Objective To investigate the effects of exogenous hydrogen sulfide on brain edema and injury and their mechanisms. Methods Sixty male SD rats were randomly divided into a sham operation group, an ischemia-reperfusion group, a 30 ppm hydrogen sulfide group, and a 60 ppm hydrogen sulfide group (n =15 in each group; 1 ppm =1 mg/L). A model of focal cerebral ischemia for 2 h and reperfusion for 24 h was induced by middle cerebral artery occlusion. The neurological scores were observed after 24 h cerebral ischemia-reperfusion. The cerebral infarction volume, the degree of brain edema, and the changes of blood-brain barrier permeability were measured. Western blotting was used to detect the expressions of occludin and zonula occludens-1 protein (ZO-1) in ischemic penumbra. Results Compared with the ischemia-reperfusion group, the neurological function scores in the 30 ppm and 60 ppm hydrogen sulfide group significantly increased in a dose-dependent manner (al P <0.05) and the neurological deficits and infarct volume reduced (al P < 0.05), and the
brain edema aleviated (al P < 0.05). The content of Evans blue in the ischemic brain tissue in the ischemia-reperfusion group increased significantly compare with the sham operation group (0.74 ±0.14 μg/100 mg vs. 0.19 ±0.06 μg/100 mg; P <0.05). The content of Evans blue in the brain tissue in the 30 ppm hydrogen sulfide group (0.55 ±0.10 μg/100 mg ) and the 60 ppm hydrogen sulfide group (0.35 ±0.08 μg/100 mg ) decreased significantly compared with the ischemia-reperfusion group (al P < 0.05), among them the 60 ppm hydrogen sulfide group was significantly lower than the 30 ppm hydrogen sulfide group (P <0.05). Western blot analysis showed that expression levels of occludin in penumbra (0.621% ±0.101% vs.0.787% ±0.087% vs.0.453% ± 0.127%; P <0.05) and ZO-1 (0.602% ±0.118% vs.0.778% ±0.805% vs.0.426% ±0.146; P <0.05) in the 30 ppm and 60 ppm hydrogen sulfide groups increased significantly compared with the ischemia-reperfusion group, among them, the expression levels of occludin and ZO-1 in the 60 ppm hydrogen sulfide group were significantly higher than those in the 30 ppm hydrogen sulfide group (al P < 0.05). Conclusions Inhalation of exogenous hydrogen sulfide can significantly attenuate brain edema after ischemia-reperfusion in a dose dependent manner, reduce infarct volume, and improve neurological function.Their mechanisms may be associated with inhibiting the downregulated expressions of occludin and ZO-1 and maintaining the integrity of the blood-brain barrier.

Objective To evaluate the changes in the expression of aquaporin 1 (AQP1) and aquaporin4 (AQP4) in lung tissues during one-lung ventilation in patients undergoing pulmonary lobectomy.Methods Forty ASA physical status Ⅰ or Ⅱ patients,aged 30-64 yr,weighing 45-79kg,undergoing pulmonary lobectomy,were randomly divided into 2 groups(n=20 each):two-lung ventilation group (group T) and one-lung ventilation group (group O).Anesthesia was induced with iv injection of midazolam,fentanyl,vecuronium and propofol.In group T,the patients were intubated with a single-lumen endotracheal tube and two-lung ventilation was performed.In group O,double-lumen endobranchial tube was inserted,and two-lung ventilation was performed followed by onelung ventilation after chest opening.PET CO2 was maintained at 5.3-24.0 kPa and SpO2 was maintained ＞ 92％.Anesthesia was maintained with iv infusion of remifentanil,propofol and vecuronium.The normal lung tissues were obtained from the site near the pathologic changes for microscopic examination (with light microscope) and examination of the ultrastructure (with transmission electron microscope),and for determination of W/D lung weight ratio,the expression of AQP1 mRNA and AQP4 mRNA (by RT-PCR) and the expression of AQP1 protein and AQP4 protein (by Western blot).Results Compared with group T,W/D lung weight ratio was significantly increased,the expression of AQP1 mRNA and protein was down-regulated in group O (P ＜ 0.05),and no significant changes were found in the expression of AQP4 mRNA and protein in group O (P ＞ 0.05).Pathological changes were observed in group O.Conclusion Down-regulation of AQP1 expression may be involved in the acute lung injury induced by one-lung ventilation in patients undergoing pulmonary lobectomy,however,AQP4 has no such effect.

OBJECTIVETo analyze the neglected hidden blood loss before and after operations in the elderly patients with intertrochanteric fractures and strengthen the treatment and clinical nursing in the perioperative period in order to ensure clinical effects.

METHODSThe clinical data of 99 patients with intertrochanteric fracture treated with intramedullary nailing from January 2010 to January 2014 were retrospectively analyzed (47 males and 52 females). Forty-seven cases got blood transfusion supporting and 52 cases were not (blood transfusion group and no-blood transfusion group respectively). According to the Gross equation, the average hemoglobin (Hb) and hematocrit (HCT) were used to analyze blood loss in perioperative period and assess the patients' hidden blood loss situation.

RESULTSThere were 22 males and 30 females in blood transfusion group. The average operative time was (62.13±4.01) min; intraoperative visible blood loss and postoperative drainage were 215 ml, totally; preoperative Hb was (103.22±9.01) g/L and postoperative was (81.13±6.20) g/L; preoperative HCT was (96.93±3.38) I/L and postoperative was (308.00±11.81) I/L. There were 25 males and 22 females in no-blood transfusion group. The average operative time was (60.12±3.27) min; intraoperative visible blood loss and postoperative drainage were 196 ml, totally; the average blood transfusion were 621 ml; preoperative Hb was (92.15±5.46) g/L and preoperative was (95.20±8.93) g/L; preoperative HCT was (96.52±3.63) I/L and preoperative was (392.70±14.03) I/L. According to the Gross equation, the blood loss of no-blood transfusion group and blood transfusion group in peroperative period were (937.29±63.04) ml and (706.43±35.02) ml, respectively. The hidden blood loss was dominant. At 1, 3 months after operation, Harris score of blood transfusion group was better than that of no-blood transfusion group, and 12 months after operation, there was no significant difference between two groups.

CONCLUSIONThe hidden blood loss of intramedullary nailing for intertrochanteric fracture should be emphasized in perioperative period, it can avoid the perioperative complications caused by anemia and affect the prognosis of patients.

Aged ; Blood Loss, Surgical ; Blood Transfusion ; Case-Control Studies ; Female ; Fracture Fixation, Intramedullary ; adverse effects ; methods ; Hip Fractures ; surgery ; Humans ; Male ; Middle Aged ; Operative Time ; Perioperative Period ; Retrospective Studies

This paper aims at discussing the clinical characteristics and experiences of ZHU Lian, the renowned contemporary acupuncture master from the following three aspects: "characteristics of clinical manipulations and techniques", "thoughts on diagnosis and treatment" and "examples of clinical cases". The study has shown that ZHU Lian invented the slow insertion technique by rotating needle and the embedding needle technique, improved moxibustion technique with moxa roll and proposed the three keys on the treatment with acupuncture and moxibustion, as well as discovered new acupoints for treatment. The pioneering and distinguished achievements she con tributed play the great demonstrating and driving role in the development of clinical study and practice of acupuncture and moxibustion.
Acupuncture ; education ; history ; Acupuncture Therapy ; history ; methods ; China ; History, 20th Century ; Humans ; Moxibustion ; history ; instrumentation ; methods ; Needles ; Teaching

Biliary Atresia ; Child, Preschool ; Female ; Humans ; Male ; Pedigree

OBJECTIVETo explore the application value of morphology assessment of sperm from fresh semen in routine in vitro fertilization (IVF).

METHODSWe analyzed the morphology of the sperm from fresh or optimized semen samples and, based on the sperm morphology of the raw semen, allocated 908 IVF cycles due to the pure tubal factor to different groups: morphologically normal sperm (MNS) ≤ 4%, > 4% - ≤ 15%, and > 15% in Trial 1 and MNS ≤ 1%, > 1% - ≤ 2%, > 2% - ≤ 3%, and > 3%-- ≤ 4% in Trial 2. We compared the rates of fertilization, cleavage, high-quality embryo, -blastocyst formation, and pregnancy among different groups.

RESULTSThe total fertilization rate was significantly lower in the MNS ≤ 4% than in the MNS > 4% - ≤ 15% and >15% groups (74.40% vs 78.61% and 80.03%, P < 0.01). Compared with the MNS ≤ 1%, > 1% - ≤ 2%, and > 2% - ≤ 3% groups, the MNS > 3% - ≤ 4% group showed remarkably increased rates of 2PN normal fertilization (77.23%, 78.97% and 78.99% vs 85.47%, P < 0.01), cleavage (95.71%, 96.01% and 97.27% vs 98.73%, P < 0.05), and blastocyst formation (53.85%, 49.01% and 49.55% vs 63.41%, P < 0.01). No statistically significant differences were observed in the rates of clinical pregnancy, implantation, early abortion, live birth, or malformation at birth among different groups (P > 0.05).

CONCLUSIONMNS ≤ 4% affected the total rate of fertilization while MNS ≤ 3% reduced the rate of normal fertilization in IVF. However, even MNS ≤ 1% did not result in fertilization disorder or failure. Therefore, teratozoospermia alone was not an indicator of ICSI and sperm mor- phology assessment had no obvious value for predicting the rates of embryo quality, clinical pregnancy, and live birth in IVF.

Female ; Fertilization in Vitro ; Humans ; Male ; Pregnancy ; Pregnancy Outcome ; Spermatozoa ; cytology

Objective Excision repair cross-complementing gene-1(ERCC1) are key regulatory enzymes whose expression patterns are associated with overall survival(OS) in several malignancies.Their expression patterns and prognostic value in resected gastric adenocarcinoma(GAC) are not known and need to investigate.Methods A total of 109 patients who underwent resection for GAC in Liu′an People′s Hospital from January 2010 to June 2013 had tissue available for analysis.The primary objective was to assess for the differential expression of ERCC1 using by immunohistochemistry.The secondary objective was to assess for the association between OS and the expression of ERCC1.Results The median follow-up was 21.2 months,and the median OS was 28.8 months.Resected GAC exhibited differential expression of ERCC1(high expression,n=25(23%)).ERCC1 expression was not associated with OS(18.9 months vs.27.7 months,P=0.72).In a subset analysis of patients who received chemotherapy(n=73),high ERCC1 expression was associated with decreased OS(16.7 months vs.53.8 months,P=0.03).After controlling for known adverse pathologic features,high ERCC1 expression persisted as a negative prognostic factor in multivariate Cox regression analysis(HR=2.22,95% CI1.05-4.98,P<0.05).Conversely,in patients who underwent resection only(n=35),high ERCC1 expression demonstrated a trend toward improved OS(40.4 months vs.12.7 months,P=0.10).A positive prognostic influence also was present on multivariate analysis(HR=0.20,95% CI0.05-0.84,P=0.03).Conclusion Resected GAC exhibited differential expression of ERCC1.Among all patients,ERCC1 expression levels were not associated with OS.High ERCC1 tumor expression is associated with decreased OS in the patients who received chemotherapy but is associated with increased OS in those who underwent surgery alone.ERCC1 expression have prognostic value in resected gastric cancer,and further investigation is needed.

OBJECTIVETo investigate the effect of a modified technique for repairing secondary defect of unilateral cleft lip.

METHODSThe incision line was designed along the oral-nasal contour line. The lateral crus of nasal alar were rotated and repositioned in order to reconstruct the nasal sill and base. V-Y plasty was performed with a muco-cartilage flap inside the nasal cavity to reset the alar cartilage backwards and correct the nasal deformity.

RESULTSSatisfactory results were achieved in all 69 patients with this modified technique. The post-operative scar was inconspicuous.

CONCLUSIONSThis modified technique with advantages of contour line incision and alar cartilage backward re-reposition is a good option for the repair of secondary defect of unilateral cleft lip.

Adolescent ; Adult ; Cleft Lip ; complications ; surgery ; Female ; Humans ; Lip ; abnormalities ; Male ; Nose ; abnormalities ; Nose Deformities, Acquired ; surgery ; Reconstructive Surgical Procedures ; methods ; Young Adult

Objective To compare the clinical effect of minimally invasive surgery transforaminal lumbar interbody fu-sion(MIS-TLIF)and posterior lumbar interbody fusion(PLIF)in the treatment of recurrent lumbar intervertebral disc hernia-tion(LIDH). Methods Twenty-nine patients with recurrent LIDP were selected from May 2014 to May 2016 in Weifang Peo-ple's Hospital and the clinical data were analyzed retrospectively. Thirteen patients were given MIS-TLIF(MIS-TLIF group) and sixteen patients were given PLIF(PLIF)group. The operative incision length,intraoperative bleeding volume,postoperative drainage volume,hospitalization time and complications were compared between the two groups. The lumbar function was evalu-ated with the Japanese Orthopaedic Association(JOA)score standard,and the clinical effect was compared between the two groups according to the modified Macnab standard one year after treatment. Results The operativeincision length,intraopera-tive bleeding volume,postoperative drainage volumeand hospitalization time in MIS-TLIF group were significantly less than tho-sein PLIF group (P < 0. 05). The preoperative JOA score of lumbar function in PLIF group and MIS-TLIF group was 7. 9 ± 1. 9 and 8. 0 ± 1. 6 respectively,it was 24. 0 ± 2. 7 and 24. 2 ± 2. 5 respectively at one year after treatment,there was no significant-difference in the JOA score between the two groups before and one year after operation (P > 0. 05). The JOA score atone year after operation was significantly higher than that before operation in the two groups (P < 0. 05). According to the modified Macnab standard one year after treatment,the fineness rate of the patients in PLIF group was 87. 50％(14 / 16),the fineness rate of the patients in the MIS-TLIF group was 84. 62％(11 / 13). There was no significant difference in the fineness rate be-tweenthe two groups (χ2 = 1. 380,P > 0. 05). The incidence of postoperative complications in the MIS-TLIF group and PLIF group was 7. 7％(1/ 13)and 6. 3％ (1/ 16)respectively,there was no significant difference in the incidence of postoperative complications between the two groups (χ2 = 0. 020,P > 0. 05). There were 8 cases (61. 5％)with gradeⅠfusion and 5 cases (38. 5％)with gradeⅡfusion in MIS-TLIF group,there were 9(56. 3％)with gradeⅠfusion and 7(43. 8％)with gradeⅡfu-sion,there was no significant difference in the constituent ratio with gradeⅠandⅡfusion between the two groups (χ2 = 0. 080, P >0. 05). Conclusion MIS-TLIF in treatment of recurrent LIDH has the advantages of less incision,less intraoperative bleed-ing,less postoperative drainage and shorter hospitalization time;and the clinical effect of MIS-TLIF is similar to that of PLIF.

OBJECTIVETo explore the silencing effect of short hairpin RNA (shRNA) on the CD28 of mice T lymphocytes by CD28-shRNA expressing plasmid evaluate the interfering effects (chronology and stability) mediated by shRNA and select out the most efficient CD28 shRNA sequence.

METHODSThree CD28 specific and one non-specific shRNA expressing plasmids were constructed and then transfected separately into mice spleen T lymphocytes. Non-transfected cells and non-specific shRNA were taken as controls. Inhibitory effect of CD28 shRNA was demonstrated by real-time quantitative PCR and Western blots. The sequence of the highest RNA interference (RNAi) efficacy was screened.

RESULTS(1) CD28 shRNA expressing plasmids were successfully constructed; (2) Three CD28 specific shRNAs effectively inhibited the expression of CD28 at the mRNA and protein levels, and there was a statistically significant difference comparing with the controls (P < 0.01): The copies of CD28 in mice spleen cells at the mRNA levels were persistently decreased by 99.62%, 99.89% and 99.80% respectively after 20 days, and so did at the protein level [(84.90 +/- 0.65)%, (96.49 +/- 0.03)%, (91.76 +/- 0.32)% respectively]. The highest inhibitory rate was in CD28 shRNA-2 group.

CONCLUSIONS(1) Specific shRNA can mediate long-term and stable silencing effects on CD28 gene; (2) shRNAs matching different sites of CD28 gene exert differential inhibitory effects.

Animals ; CD28 Antigens ; genetics ; Cells, Cultured ; Gene Expression Regulation ; Mice ; Mice, Inbred C57BL ; Plasmids ; genetics ; RNA Interference ; T-Lymphocytes ; metabolism ; Transfection