1.Isolation of chondrocytes from rabbit rib cartilage with three-step enzymatic digestion and their biological characteristic in vitro
Qiang ZHOU ; Qihong LI ; Jianzhong XU ; Guohua SHI
Journal of Third Military Medical University 2003;0(16):-
Objective To observe the effect of isolating and harvesting the chondrocytes from rabbits rib cartilage with the method of three-step enzymatic digestion, and the biological characteristic of the isolated chondrocytes during cultivation in vitro to evaluate their biological activity. Methods The method of three-step enzymatic digestion was designed that the rib cartilage was digested one by one with 1 g/L trypsin and 1 g/L EDTA, 1 g/L hyaluronidase and 2 g/L collagenaseⅠ in the culture medium to isolate chondrocytes. The harvesting and viability rate of the primary chondrocytes were detected. During the passage cultivation in vitro, the changes of the chondrocyte shape and growth were observed, and the changes of the collagen typeⅠ and Ⅱ and aggrecan in the extracellular matrix were detected. Results ① The extracellular matrix of rib cartilage was completely dissolved by the three-step enzymatic digestion, and the chondrocytes were completely isolated from the solid matrix. The number of the harvested chondrocytes from every gram of wet cartilage was (4 295.7)?10~(4) on average,and their viability rate was 97.2% on average. ②The primary and first passage chondrocytes had triangle or multi-angle shape, and became elliptic shape at the growing confluence with the positive immunohistochemical staining of collagen type Ⅱ and the strong heterochromia to toluidine blue. The content of sulfate glycosaminoglycans(GAG) in the extracellular matrix of the primary passage cells was (80.61?11.40) ?g/cm~(2). The chondrocytes after the third passage gradually became spindle shape with the negative staining of collagen typeⅡ and the weak heterochromia to toluidine blue. The content of sulfate GAG of the fourth passage cells was (44.74?10.18) ?g/cm~(2). Conclusion ① The method of three-step enzymatic digestion can make the extracellular matix of rib cartilage to be completely degraded, and has advantages of the high efficiency of harvesting primary chondrocytes with high cellular viability rate and simple manipulation. ②The primary and first passage chondrocytes have fine biological activity.
2.Risk factors of spontaneous rupture of hepatocellular carcinoma
Wei XU ; Jingdong LI ; Gang SHI ; Quanlin LI ; Qiang LI
Chinese Journal of General Surgery 2011;26(2):149-153
Objective To explore risk factors relating to occurrence of spontaneous rupture (SR)of hepatocellular carcinoma (HCC). Methods We retrospectively reviewed medical records of 409 HCC patients treated in our department from Jan. 1st 2005 to Aug. 31st 2009. Clinicopathologic factors were explored for their possible association with occurrence of SR by univariate and multivariate analysis using Logistic regression model. Results Among 409 patients, SR occurred in 40 patients (9. 8% , 40/409).Type of SR was defined according to presentation of acute abdominal emergency, especially unstable hemodynamic status. Nineteen cases (4. 7%, 19/409) were grouped as type of HCC-SR Ⅰ and 21 cases (5. 1% ,21/409) as HCC-SR Ⅱ. Patients in the two groups possessed similar hepatitis infection status,severity of background liver disease and tumoral factors except for tumoral location, while HCC-SR Ⅰ group often needed emergency treatment demonstrating elevated values of aspartate aminotransferase (AST) and WBC, decreased PLT counts and worse Child-Pugh classification. Patients in the HCC-SR Ⅱ group had more opportunities of receiving curative hepatectomy and had longer overall survival. The 1,2 and 3 year survival rates were 26. 3 % (5/19), 5. 3% ( 1/19 ) and 0% (0/19)in the HCC-SR Ⅰ group and 66. 7% ( 14/21 ),42.9% (9/21)and 19. 5% (5/21) in the HCC-SR Ⅱ group, respectively. Differences reached statistical significance( P = 0. 011,0. 009,0. 049). Multivariate analysis identified that severity of concomitant liver cirrhosis , WBC > 10 × 109/L and AST level more than twice normal (2N) as independent risk factors associating with occurrence of HCC-SR Ⅰ , while elevated values of AFP and presence of tumor thrombi in portal vein branch related to HCC-SR Ⅱ. Conclusions HCC-SR includes two different types, since different risk factors predict occurrence of each HCC-SR type.
3.Expression of Tspan-1 in benign and malignant lesions of the colon
Ting LI ; Meirong XU ; Qiang SHI ; Jianwei ZHU
Chinese Journal of General Surgery 2010;25(9):751-754
Objective To study the protein expression of Tspan-1 gene in colorectal carcinoma,and investigate the relationship between the expression and biologic behavior of colorectal carcinoma. Methods Immunohistochemical ELIVISION two-step method was used to detect the protein expression of Tspan-1 gene in 80 cases of colorectal carcinoma,13 cases of colorectal adenoma and 27 cases of normal colorectal tissues. Results The positive expression rate of Tspan-1 in colorectal carcinoma was significantly higher than that in colorectal adenoma and normal colorectal tissues,there was significant difference in the expression among the three groups.The positive expression rate of Tspan-1 was 90% in colorectal carcinoma,23% in colorectal adenoma and 7% in normal colorectal tissues (P < 0.01).The positive expression rate of Tspan-1 in poor and moderately differentiated carcinoma was significantly higher than that in well-differentiated carcinoma (P < 0.01).The expression of Tspan-1 was significantly associated with lymph node metastasis (P<0.01),and with the 5-year survival rate of colorectal carcinoma patients,with also TNM stage and the depth of tumor invasion (P <0.01),and while it was not associated with gender,age,location,tumor size,and type (P > 0.05). Conclusion The expression of Tspan-1 gene could be as a marker predicting the prodnosis of colorectal adenocarcinoma patients,also it may play an important role in the pathogenesis of colorectal adenoma.
4.Application of case-based teaching method on the basis of treatment guidelines of respiratory ;medicine diseases in medical internship education
Jingxi ZHANG ; Xianbao ZHAN ; Hui SHI ; Maojin XU ; Xiaolu XU ; Qiang LI
Chinese Journal of Medical Education Research 2013;(12):1229-1231,1232
Case-based teaching (CBT) on the basis of treatment guidelines was carried out to develop standard medical behavior, improve learning efficiency and students' ability of solving clini-cal problems. In clinical internship teaching, guidelines for common and frequently-occurring respira-tory diseases and CBT were organically combined. Cases were carefully selected and questions were meticulously set. Guidelines were thoroughly analyzed and teaching was reasonably evaluated. There-fore, students' learning interests were initiated and learning efficiency was improved. It not only trained evidence-based medicine thinking of intern students, but also improved the teaching ability of clinical teachers.
5.Effects of C4d deposition in peritubular capillary of patients with acute renal allograft rejection one year post-transplant on the prognosis of renal allograft
Ming CAI ; Liang XU ; Xiaoguang XU ; Qiang WANG ; Zhouli LI ; Yong HAN ; Bingyi SHI
Chinese Journal of Organ Transplantation 2010;31(6):332-335
Objective To analyze C4d deposition in the patients with late acute renal allograft rejection,and explore the role of C4d in grafts survival and grafts loss. Methods Thirty-six patients clinical and pathologically diagnosed as having acute rejection more than one year post-transplant were selected. C4d was detected by immunohistochemistry in renal allograft biopsies. The effect of C4d deposition on long-term graft survival was studied. Results Among 36 recipients with late acute renal allograft rejection, 16 cases were positive for C4d (44.4 %) and 20 negative for C4d (55.6 %). Five cases experienced graft loss in C4d positive group (31.3 %), while 6 cases in C4d negative group (30.0%). There was no significant difference in the graft loss rate between C4d-positive group and C4d-negative group. Log-Rank test demonstrated there was no significant difference in graft survival between C4d-positive group and C4d-negative group. The count of the interstitial infiltrated eosinophils in renal allograft was (9.4 + 4.5) and (2.6 + 1.8) respectively in the C4d-positive group and C4dnegative group (P<0.05). Conclusion C4d deposition in peritubular capillary of the recipients with late acute renal allograft rejection might not be a prognostic marker for graft outcome.
6.Comparison of radiography,CT and MR imaging in detection of arthropathies in patients with hemophilia
Wei YU ; Qiang LIN ; Wei SHANG ; Hai-Feng ZHU ; Wei MENG ; Yong-Sheng SHI ; Rui-Yi XU ; Yong-Qiang ZHAO ;
Chinese Journal of Radiology 2001;0(02):-
Objective To compare MR,CT,and radiography in the detection of arthropathies in patients with hemophilia.Methods Forty-one symptomic joint images in the 14 patients with hemophilia, aged from 11 to 24 years,were used in this study.Each joint had the examinations of radiography,CT and MR within one day.The severity of each joint was staged using conventional radiographic classification. Severe HA patients with stage 5 were excluded from the study.Imaging findings of soft tissue swelling, osteoporosis,epiphyseal overgrowth,joint erosion,cyst,joint space narrowing,bone marrow,joint effusion, hemorrhage,synovial hypertrophy,widened intercondylar notch as well as anterior and posterior crueiate ligaments(only for knee joint)were used for the all imaging comparison.Results The 41 symptomatic joints in 14 patients with hemophilia were classified by radiographic criteria into stage 0(n=5),stage 1(n=7),stage 2(n=6),stage 3(n=8)and stage 4(n=15).Soft tissue swelling or joint effusion was observed in 33 joints by radiographs,in 34 joints by both CT and MR.Joint erosions were demonstrated in 34 joints by MR,in 33 joints by CT and 20 joints by radiographs.Joint cysts were shown in 21 joints by MR,in 18 joints by CT and 9 joints by radiographs.Significant differences in detection of erosion and cyst were found between radiography with either CT(P0.05).MR showed improvement for detecting nlore loci of both erosion and cyst than CT and radiography,and also CT showed the improvement than radiography.Bone marrow edema 14 joints, hemon'hage in 34 joints and synovial hypertrophy in 27 joints were revealed on MR images.Conclusion MRI is superior to CT and conventional radiography in detecting the abnormal changes and should be considered as the first choice among the imaging modafities in evaluating hemophilic arthropathies.
7.Magnetic properties and heavy metal contents of automobile emission particulates.
Sheng-gao LU ; Shi-qiang BAI ; Jing-bo CAI ; Chuang XU
Journal of Zhejiang University. Science. B 2005;6(8):731-735
Measurements of the magnetic properties and total contents of Cu, Cd, Pb and Fe in 30 automobile emission particulate samples indicated the presence of magnetic particles in them. The values of frequency dependent susceptibility (chi(fd)) showed the absence of superparamagnetic (SP) grains in the samples. The IRM(20 mT) (isothermal remanent magnetization at 20 mT) being linearly proportional to SIRM (saturation isothermal remanent magnetization) (R(2)=0.901), suggested that ferrimagnetic minerals were responsible for the magnetic properties of automobile emission particulates. The average contents of Cu, Cd, Pb and Fe in automobile emission particulates were 95.83, 22.14, 30.58 and 34727.31 mg/kg, respectively. Significant positive correlations exist between the magnetic parameters and the contents of Pb, Cu and Fe. The magnetic parameters of automobile emission particulates reflecting concentration of magnetic particles increased linearly with increase of Pb and Cu content, showed that the magnetic measurement could be used as a preliminary index for detection of Pb and Cu pollution.
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Environmental Monitoring
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Statistics as Topic
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Vehicle Emissions
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analysis
8.Renal transplantation using brain death free-donated kidney in 6 cases
Liang XU ; Ming CAI ; Zhouli LI ; Qiang WANG ; Yeyong QIAN ; Bingyi SHI
Chinese Journal of Tissue Engineering Research 2010;14(5):899-902
BACKGROUND: Brain death patient is the optimal donator due to the short warm ischemia time, which is conductive to renal function recover following transplantation. However, there are no reports concerning the recovery of renal function in uremia patients following renal transplantation with brain death patients' kidney. OBJECTIVE: To summarize the experience and therapeutic efficacy of renal transplantation using brain death free-donated kidney. METHODS: Six patients with urinsmia underwent renal transplantation with donor kidney of brain death patients from May 2006 to November 2008 at the Organ Transplantation Center, 309~(th) Hospital of Chinese PLA, were selected, including 2 patients receiving kidneys from a brain death patient, 4 patients receiving kidneys from 3 brain death patients. Four recipients received immunosupprsssive regimen of mycophenolate+ciclosporin+steroid, and 2 recipients received mycophenolate+ acrolimus+steroid. The renal function and medicine density were detected regularly, and change of renal function and pathogenetic condition were retrospective analyzed. RESULTS AND CONCLUSION: All 6 patients accepted renal transplantation successfully. The serum creatinine level was obvious descended in 5 patients within a week after transplantation, which meant that the transplanted kidney had begun to work. One patient suffered delayed renal graft function, and returned to normal at 10 days after transplantation. Three patients suffered acute rejection in the first year, and recovered by intravenous glucocorticoid therapy. One patient died after 1 year for pulmonary infection, which accompanied by serum creatinine of 469 pmol/L. The other patients reexamined regularly, and they had good quality of life up to now. The results reveled that renal function recovers in time after transplantation using brain death free-donated kidney, which can ameliorate life quality of patients.
9.Medical assessment of living-relative kidney donors prior to transplantation in 77 cases
Qiang WANG ; Ming CAI ; Bingyi SHI ; Yeyong QIAN ; Zhouli LI ; Xiangke PEI ; Liang XU
Chinese Journal of Tissue Engineering Research 2010;14(5):874-878
BACKGROUND: Living-donor kidney transplantation is not only associated to prognosis of recipients, but also donors' healthy. Complete medical and psychological assessment should be performed prior to transplantation to ensure the safety of donors. OBJECTIVE: To analyze and summarize the assessment experience of living-relative kidney donors prior to transplantation. METHODS: Totally 77 cases of living-relative kidney donors admitted at Organ Transplantation Center, Second Affiliated Hospital of General Hospital of Chinese PLA between January 2006 and March 2008 were reviewed. Among them, the analysis was carried out respectively according to the live donor nephrectomy guide of the United Kingdom (2005 Edition) before January 20, 2008, and live donor kidney transplantation consensus Boao meeting after January 20, 2008. In common practice, hypertension, diabetes mellitus, cardiovascular system, infectious disease study, age, obesity, proteinuria, renal artery, renal function, receptor for HLA typing and medical ethics, were systematically evaluated. RESULTS AND CONCLUSION: Of the 77 cases of assessed patients, 69 were qualified, successful donors, and completely cured, without complications. Totally 8 cases of non-donors were due to: 2 cases for hypertension combined with end organ damage; 2 for diabetes mellitus; 1 confirmed malignant tumor in kidney-donated surgery; 1 in the activity period of hepatitis B; 1 for resistance from his wife with medical ethics. The average age of donors was 45.3 years old, including and 7 cases above 60 years old, 24 of 50-59 years old, 29 of 30-49 years old, and 9 below 30 years old. There were 39 cases of parent child donation, 1 child parent donation, 19 siblings donation, 7 cases of three generations of collateral serum, and 3 cases of donation between husband and wife. Of successful donors, blood pressure was above 140/90 in 8 cases; Successful donors were without symptoms of myocardial ischemia but 14 cases had consciously ECG ST-T changes; 3 cases had abnormal fasting blood glucose. The successful donors' body mass index (BMI) reached the average of 23.05 kg/m~2, were below 30 kg/m~2; In assessment of infectious diseases, 3 cases were hepatitis B HBs and HBc-positive in a non-activity period, and the antibody titers were below 500 IU/L. In renography, glomerular filtration rate (GFR) was assessed to average (137.3±28.5) mL/min, and no significant statistical difference emerged (P < 0.05). Vascular three-dimensional CT prompted many left renal artery root in 3 cases, accounting for 4% in successful donors, 1 case did not match, accounting for 1%. It demonstrated that the primary purpose of assessment of -living-donor renal transplantation is to ensure that the adaptability, safety and health of donors. In order to avoid the omission of important medical information and unnecessary invasive inspection, as well as reducing the fees of medical assessment, the assessment should be based on the familiar, universally recognized, clinical evidence-based and reasonable procedures and the flexible assessment process.
10.A new understanding of the anatomic structure of posterior abdominal wall in retroperitoneal laparoscopic renal surgery
Wei CAI ; Hongzhao LI ; Xu ZHANG ; Shengkun SUN ; Jun DONG ; Lixin SHI ; Yong SONG ; Qiang ZHU
Chinese Journal of Urology 2012;(12):898-902
Objective To provide reliable technical method by identifying referential anatomic landmarks for retroperitoneal laparoscopic renal surgery,with respect to the renal hilum and renal artery.Methods The regional anatomy of the posterior abdominal wall was studied in 35 cases of retroperitoneal laparoscopic renal surgery from January to August 2010.These included 27 cases of renal cancer,6 cases of renal pelvis cancer and 2 cases of renal tuberculosis.Distended the retroperitoneal space using balloon dilation along with sharp and dull dissection.We recorded the forms and positions of the posterior abdominal cavity's anatomical landmarks and evaluated the relationship between each anatomical landmark with respect to the renal hilum and renal artery.Results The perirenal fascia posterior layer and perinephric fat on the renal side were observed,and several anatomical landmarks gradually appeared on the posterior abdominal wall.The diaphragm extended across the upper retroperitoneal space near the superior pole of the kidney,and the psoas major and the quadratus lumborum muscles were located at the lower retroperitoneal space,near the inferior part of the kidney.The intersection of the upper diaphragm muscle with the lower psoas major and quadratus lumborum muscles were bordered by the lateral and medial arcuate ligaments.The lateral arcuate ligament arched across the upper part of quadratus lumborum,while the medial arcuate ligament arched across the upper part of psoas major.The medial arcuate ligament points extended towards the upper border of the renal hilum.These landmarks enable us to locate the position of the kidney,reach the renal hilum and identify the renal vessels in all 35 cases.Conclusions The relative position of the muscles and ligaments of the posterior abdominal wall are consistent and can be clearly seen under retroperitoneoscopy.Based on the position of the diaphragm and psoas major,the kidney can be located.In addition,based on the position of the medial arcuate ligament,the renal hilum and renal artery can be located.Assistance from these anatomical landmarks will simplify the retroperitoneal laparoscopic renal surgery.