Objective To explore the microbial etiology of early onset pulmonary infection after liver transplantation.Methods The 40 episodes of early onset pulmonary infection in 75 patients receiving liver transplantation in our hospital were reviewed and analyzed retrospectively.Results The incidence rate of pulmonary infection was 53.30% in these patients.A total of 54 pathogens were isolated,including 41(75.9%)strains of bacteria and 13(24.1%)fungal isolates.Gram-negative bacillus ac- counted for 68.3%(n=28)of the bacterial isolates,11(39.3%)of which were positive for extended spectrum?-lactamase. Gram-positive coccus accounted for 31.7%(n=13).Seven (58.3%)of the staphylococcal strains were methicillin-resistant. Conclusions The incidence of pulmonary infection is high early af- ter liver transplantation.Most of the isolated pathogens are drug resistant.Culture of sputum or secretion of lower respiratory tract and bedside X-ray examination are useful for the diagnosis.

UNLABELLEDOBJECTIVE To observe the clinical efficacy by Qingying Huoxue Decoction (QHD) combined ursodeoxycholic acid (UDCA) in treating patients with early and mid-term primary biliary cirrhosis (PBC). METHODS Totally 78 patients were randomly assigned to the treatment group and the control group, 39 in each group. All patients received basic treatment and took UDCA (at the daily dose of 13-15 mg/kg). Patients in the treatment group took QHD, one dose per day. The treatment course for all was 6 weeks. Clinical efficacy, gamma-glutamyl transferase (γ-GGT), alkaline phospatase (ALP), TBIL, alanine aminotransferase (ALT), and aspartate transaminase (AST) were observed before and after treatment. RESULTS Totally 21 (53. 8%) patients obtained complete response in the treatment group, with statistical difference when compared with that of the control group (11 cases, 30. 8%). Levels of GGT, ALP, ALT, AST, and TBIL decreased in the two groups after treatment (P < 0.01). Levels of ALP, GGT, and TBIL were obviously lower in the treatment group than in the control group (P < 0.05).

CONCLUSIONSQHD combined UDCA in treating early and mid-term PBC patients was superior to the effect of using UDCA alone. It also could improve patients' liver function.

Alanine Transaminase ; metabolism ; Aspartate Aminotransferases ; metabolism ; Drug Combinations ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Liver Cirrhosis, Biliary ; drug therapy ; Ursodeoxycholic Acid ; therapeutic use ; gamma-Glutamyltransferase ; metabolism

OBJECTIVETo establish and evaluate a rabbit model of fecal incontinence.

METHODSTwelve normal adult male New Zealand rabbits were randomly divided into experimental group and control group. The nerve innervating the external anal sphincter, namely the fourth sacral nerve, was functionally located and selectively damaged with local injection of 50 g/L ropivacaine in the experimental group, and normal saline injection was administered in the control group. The changes in the resting anal pressure was examined before and after the surgery, and the electromyogram (EMG) of the external anal sphincter was recorded for comparison with the pathological changes of the fourth sacral nerve.

RESULTSCompared with the control group, the experimental group exhibited significantly decreased resting anal pressure after the surgery. The EMG of the experimental group showed abnormal nerve conduction velocity of the fourth sacral nerve, suggesting successful nerve block. Transmission electron microscope revealed irreversible pathological changes in the ultrastructure of the axons of the fourth sacral nerve.

CONCLUSIONThis method allows successful establishment of fecal incontinence in rabbits, which facilitates further in vivo study of artificial sphincters for treatment of anal incontinence.

Amides ; administration & dosage ; Anal Canal ; physiopathology ; Animals ; Disease Models, Animal ; Electromyography ; Fecal Incontinence ; Lumbosacral Plexus ; Male ; Nerve Block ; Rabbits ; Random Allocation

BACKGROUNDBoth p16(INK4) and p21(Waf1) are tumor suppressors with similar biological functions in the regulation of cellular senescence. Previous reports showed that p16(INK4) could be activated by p21(Waf1) through transcriptional factor Sp1 in HeLa cells. This study was undertaken to determine the effects of p16(INK4) on the expression and functions of p21(Waf1).

METHODSHuman diploid fibroblast 2BS cells were stably transfected with sense (2BS/p16(INK4)), antisense p16(INK4) (2BS/asp16(INK4)) or empty vector (2BS/neo). Then they were assayed by reverse-transcription polymerase chain reaction (RT-PCR), fluorescence activated cell sorting (FACS) and Western blot.

RESULTS2BS/p16(INK4) cells exhibited cell cycle arrest in both G1 and G2/M phases. Endogenous p21(Waf1) protein levels increased twofold in the 2BS/p16(INK4) cells, but not decreased in the 2BS/asp16(INK4) cells. p21(Waf1) mRNA levels were not affected in neither 2BS/p16(INK4) nor 2BS/asp16(INK4) cells.

CONCLUSIONp16(INK4) may play an important role in the regulation of cellular senescence by modulating the p21(Waf1) protein level via the posttranscriptional mechanism.

Cell Cycle ; Cells, Cultured ; Cellular Senescence ; Cyclin-Dependent Kinase Inhibitor p16 ; physiology ; Cyclin-Dependent Kinase Inhibitor p21 ; physiology ; Fibroblasts ; metabolism ; Humans ; Transcription, Genetic

Objective To investigate the three-dimensional structure of normal male canine prostat- ic duct and acinus system,and to study the mechanism of intraprostatic urinary reflux(IPUR)resulting from high pressure of the posterior urethra by experiment.Methods Using scanning electron microscopy (SEM)and corrosion casting methods,high pressure of the prostatic urethra was produced based upon IPUR in normal male canines.Acrylonitrile-butadiene-styrene(ABS)casting solution was injected into 8 Beagle canines'normal prostates to induce intraprostatie resin solution reflux.Results Six casting molds of nor- real canine prostate specimens were obtained,and the casting failed in 2.By corrosion and casting treatment, the prostate appeared to consist of several glandular lobes.The columnar apophyses of glandular surface were observed.The most glandular ducts pointed outward from urethral peristome.Each glandular duct system was made up of many bifurcated branches from the bough as a duct tree.More than 90% of the bifurcations were Y-shaped,and 6 bifurcated branches were rarely seen.The tip of the duct was vesicular.The diameter and length of the bough were(0.37?0.14)mm and(1.14?0.04)mm,respectively.The intersectional angle of urethra and peripheral glandular duct was the biggest.Peripheral glandular duct was perpendicular or con- verse to urinary flow.Peripheral glandular aeinus appeared elliptic and velvet.The mesh-like and crater-like depressions were shown on the surface of central glandular aeinus.Ejaculatory ducts independently and branchlessly entered the urethra.Conclusions The resin corrosion casting methods combined with SEM can clearly show the three-dimensional structure of normal male canine prostatic duct and acinus system. IPUR may easily occur in the peripheral glands from the morphological view.It is suggested that prostatitis occurs more commonly in peripheral glands,confirming a fact that high pressure of the posterior urethra can induce IPUR.

Objective:To summarize and analyze the status of health cooperation achievement strategies between China and the countries along the "Belt and Road",determine the implications thereof, and provide reference for future practical cooperation between the China and those countries in the field of health. Methods : The relevant literature was retrieved from the research database from articles published in both Chinese and English during the period from 2013 to 2017, and the literature research method was used to summarize the status quo of health cooperation. Results : According to the exclusion criteria, 116 articles were selected. The analysis showed that the main research focus falls in the following seven aspects for both domestic and foreign scholars : The dissemination of Chinese medicine culture promotes international cooperation in Chinese medicine; the prevention and control of infectious diseases needs to further strengthen the construction of international mechanisms; the health services and systems requiremutual learning from international experience; health industry has broad prospects for development; health emergency cooperation encounters the problem of inadequate coordination mechanisms and language barriers; the research on health development assistance goes deep; and health professionals training focuses on training mode. Conclusions: The existing research topics were of great coverage in range and had the highest attention to Chinese medicine,yet least considered talent cultivation. The research showed that cooperation in various health departments emphasized on international experience and the joint participation of the government and civil society. However, the research on laws and regulations, international conventions and practices, and different families' cooperation requirements related with health cooperation mechanisms need to be further strengthened.

OBJECTIVETo investigate the rules of proliferation of epithelial cells of sweat glands in deep partial-thickness burn wound and its transdifferentiation towards epidermal cells during healing process to explore its mechanisms.

METHODSTwenty-eight patients with limbs and trunk burn hospitalized in the Fourth People's Hospital of Taizhou City of Jiangsu Province and the Second Hospital of Shandong University from January 2004 to December 2007 were enrolled in the study. Tissue samples of deep partial-thickness burn wound (DPBW, n = 37), superficial partial-thickness burn wound (SPBW, n = 21), and normal skin (NS, n = 10) were harvested. Expressions of cytokeratin 10 (CK10), bcl-2, P63, CK14 and CK19 of epithelial cells in glandular secretory portion (GSP) in DPBW, SPBW and NS were detected with immunohistochemical double staining method.

RESULTSIn NS, CK19, CK14 and CK10 expressed in medium intensity in GSP epithelial cells, P63 and CK14 weakly expressed in basal myoepithelial cells, while no expression of bcl-2 or P63 was observed in all CK10 positive terminally differentiated cells. In SPBW, no change of the construction of GSP and above-mentioned proteins during healing process was observed. In DPBW, as examined on 7(th) post burn day (PBD), expression of P63 and bcl-2 in GSP epithelial cells was enhanced. In DPBW on 8 - 10 PBD, bcl-2, P63, CK19 and CK14 strongly positive solid island-like epithelial structure was formed by proliferation, migration and squamous epithelization of basal cells. Such structure, along with granulation tissue, migrated towards the superficial layer of wounds. The hyperplasia of squamous epithelium resulted in complete reepithelialization. In DPBW, bcl-2, CK14, CK19 and P63 still strongly expressed in hyper-proliferative epidermal basal and suprabasal layers on 13 - 30 day after healing.

CONCLUSIONSDuring the natural healing process of DPBW, monolayer epithelium (CK19 and CK10 positive) of GSP slowly develops into stratified squamous epithelium (bcl-2, P63, CK19, and CK14 positive), suggesting that the epithelial-epidermal transdifferentiation of GSP undergoes slow retrodifferentiation process of stem cells and transient amplifying cells, resulting in the imbalance between lagged growth of epithelium and the hyperplasia of granulation tissue, constituting one of the important mechanisms of disturbance in DPBW repair.

Adolescent ; Adult ; Burns ; metabolism ; pathology ; Cell Differentiation ; Epithelial Cells ; metabolism ; Female ; Humans ; Keratin-10 ; metabolism ; Keratin-14 ; metabolism ; Keratin-19 ; metabolism ; Male ; Membrane Proteins ; metabolism ; Stem Cells ; metabolism ; Sweat Glands ; cytology ; metabolism ; Wound Healing ; Young Adult ; bcl-2-Associated X Protein ; metabolism

OBJECTIVETo establish the rat model of acute spinal cord injury, followed by aprimary study on this model with ¹H NMR based on metabonomics and to explore the metabonomics and biomarkers of spinal cord injury rat.

METHODSTwenty eight-week-old adult male SD rats of clean grade, with body weight of (200±10) g, were divided into sham operation group and model group in accordance with the law of random numbers, and every group had 10 rats. The rats of sham operation group were operated without damaging the spinal cord, and rats of model group were made an animal model of spinal cord incomplete injury according to the modified Allen's method. According to BBB score to observate the motor function of rats on the 1th, 5th, and 7th days after surgery. Postoperative spinal cord tissue was collected in order to pathologic observation at the 7th day, and the metabolic profilings of serum and spinal cord from spinal cord injury rats were studied by ¹H NMR spectroscopy.

RESULTSThe hindlimb motion of rats did not obviously change in sham operation group, there was no significant difference at each time point;and rats of model group occurred flaccid paralysis of both lower extremities, there was a significant difference at each time; there was significant differences between two groups at each time. Pathological results showed the spinal cord structure was normal with uniform innervation in shame group, while in model group, the spinal cord structure was mussy, and the neurons were decreased, with inflammatory cells and necrotic tissue. Analysis of metabonomics showed that concentration of very low density fat protein (VLDL), low density fat protein (LDL), glutamine, citric acid, dimethylglycine (DMG) in the serum and glutathione, 3-OH-butyrate, N-Acetyl-L-aspartic acid (NAA), glycerophosphocholine (GPC), glutamic acid, and ascorbate in spinal cord had significant changes(<0.05).

CONCLUSIONSThere are significant differences in metabolic profile from serum and spinal cord sample between model group and sham operation group, it conduces to explain the changes of small molecular substances in serum and spinal cord tissue after spinal cord injury, this provides the research basis for targeted research on the role of metabolic markers in patients with acute spinal cord injury.

OBJECTIVETo observe the cell apoptosis after tractive spinal cord injury in rats, determine expression of apoptosis correlative genes, and study the molecular mechanism of cell apoptosis.

METHODSThe T(13)-L(2) spinal cord of rats was injured by traction after the amplitude of P1-N1 wave decreased to 70% in postoperation than in preoperation through cortical somatosensory evoked potential (CSEP) monitor. Then rats were killed in 30 min, 6 h, 1, 4, 7, 14 and 21 d respectively after operation (n = 4). Cell apoptosis was examined by the flow cytometer and terminal deoxynucleotidyl transferase-mediated DUTP-biotin nick end labeling (TUNEL) reaction, the expression of p53, bax and bc1-2 genes was tested with immunohistochemistry.

RESULTSThe flow cytometer test and TUNEL method showed that the apoptosis cell ratio raised in 6 h and reached at peak in 7 d after injury, and then declined till 21 d, they showed significant difference (P < 0.05, 0.01). TUNEL method showed that injured group had a large number of apoptosis glial cells in white matter. Immunohistochemical staining showed that the positive expression of p53, bax and bc1-2 protein raised at 6 h, expression of p53 protein reached at peak in 4 d, bax and bc1-2 protein reached at peak in 7 d after injury. Compared with control group and laminectomy group, the injured group showed significant difference (P < 0.05, 0.01).

CONCLUSIONThere is cell apoptosis phenomenon after tractive spinal cord injury in rats. Morphology indicates that apoptosis includes neurons and glialcytes, which is an important form of cell death and pathological changes in secondary lesion period after tractive spinal cord. There exist high expression of apoptosis correlative gene p53 and bax after spinal cord injury, they may play an important role in reduction of cells to apoptosis.

Animals ; Apoptosis ; genetics ; Disease Models, Animal ; Female ; Gene Expression ; Genes, bcl-2 ; genetics ; Genes, p53 ; genetics ; Male ; Proto-Oncogene Proteins c-bcl-2 ; genetics ; Rats ; Rats, Sprague-Dawley ; Spinal Cord Injuries ; genetics ; pathology ; bcl-2-Associated X Protein

Objective: To investigate whether insulin stimulates the translocation of glucose transporter-4 (GLUT4) and glucose uptak e in ischemic myocardium. Methods: Plasma concentration of gluc ose, lactate, free fatty acid and insulin were determined by autoanalyser, and G LUT4 was studied by Western blotting analysis. Results: Insulin increased GLUT4 significantly in sarcolemma of ischemic myocardium ［(25±4)% vs (40±6)%］, and GLUT4 content in intracellular membrane decreased proporti onally. The glucose uptake increased significantly in insulin-ischemic myocardi um. The uptake of insulin-ischemic myocardium was almost 2 times that of ischem ic myocardium. Conclusion: Insulin stimulation results in GLUT4 translocation and increases glucose uptake in ischemic myocardium. When myocardi al ischemia occurs, insulin is helpful in increasing myocardial glucose uptake a nd utilization.