Objective:To study the functional status of the monocytes-derived dendritic cells (DCs) plused with HBsAg from patients with chronic hepatitis B and their capacity of inducing the HBV- special cytotoxic T lymphocytes (CTLs),and explore a new method of inducing the special anti-HBV cell-mediated immunity.Methods:Monocytes of patients were isolated from peripheral blood and incubated with GM-CSF+IL-4+TNF-? to induce DCs generation. Those DCs were pulsed with HBsAg to induce HBV- special DCs. The phenotype of DCs including CD1a,CD80,CD83,CD86,CD40 and HLA-DR was characterized by FCM and the stimulating reaction of allogenic T lymphocytes was detected by MTT assay. The concentration of cytokines such as IL-12 and IL-6 in supernate was tested by ELISA and the cytotoxicity of CTLs inducing by the DCs against HepG2 2.2.15 cells,HepG2 cells and K562 cells were detected by LDH assay.Results:The expression of CD1a, CD80, CD83,CD86, CD40, HLA-DR molecules on the DCs pulsed with HBsAg was higher than those of the control group (P

Objective Acute respiratory dysfunction (ARD) can occur after aortic surgery with the use of cardiopulmonary bypass and deep hypothermic circulation arrest, but relatively little is known about acute respiratory dysfunction in the patients with type A aortic dissection. This study aims to analyze the independent risk factors of acute respiratory dysfunction after A type aortic dissection surgery and to assess possible prevention and treatment option in the future. Methods Clinical data of the 252 patients including 193 male patients and 59 female patients who underwent type A aortic dissection surgery from February 2009 to October 2010 were collected. The mean age was 47 years. Postoperative acute respiratory dysfunction was defined as oxygenation impairment (PaO2/FiO2 ＜ 150) that occurred within 72 h of surgery except pleural effusion, cardiogenic pulmonary edema, pneumonia, pulmonary embolism and haemato-/ pneumothorax. There were 187 acute A type aortic dissection patients and 65 chronic type A aortic dissection patients. Clinical characteristics including age, gender, weight, height, history of hypertension, history of smoking, preoperative complications such as preoperative shock and acute renal failure, pericardial effusion, previous cardiac surgery, time from event to surgery, malperfusion syndrome, cardiopulmonary time, cross-clamp time,deep hypothermia circulation arrest time, surgical procedure, duration of intensive care unit stay and postoperative complications including tracheotomy, dialysis dependent renal failure and hospital mortality were gathered. Arterial blood analysis, chest X ray, ventilator parameters, number of blood transfusion and flood balance were assayed after operation. All the factors were evaluated by means of univariate and multivariate logistic regression analysis to identify relative risk factors of ARD. Results Acute respiratory dysfunction occurred in 32 (12.7% ) patients. The in-hospital mortality was significant difference between acute respiratory dysfunction group and non- acute respiratory dysfunction group (P ＜ 0.05). The value of BMI, incidence of acute aortic dissection, preoperative SBP level, cardio-pulmonary bypass time, aortic clamp time and total arch replacement in acute respiratory dysfunction group were significantly higher than the values in non- acute respiratory dysfunction group. Multivariate Logistic regression analysis showed blood transfusion more than 10 units and cardio-pulmonary bypass time more than 160 minutes were independent risk factors of early stage acute respiratory dysfunction after type A aortic dissection surgery.Conclusion Acute respiratory dysfunction after type A aortic dissection was a severe early stage postoperative complication and was associated with in-hospital mortality. The patients in acute aortic dissection were prone to have acute respiratory dysfunction. The independent risk factors of acute respiratory dysfunction included blood transfusion more than 10 units and cardio-pulmonary bypass time more than 160 minutes.

Huoxue Tongmai Lishui method, a traditional Chinese medicine treatment for eliminating water, activating and promoting blood circulation, could inhibit fundus hemorrhage on experimental retinal vein occlusion (RVO) with high obvious effective rate, and improve symptoms in traditional Chinese medicine. The action mechanism may be related to reducing plasma viscosity and non-perfusion area, and the formation of collateral circulation.

Diabetes is a kind of metabolic syndrome, always hap-pening in the case of insufficient secretion of insulin or insulin resistance, inducing the increase of blood glucose. While, dia-betic osteoporosis is a kind of chronic diabetic complications, which happens when insulin secretion is absolutely or relatively insufficient and then the insufficiency induces imbalance of hor-mone, calcium phosphorus metabolic disorders, thus leading to the decline of bone mineral density and change of bone micro-structure. The overnutrition, less exercise and the environment change lead to the increased incidence of diabetes. For all the diabetes, type 2 diabetes accounts for about 90%. Patients with type 2 diabetes show the increasing risk of fracture. This review summarizes the recent advances in the influence of type 2 diabe-tes on bones.

Objective To investigate the clinical and pathological features of gastric cancer with ovarian metastasis and to analyze the reasons for its misdiagnosis. Methods There were 52 cases of gastric cancer with ovarian metastasis who had pathologic diagnoses from Jan. 1990 to Jun. 2004, whose clinical datum, pathological classification and the reasons for misdiagnosis were reviewed retrospectively and analyzed. Results The average age of the patients was 40.15?1.28 ( the ages ranging from 22 to 64 ). These patients's first symptoms and signs often were a metastatic ovary cancer. The main ultrasonographic findings were either a complex type of mass with both solid and cystic characteristics or only solid one, most of which accompany hydroperitonia, and among them metastatic ovary tumors on both sides reached 76.9 %. The serum CA125 levels increased, amounting to ( 99.85?14.23)U/mL on the average. It was greatly lower than a primary ovarian cancer(P

treated with heat shock and OK-432 demonstrated enhanced biological activities,and could induce host lymphocytes to highly effective and specific eytotoxieity against PANC1 cells.

Objective Metabonomics method based gas chromatography-mass spectrometry (GC/MS)were used to analyze the urine samples of patients with hyperlipidemic pancreatitis (HLP) to describe the characteristics of metabolism changes of HLP,identify potential biomarkers,and investigate the role of metabonomics study in the management of AP.Methods 24 patients of HLP and 40 age,sex matched volunteers were enrolled and their urine samples were collected.The urine samples underwent preparation,derivation and GC/MS analysis,Orthogonal-Projection to Latent Structures-Discriminant Analysis (OPLS-DA)were performed to detect the metabolic profile difference between the HLP and control group.Results HLP patients can be precisely distinguished from healthy controls.21 metabolites (credibility ＞ 700 ) were identified using the reference compounds available in the libraries of NIST and Wiley.It was identified that levels of nicotinic acid,aconitie acid,citric acid,hippurie acid,hydroxyphenylacetic acid,hydroxyphenylpropionicacid were decreased,while the levels of tryptophan,tyrosine,tyramine,16-hexadecanoic acid,18octadecanoie acid were increased.It was also suggested that there was change in tricarboxylic acid cycle and gut bacterial flora,as well as fat metabolism and metabolism of amino acid.Conclusions There are differences between healthy controls and HLP patients in the term of GC/MS metabolic profiling,and the biomarkers in the metabolites could be found through metabonomics analysis,and the mechanisms of the metabolic changes could be explored.It was noted that the research of metabolites in the urine samples may be a useful tool to help diagnose and understand the pathogenesis of HLP.Metabonomics analysis is a promising research method.

Objective To summarize our experience with off-pump coronary artery bypass grafting (OPCAB) during previous 13 years. Methods Data from 3703 patients who underwent OPCAB between October 1996 and December 2008 were collected and analyzed in this study. Following perioperative variables were reviewed and evaluated: changes in the number of patients, demographic characteristics of patients, coexisting conditions such as hypertension, and diabetes, grafting options,numbers of grafts per patient, and postoperative complications and clinical outcomes. Patients were divided into four age subgroups: those who were less than 45 years were assigned to group 1, those who were 45 to 60 years were assigned to group 2,those who were 60 to 75 years were assigned to group 3, and those older than 75 years of age were assigned to group 4. Perioperative data, including the use of internal mammary artery and the constituent of the grafts, were collected retrospectively and analyzed. Results Three thousand and twenty-five patients were male (81.7%) and 678 were female ( 18.3% ), mean age was (61.35 ±9.38) years old. The number of patients who underwent OPCAB increased steadily over time. The mean grafts per patient were 3.3 ± 0.8. The use of left internal mammary artery and "hybrid" bypass grafts composed of vein and artery played a predominant role in this cohort (P<0.05) . During this period of 13 years, intra-aortic balloon counterpulsation (IABP)was performed in 41 patients and continuous renal replacement therapy (CRRT)was required in 12 patients. Main complications included rethoracotomy for bleeding and tamponade in 1.49% of patients, deep sternal wound infection requiring re-exploration in 1.38%, perioperative myocardial infarction in 1.03%, neurological adverse events in 0.62%, tracheotomy in 0.59%, acute renal dysfunction in 0.77%, and other complications in 0.77%. The overall in-hospital mortality was 0.7% (26 of 3703 patients). A trend toward a reduction in morbidity and mortality was shown in this study. Diseases associated with hospital mortality were cardiac sudden death, multiple organ dysfunction syndrome, low cardiac output syndrome, severe infection, extensive myocardial infarction and neurological adverse events. Conclusion The indications for OPCAB, an innovative revascularization strategy, have been expanded and the curative rate for OPCAB has been improved in recent years. Appropriate and practical grafting strategies, as well as complete perioperative management, are considered as contributors to the improved outcomes.

ObjectiveTo study the method of cell isolation,primary culture and identification of subchondral bone cell of osteoarthritis(OA) rabbits.Methods The rabbit instable knee joint models were made by modified Hulth modeling method.The osteoblasts were harvested from the subchondral bone of rabbits by collagenase and tissue explants attachment.The morphology observation and biological identification were performed by inverted microscope and immunocytochemistry staining,respectively.The proliferative activity of cells were detected by MTT and the expression of Ⅰ-collagen at gene level was detected.ResultsThe cells started to appeared on the 11th day after the attachment.The cells form were fusiformis and triangle,the nucleolus were clear.The cultured cells had typical osteoblast morphological characteristics.The cells obtained from subchondral bone of rabbits were identified to be osteoblast by immunocytochemistry staining.The proliferative activity of cells were equably proliferation which detected by MTT.ConclusionThe modified method provides better way to obtain ideal subchondral osteoblast and the co-culture method is suitable for the study of OA microenvironment,which can simulate interactions of the subchondral osteoblast,synovial cells and chondrocyte.

Objective To explore the clinical prognostic significance of arterial blood lactate level and early lactate clearance rate in elderly septic patients. Methods Totally 82 elderly septic patients who were admitted into emergency department were enrolled.Their arterial blood lactate levels were tested at admission and 6 hours later. Early lactate clearance rate was calculated as following:(lactate level of admission minus lactate level of 6 hours later) /lactate level of admission ×100 ％. Heart rate and blood pressure were recorded at admission,and the acute physiology and chronic health evaluationⅡ (APACHE Ⅱ ) score was evaluated in the first 24 hours.28 days after admission was the end of research.Patients were divided into survival group (n=59) and death group (n=23).Taking 10％ as cut-off,patients were divided into high lactate clearance (≥ 10％) group (n=59) and low lactate clearance (＜10％) group (n=23).Values of arterial blood lactate level,APACHE Ⅱ score and early lactate clearance to predict the prognosis of elderly septic patients were determined by ROC curves. Results Arterial blood lactate level was lower in survival group than death group[(2.4± 1.7)mmol/L vs.(3.9±3.2)mmol/L,P＜0.01].Early lactate clearance was higher in survival group than death group [(339.0 ± 28.0) ％ and (300.0 ± 81.0) ％,P ＜ 0.01].Mortality of high lactate clearance group was decreased as compared with low lactate clearance group [18.6％ (11/59) and 52.2％ (12/23),P＜0.01].The thresholds of early lactate clearance to predict mortality of elderly septic patients were 24.0％ (sensitivity 72.9％,specificity 65.2％) which was more valuable than APACHE Ⅱ score ( sensitivity 65.2 ％,specificity 57.6 ％). Conclusions Arterial blood lactate level and early lactate clearance were meaningful predictors for prognosis of elderly septic patients.