Objective To investigate the effects of HO-1 on renal allografts after HO-1 gene transfection in rat chronic allograft nephropathy model. Methods Twenty F344 and twenty-six Lewis rats were included in this experiment. They were divided into 3 groups at random. Six Lewis rats were in pseudo-operation group, 10 Lewis were in empty carrier group (transfected with adenovirus) and 10 Lewis were in the gene transfection group (transfected with Ad-HO-1 adenovirus). The expression of HO-1 protein was detected by WB at the 1st ,2nd,3rd and 4th week. The content of creatinine in blood was assayed at the 4th,8th, 12th and the 16th week. The weight of rat, the value of patholiogical changes and the expression of ?-SMA,TGF-?1 and PDGF-B were analysized at the 16th week. Results The weight of rats in 3 groups had not any changes at 16th week. The content of creatinine in blood of gene transfection group were lower than those in the empty carrier group. The expression of HO-1 protein were very high in the 1st and 2nd week and decreased at 3rd and 4th week. The Banff value of kidney in the gene transfer group was better than that of the empty carrier group at the 16th week. The level of ?-SMA, TGF-?1 and PDGF-B in the gene transfection group were significantly lower than those in the empty carrier group. Conclusions Ad-HO-1 could efficiently transfer HO-1 gene into rat donor kidney. The prevention of chronic allograft nephropathy may have relationship with the decreasing expression of ?-SMA, TGF-?and PDGF-B.

Objective To observe the cytotoxicity of Ad-HO-1 and its capacity of mediating the expression of HO-1 in cultured HK-2 cells. Methods The HK-2 cells were infected by Ad-HO-1 with 100, 200 and 400 MOI for 3 h, followed by the green fluorescence observation 2 days later. The live cells ratio was detected 2 and 4 days later. The expression of HO-1 and GFP in HK-2 were detected under laser scan confocal microscope. The expression of HO-1 was detectee by Western blot analysis. 3H-TdR was used to assay the ability of HO-2 cells infected with Ad-HO-1 to inhibit the PBMC proliferation. Results Over 90% HK-2 cells expressed green fluorescence after infected by Ad-HO-1 (MOI 200) for 2 days. The live cell ratio at 2 and 4 days had not any difference from those of the control group. The expressions of HO-1 and GFP in the Ad-HO-1 transfected HK-2 cells were determined under laser scan confocal microscope. The locations of these two proteins were the same. HK-2 cells infected by Ad-HO-1 had protein immune blot strap combined with HO-1 antibody. When the MOI of Adv-HO-1 was 0.01, 0.1, 1 and 10, the proliferative capacity of PBMC was inhibited significantly. Conclusion The stable expression of HO-1 mediated by Ad-HO-1 in cultured tubular epithelial cells can inhibit the cell proliferation of PBMC.

AIM: To observe the effect of continuous epidural analgesia (CEA) of tramadol on postoperative gastrointestinal function and serum motilin level in the patients with cholecystectomy. METHODS: Twenty eight ASAⅠ-Ⅱpatients (8 male, 20 female) aged 24-56 yr, scheduled for elective cholecystectomy under epidural anesthesia, were randomly divided into tramadol group (T, n=14) and control group (C, n=14). The combination of tramadol 800 mg+ bupivacaine 150 mg+ droperidol 5 mg, which diluted with normal saline to 100 ml and pumped 2 ml?h -1, was administered in group T. The combination in group C was bupivacaine 150 mg+ droperidol 5 mg. The VAS values, the first anorectum exhaust timing (FAET), and the time of the first eliminating stool timing (FEST) were recorded, and serum motilin level measured with radioimmunoassay at the different times after surgery. RESULTS: There was a significant difference in the mean VAS values between group T ( 1.2? 1.2) and group C ( 3.3? 1.3) (P

A management window model for patients with atrial fibrillation (AF) was established in Tilanqiao Community Health Service Center cooperated with tertiary hospitals.Patients were screened and treated in the community health service center,and a comprehensive management plan was conducted and patients were followed-up.A total of 105 patients with atrial fibrillation (97.2％) were effectively managed with an average follow-up of 10.6 months.The CHADS2 score ≥ 2 in 78 cases,including 11 cases with administration of warfarin (14.1％) and 26 cases with paroxysmal AF without transition to persistent atrial fibrillation.Compared to the data before management,the rate of taking aspirin and warfarin in managed patients was increased (all P ＜ 0.05),the international normalized ratio (INR) of patients receiving warfarin was improved (P ＜ 0.05) ; the ratio of receiving comprehensive treatment program,standardized treatment and health education were significantly increased (P ＜ 0.05) ; the awareness of the disease,treatment compliance and satisfaction of patients were improved significantly (all P ＜ 0.05).The results suggest that the management widow model is feasible and effective for management of patients with atrial fibrillation in community health service centers.

Objective To study the ralationship of arrhythmias and heart electrical parameters changes after transcatheter closure of ventricular septal defect (VSD) .Method 50 patients had been successfully finnished the transcatheter closure of ventricular septal defect,and then we observed ralationship of arrhythmias and heart electrical parameters changes. Results (1) Compared with the situation of VSD occluder preoperative and postoperative, during follow-up there were 20 arrhythmia cases, including bundle branch block 16 cases, including the complete left bundle branch block 2 cases,complete right bundle branch block 4 cases,a transient third-degree trioventricular conduction block 1 case, most return to normal in the follow-up. 2 Intracavitary electrogram showed before and after transcatheter closure:A-V conduction parameters A-H,H-V value of (75.10 ± 14.34) ms vs (80.67±23.03) ms and (47.9±12.61) ms vs (50.07±15.23) ms,the difference was not statistically significant ( >0.05) . Conclusions (1) Some patients with new ECG changes after transcatheter closure of VSD, manifested as an increase in bundle branch block in a week, but most return to normal,the prognosis is good. (2) Intraoperative A-H,H-V extension is not related with with postoperative slow arrhythmia;(3) Arrhythmia is a common complication after VSD transcatheler closure, to strictly selecte indications,and to avoid too large diameter are the effective measures to reduce the arrhythmias after transcatheter closure of ventricular septal defect (VSD) .

Objective To observe the clinical efficacy of bosentan in treatment of severe pulmonary hypertension related to congenital heart disease (CHD-PAH) .Methods 5 patients with severe CHD-PAH patients received bosentan therapy, then pulmonary artery pressure, pulmonary vascular resistance (PVR), 6min walk test,right ventricular end-systolic diameter (RVSD) changes were observed and statistically analyzed after six months medication. Results Pulmonary arterial systolic pressure (sPAP) was significanfly decreased from (96±11) mmHg to (86±10) mmHg, <0.01.pulmonary arterial diastolic pressure (dPAP) was significanfly decreased from (56±10) mmHg to (46±9) mmHg ( <0.01),pulmonary arterial mean pressure (mPAP) was significanfly decreased from (73 ±11) mmHg to (59 ±10) mmHg ( <0.05), pulmonary vascular resistance was significanfly decreased from (17.8±1.9) Wood to (13.1±1.7) Wood (<0.01) . 6min walk test was improved from (136±40) m to (198±55) m, <0.01.right ventricular end-systolic diameter significanfly decreased from (40±5) mm to (36±6) mm after 6 months therapy ( <0.05) . Conclusion Bosentan can decrease pulmonary arterial systolic pressure, improve exercise tolerance, improve right ventricular function in patients with severe CHD-PAH.

Objective To evaluate the efficacy of unilateral open door laminoplasty and individualized cervical pedicle screw fixation for multisegmental cervical spondylotic myelopathy with flexibility type kyphosis.Methods Twenty one cases of multisegmental cervical spondylotic myelopathy with flexibility type kyphosis received surgical treatment.Unilateral open door laminoplasty and individualized cervical pedicle screw fixation.The Japanese Orthopaedic Association ( JOA) scoring system and disability index ( NDI) were applied to evaluate the neurological function and axial neck /shoulder pain before and after surgery.The Borden′method was employed to measure the cervical curvature.CT plain scan of cervical pedicle and sagittal two-dimensional imaging of transpedicular on the axial was examined.The unilateral open door laminoplasty and individualized cervical pedicle screw fixation was performed .Results A total of 168 pedicle screws were fixed successfully in 21 patients, the accuracy of screw placement reached 93.5%.The cervical curvature measured by Borden′method showed significant differences before and after operation.Compare to those before surgery , the JOA scores at 1 week after operation and at final follow-up were decreased and NDI scores were significant increased ( P <0.05 ).Conclusion Unilateral open door laminoplasty and individualized cervical pedicle screw fixation is effective for treatment of multisegmental cervical spondylotic myelopathy with flexibility type kyphosis.

BACKGROUND:Animal model of infection is established using bioluminescent gene-labeled bacteria, which stimulate local environment of spine infection and reveal the pathophysiological mechanism of spine infection.
OBJECTIVE:To evaluate the feasibility and safety of anterior one-stage debridement, autogenous iliac bone grafting and titanium plate internal fixation in the management of pyogenic spinal infections in spine.
METHODS:Total y 24 Chinese dogs were adopted in the study to develop a canine model of acute pyogenic spondylodiscitis using a bioluminescent strain of Staphylococcus aureus Xen29. The animal models were detected by X-radiography, CT and MRI examinations. After 4 weeks of modeling, al the animals underwent one-stage debridement, autogenous iliac bone grafting and anterior titanium plate internal fixation. Antibiotics contained Cefazolin and Gentamicin were administrated daily since perioperative period to 4 weeks after surgery. The titanium plate and adjacent vertebra were removed surgical y at various postoperative time points (4, 8, 12, 24 weeks) when the dogs were kil ed. The excised tissues and retrieved implants were cultured with conventional bacteria, bacteria 16S rRNA and specific Nuc gene of Staphylococcus aureus. PCR and bioluminescence imaging technique were used to detect the presence of bacteria.
RESULTS AND CONCLUSION:The surgical wound was healed uneventful y. Gross observation and MRI examination of the specimens showed that there was no abscess formation or signs of infection recurrence. The infection rate was 41.7%(10/24) and 75%(18/24) in the procedure of conventional bacteria and bacteria 16S rRNA cultivation. The results showed that the sensibility of PCR technique used to detect the presence of bacteria by amplifying the highly conservative gene sequence of 16S rRNA was significantly higher than that of conventional bacterial cultivation procedure (P<0.05). The PCR detection of specific Nuc gene of Staphylococcus aureus showed the existence of Staphylococcus aureus (1/24). However, Staphylococcus aureus Xen29 with genetic marker was not detected around the implant by bioluminescence imaging technique (0/24). Al of the results showed that bacterium adhering to prosthesis in vivo is an universal phenomenon. The bacteria identified from prosthesis which was taken during the surgery and the bacteria by which the spine was infected before the surgery was not homologous. The one-stage debridement, autogenous bone grafting and anterior titanium plate internal fixation is safe and effective in the management of pyogenic spinal infections. Using of internal fixator can not lead to recurrence or persistence of infection.

Objective To analyze the variations of surface(S) region,basic core promoter (BCP) and precore (preC) regions in genomes of hepatitis B virus (HBV) from patients with coexistence of hepatitis B surface antigen (HBsAg) and hepatitis B surface antibody (anti-HBs).Methods S region,BCP and preC regions in genomes of HBV were amplified and sequenced in 62 HBV-infected patients including 27 HBsAg-positive/anti-HBs-positive patients (double positive group) and 35 HBsAg-positive/ anti-HBs-negative patients (single positive group).The sequencing results and amino acid variants in these regions were analyzed.Difference of means between groups was compared by t test.Sample rate and variation rate were compared by chi-square test.Results One hundred and fifty-six amino acids mutations within the S region were detected in 27 patients of double positive group and 100 mutations in 35 patients of single positive group.The mutation rate in double positive group was significantly higher than those in single positive (2.56％ vs 1.26％,x2 =32.07,P＜0.05).The amino acid variants in double positive group were much higher than those in single positive group within major hydrophilic region (MHR),especially in the first loop area of a-determinant in S region (4.76 ％ vs 1.02 ％,x2 =11.58,P＜0.05).The mutation rate of A1762T/G1764A in BCP in double positive group was significantly higher than those in single positive group (59.3％ vs 28.6％,x2 =5.895,P＜0.05).The mutation rate of A1846T in preC region was higher in double positive group than those in single positive group (40.7％ vs 17.1％,x2-4.265,P＜0.05).The mutation rate of A1762T/G1764A+G1896A in double positive group was also higher than that in single positive group (37.0％ vs 14.3％,x2 =4.302,P＜0.05).Conclusions The mutation rates of S region,especially in the first loop area within a-determinant,BCP and preC regions which are related with hepatocellular carcinoma development in HBsAg and anti-HBs double positive group are higher than those in HBsAg single positive group in chronic HBV infected patients.