Objective To study the curative effect of continuous renal replacement therapy (CRRT) to the patients with acute renal failure after liver transplantation. Methods From Mar. 2004 to Jan. 2005, the continuous renal replacement therapy was applied to 7 patients with acute renal failure after liver transplantation. The average time of CRRT was 36.1h. The volume of fluid displacer during CRRT was 2-4L/h and the volume of blood flow was 150～250ml/min. Normal heparin was used as anticoagulant. Results For the 7 patients, 4 improved, 2 died. The contents of blood urea nitrogen (BUN) and blood Cr of all the 7 patients have obviously declined(P0.05). The haemodynamic variables were stabilized during CRRT and no obvious side-effect related to CRRT was found. Conclusions CRRT improved the prognosis to the patients with acute renal failure after liver transplantation, showed a favorable tolerance, and may be applied as a emergency measure to the patients with acute renal failure.

Objective To investigate the effects of electrical stimulation on the differentiation of rat bone marrow mesenchymal stem cells (MSCs) to cardiomyocyte induced by 5-azacytidine in vitro. Methods MSCs from Sprague-Dawley (SD) rats were cultured and passed repeatedly to P3. MSCs were treated with 5-azacytidine (10 ?mol/L) and incubated for 24 h.The induced MSCs were divided to stimulated group and non-stimulated group, and every groups divided by incubated for 1,2,3 and 4 weeks were named as subgroup Ⅰ,Ⅱ, Ⅲ and Ⅳ respectively.MSCs of stimulated group were stimulated for 30 min every day by supra-threshold square biphasic pulses (2 ms duration, 1.5 Hz, 20 ?A), and the stimulation was initiated 1 d after inducing. Light and electronic microscope were used to identify the influences of characteristic morphological of MSCs in every subgroups,and immunocytochemistry was used to identify the expression of ?-actin,cTnT, Cx43 in MSCs. Results The growth of MSCs in stimulated group was better than that of non-stimulated group. MSCs of stimulated group exhibited differentiation into cardiomyocyte-like cell at 1 week after inducing, earlier than that of no-stimulated group (2 weeks). In stimulated subgroup Ⅰ, scattered myogenic structure was observed in the plasma of some cells under electronic microscope, and ?-actin,cTnT expressed in some cells, but not that be observed in non-stimulated subgroup Ⅰ. In cells of stimulated subgroups Ⅱ to Ⅳ, the expression level of ?-actin, cTnT, Cx43 of were all higher than that of non-stimulated subgroups respectively. Conclusion Electrical stimulation (simulating the heart beating) could redound differentiation of rat bone marrow mesenchymal stem cells (MSCs) to cardiomyocyte induced by 5-azacytidine in vitro.

ObjectiveTo investigate the effect of continuous renal replacement therapy (CRRT) on the elderly patients with acute renal function failure.Methods11 elderly patients with acute renal function failure were treated with continuous renal replacement therapy. The average time of CRRT was 24.8 h. The ultrafiltration rate during CRRT was 2～4 L/h and blood flow rate was 150～250 ml/min. Normal heparin was used as anticoagulant.ResultsAmong 11 patients, 7 were mend, 3 died. The blood urea nitrogen (BUN) and creatinine (Cr) levels of all patients obviously declined (P<0.01). The haemodynamic variables of all patients were stabilized during CRRT and no obvious side-effect related to CRRT was found.ConclusionThe treatment of CRRT can improve the sufferer prognosis to the elderly patients with acute renal function failure, not restricted by age, and is the effective means to the elderly patients with acute renal function failure.

OBJECTIVE To investigate the epidemiological conditions of bacterial colonization in respiratory tract,and antibiotic resistance under the antibiotic pretreatment in liver transplanted patients. METHODS From Oct 2002 to Jan 2005,121 liver transplanted patients were admitted to ICU.Among them,45 patients who were intubated more than 48 hours were included in this study.All of the patients received antibiotic pretreatment after operation.Sputum specimens were collected after 24 hours and 48 hours in ICU via the intubated tube with bronchoscopy. RESULTS Thirty nine pathogens were isolated from 36 patients during 48 hours.Pseudomonas aeruginosa was the predominant pathogen.Only 8 bacilli were susceptible to the antibiotics. CONCLUSIONS Although antibiotic pretreatment performed,bacterial colonization in respiratory tract emerges early in liver transplanted intubated patients.Antibiotic pretreatment may make the susceptible bacteria escape.

ObjectiveTo observe the risk factors influencing the prognosis of critical ill patients with acute respiratory distress syndrome (ARDS).MethodsThe clinical data of 67 critical ill patients with ARDS from 2003 to 2004 were reviewed retrospectively.ResultsThe acute physiology and chronic health evaluation (APACHEⅡ) scores and age were all differed significantly between survivors and non-survivors groups (P<0.05). The earlier of respiratory supported, the lowest of mortality (P<0.05).Conclusion APACHEⅡ scores, age and the time of starting respiratory support are main risk factors for mortality of critical ill patients with ARDS.

Objective To investigate the analgesic effects of intraperitoneal lithium chloride injection on radicular pain behaviors in rats.Methods Using rat model of radicular pain induced by chronic compression of dorsal root ganglion(CCD) ,40 male SD rats were randomly divided into model group and Sham-operation group (group S, n= 12) of radicular pain were established.The rats in the model group were subdivided randomly into Control group(group C, n= 12) ,Early treatment group(group E, n=8) and Later treatment group(group L, n= 8 ).Rats in group E were intraperitoneal injected with lithium chloride once daily on day 2 ～ 4 after CCD respectively,while rats in L,group C and S treated with Vehicle(0.9% NaCl).Rats in L group were intraperitoneal treated with lithium chloride on day 12 ～ 14 after CCD respectively,while rats in E,group C and S received Vehicle.The pain ethology indexes such as paw withdrawal mechanical threshold (PWMT) and paw withdrawal thermal latency (PWTL) were tested on day 1 before operation and day 1,4,7,10, 14, 17 and 21 after operation.Results Compared to S group and preoperative level, PWMT and PWTL decreased at Day 1 postoperative in group C (P＜0.05).At day 4 after the operation,compared with group C(7.712 ±0.237)g and (8.190 ±0.382) s,PWMT and PWTL of E group increased to ( 14.607 ± 0,280) g and ( 19.940 ± 0.933 ) s (P ＜ 0.05 ) after intraperitoneal injected lithium chloride.At day 14, compared with group C ( 6.788 ± 0.331 ) g and ( 7.301 ± 0.481 ) s, PWMT and PWTL of group L increased to ( 11.700 ± 0.379) 8 and ( 18.524 ± 1.060) s (P ＜ 0.05 ).This analgesic effect of lithium chloride continued to exist at day 21.However, there was still a significant difference between S group and E,group L(P＜0.05).Conclusion Intraperitoneal lithium chloride injection alleviates pain behavior on radicular pain in rats.

Objective To investigate the effects of intrathecally coadministered dexamethasone and spironolactone in trathecally on radicular pain behaviors.Methods Using rat model of radicular pain induced by chronic compression of dorsal root ganglion (CCD) ,48 male SD rats successfully received intrathecal catheter implantation and without motor dysfunction were randomly divided into Sham-operation group (Sham group, n= 12),Control group ( C group, n = 12 ), Dexamethasone group ( D group, n = 8 ), Spironolactone group ( S group, n = 8 )and Dexamethasone plus spironolactone group (DS group, n=8).Rats in D group,S group or DS group were intrathecally treated with dexamethasone 4 μg, spironolactone 3 μg or dexamethasone 4 μg plus spironolactone 3 μg twice daily on day 2 ～4 after CCD respectively,while rats in C and Sham group received 10μl 10% alcohol.Paw withdrawal mechanical threshold(PWMT) and paw withdrawal thermal latency (PWTL) were tested on day 1 before CCD and day 1,4,7,10,14,17 and 21 after CCD.Results Compared with Sham group, both PWMT and PWTL were significantly decreased after CCD surgery on the ipsilateral side(P＜0.01 ＝.Intrathecally administrated with dexamethasone significantly improved pain behaviors (P＜0.01 ＝ and these therapeutic effects lasted up to 10 days after CCD surgery.As with dexamethasone,intrathecal spironolactone also significantly attenuated PWMT (P＜0.01 ＝ and PWTL (P＜0.01 ＝ and the change lasted up to 7 days after CCD surgery.Coadministration spironolactone and dexamethasone exhibited significant synergies( PWMT: ( 13.52 ± 0.72) g vs ( 11.58 ± 1.38 ) g, P ＜0.01; PWTL: ( 19.63 ± 1.68) s vs ( 14.14 ± 1.52) s, P ＜ 0.01 ＝.These effects lasted up to at least 10 days.Conclusion Both dexamethasone and spironolactone intrathecally have therapeutic effects on radicular pain behaviors, combination injection of these two drugs could generate significant synergies.

Objective To investigate the effects of Ethephon on spermatogenic cells and sex hormones levels of adolescent male rats.Methods The male SD rats of 25-day old were randomly (from the random number table) divided into high dose group (2 000 mg/kg),middle dose group (1 000 mg/kg),low dose group (500 mg/kg) and control group (the same amount of physiological saline).They were given Ethephon through stomach for 14 d.The pathological changes in testis tissues were observed by HE staining.The apoptosis of germ cells were detected by terminal transferase labeling (TUNEL).The automatic chemical luminescence immunoassay analyzer was used to test the serum sex hormone levels.Results After ethephon and saline lavage for 14 days in the dose of 2 000 mg/kg,1 000mg/kg,500 mg/kg concentrations respectively,body weight growth was significantly decreased (F =3.58,P =0.03).Testis mass growth [(0.91 ± 0.17) g,(1.13 ± 0.15) g,(1.21 ± 0.11) g,(1.29 ± 0.28) g] was significantly decreased (F =4.31,P =0.02).Experimental group spermatogenic cell apoptosis,the apoptosis index increased (F =156.00,P =0.00),high dose group[(2.40 ±0.18)％] and middle dose group[(1.72 ±0.14)％] was significandy increased (P ＜ 0.01).The levels of testosterone and estrogen in serum showed a decreasing trend along with the increase of the doses,and there was a statistical significance (F =11.85,38.93,all P =0.00).Compared with the control group [(0.86 ± 0.10) μg/L],the testosterone levels in high dose group [(0.31 ± 0.08) μg/L],middle dose group [(0.36± 0.05) μg/L] decreased significantly (P ＜ 0.01).Compared with the control group,low dose group,middle dose group [(36.43 ± 3.57) ng/L,(38.62 ± 2.24) ng/L,(31.87 ± 5.78) ng/L],the estrogen level in high dose group[(27.39 ± 2.11) ng/L] was significantly reduced (P ＜ 0.01).Conclusion Ethephon has reproductive toxicity,and can cause the serum level of testosterone and estradiol decreased,resulting in spermatogenic cell apoptosis index increased and the spermatogenic capability decreased.

ObjectiveTo investigate the value of diffusion tensor imaging (DTI) at high b value for unilateral middle cerebral artery (MCA) occlusive disease in patients without obvious infarct lesions on conventional MR imaging.MethodsDTI at high b value (2200 s/mm2 ) was performed using a 3.0 Tesla MR scanner in 34 patients with unilateral middle cerebral artery occlusion,who had no obvious infarct lesions on conventional MR imaging. Fractional anisotropy (FA),apparent diffusion coefficient (ADC),axial diffusivity (eigenvalue λ1) and radial diffusivity (eigenvalues λ2,λ3) were measured at the ipsilateral and contralateral corona radiata,anterior and posterior limbs of the internal capsule,cerebral peduncle and pons in all subjects.Mean ADC,FA,λ1,λ2 and λ3 values of corona radiata,anterior and posterior limbs of the internal capsule,cerebral peduncle and pons were compared between the ipsilateral and contralateral MCAterritory by t test. Results Among the 34 patients,left MCA occlusion in M1 segment occurred in 16 patients and right MCA occlusion in Ml segment occurred in 18 patients.At the ipsilateral corona radiata,mean FA,ADC,λ1,λ2 and λ3 were 0.419 ±0.032,(5.975 ±0.272) × 10 3,(5.704 ±0.365) ×10-3,(6.412 ±0.368) × 10-3 and (6.605 ±0.343) × 10-3 mm2/s,respectively.At the contralateral corona radiata,mean FA,ADC,λ1,λ2 and λ3 were 0.443 ± 0.033,(5.804 ± 0.282) × 10 -3,(5.651 ±0.350) × 10-3,(6.099 ±0.353) × 10-3 and(6.372 ±0.355) × 10-3 mm2/s,respectively.At the ipsilateral corona radiata,mean FA was significantly decreased(t =11.614,P ＜0.01),and mean ADC (t=12.421,P＜0.01),λ1(t =7.447,P＜0.01),λ2(t=10.244,P＜0.01) and λ3(t=9.890,P＜0.01) were significantly increased.At the ipsilateral anterior and posterior limb of the internal capsule,mean FA were 0.609 ±0.026 and 0.674 ±0.033,λ1 were(5.330 ±0.462) × 10 -3 and(5.171 ±0.456) ×10-3 mm2/s,respectively.At the contralateral anterior and posterior limb of the internal capsule,FA were 0.622 ±0.026 and 0.694 ±0.034,λ1 were(5.064 ± 0.448) × 10 -3 and(4.924 ± 0.365) × 10 -3 mm2/s,respectively.Mean FA was significantly decreased (t =7.823,8.013,all P ＜ 0.01) and mean λ1 was significantly increased (t =7.811,8.800,all P ＜0.01) at the ipsilateral anterior and posterior limbs of the internal capsule.There was no significant difference in ADC,λ2 and λ3 value between the ipsilateral and contralateral sides.And all the DTI parameters,including mean ADC,FA,λ1,λ2 and λ3 values,showed no statistical difference between both sides of cerebral peduncle and pons.ConclusionDTI at high b valuc can provide useful information for visualizing ischemic white matter injury in patients without obvious infarct lesions on conventional MR imaging.

Background and purpose:Struma ovarii is a rare tumor, especially with extraovarian spreading. The study aimed to investigate the clinical and pathological features, diagnosis and differential diagnosis of ovarian goiter. Methods:Clinical and pathological features of 14 cases of benign and malignant ovarian goiter were observed. Immunohistochemical EnVision staining, PCR-DNA sequencing and review of related literature were also used. Results:In 14 cases of benign and malignant ovarian goiter, the average age of onset is 45.6 years (18-71 years old), and pelvic tumor is the main clinical manifestation. According to the related literature of diagnostic criteria, 12 cases are struma ovarii, which is consisted of hyperplasia of the thyroid tissue under microscopic examination, 1 case is malignant struma ovarii, which is papillary thyroid carcinoma by microscopic presentation, and 1 case is highly differentiated follicular carcinoma of ovarian origin (HDFCO), which is histological benign by microscopic presentation, but is malignant by biological behavior. Conclusion:Struma ovarii is a rare ovarian mondemal teratoma, with low rate of malignant change and beyond ovarian lesions disseminated microscopic histological benign struma ovarii is lower incidence, which has unique clinical and pathological features. Comprehensively considering the related literatures, this study indicates that the disease is in accordance with HDFCO. Struma ovarii prognosis is good, and should be differentiated from carcinoid and granular cell tumor.