Objective To explore the effect of intrahepatic injection of liposome-mediated VEGF plasmid on ischemia-reper-fusion liver injury and its mechanism. Methods Rabbits were randomly divided into normal group, ischemia-reperfusion group and recombinant VEGF therapy group( liposome-mediated transfer of VEGF plasmid into liver via portal vein 20 min before ischemia of liver). The model of liver ischemia-reperfusion injury was established. Liver function and the activity of SOD.XO in blood were determined at the 0,2nd,6th,12th,and 24th h after operation. RT-PCR technique was applied to detect the expression level of Fas mRNA in liver tissues of every group,and flow cytometry was used to measure cell apoptosis rate at the 6th h after operation. At the 24th h after operation,all rabbits were killed and liver tissues of ischemia were taken to make pathological sections for observing the morphology and microstructure under the light microscopy and electron microscopy. ResuJts The level of ALT in recombinant VEGF therapy group was markedly reduced as compared with ischemia-reperfusion group at the 6th,12th,and 24th h after operation( P<0. 05). The activity of SOD in recombinant VEGF therapy group was significantly higher than in ischemia-reperfusion group at the 6th, 12th,and 24th h after operation. The activity of XO in recombinant VEGF therapy group was significantly lower than that in ischemia-reperfusion group at the 6th,12th,and 24th h after operation(P< 0. 05 or P<0. 01). In addition,there was significant difference in the expression of Fas mRNA and cell apoptosis rate between recombinant VEGF therapy group and ischemia-reperfusion group(P<0. 01). The injury of hepatocytes in recombinant VEGF therapy group was significantly alleviated as compared with that in ischemia-reperfusion group under the light microscopy and e-lectron microscopy. Conclusion Liposome-mediated transfer of VEGF plasmid into liver before ischemia of liver can obviously protect hepatocytes by increasing anti-oxidative ability, decreasing the expression of Fas mRNA, and finally inhibiting hepato-cyte apoptosis.

Objective To investigate the prognostic factors of differentiated thyroid carcinoma (DTC) in patients younger than 45 years. Methods Clinical data of all patients less than 45 years old at presentation with DTC in our hospital from Jan 1985 to Dec 1997 were analyzed retrospectively. Single variable analysis was performed by life-table method. Multivariate analysis was performed by Cox proportional hazard model. Results Two hundred and seventy two cases were analyzed. The overall 10-year survival rate was 93. 0%. The main prognostic factors influencing survival were age at presentation, the status of lymph node metastasis and distant metastasis; distant metastasis was the risk factor independently influencing survival by multivariate analysis. Conclusions Distant metastasis is the factor influencing survival significantly. The prognosis of these patients without distant metastasis is good. Total or near-total thyroidectomy and postoperative 131I therapy may be essential for a better prognosis in patients with distant metastasis.

Objective To investigate the association between Metabolic syndrome and colon cancer.Methods A literature search was performed through PubMed,Ovidsp,CNKI and Wangfang Data within the time limit of January 1 990 to May 2014.Ac-cording to the inclusion and exclusion criteria,the studies were screened and the data were extracted.Then Meta-analysis was per-formed using Stata Statistical Software version 12.0.Results A total of 8 studies(6 cohort studies and 2 case-control studies)met the inclusion criteria.Meta analysis showed that patients with Metabolic syndrome had a higher risk of colon cancer incidence com-pared with the control group without Metabolic syndrome(OR =1.43,95%CI :1.23 - 1.66,P <0.05 ).Stratified analysis showed Metabolic syndrome had a higher risk of colon cancer incidence in male(OR=1.50,95%CI :1.22-1.84,P <0.05),but in female, this association was not found(OR=1.39,95%CI :0.98- 1.96,P =0.07).In addition,Meta analysis showed that Metabolic syn-drome was not associated with an increased risk of colon cancer mortality(OR=1.22,95%CI :0.92-1.63,P =0.1 7).Conclusion This Meta analysis indicated a positive association between Metabolic syndrome and colon cancer incidence in male,but not in fe-male.Metabolic syndrome might not be associated with an increased risk of colon cancer mortality,yet it needs more prospective co-hort studies to confirm the conclusion.

Objective To investigate the safety and efficacy of a customized guide plate which is designed by digital medical technology and manufactured by 3D printing in clinical percutaneous needling at the hip joint.Methods Enrolled in this study were 9 patients with hip disorder who required hip joint needling during the period from April 2015 to August 2015.They were 7 males and 2 females,21 to 53 years of age (average,42 years).Laterality:5 left sides and 4 right sides.Conditions:4 cases of traumatic arthritis and 5 cases of osteoarthritis.All of them underwent lamellar CT scans whose data were imported into the software of Mimics 10.01 for 3D reconstruction.Then the software of 3-matic was used to design a customized guide plate on the reconstructed models.Finally,3D printing was used to manufacture the guide plate.The needle angle,direction and depth were adjusted in vitro and the operation was simulated before actual needling in clinic.After percutaneous hip joint needling was performed in the 9 patients separately,the accuracy of needling was checked using C-arm fluoroscopy.Results The percutaneous hip joint needling was performed successfully in the 9 patients in whom the customized guide plate was used.The results were consistent with what had been designed on the reconstructed models.The operation time in the 9 patients averaged 417.7 s (range,from 387 s to 590 s).Little intraoperative bleeding was observed at the site of needling,fluoroscopy was applied only once for check.No neurovascular injury or other operation-related complications occurred.Conclusion For patients who need repeated percutaneous needling at the hip joint,the customized guide plate designed by us can improve accuracy and ensure safety and efficacy of needling.

Objective: Acute pancreatitis(AP) often impairs peripancreatic tissues and involves more distant organs,such as the liver,which would exacerbate the progression of the disease.This study aimed to explore the clinical characteristics of acute pancreatitis-associated liver injury.Methods: We randomly retrieved 156 cases of AP from the medical records retrieval system of Jinling Hospital,of which 102 were complicated by liver injury.The latter were divided into a severe AP(n=44) and a mild AP group(n=58) for comparative analysis of the severity of liver injury and time of recovery.Results: Liver injury occurred in 65.38% of the AP patients,and it was more serious,had a longer disease course and took more time to recover in the severe than in the mild AP group.Conclusion: The incidence and severity of acute pancreatitis-associated liver injury are positively correlated with the severity of acute pancreatitis.

Objective To optimize the helicopter pilot helmet with mounted display in order to enhance wearing comfort.Methods The problems of the helmet were analyzed,and the trends of the helmet were discussed in foreign countries and China,and then optimization was carried out from the aspects of function,structure,design,material and etc.Results Optimization measures were proposed from the aspects of safety protection,ergonomics,platform display,night vision,tracking and positioning,material and industrial art to improve the designs of all functional modules of the helmet.Theoretical references were provided for the design of lightweight and tailored helmet.Conclusion Aviation ergonomics has to be considered to enhance wearing comfort and reliability when designing new-type helicopter pilot helmet with mounted display.

Natural products are important sources for the discovery of anti-tumor drugs. Evodiamine is the main alkaloid component of the traditional Chinese herb Wu-Chu-Yu, and it has weak antitumor activity. In recent years, a number of highly active antitumor candidates have been discovered with a significant progress. This article reviews the research progress of evodiamine-based antitumor drug design strategies, in order to provide reference for the development of new drugs with natural products as leads.

Three-way laryngeal mask airway (tLMA) was used in 31 patients aged 4-68 yr, weighing 10- 79 kg undergoing tracheal foreign body removal under general anesthesia. Anesthesia was induced with propofol 3 mg/kg, vecuronium 0.12 mg/kg and remifentanil 0.4 μg/kg. tLMA was inserted. The patients were mechanically ventilated. Anesthesia was maintained with iv infusion of propofol 2 mg . Kg-1 ? H-1, vecuronium 0.08 mg·kg-1·h-1 and remifentanil 0.15 μg·kg-1 ·min-1 . Radial artery was cannulated for BP monitoring and blood sampling. The operation time was 6-34 min and mechanical ventilation time 19-45 min. There was no significant change in SP, DP, HR, VT, Ppeak and Ppeak CO, during operation as compared with the baseline values before anesthesia. SpO2 was significantly increased at T2-6. PCO2, PO2 and O2sat were obviously improved after tLMA was used. All the patients emerged bom anesthesia within 30 min after operation. No aspiration, obvious gastrointestinal inflation, and pharyngeal and laryngeal edema and injury occurred. Mild agitation occurred in a short time during the recovery period in one patient. No complication occurred.

Objective To investigate the effect of aerobic exercise combined with routine rehabilitation therapy on cardiorespiratory exercise function and rehabilitation efficacy in stroke patients with hemiplegia.Methods Thirty consecutive stroke patients with the first-ever hemiplegia were enrolled prospectively.They were randomly assigned to an experimental group (n=13) or a control group (n=13) according to the random number table (n=15 in each group).Four patients withdrew,and finally 26 patients completed the study (n=13 in each group).The two groups of patients were given routine rehabilitation therapy.On the basis of routine rehabilitation therapy,the experimental group was also treated with aerobic exercise training,once a day,30 min each time for 4 weeks.The evaluations of cardiopulmonary exercise tests were performed on both groups before treatment and after 4 weeks of treatment (peak oxygen uptake [VO2peak]),anaerobic threshold [AT],peak minute ventilation [VEpeak]),and motor function (Fugl-Meyer assessment scale [FMA],activities of daily living (Barthel index [BI]) were performed.The differences between the two groups before and after treatment were compared.Results (1)Cardiopulmonary exercise test results:Compared with before treatment,VO2peak,AT,and VEpeak were increased significantly (16±4 ml/[kg·min] vs.13±3 ml/[kg·min],12.9±2.5 kg·min vs.10.0±2.7 ml/[kg·min],41±12 L/min vs.34±9 L/min,t=9.668,4.328,and 3.662,respectively,all P<0.01).There were no significant differences in VO2peak,AT,and VEpeak (14±4 ml/[kg·min] vs.14±4 ml/[kg·min],11.8±2.6 ml/[kg·min] vs.11.5±2.9 ml/[kg·min],29±8 L/min vs.28±6 L/min) in patients of the control group between before treatment and after treatment.There were no significant differences (t=0.863,0.583,and 0.314,respectively,all P>0.05).The differences in VO2peak,AT,and VEpeak in the patients of the control group before and after treatment were 0.4 (0.2,0.6),0.1 (-0.5,0.7 ml/kg·min) and 0 (-2.5,5.0 L/min),respectively.The differences of VO2peak,AT,and VEpeak in patients of the experimental group before and after treatment were 3.0 (2.2,3.9 ml/[kg·min],2.7 (1.8,5.3 ml/[kg·min],and 7.0 (1.0,13.0 L/min),respectively.There were significant differences in VO2peak,AT,and VEpeak before and after treatment between the two groups (Z=4.287,3.721,and 2.236,respectively,P<0.05).(2) FMA score and BI evaluation results:Compared with before treatment,the FMA score and Barthel index after treatment in patients of the experiment group were 70±24 vs.52±28 and 78±20 vs.60±28 respectively,t=4.076 and 4.239 respectively,P<0.01).Compared with before treatment,the FMA score and BI in the control group after treatment were improved significantly (68±25 vs.60±27 and 69±22 vs.59±26 respectively,t=3.168 and 5.436 respectively,all P<0.05).The FMA score and the difference of BI in the control group before and after treatment were 5.0 (2.0,12.0) and 10.0 (5.0,15.0) respectively,and those of the experimental group before and after treatment were 10.0 (4.5,32.0) and 11.0 (10.0,27.5) respectively,and there were no significant differences between the two groups (Z=1.393,1.352,all P>0.05).Conclusion On the basis of routine rehabilitation therapy,stroke patients with hemiplegia increasing aerobic exercise training may improve their cardiopulmonary exercise function.

To develop a more efficient antithrombotic way after coronary artery bypass grafting (CABG), the anticoagulant effects were compared of human tissue factor pathway inhibitor (TFPI) gene transfection and aspirin oral administration (traditional method) on vein grafts. An eukaryotic expression plasmid pCMV-(Kozak) TFPI was prepared. Animal model of carotid artery bypass grafting was constructed. In operation, endothelial cells of vein grafts in TFPI group and empty plasmid control group were transfected with pCMV-(Kozak) TFPI and empty plasmid pCMV respectively, while no transfection was conducted in aspirin control group. After operation, aspirin (2 mg.kg(-1).(-1)) was administered (i.g.) in aspirin control group. Three days later, grafts (n=10) were harvested for RT-PCR, Western blotting and immunohistochemical analyses of exogenous gene expression and for pathological, scanning electron microscopic observation of thrombus. Thirty days later, the patency rates of remnant grafts (n=10) were recorded by vessel Doppler ultrasonography. Human TFPI gene products were detected in gene transferred vein grafts. Three days later, thrombi were found in 7 animals of aspirin control group and in 8 animals of empty plasmid control group, but in only 1 of TFPI group (P<0.01). Thirty days later, 5 grafts were occluded in empty plasmid control group, but none of grafts was occluded in the other groups (P<0.05). The endothelial surfaces of grafts in both of the control groups were covered with aggregated erythrocytes and platelets, and it were not seen in TFPI group. It was suggested that the anticoagulant effects on vein grafts of human TFPI gene transfection are better than those of aspirin.
Administration, Oral ; Anticoagulants/*metabolism ; Aspirin/*administration & dosage ; Aspirin/metabolism ; Coronary Artery Bypass ; Disease Models, Animal ; Lipoproteins/*metabolism ; Plasmids/metabolism ; Tissue Transplantation/*methods ; Transfection ; Ultrasonography, Doppler/methods ; Veins/*transplantation ; Venous Thrombosis/metabolism