10.3969/j.issn.2095-4344.2013.25.015

BACKGROUND:At present, a heparin-coated extracorporeal circulation pipe is used widely, but the price is expensive and limits its wide application.
OBJECTIVE:To screen the optimal coating condition of oxidated sodium alginate as a coating material to coat the medical polyvinyl chloride pipe and to evaluate the anticoagulant properties and the stability of the coated pipe.
METHODS:Oxidized sodium alginate was prepared with sodium periodate, and the mole ratio of sodium periodate and sodium alginate was 1:8, 1:10 and 1:12, respectively. Oxidized sodium alginate with different
degree of oxidation was coated on the surface of medical polyvinyl chloride pipes by chemical methods, then to select the best degree of oxidation. The optimal coating condition was screened through an orthogonal
experiment based on concentrations of sulfuric acid, polyethyleneimine and oxidized sodium alginate, and pH
value and temperature of oxidized sodium alginate. Additional y, the anticoagulant properties and expulsion rates of the prepared pipes were evaluated in comparison with the blank control group and heparin-coated group.
RESULTS AND CONCLUSION:The optimal oxidation degree for oxidized sodium alginate was 1:10 for the mole ratio of sodium periodate and sodium alginate. The best coating conditions were 50%concentrated sulfuric acid, 0.05%polyethyleneimine, 40 ℃ of reaction temperature, 2 g/L oxidized sodium alginate, and pH value=3.5. The oxidized sodium alginate coating group had a similar trend compared with heparin-coated group in the expulsion rate. The anticoagulant properties of oxidized sodium alginate coating group were little weaker than those of
heparin-coated group (P<0.05), but significantly better than those of the blank control group. The oxidized sodium alginate-coated extracorporeal circulation pipe has a good anticoagulant property and stability.

Objective To prepare and evaluate the biocompatibility of polycarbonate coated with low molecular weight heparin (LMWH) and partial oxidation sodium alginate(OSA).Methods Coating material was prepared by means of chemical graft-modification and the feature of the material was determined with infrared spectrum and the stablity of the coating in fluid was examined.Biocompatibility was evaluated by contact angle and in-vitro tests including protein adhesion,platelet adhesion and caugulation.Results LMWH or OSA was tightly combined with polycarbonate.After being coated,the contact angle,albumin and fibrinogen adhering to materials were decrease (P＜0.05).The anticoagulant activity was notably promoted by coating.Compared with LMWH coated material,the contact angle,albumin and fibrinogen adhering were decreased significantly,but the improvement of anticaugulation was limited(P＜0.05).Conclusion Chemical graft-modification LMWH or OSA can be applied to polycarbonate.The biocompatibility of the coated materials was significantly promoted.

Objective: To study the surgical treatments of scapula fracture through the muscle space of rotator cuff approach and the Judet approach, and to evaluate and compare the clinical results. Methods: Between January 2014 and December 2015, 50 patients with scapula fractures were treated with open reduction and internal fixation of reconstruction plate. Twenty-four patients were treated through the muscle space of rotator cuff approach (group A), and 26 patients were treated through the Judet approach (group B). There was no significant difference in gender, age, cause of injury, type of fracture, and the interval between injury and operation ( P>0.05). The operation time, intraoperative blood loss, and incision length were recorded, and the shoulder functions after fracture healing confirmed by X-ray films were evaluated according to the Hardegger's scoring system. Results: The operation time, intraoperative blood loss, and incision length in group A were significantly lower than those in group B ( P < 0.05). The incisions of the two groups healed by first intention. All patients were followed up 6-13 months (mean, 11.6 months) in group A and 7-15 months (mean, 12.1 months) in group B. According to Hardegger standard, the effectiveness was rated as excellent in 19 cases, good in 4 cases, and fair in 1 case, with the excellent and good rate of 95.8% in group A, and as excellent in 15 cases, good in 4 cases, fair in 5 cases, and poor in 2 cases with the excellent and good rate of 73.1% in group B. The difference in effectiveness between 2 groups was significant (χ 2=4.81， P=0.03). X-ray films showed that the reduction and internal fixation were satisfied and the fractures healed in 2 groups. The fracture healing time were (29.86±8.38) weeks in group A and (30.05±7.99) weeks in group B, showing no significant difference between 2 groups ( t=0.16, P=0.87). Conclusion: Compared with the Judet approach, the muscle space of rotator cuff approach has advantages of clearly exposure, less muscular dissection, less intraoperative blood loss, less operation time, easier operation, and satisfied shoulder function can be obtained.

Objective:To evaluate the association between RUNX3 expression and Helicobacter pylori(H.pylori)-associated precancerous gastric lesions.Methods: A population-based study was conducted in Linqu County,Shandong Province,a high-risk area of gastric cancer in China.RUNX3 expression was determined by immunohistochemistry analysis in 1 026 H.pylori infected subjects with different gastric lesions.Results: Among 1 026 subjects,359(35.0%,359/1 026) was positive.The prevalence rates of RUNX3 expression decreased steadily with severity of gastric lesions,65.6%(40/61) among those with superficial gastritis /normal(SG/N),and 22.4%(60/268) among those with dysplasia(DYS)(P

Objective To compare the clinical efficacy of primary closure versus T-tube drainage after laparoscopic common bile duct exploration in acute cholangitis cases.Methods The clinical data of 100 patients with acute cholangitis undergoing laparoscopic common bile duct exploration from January 2012 to December 2014 were reviewed.54patients received primary closure of the common bile duct and 46 patients were subjected to T-tube drainage after choledochotomy.Results One hundred patients underwent the surgery successfully.Compared with the T-tube group,the operation time(96.72 min vs 123.00 min,P =0.001),intraoperative blood loss(27.13 ml vs 38.48 ml,P =0.009),postoperative gastrointestinal function recovery time(1.57 d vs 2.33 d,P=0.003) and postoperative hospital stay(6.19 d vs 9.20 d,P=0.000) were significantly less in the primary closure group.There were no statistical differences in the incidence of postoperative drainage (309.22 ml vs 212.46 ml,P =0.070),drainage time (3.96 d vs 4.02 d,P =0.875),incidence of bile leakage(9.3％ vs 0,P =0.060) and postoperative bleeding rate(5.1％ vs 2.2％,P =0.622) between these two groups.Conclusion Laparoscopic common bile duct exploration with primary closure of the common bile duct is an effective and safe procedure in acute cholangitis cases compared with T-tube drainage.

Acute myocardial infarction (AMI) and acute massive pulmonary embolism can be characterized by no pulse electrical activity. Patients of cardiac arrest (CA) with no pulse electrical activity have a high mortality rate before the cause was corrected. Extracorporeal membrane oxygenation (ECMO), as a kind of artificial heart-lung support organ, provides treatment for CA patients. A case of massive pulmonary embolism similar to AMI was treated in the Third Central Hospital of Tianjin, who received interventional thrombolysis assisted by ECMO. Through the review of the overall development of the case, we aim to broaden the diagnosis and treatment of CA patients with no pulse electrical activity, and to improve the understanding of the complications secondary to ECMO.

Objective: To analyze the relationship between body fat distribution and bone mineral content (BMC) in adolescents and gender differences among Chinese adolescents, and to provide a scientific basis for the prevention and treatment of bone metabolic diseases. Methods: A total of 1 575 adolescents aged 12-18 years old were selected from Yinchuan by cluster random sampling. Body composition and bone mineral content were measured by bioelectrical impedance analysis(BIA). Multiple linear regression analysis was used to explore the relationship between body fat distribution and BMC after adjusting for confounding factors. Results: Except for LTFR, the levels of FM, AFM, TFM, TrTFR and TrLFR in boys were lower than those in girls( t =-13.52， -15.18 ，-12.47，-12.25，-7.96， P <0.05); After adjusting for age, sex and weight, FM, AFM, TFM, TrTFR and TrLFR were all negatively correlated with BMC level( P <0.05). For each increase of 1 standard deviation in TFM, BMC level decreased by 0.53 standard deviation(95% CI=-0.57--0.49, P<0.01]. LTFR had a linear negative correlation with BMC level in boys( B=0.07, P <0.01), no similar correlation was found in girls( B=0.01, P =0.74). There was a linear negative correlation between TrLFR and BMC level in girls( B=-0.06, P =0.03), but the correlation was of no significance in boys( B=-0.01, P =0.55). Conclusion Sex difference in body fat distribution in Chinese adolescents is observed. Body fat distribution is closely related to bone minerals content in adolescents.

Liver fibrosis is a common pathological response in chronic liver injury. In the pathological process of hepatic injury, signaling pathways associated with hepatic fibrosis, which mediates the repair, proliferation and fibrosis of the liver secrete different cytokines. In these pathways, transforming growth factor beta (TGFβ) and signal transducer and activator of transcription 3 (STAT3) play key roles in the proliferation and activation of hepatic stellate cells (HSCs) and promote epithelial mesenchymal transition. In addition, it is also involved in the process of proliferation and transformation of collagen and extracellular matrix molecules into myofibroblasts. TGFβ and STAT3 molecular-related signaling pathways mediate the loss of epithelial phenotype and gene expression in mature epithelial cells, transforming them into mesenchymal cells, and producing anti-apoptosis to hepatocytes and promoting the proliferation of HSCs. However, the mechanisms by which STAT3 and TGFβ molecules are involved in the development and progression of liver fibrosis are not sound distinct. In this review, we attempt to know the mechanisms and interactions of TGFβ and STAT3 molecules that mediate potential liver fibrosis, and promote their role in promoting HSCs production and epithelial mesenchymal transition.