Objective To investigate the effect of pioglitazone on the expression of thrombospondin-1(TSP1)and transfor ming growth factor-β1 (TGF-131)in the kidney of diabetic rats.Methods Forty Sprague-Dawley(SD)rats were randomly divided into 4 groups:normal control(NC),streptozocin-induced diabetic mellitus(DM),diabetic rats treated with pioglitazone(DP)and normal control rats treated with pioglitazone(NP).24-h urine protein quantity,serum creatinine(Scr) and kidney hypertrophy index were measured after treatment for 10 weeks,and the expression of TSP1 and TGF-β1 in the kidney was detected by using RT-PCR and immuohistochemistry.Results As compared with DM group,urine protein level and kidney hypertrophy index were significantly attenuated in DP group(P<0.05),but there was no significant difference in plasma glucose between them(P>0.05).As compared with NC and NP groups,the expression of TSP1 and TGF-β1 was significantly elevated in the kidney of DM and DP groups(P<0.01).Both TSP1 and TGF-β1 expression in DP group was lower than in DM group(P<0.05).Conclusion Pioglitazone can exert a direct protective effect on the kidney in diabetic rats,which is independent of the role of insulin sensitizer,and the mechanism may be associated with the decreased TSP1 expression in the kidney.

AIM: To study the protective effect of hyperpolarized cardioplegic arrest on reperfused rat heart performance and to investigate the role of mitochondrial ATP-sensitive K+ channels(mitoKATP) opening in the protection of hyperpolarized cardioplegia against ischemia/reperfusion damage.METHODS: Forty Sprague-Dawley rats were randomized into five groups(n=8 in each group): control group(Con);depolarized arrest group(D);hyperpolarized arrest group(H);depolarized cardioplegia with 5-hydroxydecanoate(5-HD) group(5HD+D);hyperpolarized cardioplegia with 5-HD group(5HD+H).The rat hearts were quickly removed to Langendorff apparatus.The heart perfusion was performed for 20 min with 37 ℃ Krebs-Henseleit buffer balanced with gas mixture(O2∶CO2=95%∶5%) at 5.8 kPa perfusion pressure,then cardial arrest was induced by different cardioplegic solution.Hearts were subjected to ischemia at 37 ℃ for 40 min followed by 30 min reperfusion.(1) The hemodynamics was detected at recovery after 30 min reperfusion.(2) Before ischemia and at the end-reperfusion,tissue was harvested for mitochondrial isolation and ultrastructure was observed by transmission electron microscopy(TEM).(3) Production of reactive oxygen species(ROS) was also determined at different time points.RESULTS:(1) Compared with end-equilibration,30 min reperfusion caused significant differences in left ventricular developed pressure(LADP),left ventricular end-diastolic pressure(LVEDP),double product(DP),heart rate (HR),coronary flow(CF)(P

Objective To explore the value of dual-source dual-energy CT (DSDE-CT) in differentiating extravasation of iodine contrast agents from secondary hemorrhage after revascularization in acute ischemic stroke. Methods 46 acute ischemic stroke patients following intra-arterial thrombolysis were examined with DSDE-CT within 2 hours after the procedure. Simultaneous imaging at 80 kV/392 mA and 140 kV/196 mA was employed, and then mixed images, virtual unenhanced non-contrast images and iodine overlay maps were calculated. Mixed images alone, as conventional CT, and DUDE-CT interpretations were assessed separately by two radiologists and compared with follow-up CT. Results 6 of 34 patients were negative cases proven by CT without high density, and another 28 cases were proven positive cases with 3 cases of cerebral hemorrhage, 21 cases of contrast agent extravasation, and the remaining 4 cases of combined cerebral hemorrhage and contrast agent extravasation. The sensibility, specificity, positive predictive value, negative predictive value and accuracy of mixed imaging alone in diagnosing hemorrhage was 66.67%, 100%, 1005, 96.15% and 96.43%, while the sensibility, specificity, positive predictive value, negative predictive value and accuracy of hemorrhage with DUDE-CT was 100%, 96%, 75%, 100% and 96.43% . The diagnostic accuracy of superimposed fusion images for intracranial hemorrhage, extravasation of contrast agent and hemorrhage with extravasation of contrast agent was relatively high, and the difference was statistically significant (P < 0.05). The diagnostic accuracy of superimposed fusion images consistent with clinical follow-up was significantly higher (Kappa=0.815),as compared with that of mixed imaging alone (Kappa=0.0.564). Conclusion DUDE-CT has great value in differentiating hemorrhage from iodinated contrast after intra-arterial thrombolysis in acute ischemic stroke.

Adolescent ; Adult ; Aged ; Carbon-Nitrogen Ligases ; genetics ; Female ; Gene Expression ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; genetics ; pathology ; Nasopharynx ; pathology ; Young Adult

Objective To compare the efficacy of self-made bone cement spacers containing vancomycin(vancomycin spacer)and Link infection-treating spacers(Link type spacer)for chronic infection after total hip arthroplasty(HTA)and investigate the choice of spacers for the two-stage revision of infection.Methods The study included 26 patients with infection combined with HTA,aged 32-82 years(mean 69.5 years).In the first stage,after complete debridement and removal of infected prostheses,the vancomycin spacers were implanted in 14 patients,while the Link type spacers were implanted in the rest 12 patients.Two weeks of intravenous administration of antibiotics and then six weeks of oral administration of antibiotics were done postoperatively.White blood cells(WBCs),erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)were measured periodically after operation.THA revision was performed in the second stage.Clinical outcomes were evaluated according to the pre-and post-operative Harris hip score.Results All patients obtained primary healing of incision after complete debridement,removal of prostheses and implant of the vancomycin spacers or the Link type spacers.Two-stage revision surgery was performed at 3-11.5 months after the one-stage surgery(mean 5.2 months).The follow-up ranging from 12 to 33 months(mean 20.8 months)manifested no signs of reinfection.The mean Harris hip score was increased from 27.9 points before one-stage operation to 52.9 points before two-stage operation,and 83.6 points at the latest follow-up(P＜0.05)One of 12 vancomycin spacers was broken before the revision surgery,as was free from the Link spacers.Conclusions(Ⅰ)Two-stage revision is an effective method in the treatment of infection after HTA because of high eradication rate of infection,effective pain relief and good postoperative functional result.(2)The vancomycin spacers and the Link type spacers can both effectively control infection and restore part of limb function.(3)The Link type spacers take advantages of simple in operation and the function improvement of the limbs during the intermittent period of treatment,but disadvantages of the catheters being prone to block,limited slow release of antibiotics and high cost of treatment.Thereby,the Link type spacer is suitable for the patients with relatively strong constitution,little serious infection,or high requirement of limb functions at the interval of two operations.

Objective To investigate the dynamic changes of microglial polarization at the perihe-matoma area and provide timepoint evidence for interventing microglial polarization as well as studying the polarization mechanism after intracerebral hemorrhage ( ICH ) . Methods Healthy male Sprague Dawley (SD) rats were randomly divided into sham group,ICH-4 h,1 d,3 d,7 d and 14 d groups with 6 in each group. The rats in ICH groups were injected collagenase VII-s into the caudate nucleus to establish the in-tracerebral hematoma model and rats in sham operated group were treated with the same amount of saline. The brains were taken at 4 h,1 d,3 d,7 d,14 d in the ICH group,1 d in sham group. Microglia typeⅠ( M1, CD11b++CD86+) and microglia typeⅡ( M2,CD11b++Arg-1+) were examined by immunofluorescence and the number of M1 and M2 around hematoma were analyzed. Results ( 1) The M1 and M2 were both ob-served at 4 h after ICH and a small quantity of branches were still presented on M1. ( 2) M1 took the main position in acute stage (1~3 d),early subacute stage(3~7 d) and chronic stage (>14 d) after ICH.The number of M2 was elevated transiently in superacute (<24 h) and late subacute stage (7 d).The number of M2 (31.40±1.69) was more than M1 (21.43±1.81) at 4 h after ICH ( t=- 4.085, P=0.002),and the number of M2 (116.25±5.06) significantly exceeded M1 (85.75±7.32) again on day 7 ( t=-0.690, P=0.001). Conclusion M1 is in a dominant position in acute,early subacute and chronic stages after ICH;M2 is dominant in superacute and late subacute stages. Investigating the mechanism of M2 formation at acute period ( such as 4 h) or late subacute stage ( such as 7 d) ,and inhibiting M1 formation in the early subacute stage ( 1~3 d) have important significance for clinical treatment of ICH.

BACKGROUND:In recent years, tissue engineering has made great progress, and skin tissue engineering is especialy noteworthy. Artificial dermis (PELNAC) is relatively used widely, but there is a lack of relevant reports on wound repair in children. OBJECTIVE:To investigate the clinical efficacy of Pelnac? METHODS:In a retrospective study, 22 patients with the wound of severe trauma were treated with Pelnac as skin graft dressings on treatment of the wounds of severe trauma in children. ? graft, negative-pressure wound therapy and split-thickness skin graft as experimental group (Pelnac? group), and another 19 patients treated with granulation formation dressing and split-thickness skin graft as control group. We colected data including the graft livability, the required re-operative times and the epithelization time after the skin graft. During the folow-up, the skin color and texture of survival skin, subcutaneous fulness, scar hyperplasia and the joint function were also evaluated. RESULTS AND CONCLUSION: In the Pelnac ? group, the graft livability was up to 90% within 10-14 days after grafting. The secondary split-thickness skin graft was required in two cases in the Pelnac? group and in eight cases in the control group. There was a significant difference in the graft livability (P < 0.05). The average epithelization time after the skin graft was (13.86±3.09) days in the Pelnac? group, which was significant shorter than the control group, (19.10±4.62) days, after the first time operation (P< 0.05). During the 10 months folow-up, the survival skin color and skin elasticity in the Pelnac? group was significantly better than that in the control group (P< 0.05). Better subcutaneous fulness and milder scar hyperplasy in the injured sites were obtained in the Pelnac? group compared with the control gorup. Five cases had certain joint function limitation in the Pelnac? group, compared to 10 cases in the control group, with a significant difference (P < 0.05). Artificial dermis Pelnac? has a stronger anti-infectious ability and higher graft livability. Pelnac? graft combined with negative-pressure wound therapy, granulation culture and split-thickness skin graft can shorten the epithelization time, improve wound healing and aleviate harm to the joint function after the skin graft.

0.05).However,significant difference in NCT and DST performance,incidence of HE the 4th week after(P

Objective To explore the changes of nitric oxide (NO) and superoxide dismutase(SOD) in the serum and intestine mucosal and the treatment of ulcerative colitis(UC) with Tanshinone.Methods Seventy-nine patients with UC were randomly divided into the treatment group(group A,n=40) and the routine treatment group(group B,n=39).Patients in the group A were given Tanshionon and routine treatment.Patients in group B were given routine treatment.The levels of NO and SOD were measured in all patients before and after the treatment.The clinical symptom,enteroscopy,and hospital day were compared in the patients of the two groups.Twenty normal healthy controls(group C) were involved in the study.Results The NO level in the serum and intestine mucosal was significantly increased and the SOD level was significantly decreased in the patients with UC compared with those of the controls(all P

Objective To investigate the levels of adiponectin and the relation with insulin and tumor necrosis factor(TNF)- ? in patients with cirrhosis. Methods Adiponectin,insulin and TNF-? levels were determined in 73 patients with cirrhosis and 30 healthy controls, and were correlated with various clinical and biochemical parameters. Meanwhile Child-Pugh liver function was classified. Results Adiponectin was significantly elevated in patients with cirrhosis compared with the control. Adiponectin levels in cirrhosis was correlated positively with insulin and negatively with insulin sensitively index,and did not correlate with TNF-? and liver function.Conclusion Serum adiponectin levels in cirrhosis are significantly elevated. Adiponectin levels do not correlate with TNF-? and liver function, but exclusively insulin and insulin sensitivity index.