Objective To propose a new blood purification modality-hemodialysis with plasma- based dialysate (HD-PBD) plus high volume hemofiltration (HVHF) for patients with liver failure, and to evaluate the effect of this treatment on plasma cytokines.Methods Twelve patients with liver failure were included in this study.All patients received HD-PBD therapy in the first 6 hours,and then were treated with HVHF for 24 hours with the same filter (AV600).The levels of TNF-?,IL-1?, IL-6 and IL-8 in plasma before and after HD-PBD plus HVHF for 6 and 24 hours were examined respectively by ELISA,and changes of clinical parameters were observed at the same time point. Serum bilirubin,total bile acids (TBA),serum ammonia,blood urea nitrogen (BUN) and serum creatinine (Scr) were detected before and after treatment.Arterial blood gas analysis and the concentration of electrolytes were monitored before and after treatment.Results (1)HD-PBD for 6 hours was more effective than HVHF for 24 hours in removal of serum bilirubin and TBA(P＜0.05). (2)Serum ammonia,BUN,Ser,arterial blood HCO_3~-,PCO_2,PO_2 and electrolytes did not show significant difference before and after HD-PBD (P＞0.05),but these parameters significantly changed before and after HVHF (P＜0.05).(3)The average level of serum bilirubin was sharply decreased after HVHF for 24 h following HD-PBD(P＜0.05).(4)After HD-PBD plus HVHF,there was a marked reduction of the plasma levels of TNF-?,IL-6 and IL-8.Conclusions HD-PBD plus HVHF,a newly proposed modality for patients with liver failure,can effectively decrease serum bilirubin,TBA,BUN,Scr,ammonia and cytokines,and adjust water-electrolyte as well as acid- alkali balance.It is a low-cost,safe,simple and convenient therapy.

ObjectiveTo investigate the possible mechanisms for biocompatibility of chitosan material using agarose/chitosan blended hydrogels as a model.Methods A series of agarose/chitosan blended hydrogels with different chitosan content were prepared by the blending method.The chemical groups of the blended hydrogels were analyzed by the Fourier transform infrared (FTIR) spectroscopy.The blending compatibility between the agarose and chitosan was evaluated with the fluorescein-4-isothiocyanate (FITC) staining method.The charge of the blended hydrogels was determined by the zeta potential measurement.The adsorption of total fetal bovine serum (FBS) proteins and bovine serum albumin (BSA) on the blended hydrogels was measured by the bicinchoninic acid (BCA) method.The adsorption of fibronectin (FN) on the blended hydrogels was measured with ELISA.Cell culture experiment adopted human microvascular endothelial cell line (HMEC-1) as the model.The cytocompatibility was studied by evaluating adhesion,proliferation,and morphology of the cells on the blended hydrogels.Results Characteristic chemical groups of chitosan could be detected in the agarose/chitosan blended hydrogels.The chitosan had a good blending compatibility with the agarose.The amino groups of chitosan were uniformly distributed in the blended hydrogels.The blended hydrogels were strongly positively charged at acidic pH (pH 3.0),however,the zeta potentials of all the hydrogels were reduced to nearly 0 mV at neutral pH (pH 7.4).There were no significant differences in the adsorption of total FBS proteins and BSA between the blended hydrogel groups.However,the adsorption of FN on the hydrogels significantly increased with the increase of chitosan content.Cell culture experiment indicated that the cytocompatibihty of the blended hydrogels was significantly improved with the increase of chitosan content.The HMECs exhibited higher levels of adhesion,spreading,and proliferation on the hydrogels with higher chitosan content.ConclusionResults in this study indicated that the chitosan component preferentially adsorbed FN compared to the other serum proteins,leading to adhesion and spreading of the cells on the blended hydrogels.In contrast to prevailing views,it was found in the present study that the biocompatibility of chitosan did not relate to its positive charge.

OBJECTIVERecent studies have found that the variation of G894T on the region of T786C and 7th exon promoted by endothelial nitric oxide synthase (eNOS) gene is associated with cardiovascular disease. This research explored possible correlations between eNOS gene polymorphisms and orthostatic intolerance (OI) in children through linkage disequilibrium analysis between eNOS genes T786C and G894T and OI.

METHODSPCR, Macrorestriction Map and other molecular biotechnology were used to determine the genotypes of eNOS/T786C and G894T in 60 OI probands and their parents. Correlation analysis and transmission disequilibrium test (TDT) between T786C, G894T and OI were performed.

RESULTSThere was linkage disequilibrium of eNOS/T786C and G894T gene polymorphisms in the occurrence of childhood OI (P<0.05).

CONCLUSIONSeNOS genes T786C and G894T may be associated with the pathogenesis of OI.

Adult ; Child ; Female ; Humans ; Linkage Disequilibrium ; Male ; Nitric Oxide Synthase Type III ; genetics ; Orthostatic Intolerance ; genetics ; Polymorphism, Genetic

Objective Mutated inbred animal model is introduced to the practical course of genetic diagnosis in the hope that medical students are able to apply what they have learned to clinical cases, based on a deep understanding of principle and technology on gene mutation detection. Methods We integrated DNA extraction, polymerase chain reaction, agarose gel electrophoresis, and gel imaging analysis into a comprehensive experiment and arranged 4-year-programme undergraduates majoring in preclinical medical sciences to conduct it with the purpose of investigating the internal relations between phenotype and genotype in a hairless Uncv mouse model. Subsequently, the questionnaire aimed at evaluating learning effect on the part of students was handed out and their feedbacks were analyzed. Results More than 90% of respondents are satisfied with the general learning effect. Especially, 98. 7% of students support the enhancing effect of the new teaching mode on their research skills and 96% consider the practical course helpful to their problem-solving ability. Conclusions The introduction of mutated inbred animal model to the practical system of molecular diagnostics proves beneficial to boost students' learning effect and scientific research quality. Our practice also provokes thoughts on the further utilization of animal models in teaching system of medical sciences.

Objective To evaluate the efficacy of MR angiogrphy(MRA) for detecting cerebral vasospasm after subarachnoid hemorrage(SAH) and compare it with spiral CT angiography(CTA).Methods Ten patients with SAH under MRA and CTA studies were performed within 24 hours after MRA,which was performed 5 to 10 days after SAH.Maximum intensity projection(MIP) images were produced for MRA and CTA studies.Five arterial locations were examined for spasm:the suprasellar internal carotid artery(ICA),the M1 and M2 segments of the middle cerebral artery(MCA),the A1 and A2 segments of the anterior cerebral artery(ACA).Vasospasm was cate- gorized as none,mild(50 % reduction).Results The overall correlation between MRA and CTA was 82 %(r=0.76),but it was better for proximal than distal lo- cations vessels.Agreement between MRA and CTA was greater for no spasm(89%) and severe spasm(100%)(r= 0.85～0.91)than for mild(56%)or moderate(67%)spasm(r=0.21～0.51).Conclusion MRA is highly accu- rate in the detecting no spasm or severe cerebral vasospasm in proximal arterial locations vessels;it is less accurate in detecting mild and moderate spasm in distal locations vessels.

Objective: To explore the determinants for health-seeking behavior of the residents after cough for more than 3 weeks in Yiwu, Zhejiang Province, in order to provide reference for prevention and control of respiratory diseases. Methods: A multi-stage cluster random sampling method was used to recruit the community residents aged 5 years and above in Yiwu. A face-to-face questionnaire survey was conducted to collect demographic information, features of cough and health-seeking behaviors in the past month. The multivariate logistic regression model was employed to analyze the associated factors for health-seeking behavior after a cough for more than 3 weeks. Results: Among 6 374 residents investigated, 152 cases had a cough for more than 3 weeks in the past month, accounting for 2.48%. They were( 45.00±21.15 ) years old, including 70 ( 46.05% ) males and 82 ( 53.95% ) females. About 58.55% ( 89 ) of them sought medical treatment. The results of multivariate logistic regression analysis showed that females ( OR=2.100, 95%CI: 1.005-4.391 ), middle school education level ( OR=0.406, 95%CI: 0.168-0.983 ), family annual income of 100 000 to 199 999 yuan ( OR=2.993, 95%CI: 1.215-7.373 ) were associated factors for health-seeking behavior after a cough for more than 3 weeks. Conclusion The rate of health-seeking behavior after a cough for more than 3 weeks among the residents in Yiwu is 58.55%, which is associated with gender, education level and income.

Objective To investigate the relationship between the characteristics of psychological defense style and clinical symptoms of eating attitude in patients with anorexia nervosa patients. Methods Totally 92 ca?ses ( 46 cases of restricting type,46 cases of binge?eating/purging type,48 cases of early onset before 16 years old, 44 cases of late onset after 16 years old) meeting the Diagnostic and Statistical Manual of Mental Disorders,Forth Edition ( DSM?4) for anorexia nervosa (AN) were collected.92 gender?marriage?and education?matched normal cases in a psychiatric hospital were selected as the healthy control group(HC) .All were assessed with defensive style questionnaire(DSQ) and eating attitude test?26(EAT?26).DSQ and EAT?26 were compared between AN and HC,between early onset of AN( before 16 old years) and late onset of AN( after 16 old years) ,and between AN?R and AN?P.Then correlation study was done for the AN. Results Compared with HC,AN showed higher scores in the immature defense,neurotic defense ((4.49±1.13)vs (3.55±0.93),(4.33±0.76)vs (3.88±0.69), P<0.001), and higher EAT?26 median total and factor scores of dieting scale items,bulimia&food preoccupation scale items, oral control subscale items (P<0.01).Compared with AN?R,AN?P showed higher scores in the immature defense ((4.49±1.03)vs (4.79±1.13), P=0.01),and higher EAT?26 median total and factor score of bulimia&food pre?occupation scale items (P<0.05, P<0.01).The correlations between immature defense and EAT?26 total score,be?tween neurotic defense and EAT?26 total score were significant( r=0.472, P<0.001;r=0.315, P=0.002). The correlations between immature defense and EAT?26 dieting score, between neurotic defense and EAT?26 dieting score were significant( r=0.343, P<0.001, r=0.257, P=0.014).The correlations between immature defense and EAT?26 bulimia & food preoccupation score,between neurotic defense and EAT?26 bulimia & food preoccupation score were significant( r=0.523, P<0.001, r=0.267, P=0.010).The correlations between immature defense and duration were significant( r=0.375, P<0.001).The correlations between all defense factors and BMI were not sig?nificant( r=-0.15?0.25, P>0.05) . Conclusion AN patients tend to use more immature defense and neurotic de?fense compared with HC,and AN?P patients use more immature defense compared with AN?R. Immature defense and neurotic defense are related to the eating attitude,and the immature defense is related the duration.

The inflammatory response is involved in the pathogenesis of the most common types of heart disease.Sanguinarine (SAN) has various pharmacological properties such as anti-inflammatory,antioxidant,antibacterial,antitumor,and immune-enhancing properties.However,few studies have investigated the effects of SAN on lipopolysaccharide (LPS)-induced inflammatory and apoptotic responses in H9c2 cardiomyocytes.Therefore,in this study,H9c2 cells were co-treated with SAN and LPS,and the mRNA levels of pro-inflammation markers and the apoptosis rate were measured to clarify the effect of SAN on cardiac inflammation.The underlying mechanism was further investigated by detecting the activation of Toll-like receptor (TLR)4/nuclear factor-κB (NF-κB) signaling pathways.As a result,increased mRNA expression of interleukin (IL)-1 β,IL-6,and TNFα induced by LPS was attenuated after SAN treatment;LPS-induced apoptosis of H9c2 cardiomyocytes and cleaved-caspase 8,9,3 were all significantly reduced by SAN.Further experiments showed that the beneficial effect of SAN on blocking the inflammation and apoptosis of H9c2 cardiomyocytes induced by LPS was associated with suppression of the TLR4/NF-κB signaling pathway.It was suggested that SAN suppressed the LPS-induced inflammation and apoptosis of H9c2 cardiomyocytes,which may be mediated by inhibition of the TLR4/NF-κB signaling pathway.Thus,SAN may be a feasible therapy to treat sepsis patients with cardiac dysfunction.

Objective To explore the characteristics of human plague using a sero-epidemiologic method in the source of the three rivers area in Qinghai for possible plague control strategies. Methods Investigate human plague sero-epidemiologically in the source of 4 counties in the three rivers area in Qinghai. The human serum would be tested to confirm the sew-positive rate for plague F1 antibody using indirect hemagglutination assay(IHA). Results A total of 2508 local participants were tested in 4 counties, the overall plague sero-positive rate was 2.31%(58/2508). This represents a statistically significant difference with 4 counties(X2=19.30,P<0.01). The sew-positive rate for males and females were 2.54% (32/1261) and 2.09% (26/1247), respectively. There were no statistically significant differences between males and females(X2= 0.65,P 0.05). The sero-positive rate in herdsman, cadre, Tibetan, Hart nationalities were 3.54% (44/1243), 6.47% (11 / 170), 2.40% (56/2335) and 1.47% (2/136), respectively. The sero- positive rate increased with age. The highest titre for human plague serum antibody was 1 : 640. Conclusion There were occult infections of plague in the population on source of three rivers area in Qinghai. Sero-epidemiologic data revealed that the human plague sero-positive rate was closely correlated with the local animal plague.

OBJECTIVETo assess the treatment outcome of ligation of the intersphincteric fistula tract plus bioprosthetic anal fistula plug(LIFT-plug) for transsphincteric perianal fistulas.

METHODSClinical data of 36 patients with transsphincteric perianal fiftula who were managed by the LIFT-plug technique between November 2010 and February 2012 were analyzed retrospectively.

RESULTSClinical healing of the fistula, defined as the absence of drainage with no evidence of residual fistula tract, occurred in 34(94.4%) patients. The operative time ranged from 12 to 35 minutes(mean, 17 minutes). The median postoperative length of stay was 5 days. The median healing time was 18 days. No complications requiring intervention occurred. The postoperative follow up was at least 3 months and two patients had recurrence(5.6%).

CONCLUSIONSLIFT-plug procedure for the management of transsphincteric perianal fistulas is simple with high healing rate, minimal invasiveness, quick healing, and without disturbance to anal function. LIFT-plug is an ideal procedure for intrasphinteric fistula.

Aged ; Fecal Incontinence ; Humans ; Ligation ; Operative Time ; Rectal Fistula ; surgery ; Recurrence ; Retrospective Studies ; Treatment Outcome ; Wound Healing