Objective: To study the mechanisms and treatment of ischemia/reperfusion injury. Expression of E selectin was measured and the effect on suppression of E selectin by the Pyrrolidine Dithiocarbamate was investigated. Methods: Endothelial cells were exposed to hypoxia, then returned to reoxygenation condition. ELISA methods were used to detect expression of E selectin. Results: E selectin expression on hypoxia/reoxygenation stimulated endothelial cells increased, PDTC could suppress translation of E selectin effectively. Conclusion: It seems that E selectin may act as a critical factor. PDTC may prove beneficial in the treatment of ischemia/reperfusion injury.

Objective To explore the isometric attachment site of the posterolateral structure in the femoral lateral condyle and introduce the method of knee posterolateral complex(PLC) reconstruction with the semitendinosus tendon. Methods Isometric reconstruction of the chronic PLC injury of knee joint in 18 cases, were performed with the semitendinosus tendon from February 2001 to February 2005. Of all patients, there were 12 males and 6 females, average age was 39 years old(range, 19-52 years old). All cases were chronic injuries, with duration of 1.5-14 months. 3 cases were simple PLC injury, 10 cases were PLC injury with posterior cruciate ligament(PCL) injury, 2 of which had undergone PCL reconstruction about 6.5 months. 3 cases combined with anterior cruciate ligament(ACL) injury, 2 cases combined with ACL and PCL injury. To put in the double semitendinosus tendon from the bony tunnel of anatomical insertion of the fibular collateral ligment in caput fibulae and put out from the bony tunnel of anatomical insertion of the popliterofibular ligment in the caput fibulae, then fix them respectively in the isometic bony tunnel of the femoral lateral condyle. The posterolateral stability of the knee was evaluated mainly through examination varus instability of knee and external rotation range of leg. Results It was relatively isometric from the femoral attachment site of the popliteal tendon to the anatomical insertion of the popliterofibular ligment in the caput fibulae. The better isometric attachment site was from the anatomical caput fibulae attachment site to 8-10 mm in front of the anatomical femoral attachment site of the lateral collateral ligament. The average follow-up period was 14 months(12-24 months). There was no varus knee instability in full extension. At 30? flexion, one-grade varus instability was found in 2. At 30? and 90? flexion, external rotation range increased by 6? in 3 cases, remained the same in 14 cases, and decreased in 1 case, all compared with the healthy side. Conclusion The method provided good stability for the knee and acquired satisfactory clinical results.

Objective To observe the application of ultrasound-guided femoral nerve block (FNB) and lateral femoral cutaneous nerve block (LFCNB) for patients undergoing hip fracture surgery.Methods 60 patients scheduled for hip fracture surgery undergoing LMA general anesthesia were randomly divided into 3 groups,20 cases in each group.Before transfer patients from bed to operating table,A group received dezocine 5mg iv,B group received fascia iliaca compartment block(FICB),C group received FNB combined with LFCNB.40mL of 0.375％ ropivacaine was injected guiding by ultrasound in B group and C group.The time of sufficient sensory block and awake,the dosage of propofol and remifentanil,MAP and HR at pre-block (T1),20min after block (T2),transfer bed (T3),LMA insert (T4),skin incision(T5),LMA remove(T6) and sober(T7) were recorded.Pain was assessed using visual analogue scale(VAS) pre-and post block.The incidence of using vasoactive drugs,agitation,pain and adverse reaction were also recorded.Results The time of sufficient sensory block and awake,the dosage of propofol and remifentanil in A,B and C groups were as following:A group (not measured),(20.3 ± 1.3) min,(835 ± 6.7) mg,(1 285 ± 18) μg;B group (i2.2 ±2.7)min,(13.3 ± 1.4)min,(610 ±9.9)mg,(835 ± 15) μg;C group (9.7 ± 2.4)min,(12.8 ± 1.5) min,(555 ± 6.5) mg,(785 ± 16) μg.The time of awake,the dosage of propofol and remifentanil in B group and C group were significantly lower than those in A group(F =2.62,2.41,2.45,all P ＜ 0.05).The time of sufficient sensory block in C group was lower than that in B group (p ＜ 0.05).The MAP and HR at T2,T3,T5 and T7 in A,B and C groups were:A group (115 ± 4) mmHg,(90 ± 8) beats/min,(135 ± 6) mmHg,(98 ± 8) beats/min,(104 ±6) mmHg,(87 ± 4) beats/min,(120 ± 5) mmHg,(88 ± 8) beats/min;B group (102 ± 3) mmHg,(81 ± 6) beats/min,(112 ± 5)mmHg,(82 ± 8)beats/min,(89 ±6) mmHg,(72 ± 3) beats/min,(100 ±6)mmHg,(76 ± 8) beats/min;Cgroup (100 ± 3) mmHg,(80 x 6) beats/min,(109 ± 6) mmHg,(83 ± 5) beats/min,(86 ± 5) mmHg,(70 ± 3) beats/min,(99 ± 5) mmHg,(75 ± 5) beats/min.The levels of MAP and HR in B group and C group were significantly lower thanthose in A group(F =2.25,2.85,2.87,2.91,all P ＜ 0.05).The VAS scores at T2,T3,and T7in A,B and C groupswere:A group (3.9 ± 0.7) points,(8.2 ± 0.3) points,(6.0 ± 0.8) points;B group (2.3 ± 0.4) points,(4.1 ±0.4) points,(2.2 ± 0.7) points;C group (2.1 ± 0.5) points,(2.4 ± 0.4) points,(1.2 ± 0.4) points.The VAS scoresin B group and C group were significantly lower than those in A group (2.36,2.82,2.88,all P ＜ 0.05).The VASscores at transfer bed and sober in C group were significantly lower than those in B group (F =2.32,2.38,all P ＜0.05).The incidence of using ephedrine/atropine,urapidil/esmolol,PONV,agitation,pain and incision pain in A,Band C groups were:A group 30％,30％,25％,25％,40％;B group 10％,10％,0％,0％,10％;C group 10％,5％,0％,0％,0％.The number of patients who required vasoactive drugs and adverse reaction in B group and C group were significantly lower than those in A group(x2 =7.58,8.81,9.11,9.11,8.89,all P ＜0.05).The incidence of incision pain at sober in C group was lower than that in B group(x2 =9.21,P ＜ 0.05).Conclusion The ultrasound -guided FNB and LFCNB can obviously shorten the onset time,reduce the dosage of general anaesthetic and maintain the stability of henodynamics during the perioperative period.It has effective analgesia during transfer of patients from bed to operating table and sober.

Adolescent ; Adult ; Child ; Elliptocytosis, Hereditary ; diagnosis ; genetics ; Female ; Humans ; Male

Functional constipation (FC) is a common functional bowel disorder disease that affects life quality of a large number of people. This study aimed to explore the impact of different intensities of electro-acupuncture (EA) treatment for FC patients. Totally, 111 patients with FC meeting the Rome III criteria were randomly assigned to different intensities of EA groups (low and high intensity of EA groups) and medicine-controlled (MC) group. In EA groups, patients were treated with EA at quchi (LI11) and shangjuxu (ST37) bilaterally for 4 weeks, 5 times/week in the first 2 weeks, and 3 times/week in the last 2 weeks. In MC group, 5 mg mosapride citrate was administered orally 3 times/day for 4 weeks. Spontaneous bowel movement frequency each day was recorded using a constipation diary. Self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to assess the patients' psychological state. Cortisol (CORT), substance P (SP), and vasoactive intestinal polypeptide (VIP) were evaluated at baseline and at the end of 4 weeks after treatment. As compared with the baseline, there was statistically significant increase in stool frequency every week (P<0.01), but there was no statistically significant difference among the three groups. As compared with the baseline, after 4 weeks of EA therapy, the scores of SDS and serum levels of CORT were decreased significantly in low intensity of EA group (P<0.01), and the serum levels of SP and VIP were increased significantly (P<0.05); the scores of SAS and SDS and serum levels of CORT were decreased significantly in high intensity of EA group (P<0.05), and the serum levels of SP and VIP were increased significantly (P<0.05); the serum levels of CORT and VIP were increased significantly in MC group (P<0.05). As compared with MC group, after 4 weeks of treatment, the serum levels of SP were signifcicantly increased in low intensity of EA group (P<0.01). Low and high intensities of EA could increase the stool frequency, improve the FC patient's anxiety and depression, reduce the serum levels of CORT, and increase the serum levels of SP and VIP effectively. It is concluded that both low and high intensities of EA are effective for FC patients, but there is no significant difference between the low and high intensities of EA.

Objective To investigate the frequencies of circulating dendritic cell (DC) subsets and the function of monocyte-derived dendritic cells in patients with hepatitis B-related acute-on-chronic liver failure.Methods Peripheral blood was collected from hepatitis B-related acute-on-chronic liver failure patients (ACLF,n =40) and chronic hepatitis B (CHB,n =40) as well as normal controls (NCs,n =20).Circulating myeloid dendritic cell (Mdc) and plasmic dendritic cell (pDC) frequencies in peripheral blood mononuclear cells (PBMC) were analyzed by flow cytometric analysis.Purified monocytes were isolated by combination of Histopaque-1.077 and CD14 Microbeads.Monocyte-derived dendritic cells (MoDCs) generated in vitro in the presence of interleukin (IL)-4 and granulocyte macrophage colony-stimulating factor upon activation by poly I:C.Costimulatory molecule expression and allostimulatory mixed lymphocyte reaction (AMLR) of MoDCs were detected in patients with hepatitis B-related ACLF.Results The number of circulating mDC decreased only in patients with hepatitis B-related ACLF compared with that in normal controls.However,pDC numbers decreased in both CHB and ACLF patients.We observed a further decrease the pDC numbers in ACLF compared to CHB patients without statistical significance (P ＞ 0.05).MoDC from ACLF patients showed lower expression of costimulatory molecules CD80,CD86 and the mature marker CD83,as well as MHC Ⅱ molecule (HLA-DR) compared to CHB and NC group.Interestingly,MoDC impaired allostimulatory mixed lymphocyte reaction from ACLF patients compared to those in CHB patients and NCs.Conclusions Patients with hepatitis B-related ACLF have a significantly lower expression of surface markers and impaired AMLR of MoDC,as well as decreased number of circulating mDC and pDC,which may be partially related to HBV disease progression in these patients.

Objective To investigate the clinical characteristics, diagnosis and treatment of primary splenic tumors.Methods The clinical data of 47 patients with spleen tumors treated in the First Affiliated Hospital of Medical College, Xi'an Jiaotong University from January 2008 to October 2014 were retrospectively analyzed.Results 28 patients had no symptoms and only on physical examination was a mass found in some patients.There were 12 patients who manifested with upper abdominal discomfort or pain, 2 patients with an epigastric mass, l patient manifested with fever and 2 patients manifested with nausea and vomiting.Preoperative examination showed anemia in 7 patients.Three patients manifested with hypersplenism.Preoperative ultrasonic examination was performed on 39 patients with a diagnostic rate of 89.7％.43 patients underwent CT examination which had a diagnostic rate of 90.7％, MRI was performed in 4 patients and the diagnoses were all correct.Of the 47 patients with splenic tumor, 38 patients had a benign tumor.34 patients were treated by surgery, including 22 patients who underwent open splenectomy, 9 patients laparoscopic splenectomy, 3 patients laparoscopic fenestration of splenic cyst.Malignant tumors were found in 9 patients.Four patients underwent splenectomy, 2 patients were treated by laparoscopic splenectomy.Preoperative examination and postoperative pathological examination showed a benign tumor in 38 patients, including 1 1 patients with a splenic cyst, 6 patients with a cavernous hemangioma, 5 patients with an inflammatory pseudo tumor of spleen (accounting for 57.3％ of all the benign tumor).Malignant tumors included 5 patients with malignant lymphoma, 1 patient with splenic angiosarcoma, 1 patient with gastric carcinoma which metastasizes to the spleen, 1 patient with cervical carcinoma metastasizing to the spleen and 1 patient with liver carcinoma metastasizing to the spleen.Adjuvant chemotherapy and (or) radiotherapy after surgery were performed for patients with malignant lymphoma of the spleen.For 2 patients who were diagnosed early, surgery combined with radiotherapy or chemotherapy and immunotherapy were alive for more than 18 months.Conclusions The clinical manifestations of splenic tumors lack specificity.The diagnosis mainly depends on ultrasonic examination, CT and MRI.Early diagnosis, radical operation and comprehensive treatment are important to improve the prognosis of patients with malignant tumors of the spleen.

Objective To investigate the CT imaging characteristics of primary malignant fibrous histiocytoma (MFH) of the liver.Methods The CT, clinical and histopathologic data of 6 patients with MFH were analyzed retrospectively.All the cases were confirmed by surgery and histopathological examinations.Results The tumors were located in the right liver in 4 patients and the left liver in 2 patients.The maximum diameter of the tumors ranged from 5 to 20 cm.All the tumors were unevenly hypodense on plain CT scan.Four tumors had relatively well-defined margins, while 2 tumors had ill-defined margins.After contrast enhancement, the peripheral and internal divisions of the three storiform-pleomorptic MFH showed progressive enhancement.The peripheral and internal divisions of the two inflammatory MFH were obviously enhanced in the arterial phase, and the enhancement decreased in the portal and delayed phases.The hypodense areas of the one myxiod MFH were not enhanced, but the internal floc and divisions were progressive enhanced.On gross pathology, the tumors were round or irregular in shape, most had a complete capsule with multiple surrounding vessels.These findings correlated well with the CT findings.Conclusions CT findings of primary Hepatic MFH have some characteristics.The enhancement pattern is manifested in a fast wash-in and slow wash-out pattern.However, the final diagnosis still relies on histopathological examination.

Objective To explore the effect of wash pipe frequency on complications of double-lumen power peripherally inserted central catheter (PICC) connected to infusion pump during continuous chemotherapy. Methods A total of 160 patients with malignant lymphoma whose PICC connected to infusion pump were divided into 4 groups by random digits table method with 40 cases each: flushing and sealing the tube once every 4 hours(group A), every 8 hours(group B), every 12 hours(group C) and every 24 hours (group D). The incidence of blocking pipe and phlebitis were observed. Results The incidence of blocking pipe were 0,2.5%(1/40) , 27.5%(11/40), 42.5%(17/40) in group A, B, C, D, the differences among them were significant, χ2= 30.870, P<0.01. There was no significant difference in the incidence of phlebitis among 4 groups, P>0.05. Conclusions Flushing and sealing the tube of PICC connected to infusion pump once every 8 hours during continuous chemotherapy seems to be appropriate and worthy of being applied clinically due to its low blocking pipe incidence, and low incidence of phlebitis.

BACKGROUND:Poststroke depression is one of the most common psychological behavior disorders after stroke and its mechanism remains unclear. Studies have suggested that microRNAs (miRNAs) involved in neurogenesis and synaptogenesis may play an important role in psychology diseases. OBJECTIVE:To observe the expression of miR-137 in the blood and brain of poststroke depression rats and its effect on the behaviors of rats. METHODS:Thirty-six rats were equal y divided into six groups:control, model, agomir-137, agomir-NC, agomir-137+Grin2A and agomir-137+vector groups. Control group had no treatment. Poststroke depression models were established by ligation of middle cerebral artery and chronic mild stimulation in the latter four groups fol owed by receiving an injection of nothing, agomir-137, agomir-NC, LV-CMV-Grin2A or control plasmids into the left lateral ventricle, respectively. RESULTS AND CONCLUSION:We found significantly lower miR-137 levels in the brain and peripheral blood of post-stroke depression rats compared with normal rats. Vertical scores and horizontal scores on the behavior test were significantly higher in the agomir-137 group than the agomir-NC and model groups at 3 weeks after cerebral ischemia;while, sucrose consumption percentage was also higher in the agomir-137 group at the end of 2 weeks after cerebral ischemia. Luciferase assays showed miR-137 bound to the 3’ UTR of Grin2A, regulating Grin2A expression in a neuronal cel line. Grin2A gene overexpression in the brain of post-stroke depression rats noticeably suppressed the inhibitory effect of miR-137 on post-stroke depression. Overal , these findings show that miR-137 suppresses Grin2A protein expression through binding to Grin2A mRNA, thereby exerting an inhibitory effect on post-stroke depression and offering a new therapeutic target for poststroke depression.