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.

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.

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.

Objective To investigate prenatal diagnosis and treatment of toxoplasmosis in fetuses with fluorescence quantitative polymerase chain reaction (FQ PCR) technique Methods Of the 70 pregnant women with toxoplasma(TOX) DNA positive , TOX DNA in amniotic fluid and/or fetal umbilical cord blood was detected with FQ PCR technique to diagnose fetal infection 48 ones were given routine treatment with spiramycin for 2 therapy periods Ultrasound examination were undertaken in all of pregnant women to monitor fetal growth Results Of the 70 cases with TOX DNA positive, TOX DNA was detected in 21 fetuses TOX DNA positive rates were similar in amniotic fluid and umbilical cord blood The higher the TOX DNA, the higher fetal infectious rate Fetal infectious rate was lower in treatment group(21%) than that in control group (50%), there was a statistically difference between two groups Conclusions Maternal TOX infection may cause fetal damage Detection of TOX DNA in amniotic fluid with FQ PCR technique can diagnose fetal toxoplasmosis exactly Treatment in pregnant period may decrease intrauterine infection rate

After a description of the demand for medical information in grass-root PLA health units, the experiences of Medical Library of Chinese PLA in providing medical information service for grass-root PLA health units were summarized, and suggestions were proposed for medical library and information institutions to provide information service for them.

AIM:To explore the inhibitory action of recombinant human tumor necrosis factor-related apoptosis-inducing ligand(rhTRAIL) on mouse breast cancer. METHODS:Each mouse was inoculated 0.2 mL (1?106) D2F2 cells subcutaneously in the right lower limb and they were divided into five groups randomly. The control group was infused PBS 0.2 mL,while the low-dose,medium,high groups received purified rhTRAIL 2.5 mg/kg,5.0 mg/kg,10.0 mg/kg,respectively,the positive group was administered cyclophosphamide 30.0 mg/kg. Every group was operated by peritoneal injection once a day for fifteen days. The mice were weighed every day. The growth state was viewed and the size of the tumor was measured every 3 d to calculate the tumor volume and tumor suppression rate. All mice were killed after 15 d. The pathologic changes of the tumor were observed under light-microscopy and electronic microscopy. The cell cycle and apoptosis index of D2F2 cells were analyzed by flow cytometry. RESULTS:The body weight and tumor volume in low-dose,medium,high groups were lower than those in control group and the restriction effect was more significant than that in the control group (P

OBJECTIVE To investigate the causes of stomal recurrence after laryngectomy and the possibility of surgical management.METHODS The clinical data of 13 cases of stomal recurrence were analyzed retrospectively.RESULTS In 13 cases of stomal recurrence after laryngectomy,the survival period of 9 cases treated surgically was longer than that of 4 cases untreated or palliative treatment.CONCLUSION The overall prognosis of stomal recurrence after laryngectomy is poor.A proper surgical treatment in some cases will prolong the patient's lifetime obviously and improve his quality of life.

Objective To analyze risk factors of continuous renal replacement therapy (CRRT) in patients with severe serum creatinine levels elevation undergoing off-pump coronary artery bypass grafting (OPCABG).Methods The perioperative data of 45 patients with severe elevation of preoperative serum creatinine levels undergoing OPCABG were investigated based on the perioperative CABG database from Feb, 2012 to Jul, 2016.The postoperative treatment rates of CRRT were recorded and the risk factors were identified by multivariate logistic regressions.Results There were 9 patients (20%) who suffered from CRRT after OPCABG in all 45 recruitment patients.Compared with non-CRRT patients, there were higher levels of serum creatinine (Cr) and blood urea nitrogen (BUN) before surgery, a lower volume of urine during surgery, a higher level of serum creatinine at postoperative 12 hour and 24 hour, longer ICU staying time and higher in-hospital mortality after surgery in patients with CRRT (P＜0.05 or P＜0.01).Multivariate logistic regression analysis demonstrated that preoperative level of serum creatinine (OR=1.05, 95% CI 1.05-1.10, P=0.046) was the independent risk factor of postoperative CRRT in patients with severe serum creatinine levels elevation undergoing OPCABG.At the value of postoperative 12 hour serum creatinine up to 166 μmol/L, the incidence of postoperative CRRT in patients increased 5% by postoperative 12 hour serum creatinine increasing 1 μmol/L(OR=1.05, 95% CI 1.01-1.08, P=0.013).However at the value of postoperative 12 hour serum creatinine above 350 μmol/L, ceiling effect was apparent.Conclusion This study shows that 20% patients with preoperative severe serum creatinine level elevation are suffered from CRRT after OPCABG procedure and preoperative level of serum creatinine is predominant factor of postoperative CRRT.

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.