Epidemiological studies have shown that the incidence of patent foramen ovale (PFO) in patients with cryptogenic stroke is significantly higher than general population.The close association between cryptogenic stroke and PFO supports the hypothesis that paradoxical embolism is a cause of stroke.However,the detection of PFO alone does not establish the diagnosis of paradoxical embolism in patients with cryptogenic stroke. The risk of ischemic stroke will increase significantly when PFO and other factors coexist.Some studies tave shown that there is significant difference between the MRI lesion patterns in patients with cryptogenic stroke and PFO in those without cryptogenic stroke,particularly in multiple ischemic lesions.Therefore,it does not support the theory of paradoxical embolism as a cause of stroke in patients with PFO.The PFO detection methods include transthoracic echocardiography,transesophageal echocardiography (TEE) and transcranial Doppler (TCD).TCD and TEE have a good consistency.Accordingly,TCD should be recommended as a simple,noninvasive,and reliable technique,while TEE should be only restricted to the selected patients.The treatment options of PFO include antiplatelet drugs,anticoagulant drugs,percutaneous vascular closure,and thoracotomy.Percutaneous vascular closure should only be considered the recurrent events during the medical treatment,the contraindications of medical treatment,and PFO with some anatomical high risks for patients with cryptogenic stroke with PFO before the completion of several large randomized controlled trials.

Objective To explore the diagnosis and treatment of the congenital membrane atresia of duodenum(CMAD). Methods The clinical data of 32 cases of CMAD admitted from 1980 to 1996 were analysed retrospectively.Results Of the 32 cases,28 cases had single membrane in the duodenum,4 two membranes;and 6 accompanied with intestinal malrotation, 2 circular pancrease and 1 anal atresia. 24 patients were treated with membrane resection only,2 underwent membrane resection and gastrojejunostomy,6 underwent membrane resection plus Ladd's operation.28 cases were cured,4 cases died.Among the 28 cases discharged,20 cases were followed-up for the period from five months to three years,their sympotoms disappeared, nutrition and development were good.Conclusions Patients with CMAD have vomit, and containing bile in most cases;abdominal erect plain film shows "double bubble sign",and gastrointestinal series can help make the diagnosis.Membrane resection is the best way of therapy,but we should pay attention to correct the double membranes and other deformity,and should strengthen perioperative period management.

ObjectiveTo systemically review the effects of timing of initiation of renal replacement therapy (RRT) on prognosis in septic patients with acute kidney injury (AKI).Methods A systematic search for randomized controlled trials (RCTs) and other clinical studies focused on comparing varied timing of initiation of RRT in septic AKI patients was performed in English or Chinese from PubMed, Web of Science, EMBASE, CNKI, Wanfang data, VIP from January 2000 to July 2014. Data screened were extracted with Cochrane systemically review method, and enrolled literature was collected for Meta analysis with RevMan 5.2 software. Total mortality, 28-day mortality, the total length of hospital stay and intensive care unit (ICU) stay in septic AKI patients with early or late initiation of RRT was analyzed. Funnel plots were drawn to detect publication bias.Results Five retrospective comparative studies with a total of 885 patients were enrolled. Random effect model in Meta analysis showed that there was no significant difference in total mortality between early RRT group and late RRT group [65.7% (226/344) vs. 68.7% (239/348), odds ratio (OR) = 0.71, 95% confidence interval (95%CI) = 0.38-1.31,P = 0.27]. The funnel plot demonstrated publication bias. Fixed effect model showed that there was significant difference in 28-day mortality between early RRT group and late RRT group [43.4% (66/152) vs. 55.3% (94/170),OR = 0.59, 95%CI = 0.36-0.94,P= 0.03]. The funnel plot demonstrated publication bias too. The data of total length of hospital stay and ICU stay could not be Meta-analyzed because of different data distribution, but no differences in total length of hospital stay and ICU stay between early and late RRT groups for septic AKI patients were found.ConclusionEarly RRT could reduce the 28-day mortality in patients with septic AKI compared with late RRT, but it did not lower the total mortality.

Objective:To improve the method for isolating platelet-rich plasma (PRP). Methods:Whole blood was collected from 8 healthy donors and then PRP was separated by both the tube method and the syringe method respectively. Samples were activated to get serum rich-in growth factors (SRGF).Platelets in the SRGF were counted and the level of TGF-?1 was assayed by enzyme-linked immunosorbent assay (ELISA).Results:The end product of syringe method has both a higher platelet count in PRP (P=0.003) and a higher level of TGF-?1 in SRGF(P=0.041) than that of tube method.Conclusion:The syringe method is an effective method in preparation of PRP.

The present study shows that mushroom juice exhibits a significanteffect on growth of L. acidophilus in reconstituted skim milk. When 5% - 10% mushroom juice was added in skim milk, they shorten generation time and the rate of lactic acid production was accelerated. After 10h incubation at 37℃ cell counts of L. acidophilus in test groups were much more than in control group, were up to 108/mL.

Antineoplastic Protocols ; Child ; Humans ; Neoplasm, Residual ; therapy ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; therapy

Objective To investigate the inhibitory effect of RNA interference on the expression of Aurora A in U251 cells, and the influence on proliferation and apoptosis of U251 cells. Methods The siRNA specific for Aurora A was synthesized and transfected into U251 cells in vitro. Aurora A mRNA expression and protein content were detected by RT-PCR and Western blotting respectively. The cell proliferation and apoptosis were observed by methyl thiazolyl tetrazolium(MTT) and flow cytometry(FCM). Transmission electron microscope was used to observe the ultrastructural changes of U251 cells. Results After transfection, the expression level of Aurora A mRNA was significantly decreased(P<0.01), and the protein content of Aurora A was also obviously reduced. The inhibitory rate of cell proliferation reached up to 67.57% 72 hours after transfection, which was significantly higer than that of normal control group(P<0.01). The apoptosis rate of U251 cells was significantly increased from (3.69±0.87)% to (15.34±2.16)% (P<0.01). Under the transmission electron microscope, it was observed that the U251 cells showed typical morphologic changes of apoptosis after transfection, such as karyopyknosis, chromatin condensation and margination, intracytoplasmic vacuoles formed, and apoptotic bodies formed. Conclusion The expression of Aurora A gene can be inhibited by siRNA successfully, and it results in the suppression of cell growth and induce apoptosis of human glioma cells in vitro. Aurora A may become a new target for the gene therapy of gliomas.

A 880 bp cDNA localized to the putative NS5 region of HGV genome was expressed in E.coli BL21(DE3). The cDNA fragment was inserted into a plasmid pGEX-5X-1,at the downstream of the DNA sequence encoding Schistosoma japonicum glutathione S- transferase(GST),in the same reading frame with the gene of GST. A 60KD GST-NS53 fusion protein was expressed at 37℃ in a form of inclusion bodies amounting to 30 percent of total host protein whereas at 20℃ mainly in a form of soluble protein . The fusion protein was extracted and purified to homologue. The purified GST-NS53 fusion protein could be specifically recognized with either the sera from the patient infected by HGV or the antisera directed against GST.

Objective To explore the related factors with skin flap necrosis,we concluded the cases of patients with skin defects after free flap plantation.Methods From 2001 to 2016,188 cases about 20 influencing factors were analyzed (The characteristics of patients:age,sex,smoke,diabetes,high blood pressure;Preoperative factors:injured sections,injured causes,preoperative wound infection,preoperative wound osteomyelitis,the time from injury to operation;Intraoperative factors:operator,operation time,anesthesia time,intraoperative rehydration fluids,the way of vascular anastomosis,the number of venous anastomosis,the area of flap;Postoperative factors:flap hematoma,flap infection,vascular crisis) and multivariate logistic regression analysis was used to analyze the relationship between these risk factors and flap necrosis.Results All 188 cases were treated with free anterolateral thigh flap to repair soft tissue defect and it was revealed that the 174 cases were successful (92.55％) and 23 cases were occured vascular crisis (12.23％),8 cases were arterial crisis,11 cases were vein crisis,4 cases were ateriovenous crisis.After the treatment,the rescue was successful in 5 cases (38.46％).After the analysis we made the conclusion that the number of venous anastomoses,flap hematoma and vascular crisis were related with the skin flap necrosis.Conclusion The number of venous anastomose (≥2) will increase blood return to make the flap easier to survive.Intraoperative stanching and drainage tube placement work will reduce the skin flap hematoma as a result of reducing the skin flap necrosis.Artery and venous crisis handled in time,can enhance the survival rate of flap.

Objective:To investigate the effect of c-fos on the proliferation and migration of oral squamous cell carcinoma and potential mechansism.Methods:The expression of c-fos,CyclinD1 and p16 in 60 oral squamous cell carcinoma samples and 60 oral mucosa tissue samples was examined by immunohistochemistry.HN6 and SCC9 cells were respectively transfected with siRNA-c-fos and siRNA-scramble,then were respectively divided into control group,siRNA-scramble group and siRNA-c-fos group.The mRNA and protein expressions of CyclinD1 and p16 were decteted,meanwhile cell proliferation and migration were tested.Results:Compared with the oral mucosa tissue samples,the expressions of CyclinD1 and c-fos were increased in the carcinoma samples,while the expression of p16 was reduced.Compared with control group,the expressions of CyclinD1 in siRNA-c-fos group were significantly reduced,while p16 enpression was increased,with the inhibition of cell proliferation and migration.Conclusion:c-fos may regulate pl6/CyclinD1 signaling pathways and promote the proliferation and migration of oral squamous cell carcinoma.