Objective To evaluate the hepatic pathological damage after orthotopic liver transplantation (OLT) in rats with integrated backscatter (IBS). Methods Thirty-two SD rats and 40 Wistar rats were included, and stable OLT models were established except 8 Wistar rats as blank group. The rat models were randomly divided into 4 groups (each n=8):normal group (given no treatment), CsA-treated group (30 mg/[kg·d]), SIN-treated group (40 mg/[kg·d]), SIN and CsA-treated group (SIN 40 mg/[kg·d]+CsA 15 mg/[kg·d]). Hepatic IBS (peak to peak intensity:PPI; average image intensity:AII; standard deviation of image intensity:SDI) was measured on 4th and 10th day after OLT. The rats were sacrificed and a part of liver was cut off for pathological examination. Result Four days later, AII of control and SIN groups were higher than those in other groups (P<0.05), and of CsA-treated and SIN+CsA-treated groups were higher than that of blank group (P＜0.05), while no difference of PPI and SDI was detected between each two groups. Ten days later, AII in CsA-treated, SIN+CsA-treated and SIN-treated groups were lower than that of control group (P＜0.05), no difference of PPI and SDI was detected between each two groups. IBS was positively correlated with liver pathological damage (r=0.814, P＜0.01). Conclusion Detecting hepatic IBS contributes to the diagnosis of the level of liver damage after OLT.

An electrochemical aptasensor for Pb2+ was constructed based on the layer-by-layer assembly of graphene (GR) and anthraquinone -2-sulfonic acid sodium salt (AQMS) on the surface of Pb2+ aptamer. The mercapto-modified Pb2+ aptamer was first anchored on a gold electrode. Then the highly conductive material of GR was adsorbed on apt through the unique π-π stacking interaction, which was further used for the assembly and signal amplification of the electroactive AQMS. Upon interaction with Pb2+ ions, the apt on the aptasensor undergone conformational switch from a single-stranded form to the G-quadruplex structure, causing the GR assembled with AQMS releasing from the electrode surface into solution. As a result, the electrochemical signal of AQMS on the aptasensor was substantially reduced. Base on this concept, a useful platform for detection of Pb2+ ions was constructed. Under the optimal experimental conditions, the attenuation of peak currents (△Ipa ) showed linear relationship with the logarithm of Pb2+ concentrations (lgCPb2+) over the range from 5. 0×10-10 to 5. 0×10-8 mol/ L. The detection limit was estimated to be 6. 0×10-11 mol/ L.

Objective To explore the effect of selective gut decontamination in regulation of inflammatory reaction compared with rhubarb and glycerine enema for catharsis in patients with systemic inflammatory response syndrome ( SIRS ), and to discuss its mechanisms. Methods A prospective randomized controlled trial was conducted. Fifty-seven patients with SIRS admitted to Department of General Surgery of Aviation General Hospital from June 2009 to June 2014 were enrolled. The patients were randomly divided into rhubarb decontaminate group, traditional decontaminate group and blank control group, with 19 cases in each group. Besides the treatment for primary disease, including anti-infection, operation, alleviate pain, nutritional support, and maintaining water and electrolyte balance, the patients in rhubarb decontaminate group received aqueous extract from rhubarb 15-20 g by gastric tube, enema, or peros, twice a day;and those in traditional decontaminate group received glycerine enema or glycerol enema, twice a day; while no gavage or enema was prescribed in blank control group. Peripheral blood was collected before and 72 hours after treatment. Enzyme linked immunosorbent assay ( ELISA ) was used to determine the concentration of lipopolysaccharide ( LPS ) and inflammatory mediators. Results Compared with blank control group and traditional decontaminate group, the levels of interleukins ( IL-1, IL-8 ), LPS, platelet activating factor ( PAF ), tumor necrosis factor-α( TNF-α), andγ-interferon ( IFN-γ) before treatment was similar to that of rhubarb decontaminate group [ IL-1 ( ng/L ): 53.154±5.783, 50.564±5.771, 51.082±6.403, F = 0.994, P = 0.377; IL-8 ( ng/L ): 70.492±6.146, 68.376±6.112, 68.673±8.384, F=0.514, P=0.601;LPS (μg/L ):11.630±2.449, 10.858±2.307, 10.463±2.145, F = 1.261, P = 0.291; PAF (μg/L ): 4.173±0.395, 4.051±0.362, 4.078±0.487, F = 0.446, P = 0.642; TNF-α( ng/L ):132.498±10.772, 129.735±12.881, 127.207±11.514, F=0.963, P=0.388;IFN-γ(μg/L ):45.645±4.558, 43.692±5.578, 43.767±5.028, F = 0.904, P = 0.411 ]. The above parameters after treatment were significantly lower than those before treatment in three groups. The effect on the LPS and pro-inflammatory factors of the rhubarb decontaminate group was more obvious than that of the blank control group and traditional decontaminate group [ LPS (μg/L ): 7.571±1.113 vs. 9.008±1.904, 8.874±1.808, F = 4.416, P = 0.017; IL-1 ( ng/L ): 45.309±3.563 vs. 48.731±4.466, 46.112±4.322, F = 3.557, P = 0.035; IL-8 ( ng/L ): 60.492±5.346 vs. 65.553±5.384, 63.437±5.462, F = 4.213, P = 0.020; PAF (μg/L ): 3.519±0.250 vs. 3.832±0.356, 3.766±0.309, F = 5.450, P = 0.007; TNF-α ( ng/L ): 114.988±8.772 vs. 123.230±10.433, 118.534±9.519, F = 3.525, P = 0.036; IFN-γ(μg/L ):38.683±3.190 vs. 41.831±4.122, 39.161±3.972, F=3.820, P=0.028 ]. Conclusion The usage of selective gut decontamination can inhibit the release of endotoxin and inflammatory mediators in patients with SIRS, and it will get a better effect using rhubarb, and the mechanism may be related to the protection of intestinal mucosal barrier function.

Objective To investigate the application of transthoracic echocardiography (TTE) and 320-row CT in diagnosis of complex congenital heart disease(CCHD).Methods A retrospective analysis was performed in 68 patients with CCHD,which contained the echocardiographic apprarance,320-row CT and surgical outcoming.All of malformations were divided into three groups:intracardiac group,heart-large vascular connecting group and extracardiac group.Results One hundred and eighty-four malformations were comfirmed by surgery in the 68 cases.The misdiagnosis and missed diagnosis rate of CT and TTE:for the intracardiac anomalies were 12％ (11/93),1％ (1/93) respectively (P ＜ 0.05),for the heart-large vascular connecting malformation were 4％ (2/49),6％ (3/49) respectively (P ＞ 0.05),and for the extracardiac anomalies were 2％(1/42),19％(8/42) respectively (P ＜0.05),for the total anomalies were 8％(14/184),7％ (12/184) respectively (P ＞0.05).While it was 1％ (2/184) in diagnosis of total anomalies by both CT and TTE.Conclusions Both 320-row CT and TTE have their own advantages and shortcomings in the diagnosis of CCHD.Joint application of two methods could reduce the rate of misdiagnosis and missed diagnosis of CCHD.

Objective To investigate the brain glucose metabolism in different stage of mixed-type multiple system atrophy (MSA).Methods Forty-six MSA patients with cerebellar or Parkinsonian symptoms and 18 healthy controls with similar age as patients were included.According to the disease duration,the patients were divided into three groups: group 1 (≤ 12 months,n=14),group 2 (13-24 months,n=13),group 3 (≥ 25 months,n =19).All patients and controls underwent 18F-FDG PET/CT brain imaging.To compare metabolic distributions between different groups,SPM 8 software and two-sample t test were used for image data analysis.When P＜0.005,the result was considered statistically significant.Results At the level of P＜0.005,the hypometabolism in group 1 (all t＞3.49) was identified in the frontal lobe,lateral temporal lobe,insula lobe,anterior cingulate cortex,caudate nucleus and anterior cerebellar hemisphere.The regions of hypometabolism extended to posterolateral putamen and part of posterior cerebellar hemisphere in group 2 (all t＞3.21).In group 3,the whole parts of putamen and cerebellar hemisphere were involved as hypometabolism (all t＞4.08).In addition to the hypometabolism regions,there were also stabled hypermetabolism regions mainly in the parietal lobe,medial temporal lobe and the thalamus in all patient groups (all t＞3.27 in group 1,all t＞3.02 in group 2,all t＞3.30 in group 3).Conclusions Disease duration is closely related to the FDG metabolism in the MSA patients.Frontal lobe,lateral temporal lobe,anterior cingulate cortex and caudate nucleus can be involved at early stage of the disease.Putaminal hypometabolism begins in its posterolateral part.Cerebellar hypometabolism occurs early at its anterior part.Besides,thalamus shows hypermetabolism in the whole duration.18F-FDG metabolic changes of brain can reflect the development of mixed-type MSA.

Objective To investigate the effect of hypoxic preconditioning on anti-inflammatory responses of bone marrow mesenchymal stem cells (BMSCs) in rats through in vitro and in vivo experiments.Methods In vitro experiment The isolated rat BMSCs were cultured by whole bone marrow adherence method.The cells at passage 3 were seeded in 24-well plates at a density of 1 × 106 cells/ml and randomly divided into 5 groups (n =8 wells each) using a random number table:control group (group C),normoxia-incubated group (group N),hypoxic preconditioning group (group H),hypoxia preconditioning + STAT3 inhibitor Stattic group (group HS) and hypoxia preconditioning + anti-IL-10 monoclonal antibody group (group HA).In group C,BMSCs were incubated in DMEM culture medium.In group N,BMSCs were exposed to21％ O2-74％ N2-5.0％ CO2 for48 h.In group H,BMSCs were exposed to 0.5％ O2-94.5％ N2-5.0％ CO2 for 24 h followed by 24 h exposure to normoxia.In HS and HA groups,500 μg/ml Stattic and 100 μg/rnl anti-IL-10 monoclonal antibody were added to the culture medium before hypoxia preconditioning,respectively.The expression of phosphorylated STAT3 (p-STAT3) and IL-10 was determined by Western blot.In vivo experiment Healthy male Sprague-Dawley rats,weighing 300-350 g,in which intrathecal catheters were successfully implanted without complications,underwent spinal cord ischemia by occlusion of the thoracic aorta combined with controlled hypotension.Three hundred rats with spinal cord I/R injury were randomly divided into C,N,H,HS and HA groups (n =60 each) using a random number table.Immediately after onset of reperfusion,DMEM medium 300 μl was injected intrathecally in group C,and BMSC suspension 300 μl (1 × 106 cells/ml) was injected intrathecally in N,H,HS and HA groups.Neurological function was scored before ischemia and at 4,12,24 and 48 h of reperfusion (T0-,).The animals were then sacrificed and the lumbar segment of spinal cord was removed for detection of the content of IL-10,TNF-α,IL-1β,IL-6,monocyte chemotactic protein-1 (MCP-1),and macrophage inflammatory protein-1 α (MIP-1 α) (by ELISA) and the number of activated microglia (by immuno-histochemistry).Results Compared with C and N groups,the expression of pSTATβ and IL-10 was significantly up-regulated,the neurological function score and IL-10 content were increased,the content of TNF-α,IL-1β,IL-6,MCP-1 and MIP-1α and the number of activated microglia were decreased in group H (P ＜ 0.05).Compared with group H,the expression of p-STAT3 and IL-10 in group HS and expression of IL-10 in group HA was significantly down-regulated,and the neurological function score and IL-10 content were decreased,and the content of TNF-α,IL-13,IL-6,MCP-1 and MIP-1α and the number of activated microglia were increased in HS and HA groups (P ＜ 0.05).Conclusion Hypoxic preconditioning can enhance anti-inflammatory effects of BMSCs,thus increasing BMSCs-induced reduction of spinal cord ischemia-reperfusion injury in rats.

Objective To investigate the application of prenatal ultrasonograpy in diagnosis of fetal heart disease during the medium-term and terminal pregnancy,and to avoid misdiagnosis.Methods The prenatal ultrasonographic screening was conducted in 7020 pregnant women with medium-term and terminal pregnancy.All confirmed and suspicious cases of fetal heart disease were observed by echocardiography once 4 weeks until postnatal sixth month to 1 year while normal cases was traced at the intervals of 8 weeks.All the cases were confirmed by autopsy or surgery while part of them were confirmed by postnatal angiocardiography before surgery.The reasons of misdiagnosis were analyzed.Results In fifty-three cases of fetal cardiovascular abnormality,43 cases were found,2 cases were misdiagnosis while 8 cases were missed diagnosis.2 cases of misdiagnosis included 1 case of pulmonary valve stenosis and 1 case of tetralogy of Fallot.8 cases of miss diagnosis included 2 cases of inferior vena cava in ectopic drainage and 6 cases of ventricular septal defect (defect diameter ＜ 5 mm).The accuracy rate of diagnosis of fetal heart disease was 81.1 ％ by echocardiography.Conclusions Using high frequency probe,image zoom,enhancing the detection of vein-atrium connection and the structure of right ventricular outflow with pulmonary artery are important factors to avoid missed diagnosis and incomplete diagnosis.

Objective To observe the effects of lung protective ventilation strategy (LPVS) on inflammatory mediators in bronchial alveolar lavage fluid (BALF) in pulmonary and extrapulmonary acute respiratory distress syndrome(ARDS).Methods All of 62 extrapulmonary ARDS(ARDSexp) cases and 60 pulmonary ARDS (ARDSp) cases were divided into observation group and control group by table of random digit.ARDSexp and ARDSp observation group were received LPVS treatment [tidal volume 6-8 ml/kg,positive end expiratory pressure (PEEP) 5-15 cm H2O (1 cm H2O =0.098 kPa)],and ARDSexp and ARDSp control group were received the routine ventilation strategy (tidal volume 10-12 ml/kg,PEEP 4-8 cm H2O).All groups were treated with the same conventional therapy of ARDS,same model and parameter of mechanical ventilation.The level of tumor necrosis factor (TNF)-α,interleukin (IL)-6,IL-8 in BALF were tested by enzyme linked immunosorbent assay on the 1st,4th,7th day in each group.The oxygenation index was tested at 8 o'clock each morning.Results There were 4 ARDSexp cases and 6 ARDSp cases who were expelled,because of death within 7 days.ARDSexp observation group was in 28 cases,ARDSexp control group was in 30 cases,ARDSp observation group was in 28 cases,ARDSp control group was in 26 cases.The oxygenation index had no significant difference between ARDSexp and ARDSp observation group and corresponding ARDSexp and ARDSp control group on the 1st and 2nd day (P ＞ 0.05).But the oxygenation index in ARDSexp and ARDSp observation group were significantly higher than that in ARDSexp and ARDSp control group from 3rd to 7th day (P ＜ 0.05).The oxygenation index in ARDSexp observation group was significantly higher than that in ARDSp observation group except 1st day (P ＜0.05).The oxygenation index in ARDSexp and ARDSp observation group were significantly better with the time passing (P ＜ 0.05).The BALF levels of TNF-α,IL-6 and IL-8 in ARDSexp and ARDSp observation group were significantly lower than those in corresponding ARDSexp and ARDSp control group on the 4th and 7th day (P＜ 0.05).The BALF levels of TNF-α,IL-6 and IL-8 in ARDSexp observation group and ARDSexp control group were significantly lower than those in corresponding ARDSp observation group and ARDSp control group (P＜ 0.05).The BALF levels of TNF-α,IL-6 and IL-8 in ARDSexp and ARDSp observation group were decreased significantly with the time passing (P ＜0.05).Conclusion It is more reasonable to decrease the BALF levels of inflammatory mediators,increase oxygenation index for ARDS patients to with LPVS treatment,then for ARDSexp patients obviously.

To modify uricase with PEG reagent in order to decrease uricase immunogenieity and increase its stability.Methods:The branched PEG of 40 kD was chosen to modify native uricase.The properties of the mod-ified uricase including the stabilities to protease,pH and temperature,in vivo half-life time,as well as the immu-nogenicity were evaluated.The pharmacokinetic profiles of the midofied uricase were studied in mice.Results:It is demonstrated that the conjugation of PEG to lysine residues of Candida utilis uricase resulted in higher tryp-sin resistance.reduced immune response.and prolonged in vivo half-life.PEG modified uricase retained 80% of the enzymatic activity of native uricase.In addition,it was found that half-life in serum of the intravenously injec-ted PEGylated uriease of up to 696 min was longer that that of native uficase of 45 min.Higher plasma drug con-centrations were also reached with dosing of the PEGylated uricase to mice.Furthermore,the binding affinity Was shown to be reduced for the PEG-uricase using ELISA assay.and it was one-eishth that of native uricase.Final-ly,it Was indicated that the PEG uficase induced a delayed immunoresponse in mice following repeated adminis-trations.Conclusion:These findings demonstrate that this chemically modified form of uricase may serve as a potentially effective drug to treat gout patients.

Objective To study the application of 3％ hypertonic saline (HS) in patients with severe craniocerebral injury after operation.Methods Sixty-eight cases with severe craniocerebral injury after operation were divided by random digits table method into HS group and control group with 34 cases each.The patients in control group were treated with 125 ml 20％ mannitol every 6 hours or 8 hours.The patients in HS group were given conventional mannitol and added with 130 ml 3％ HS every 12 hours or 8 hours through fast intravenous drip altemated with mannitol.The levels of intracranial pressure (ICP),mean arterial pressure (MAP),central venous pressure (CVP) were recorded within 6 hours,12 hours,24 hours of the 1st day,24 hours of the 2nd day,24 hours of the 3rd day,24 hours of the 5th day.The Na+ level of blood serum and the plasma osmotic pressure were recorded and calculated within 12 hours,24 hours of the 1st day,24 hours of the 2nd day,24 hours of the 3rd day,24 hours of the 5th day.The Glasgow coma scale( CCS) score was accounted within 24 hours of the 1 st day,24 hours of the 3rd day,24 hours of the 5th day.Results Compared with control group,the level of ICP in HS group decreased at every time point (P ＜ 0.05).The tendency of ICP in two groups was not significant on the 1st and 2rid day (P ＞ 0.05 ),but the level of ICP within 24 hours of the 3rd and 5th day obviously increased compared with those of the 1st and 2nd day (P＜0.05).The levels of MAP and CVP in HS group were significantly higher than those in control group within 6 hours,12 hours and 24 hours of the 1 st day and 24 hours of the 2nd day [ ( 87.98 ± 5.03 ),(88.56 ± 5.36),(87.04 ±6.90),(90.03 ±5.19) mm Hg (1 mm Hg =0.133 kPa) vs.(77.98 ±5.09),(79.98 ±6.09),(80.98 ± 5.27),(81.98 ± 4.32) mm Hg and (9.23 ± 1.24),(9.67 ± 1.35),( 10.21 ± 1.38 ),( 10.56 ± 1.96)mm Hg vs.(7.15 ± 2.01 ),(8.32 ± 1.53),(8.67 ± 1.89),(9.22 ± 2.03) mm Hg] (P ＜ 0.05),but the values within 24 hours of the 3rd and 5th day between two groups had no significant differences (P＞ 0.05 ).The Na+ level of blood serum and the plasma osmotic pressure in HS group at every time point was obviously higher than that in control group (P＜ 0.05).The GCS scores within 24 hours of the 1st,3rd and 5th day in HS group were (4.21 ± 2.31 ),(5.44 ± 2.46 ),(7.23 ± 1.64 ) scores,respectively,while the scores in control group were (4.14 ± 2.10),(5.15 ± 2.31 ),(7.31 ± 2.12) scores,respectively ;the score within 24 hours of the 5th day in two groups was obviously higher than that of the 1st day respectively (P＜ 0.05 ),but the scores between two groups had no statistical significance (P＞ 0.05 ).Conclusions Adding 3％ HS is more effective to decrease ICP,improve the brain perfusion and reduce the adverse reactions.3％ HS can be used as the first-line therapy for patients with severe craniocerebral injury after operation.