜0.01).(2)The expression of RASSF1A mRNA of HEC-1B cell line:RASSF1A mRNA was expressed in HEC-1B cell after 5-Aza-CdR treatment,but it was undetectable before the treatment.In the groups with different concentration of 5-Aza-CdR (0.05,0.1,1,5,10 nmol/ml),the expression of RASSF1A mRNA was respectively 0.074±0.004,0.105±0.004,0.167±0.006,0.334±0.005,0.484±0.007,which were remarkably different from the group without 5-Aza-CdR(the expression of RASSF1A mRNA was 0;P ＜ 0.01).(3) The hypermethylation of RASSF1A promoter of HEC-1B cell line:the hypermethylation of RASSF1A promoter was detected in HEC-1B cell line.The status of hypermethylation was decreased after treatment with 5-Aza-CdR of 0.05,0.1,1,5 nmol/ml,meanwhile,both methylation bands and demethylation bands were observed by methylation specific PCR.After the treatment with 5-Aza-CdR of 10 nmol/ml the hypermethylation was absent absolutely.Conclusions (1) In HEC-1B cell line,5-Aza-CdR can inhibit cell proliferation and induce cell apopotosis.(2) 5-Aza-CdR can renew the expression of RASSF1A mRNA of HEC-1B cell line and reverse the hypermethylation of RASSF1A promoter.

Objective To assess the effect of radioiodine-131 (131Ⅰ) on treatment of pulmonary metastases from differentiated thyroid carcinoma and the main prognostic factors. Methods Five databases were retrieved and all published studies which analyzed the effect of 131Ⅰ on pulmonary metastases from differentiated thyroid carcinoma and the main prognostic factors were systematically reviewed. The data about the impact of 131Ⅰ treatment and the main prognostic factors on the 5-yr and 10-yr survival rates of the patients were abstracted. RevMan 4.2 software was used to statistically analyze. Results Eleven retrospective cohort studies were included. The pooled results suggested that the 5-yr survival rates of the patients who received 131Ⅰ therapy and who did not received 131Ⅰl therapy were 74.9% and 27.1% , respectively ;The lO-yr survival rates(P<0.01)of the two groups were 60.8% % 12.2% , respectively;The difference between them had statistical significance (P<0.01). The 5-yr and 10-yr survival rates of the patients only with pulmonary metastases were higher than those of the patients with multiple metastases (P<0.01). The 5-yr (P = 0.01) and 10-yr (P = 0. 002)surviv10al rates of the patients only with papillary thyroid carcinoma were higher than those of the patients with follicular thyroid carcinoma. The 5-yr and 10-yr survival rates of male and female patients were similar(P>0.05). Conclusions 131Ⅰ treatment increases the 5-yr and 10-yr survival rates of patients with pulmonary metastases from differentiated thyroid carcinoma. The extent of metastases and the histologie type of differentiated thyroid carcinoma are two main predicting factors of prognosis. The 5-yr and 10-yr survival rates of patients are not influenced by gender.

Objective:To investigate the effect of siRNA interfering survivin gene on proliferation of human tongue cancer Tca8113 cells,and clarify the effect of survivin Tca8113 cells biomechanism.Methods: The Tca8113 cells at logarithmic growth phase were selected and divided into interference group,negative control group,and blank control group.The relative levels of survivin mRNA and survivin protein expression of 3 groups were detected by RT-PCR and Western blot assay,the inhibitory rate of proliferation of Tca8113 cells was checked by MTT method,the apoptotic rate was assessed by flow cytometry(FCM),the the migration ability of Tca8113 cells were detected by Wound healing assay.Results: Compared with control group,the survivin mRNA and protein expression was markedly down-regulated in Tca8113 cells following RNA interference treatment(P<0.05),the cell proliferation were down-regulated in interference group(P<0.05),the cell apoptotic rate were up-regulated in interference group(P<0.05),the migration ability was significantly decreased in interference group(P<0.05).Conclusion: The expression of siRNA-survivin can significantly inhibit the invasion in tongue cancer Tca8113 cells,indicating it might be a potential biological therapeutic target for tongue cancer.

Objective To investigate the short- and mid-term outcomes of after off-pump coronary artery bypass grafting (OPCABG) in patients with severe elevation of preoperative serum creatinine levels (SEPSC). Methods The perioperative data of SEPSC patients undergoing OPCABG were investigated based on the perioperative CABG database from Feb. 2012 to Jul. 2016. The patients were also followed up for the perioperative complication, short and medium-term survival were estimated. Results The mean age of the patients was 65.4(45-85) years. The in-hospital mortality was 4.4% and the CRRT rate was 19.6%(9 case). Survival analyses revealed a survival ratio of 100% at one year, 97.6% at two years. Short-Form Mini Nutritional Assessment was used to show that 13(28.3%) patients had malnutrition. Conclusions SEPSC patients can be candidates for OPCABG procedure. The mortality in hospital and 2-year survival rate of SEPSC patients after OPCABG procedure are both considered within an acceptable range. OPCABG may be performed in these patients with a satisfactory survival rate with the development of surgical instruments and medical treatment.