Objective:To investigate serum level of vascular endothelial growth factor(VEGF)in patients with rheumatoid arthritis(RA).Methods:VEGF ELISA Quantikine kit.The serum RF level was also d etermined using Beckman Array 360.Results:The serum concen tration of VEGF was significantly higher in patients with RA than in healthy co ntrol(P＜0.01).Conclusion:It suggests that VEGF is involved in the pathog enesis of RA and that measurment of serum concentration of VEGF is noninvasive, usful method for monitoring the disease activity of RA.

Objective To observe the serum lipid level of patients with branch retinal vein occlusion (BRVO).Methods A total of 71 BRVO patients (BRVO group) were enrolled in this study.The patients included 31 males and 40 females,with an average age of (52.75 ± 10.2) years.All the patients were examined for visual acuity,slit lamp ophthalmoscopy combine with preset lens,fundus color photography and fundus fluorescein angiography (FFA) examination.Seventy-two age-and sex-matched normal subjects were enrolled in this study as control group.The subjects included 32 males and 40 females,with an average age of (53.10±9.5) years.The BRVO and control group were divided into four subgroup which including age with ＜40 years,40-49 years,50-59 years and ≥60 years.The plasma cholesterol and triglyceride level of BRVO group,control group,and age subgroups of BRVO and control group were comparatively analyzed.Results The average plasma cholesterol levels were (4.529±0.100) and (4.274±0.106) mmol/L in BRVO and control group,respectively.There was no difference between two groups (t=-1.738,P＞0.05).The average triglyceride levels were (1.500±0.129) and (1.319±0.095) mmol/L in BRVO and control group,respectively.There was no difference between two groups (t=-1.135,P＞0.05).There was no difference of average plasma cholesterol (t=-1.755,1.850,-1.892,-0.507) and triglyceride (t=0.846,-0.074,-1.288,-1.887) level in age subgroups of BRVO and control subgroup (P＞0.05).Conclusion There is no significant difference of serum lipid level between BRVO patients and controls.

Objective:To study the antiviral effect of ISG20 on HCV replicon.Methods:Wild type ISG20/mutated ISG20 cDNAs were obtained by RT-PCR/two step-PCR directed mutagenesis, and wild type ISG20 and dominant negative mutated ISG20 mammal expression vectors were consuructed. The constructed pISG20wt and pISG20m expressing vectors were transfected into Huh7 cells or Huh7 cells containing HCV replicon to investigate its effects on HCV replicon replication.Results:The ISG20wt/ISG20m expression vectors were constructed and the expressions of these two vectors were confirmed at both mRNA and protein levels. The effects of ISG20wt on HCV replicon replication were evaluated by Northern blot and Western blot. The results showed that expression of ISG20wt had significant inhibitory effect on HCV RNA replication.Conclusion:ISG20 participates in the anti-HCV action of IFN-? on HCV replicon system.

OBJECTIVETo study the effect of Modified Dachengqi Decoction (MDD) as whole course therapy on mediators of inflammation in severe acute pancreatitis (SAP) model rats, and to compare interventional advantages over intestinal mucosal barrier (IMB) of SAP rats between whole course therapy of MDD and early stage therapy of MDD.

METHODSTotally 190 SD rats were divided into five groups according to random digit table, i.e., the sham-operation group, the model group, the octreotide (OT) group, the early stage MDD treatment group, the whole course MDD treatment group, 38 in each group. SAP models were established with retrograde injection of 5% sodium taurocholate into the pancreaticobiliary duct. Three hours after modeling normal saline (NS) was administered to rats in the sham-operation group and the model group by gastrogavage, once per 12 h.1.35 µg/100 g OT was subcutaneously injected to rats in the OT group, once every 8 h. 0.4 mL/100 g MDD was administered to rats in the early stage MDD treatment group, and 6 h later changed to NS (once per 12 h).0.4 mL/100 g MDD was administered to rats in the whole course MDD treatment group, once every 12 h. The accumulative survival rate and morphological manifestations of pancreas and small intestine were observed under microscope 48 h after modeling. Pathologic scores of the pancreas and small intestine were conducted at 4, 6, 24, and 48 h after modeling. Contents of serum amylase (AMY), alanine transaminase (ALT), and TNF-α were also detected. The expression of high mobility group box protein 1 (HMGB1) in the small intestine tissue was also detected by Western blot. The positive rate of bacterial translocation in mesenteric lymph nodes (MLNs) was observed within 48 h. Correlations between serum TNF-α or HMGB1 in small intestinal tissue and pathological scores of the pancreas or the small intestine were analyzed.

RESULTSThe accumulative survival rate was 100. 0% in the sham-operation group, 79. 2% in the whole course MDD treatment group, 70. 8% in the OT group, 45. 8% in the early stage MDD treatment group, and 37.5% in the model group. At 6 h after modeling, pathological scores decreased more in the whole course MDD treatment group, the early stage MDD treatment group, the OT group than in the model group (P < 0.05). At 24 and 48 h after modeling, pathological scores of the pancreas and the small intestine decreased more in the whole course MDD treatment group and the OT group than in the early stage MDD treatment group (P <0. 05). At 6, 24, and 48 h after modeling, serum contents of AMY and ALT both decreased more in the whole course MDD treatment group, the early stage MDD treatment group, the OT group than in the model group (P < 0.05). At 48 h after modeling serum contents of AMY and ALT both decreased more in the whole course MDD treatment group and the OT group than in the early stage MDD treatment group (P < 0.05). At 6 h after modeling serum TNF-α levels decreased more in the whole course MDD treatment group, the early stage MDD treatment group, the OT group than in the model group (P < 0.05). At 6, 24, and 48 h after modeling the level of HMGB1 in the small intestinal tissue decreased more in the whole course MDD treatment group, the early stage MDD treatment group, the OT group than in the model group (P < 0.05). Of them, HMGB1 levels at 24 and 48 h were lower in the whole course MDD treatment group and the OT group than in the early stage MDD treatment group (P < 0.05). The number of MLNs bacterial translocation at 48 h after modeling was lower in the whole course MDD treatment group and the OT group than in the early stage MDD treatment group and the model group (P < 0.05). Serum TNF-α contents within 6 h were positively correlated with pathological scores of pancreas (r = 0.579, P < 0.01). ROC curve showed that serum TNF-α contents could predict the severity of SAP (ROC = 0.990, 95% Cl: 0.971 to 1.000). HMGB1 in the small intestine was positively correlated with pathological scores of the small intestine (r = 0.620, P < 0.01).

CONCLUSIONSEarly stage use of MDD could effectively reduce the release of TNF-α, while whole course use of MDD could effectively inhibit the expression of HMGB1. The latter could preferably attenuate injuries of the pancreas and the small intestine, lower MLNs bacterial translocation, and elevate the survival rate.

Animals ; Bacterial Translocation ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; HMGB1 Protein ; Intestinal Mucosa ; drug effects ; Octreotide ; Pancreas ; Pancreatitis ; drug therapy ; Plant Extracts ; pharmacology ; therapeutic use ; Rats ; Rats, Sprague-Dawley ; Taurocholic Acid ; Tumor Necrosis Factor-alpha

Ultrasonic thrombus ablation is a newly-developed technology for percutaneous arterial recanalization. An ultrasound angioplasty device is described here in detail. The device has an adjustable power output range and distal tip longitudinal displacement range. Experimental data suggest that this ultrasound device is significantly effective in ablating fresh thrombi.
Catheter Ablation ; instrumentation ; Equipment Design ; Expert Systems ; Thrombolytic Therapy ; Transducers ; Ultrasonography, Interventional ; Vibration

Objective To investigate the complications and the risk factors of pancreatic fistula after pancreaticoduodenectomy.Methods The clinical data of 339 patients who underwent pancreaticoduodenectomy at the First Affiliated Hospital of Sun Yat-Sen University from January 2000 to Decembcr 2009 were retrospectively analyzed.The risk factors of pancreatic fistula were analyzed.The incidences of complications accured from 2000 to 2004 and from 2005 to 2009 were compared.All data were analyzed by the t test,chi-square test,Fisher exact probability or Logistic regression model.Results The incidence of complications of all patients was 33.0％ ( 112/339),and the incidence of pancreatic fistula was 8.6％ (29/339).Of the 29 patients complicated with pancreatic fistula,6 patients were in grade A,8 in grade B and 15 in grade C.Soft texture of remnant pancreas and the diameter of pancreatic duct smaller than 3 mm were the independent risk factors of pancreatic fistula( OR =1.75,3.75,P ＜ 0.05 ).The number of hospital death was 12,including 1 patient died during the first period (2000-2004) and 11 patients died during the second period (2005-2009).Three patients died of pancreatic fistula and abdominal hemorrhage,3 died of postoperative upper gastrointesitnal bleeding,2 died of cardiac insufficiency,1 died of respiratory failure,1 died of pancreatic fistula,abdominal infection and necrotic pancreatitis,1 died of abdominal hemorrhage and hepatic and renal failure,1 died of bililary fistula,abdominal infection and multiple organ dysfunction syndrome.Conclusions Soft texture of remnant pancreas and the diameter of the pancreatic duct smaller than 3 mm are important risk factors of postoperative pancreatic fistula.Pancreatic fistula is the main factor causing death after pancreaticoduodenectomy.

Objective To investigate the complications and the risk factors for pancreatic leakage after pancreaticoduodenectomy.Methods One hundred and sixty-nine patients who received pancreaticoduodenectomy in our hospital between January 2000 and December 2009 were reviewed.Chisquare and logistic statistic analysis were performed to determine the risk factors for pancreatic leakage.The difference in complication rates between different periods were analyzed.Results The mortality was 2.4％.The morbidity was 34.9％,and the pancreatic leakage rate was 7.7％.Logistic analysis revealed significant risk factors for pancreatic leakage included intraoperative bleeding of more than 400 ml(OR=2.87; 95％ confidence interval:1.17-8.19; P=0.048),soft texture of remnant pancreas(OR =1.95 ; 95 ％ confidence interval:0.87-6.19 ； P =0.032)and pancreatic duct diameter smaller than 3 mm(OR=3.78 ; 95 ％ confidence interval:1.01-10.63 ； P =0.019).There was no significant difference in mortality,morbidity,pancreatic leakage,and upper gastric bleeding between the periods 2000-2004 and 2005-2009.However,re-operation rate and postoperative hospital stay were significantly higher in the period of 2005-2009.Conclusions Intraoperative bleeding,soft texture of remnant pancreas and pancreatic duct diameter smaller than 3mm were significant risk factors for postoperative pancreatic leakage.A pancreaticojejunostomy anastomotic technique familiar to the surgeon might reduce postoperative pancreatic leakage.

Genomic DNA of two fungi Thamnidium elegans and Umbelopsis isabellina were extracted with an amended Cetyltrimethyl Ammonium Bromide (CTAB) method. This modified method uses repeated freezing in liquid nitrogen and thawing with combination of shocking with glass beads to replace of the tra- ditional method. Quality and concentration of DNA extracted by the modified methodwere tested. Compared with the traditional method, higher yield and purity of genomic DNA were obtained with less amount ofmy- celium. The result indicted that this is a simple and highly efficient method, which is suitable to treat many samples at one time and for basic molecular experiments, such as restriction endonuclease reaction and PCR.

Objective To investigate the effects of treatment on end-stage liver disease and diabetes mellitus by simultaneous liver-pancreas-duodenum transplantation with the pancreas of the recipients reserved.Method Simultaneous liver-pancreas-duodenum transplantations were carried out in three patients with the pancreas of the recipients reserved.The diseases of the recipient 1,2,and 3 were alcoholic liver cirrhosis and diabetes mellitus,chronic hepatitis B liver cirrhosis and diabetes mellitus,and chronic hepatitis B liver cirrhosis and diabetes mellitus complicated with renal function failure.The recipient 3 received simultaneous renal transplantation.Result The recipient 1 suffered from pancreatitis after the operation and discharged with normal liver function and blood glucose levels,and he was treated with insulin at 4th year after the operation.Intestinal fistula occurred in the recipient 2 and drainage was done without acute peritonitis,the liver allograft was experienced an acute rejection episode treated by intravenous bolus methylpredisolone at 19th month after operation,but gastrointestinal perforation happened and the patient died of acute peritonitis.In the recipient 3,peripancreatic effusion and pancreatitis happened and were treated by drainage,and the recipient survived to now with normal liver and kidney functions,but given insulin at first year after operation.Conclusion It is effective to implement simultaneous liver-pancreas-duodenum transplantation with the pancreas of the recipients reserved on the patients with end-stage liver disease and diabetes mellitus.However,how to maintain the pancreatic endocrine function after the transplantation for a long period awaits further investigation.

Objective To analysis and summarize the diagnosis and treatment of acute humoral rejection after liver transplantation.Method The clinical data of 2 patients with humoral rejection after liver transplantation were analyzed.One patient with severe hepatitis B underwent ABO-incompatible liver transplantation and the donor blood type was AB and recipient blood type was A.Another patient with autoimmune liver disease was subjected to liver transplantation with the same blood type.Result Two patients were given tacrolimus,mycophenolate mofetil and prednisone immune suppression scheme.Anti-human lymphocyte immune globulin was used in case 1 for induction therapy.Both cases recovered well after liver transplantation in one week evaluated by the transplanted liver function,but liver function deteriorated from 7 days after transplantation.Titer of anti blood type B antibody was increased in case 1,and biopsy of transplantation liver confirmed acute humoral rejection.Plasma exchange,bortezomib plus intravenous immunoglobulin (IVIG) were used for therapy for acute humoral rejection,and acute humoral rejection in case 1 was reversed after treatment and graft function recovered gradually.However,the graft function was not improved after treatment in case 2,and liver graft biopsy showed no acute cellular rejection signs.Only few liver cells necrosis and cholangiole cholestasis were seen.The levels of HLA Ⅰ and Ⅱ class antibody were 3.4％ and 95.9％ respectively.We suspected acute humoral rejection in case 2.Plasma exchange,bortezomib plus IVIG were given,but liver graft function was not improved after treatment,and liver re-transplantation was done 2 months after first liver transplantation.Acute humoral rejection diagnosed pathologically.Conclusion We should alert the occurrence of acute humoral rejection in ABO-incompatible liver transplantation,and the patients with autoimmune liver disease due to the disorder of immune function after liver transplantation.Liver graft biopsy,and detection of the levels of panel reactive antibodies will help to diagnose the acute humoral rejection.The treatment should seize the opportunity and combine a variety of approaches.Liver re-transplantation is performed once the rejection can not be reversed