Objective To investigate the effect of ulinastin on the gastro-intestinal circulation and systemic inflammatory response during open heart surgery with cardiopulmonary bypass( CPB) .Methods Thirty adult patients undergoing valve replacement with mild hypothermic CPB were randomly divided into two groups: ulinastin group (U ,n = 15) and control group (C , n = 15). In ulinastin group patients received ulinastin 6000 IU?kg-1iv after induction of anesthesia and another 6000 IU?kg-1 was added into the priming solution. In control group patients received equal volume of normal saline, instead of ulinastin. The patients were premedicated with morphine 0.2 mg?kg-1 and scopolamine 0.06 mg?kg-1 .Ranitidine 1 mg?kg-1 was given iv before induction of anesthesia. Anesthesia was induced with midazolam 0.1 mg?kg-1 , fentanyl 10?g?kg-1 and vecuronium 0.1 mg?kg-1 and maintained with fentanyl 50-60?g?kg-1, midazolam, isoflurane and vecuroinum. The patients were intubated and mechanically ventilated. PET CO2 was maintained at 35-45 mm Hg during operation. Gastric intramucosal PCO2 (PiCO2 ) was measured (pHi was calculated) and blood concentrations of TNF-?and IL-6 were determined before CPB (T0), 30 min after aorta was cross-clamped (T1), 60 min after termination of CPB(T2 ) and 6 h after operation (T3 ) .Results The two groups were comparable with regard to age, sex, body weight, ejection fraction, duration of CPB and cross-clamping time. (1) pHi decreased significantly at T1-2 as compared with the baseline value at T0 (P

Objective To provide data evidence for early diagnosis of bone and joint damage derived from brucellosis by analyzing its clinical and imaging characteristics.Methods Patients with brucellosis accepted in Ji'nan Infectious Disease Hospital form December 2013 to December 2014 were selected.Patients with bone and joint damage confirmed through imaging were further studied,their epidemiological and clinical characters,CT and MRI characteristics,treatment and outcome were summarized.Results Total of 97.8％ (45/46) patients had a clear contact history,most of them worked in poultry farming,taking up to 67.4％ (31/46).July to October was its peak time for attacking,taking up to 58.7％ (27/46).The clinical manifestations of patients were joint pain,swelling and activities obstacles.In the CT images,there was obvious bony destruction,characterized by multiple round or large areas of low density insect damage sample spots.There was osteosclerotic bone lesions or osteophyte formatted in edge.The paravertebral soft tissue was swelling,and the vertebral body deformation was not obvious,and there was vertebra small joint damage occasionally.In the MRI images,there was vertebral ligaments damage,or soft tissue damage,or osteoproliferation at the edge of the vertebral bodies.There was abnormal signal T1W1 or T2W1 signal,and FS-T1W1 showed high signal,while FS-T2W1 showed slightly high signal.The diagnosis rate of CT,MRI and CT combined MRI for bone and joint damage derived from brucellosis was 76.1％ (35/46),84.8％ (39/46) and 91.3％ (42/46),respectively.The main therapeutic drugs were doxycycline and rifampicin,and the clinical effective rate was 91.3％ (42/46).Conclusion The epidemiological characters,CT and MRI characteristics of bone and joint damage derived from brucellosis have certain representativeness,and the comprehensive investigation is beneficial for clinical diagnosis.

ObjectiveTo investigate effects of combined regimen of low dose gossypol with steroid hormones on apoptosis of spermatocyte and phagocytosis of sertoli cells. Methods Adult male rats were divided into four groups randomly, group GH: rats were fed orally with gossypol(GA) [ 12.5mg / (kg·d) ] and desogestrel(DSG)[125μg/(kg·d) ]/ethinyloestradil(E)[25μg/ (kg·d) ]/testosterone undecanoate(TU)[100mg/(kg·d) ]; group G: a single does of GA[12.5mg/(kg·d ) ] was given; group H: DSG[125μg/(kg·d) ]/E[25μg/(kg·d) ]/TU[100mg/(kg·d) ] were administered; group C: rats only received vehicle(1% methyl cellulose). Testes from all the rats were removed at 4, 6 and 8 weeks after treatment for counting of spermatocyte and round spermatid using stereological assay, and for detecting apoptosis of spermatocyte and phagocytosis of sertoli cell by TUNEL and oil red O staining respectively. Results In GH group, the number of spermatocyte and round spermatid were reduced, while apoptosis of spermatocyte and staining of oil red O in seminiferous epithelium increased significantly. All changes were caused by steroid hormones in the combined regimen. Conclusion Induction of apoptosis of spermatocyte and then being phagocytosed by Sertoli cell is one of antifertility mechanisms of the combined regimen.

Objective To analyze the features of onset, clinical pathological characteristics about the primary bladder mucinous adenocarcinoma.Methods From January 1990 to June 2015, we retrospectively reviewed the data from 15 patients diagnosed as primary bladder mucinous adenocarcinoma, including 10 male patients and 5 female patients.Their mean age was 58 years old, ranged from 41 to 78 years old.Among the fifteen patients, the initial symptoms included hematuria in 13 cases, lower abdominal pain in 1 case and urinary irritation symptom in 1 case.The ultrasound and CT scan revealed bladder tumors, which the size ranged from 2 to 6 cm.The location of bladder tumors included front wall in 12 cases, trigone zone in 2 cases and top wall in 1 case.Nine cases was suspected as tumor from urachal remnants.Eleven patients underwent partial cystectomy, three patients accepted the radical cystectomy and one case accepted transurethral resection of bladder tumor (TURBT).Result Pathological diagnosis was bladder mucinous adenocarcinoma in all patients, including nine from urachal remnant and the others from urothelimn.The tumor exhibited the mushroom liked prominence, which was associated with surface ulceration and infiltrated into the depth of bladder.Meanwhile, it was covered with thick mucinous substances.The histologic examination revealed the presence of andenoid structure, composed by various degree of diferenfiated mucinous cells.In cases with adenocarcinomas from urachus, the residue of urachal tissue could be noticed.The bladder mucous was intact or ulcerated.No sign of metaplasia was observed.In the pathological diagnosis, the classification included grade Ⅲ in 3 cases, grade Ⅱ in 7 cases and grade Ⅰ in 5 cases.Ten persons reported the information of the follow up.Eight of them, whose tumor originated from urachus, accepted bladder-sparing surgery.One died from acute myocardial infarction after 23 months postoperatively.And one died from cerebral hemorrhage 45 months postoperatively.The others have been followed up from 8 to 65 months with no sign of recurrence.In two cases with urothelial carcinoma, one was found the new urothelial carcinoma 50 months after TURBT and one died from cancer metastasis 29 months after partial cystectomy.Conclusions Primary mucinous adenocarcinoma of the bladder possess the relatively high malignant tendency.The hematuria is the main initial symptoms.The histologic examination revealed the presence of different differentiated mucinous cells and formed the andenoid structure.The case with urachal remnant adenocarcinoma has the better prognosis than other types.

Objective:To investigate the expression of NKG2D receptor on natural killer(NK)cells and the expression of its ligand MHC classⅠ-related chain A and B(MICA/B)whereby to analyze the mechanism for escaping killing were deteced by NK cells of leukemic cells.Methods:Detection of NKG2D receptor and MICA/B ligand were aleteced by flow cytometry analysis.Results:The expression of NKG2D receptor were significantly lower in both pretherapy and complete remission group,compared with that in health group(P0.05).Conclusion:NK cell function mediated by NKG2D-MICA/B was inhibited,with possibly leads to the escape of leukemic cell from NK cell cytotoxicity;And after therapy the function of NK cells mediated by MICA/B in complete remission patients may be not ameliorated indicated by farther decrease of NKG2D-cells in the patients.

Aim To observe the variation of T-cell subsets in spleen in different courses of disease and tis-sue histopathological changes in rats with adjuvant ar-thritis (AA).Methods The model of rat AA was in-duced by complete Freund’s adjuvant into the right hind metatarsal footpad of 20 male Lewis rats.Arthritis was evaluated by total score,arthritis index and paw swelling number. The percentage of total (CD3 +CD4 +), memory (CD4 + CD44 +), no-sensitizated (CD4 + CD62L +) and Th1 7 (CD4 + IL-1 7 +) on CD4 +T cells in spleen were detected by flow cytometry on days 1 4 and 22 after immuniozation.The his-topathological evaluation of heart,liver,spleen,lung, kidney,ankle joints and mesenteric lymph nodes were examined by hematoxylin and eosin (HE)stain.Re-sults The onset of secondary arthritis appeared on a-bout day 1 0 after immunization,with a peak onset on day 1 9.Systematic arthritis symptoms included front and hind paw swelling and redness (swelling was more apparent in the front rather than hind paws),nodule formation and redness on the ears,connective tissue swelling and redness of the nose and evident nodules and redness on the tail.Total score,arthritis index and the paw swelling numbers were enhanced in AA rats. Pathohistology of ankles joints showed hyperplasia, pannus formation,and inflammatory cells infiltration in AA rats.And pathohistology of heart,liver,spleen, kidney and mesenteric lymph nodes showed inflamma-tory changes.Compared with normal group,there was no change in the percentage of total,memory and no-sensitizated CD4 +T cell in the early stage inflammation but they were significantly enhanced in the peak of in-flammation.Th1 7 cell subsets were significantly en-hanced in both of the early and peak of inflammation. Conclusion These findings suggest that abnormal T cell responses and tissue histopathological changes are important features of AA rats.

Objective To investigate the role of NRAGE subcellular localization in the EMT and radioresistance of esophageal cancer cells.Methods EMT model cells were established by the treatment of TE13 cells with TGF-β1.To verify the establishment of EMT model and the phenotype of EMT-like TE13R120 cells,EMT marker mRNA and protein were detected by Real-time PCR and Western blot,respectively.Real-time PCR was also used to detect the expression of NRAGE mRNA in three groups.Total NRAGE protein,cytoplasm protein and nuclear protein were measured by Western blot.Results It was found that TGF-β1 could induce morphological alterations of TE13 cells from epithelial to mesenchymal and change the expressions of EMT maker E-cadherin and vimentin (t =13.56,-232.84,P ＜ 0.05),indicating the successful establishment of EMT model cells.Similar expression trends of EMT makers were observed in TE13R120cells (t=15.84,-54.54,P＜0.05).NRAGE mRNA (t=-8.73,-5.62,P＜ 0.05) and total protein in both EMT model cells and TE13R120 cells were higher than that in TE13 cells,especially for the nuclear proteins.However,no differences in NRAGE cytoplasm protein expression were found among the three groups.In addition,there were also no difference of NRAGE mRNA (t =-0.88,P ＞0.05),cytoplasm and nuclear protein between TE13R120 cells and EMT model cells.Conclusions The radioresistant cell line TE13R120 has the EMT-like phenotype that may cause cell radioresistance by changing the subcelluar localization of NRAGE.

Objective To investigate the effect of PXR* 1B polymorphism on postoperative analgesia with fentanyl in the patients undergoing gynecological operation.Methods A total of 102 female patients from Henan province, of Han nationality, aged 20-50 yr, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ , with body mass index of 14.8-30.0 kg/m2, scheduled for elective abdominal total hysterectomy or myomectomy under general anesthesia, were enrolled in this study.PXR genetic polymorphic sites were analyzed by polymerase chain reaction (PCR)-direct DNA sequencing.PXR* 1B haplotype was analyzed by the PHASE V.2.1 software.The patients were assigned into 3 groups according to their genotypes: PXR* 1B haplotype group (group PXR* 1B), non-PXR* 1B haplotype group (group n-PXR* 1B) and PXR* 1B/PXR * 1B group (group PXR* 1B/PXR* 1B).Postoperative pain was assessed with visual analogue scale (VAS) score.When VAS ＞ 3, fentanyl 20 μg was injected intermittently until VAS ≤ 3, and then a pump was connected to perform patient-controlled intravenous analgesia (PCIA) with fentanyl.PCIA solution contained fentanyl 1.0 mg and droperidol 5 mg in 100 ml of normal saline.The PCA pump was set up with a 2 ml bolus dose, a 5 min lockout interval and background infusion at a rate of 0.5 ml/h.The number of successfully delivered doses was set at 7 times, and the maximal amount of fentanyl was 145 μg.If exceeding the maximal dose, the VAS score was still more than 3, nonsteroidal anti-inflammatory drugs were given as rescue medication.VAS score immediately after the end of operation, and the consumption of fentanyl within 24 h after operation were recorded.Midazolam 0.1 mg/kg was injected intravenously during induction of general anesthesia, and 1 h later venous blood samples were collected for determination of plasma 1'-hydroxymidazolam and midazolam concentrations.The ratio of 1'-hydroxymidazolam concentration to midazolam concentration was calculated to reflect the activity of CYP3A4.Results No patients required rescue anesthetics in the three groups.There were 27 cases in group PXR * 1B, 53 cases in group n-PXR* 1B, and 22 cases in group PXR* 1B/PXR* 1B.PXR* 1B allele frequency was 37.2％.There was no significant difference in VAS score immediately after the end of operation, consumption of fentanyl within 24 h after operation, and activity of CYP3A4 between the three groups (P＞0.05).Conclusion PXR* 1B polymorphism has no effect on postoperative analgesia with fentanyl in the patients undergoing gynecological operation, and is not one of the genetic factors producing individual variation in postoperative analgesia.

AIM:To study the expression of Jagged 2/Notch3 signaling molecules in pulmonary vascular wall of pulmonary hypertensive rats induced by monocrotaline .METHODS: SD rats were randomly divided into normal control group (C group,n=15), solvent control group (S group,n=15) and monocrotaline model groups (M group,n=15).The model of pulmonary hypertension was established by a single subcutaneous injection of monocrotaline (50 mg/kg).The rats in S group were given a single subcutaneous injection of the same dose of solvent .After 4 weeks, the pulmonary vascular remodeling was assessed by HE staining , and the mean pulmonary artery pressure ( mPAP) and right ventricular systolic pressure (RVSP) were determined by right heart catheterization .The expression of Jagged2/Notch3 /Hes5 molecules in the pulmonary vascular wall was detected by immunohistochemical method and real -time PCR.RESULTS:Compared with S group and C group , the percentage of medial wall thickness of smaller arteries in model group increased significantly (P<0.01).The levels of mPAP and RVSP in M group were significantly higher than those in S group and C groups (P<0.01).The results of real-time PCR showed that the expression of Jagged 2, Notch3 and Hes5 was significantly increased in M group compared with S group and C group .The data from immunohistochemical detection indicated that Jagged 2 mainly expressed in the intima of small lung artery , Notch3 and Hes5 mainly expressed in the medial smooth muscle cells .Com-pared with S group and C group , the expression of Jagged 2 and Notch3 was significantly increased in the lung small arteries of M group.CONCLUSION:The activation of Jagged2/Notch3 signaling pathway might play an important role in the for-mation of pulmonary hypertension .