Objective To analyze the significance of global end-diastolic volume index (GEDVI) in acute kidney injury (AKI) after septic shock.Methods A retrospective analysis of 61 patients was performed.The patients were diagnosed of septic shock in emergency ward of Shenyang Military Hospital from 2012 March to 2013 May and were monitored by pulse indicator continuous cardiac output (PiCCO).The patients were divided into two groups:low GEDVI group (GEDVI ＜ 700 ml/m2,29 cases) and high GEDVI group (GEDVI≥700 ml/m2,32 cases) by evaluating GEDVI of 24 hour after PiCCO.Several physiologic and biochemical indexes were recorded,including the hemodynamic parameters at the beginning and the 24 h of PiCCO monitoring,Scr,BUN,lactic acid,incidence and mortality of AKI,baseline glomerular filtration rate,baseline Scr,APACHE Ⅱ scores,mortality during the period of emergency ward or within 28 d after the diagnosis.Results A total of 26 cases in high GEDVI group (81.3％) were attacked with AKI,while 16 cases in low GEDVI group (55.2％) were attacked with AKI,the incidence of AKI in high GEDVI group was significantly higher than that in the low GEDVI group.A COX regression analysis of mortality was performed between the patients staying at emergency ward and during 28 d after diagnosis.The results indicated that AKI and GEDVI had no relation with patients' death.Therefore,AKI and GEDVI could not be considered as the risk factors for the prognosis.Conclusions High GEDVI can significantly increase the incidence of AKI after septic shock,therefore high GEDVI should be avoided as much as possible in the course of clinical treatment.

The policies of healthcare big data and their common and respective characteristics in USA, Britain, France, Japan, Republic of Korea, and Singapore were analyzed in aspects of their strategic planning, infrastruc-ture construction, R&D of key technologies, professional training, and privacy protection with 5 suggestions put for-ward for improving the policies of healthcare big data in China , namely transforming thinking , establishing opera-tional systems, working out construction criteria, building platform for big data sharing, and attaching importance to professional training .

To compare and analyze the clinical treatment effect of primary pterygium with amniotic membrane transplantation, autologous corneal limbus stem cell transplantation and intraoperative application of 0. 2g/L mitomycin C.METHODS: Retrospective analysis of 232 patients who were underwent primary pterygium surgery was performed. Eighty-two cases were treated with amniotic membrane transplantation, 90 with autologous corneal limbus stem cell transplantation, and 60 with intraoperative application of 0. 2g/L mitomycin C. The postoperative recurrence and complications of three operative methods were compared.RESULTS: The recurrence rate of autologous corneal limbus stem cell transplantation and intraoperative application of 0. 2g/L mitomycin C was lower than that of amniotic membrane transplantation ( P < 0. 05 ). The recurrence rate between autologous corneal limbus stem cell transplantation and intraoperative application of 0. 2g/L mitomycin C had no difference ( P > 0. 05 ). Corneal epithelium defect, tears and photophobia were higher in 0.2g/L mitomycin C group (P<0. 05), which were no statistical difference between autologous corneal limbus stem cell transplantation and amniotic membrane transplantation (P>0. 05). Conjunctival congestion and subconjunctival hemorrhage in three groups had no statistical difference (P>0. 05).CONCLUSlON: Compared with other two operative methods, autologous corneal limbus stem cell transplantation for primary pterygium has the advantages of lower recurrence rate and less complications.

OBJECTIVETo explore the effect of ligustrazine on the migration of bone marrow mesenchymal stem cells (BMSCs) and protein expressions of matrix metalloproteinase-2 and-9 (MMP-2 and MMP-9) in vitro.

METHODSBMSCs were in vitro isolated and cultured using whole bone marrow adherent method, and phenotypes [surface positive antigens (CD29 and CD90) and negative antigens (CD34 and CD45)] identified using flow cytometry. BMSCs were divided into the blank control group, 25, 50, 100 µmol/L ligustrazine group, and the GM6001 group (100 µmol/L ligustrazine +MMPs inhibitor GM6001 ). The migration of BMSCs was tested by Transwell chamber test and wound healing assay after treated with ligustrazine for 24 h. The protein expressions of MMP-2 and MMP-9 were detected by Western blot.

RESULTSThe third passage BMSCs grew well in uniform morphology. The expression rate of CD29, CD90, CD34, and CD45 was 96.9%, 97.3%, 0.2%, and 3.0%, respectively. Compared with the blank control group, the number of migrated cells and relative distance of cell invasion increased, and the protein expressions of MMP-2 and MMP-9 were elevated in each ligustrazine group (P < 0.05, P < 0.01). Compared with 100 µmol/L ligustrazine group, the number of migrated cells and relative distance of cell invasion decreased in 25 and 50 µmol/L ligustrazine groups and the GM6001 group (P < 0.01). Protein expression of MMP-2 decreased in 25 and 50 µmol/L ligustrazine groups (P < 0.01).

CONCLUSIONLigustrazine could promote the migration of BMSCs in vitro, and its mechanism might be related to up-regulating expression levels of MMP-2 and MMP-9 protein.

Cell Movement ; Cells, Cultured ; Hematopoietic Stem Cells ; cytology ; drug effects ; Humans ; Matrix Metalloproteinase 2 ; metabolism ; Matrix Metalloproteinase 9 ; metabolism ; Pyrazines ; pharmacology ; Up-Regulation

AIM: To analyze the effect of pigment epithelium derived factor (PEDF) on nitrogen monoxide (NO) and expression of cysteine-containing, aspartate-specific proteases-3 (caspase-3) in retinal tissues of model rats with optic nerve crush injury.METHODS: A total of 60 SD rats were randomly divided into the blank control group, model group and PEDF group, with 20 rats in each group.Except the blank control group, the optic nerve crush injury rat models were established in the other groups, and left eyeballs were taken as samples.After successfully modeling, the model group were treated with intravitreal injection of 5μL of balanced salt solution while PEDF group were treated with intravitreal injection of 5μL of PEDF (0.2μg/μL).Two weeks later, the retinal tissues were collected, and changes of shape were observed under microscope after HE staining.The changes of NO level were measured by colorimetry assay, the expression of caspase-3 mRNA and caspase-3 protein was detected by reverse transcription-polymerase chain reaction (RT-PCR) and Western-blot.RESULTS: HE staining showed that retinal tissues of the blank control group arranged neatly and clearly.Retinal ganglion cells (RGCs) arranged in a monolayer, and cells were oval, uniform in size and distribution, the cell nuclei were clear, closely arranged, with clear boundaries.The retinal tissues of the model group were sparse in shape, RGCs showed vacuolar changes, the overall number of cells was reduced, and cell nuclei of residual RGCs showed pyknosis and uneven staining.RGCs in PEDF group were with slightly edema and arranged closely, and the degree of injury was significantly milder than that in the model group.Levels of Caspase-3 mRNA and protein and NO levels in the three groups showed the model group > PEDF group > blank control group (all P < 0.05).CONCLUSION: The application of PEDF can down regulate the expression of Caspase-3 and NO in rates with optic nerve injury and reduce RGCs injury.

Objective To evaluate the myocardial protective effects of Histidine-TryptophanKetoglutarate (HTK) solution on infants with tetralogy of fallot in cardiac operation through comparison with St.Thomas Ⅱ cardioplegia(STH) and HTK cardioplegia in the operation of tetralogy of fallot.Methods Forty infants with tetralogy of fallot(TOF) were enrolled in this study.Their age ranged from 7 to 35 months,and body mass from 5.3 to 9.5 kg.The infants were randomly divided into HTK (n =20) group and STH (n =20) group who received HTK or STH solution respectively.Then 3 ml blood sample were got at 1,2,4,8,24 and 48 h after the opening of ascending aorta.The serum levels of cardiac troponin Ⅰ(cTnI),creatine kinase(CK) and creatine kinase MB(CK-MB) were measured.Results There was significant difference between two groups in terms of the level of cTnI at different time (F(inner group)=49.94,P＜0.001;F(between group) =10.23,P＜0.001;F (across group) =28.49,P＜0.001),and the level of cTnI in HTK group was lower than that of STH group at 1,2,4,8,24 and 48 h after the opening of ascending aorta (P＜0.05).There was significant difference between two groups in terms of the level of CK at different time (F(inner group) =58.85,P＜0.001;F(between group) =16.43,P＜0.001;F(across group)=18.32,P＜0.001),and the level of CK in HTK group was lower than that of STH group at 1,2,4,8,24 and 48 h after the opening of ascending aorta (P＜0.05).There was significant difference between two groups in terms of the level of CK-MB at different time (F(inner group)=34.51,P ＜0.001;F(between group)=11.03,P＜0.001;F(across group)=10.28,P＜0.001),and the level of CK-MB in HTK group was lower than that of STH group at 1,2,4,8,24 and 48 h after the opening of ascending aorta (P ＜0.05).Conclusion HTK is more valid than STK for improving the ability of anti ischemia of myocardium and cardiac function,reducing arrhythmia and ischemia reperfusion injury on infants with TOF in cardiopulmonary bypass.

Objective To investigate the effect of neurolytic celiac plexus block (NCPB) on the inflammatory reaction of the remaining liver tissue and liver function after partial hepatectomy (PH) in rats.Methods Thirty male Sprague-Dawley rats of SPF were constructed as a PH model with deligation and ablation operated on their left and middle lobes,respectively.Then,they were randomly divided into two groups:NCPB group and control group.Twelve hours after the surgery,0.5％ lidocaine was given in the NCPB group once a day,while 0.9％ saline was given in the control group.Determination of liver function,generation of the remaining liver,and deposition of IL-β,TNF-α of the pathological section was respectively made on Day 1,3 and 7 after the surgery.Results On Day 1,3 and 7 after surgery,both the aspartate aminotransferase (AST) and the alanine aminotransferase (ALT) levels in NCPB group were,to different degrees,lower than those in the control group (P ＜ 0.05).Strikingly,total bilirubin in NCPB group was lower than that in control group (P ＜ 0.01) on Day 7,while the level of semm albumin was higher than that in control group (P ＜ 0.01).There was no statistically significant difference on the generation of the remaining livers between NCPB and control groups.On Day 3 and 7,the deposition of IL-β,TNF-α in the pathological sections of NCPB group were lower than those in control group.Conclusion NCPB can not only effectively reduce the damage of liver function caused by PH surgery,but also improve the inflammatory reaction of the residual liver.

Objective Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is a recently described brainstem-predominant inflammatory disorder responsive to steroids with characteristic magnetic resonance imaging(MRI) feature.There was no case report in China.The aim of this study was to characterize the clinical and imaging patterns of CLIPPERS for early diagnosis and treatment.Method Clinical and imaging data and therapeutic methods and following up after treatment of 1 patient diagnosed CLIPPERS were reviewed retrospectively.Results The patient presented with subacute weakness of the lower extremities,gait ataxia and facial numbness.Cerebellar ataxia and pyramidal signs were the main positive signs on neurological examinations.Brain MRI showed punctate gadolinium enhancement peppering the pons and cerebellar.Treatment with steroids led to rapid clinical improvement and marked resolution of MRI lesions which accorded with characteristics of CLIPPERS.Conclusions There are no characteristic clinical manifestations of CLIPPERS.Punctate gadolinium enhancement peppering the pons is the distinct magnetic resonance imaging feature which may suggest the clinical diagnosis of CLIPPERS.Early treatment with steroids can improve the prognosis.

Objective To explore the guidance significance of the functional MRI and DTI (fMRI ,DTI) ,intraoperative ultra-sound(IOUS) ,neuronavigation ,electrocorticography(EcoG) monitoring used in surgical treatment of low-grade gliomas with epi-lepsy as main symptom located near the eloquent brain regions .Methods 23 neurosurgical patients in the First Affiliated Hospital of Chongqing Medical University during 2009-2010 were performed the retrospective analysis .The preoperative fMRI ,DTI deter-mined the positional relation between the lesions with the conduction bundle and the eloquent brain regions ,the electrophysiological and imageological examinations positioned the epileptogenic focus and lesions ,the MRI-mediated neuronavigation system was adopt-ed to formulate the surgical plan and choose the best surgical approach ,IOUS was used to perform the realtime monitoring for pre-cisely positioning the lesion range and determining the extent of resection ,and the intraoperative EcoG was adopted to determine the epileptogenic focus localization ,the lesions and the epileptogenic focus was dealed by the operating microscope for avoiding the func-tional region ,and the patient′s prognosis was evaluated and recored in detail after operation .Results By the precisely positioning the lesions and epileptogenic focus by fMRI ,DTI ,neuronavigation and ultrasound ,the lesion resection degrees by the operative mi-croscope and intraopertaive pathological guidance were 17 cases of Ⅰ-Ⅱ grade ,4 cases of Ⅲ grade and 2 case of Ⅳ-Ⅴ grade .1 case of motor aphasia ,4 cases of hemiplegia and monoplegia and 1 case of disturbance of consciousness after operation were improved by the treatment of neurotrophy ,dehydration and hyperbaric oxygen and discharged from hospital with rehabilitation .No death case occurred .The evaluation of the life quality :20 cases ofⅠ-Ⅱ grade ,3 cases of Ⅲ grade and no vegetable survival case of Ⅳ grade . The evaluation of resection clinical effect :20 cases of cure ,3 cases of improvement ,no case of as before and exacerbation .After fol-lowed up for 6-24 months ,according to Engel classification of seizure efficacy assessment :Ⅰ-Ⅱ grade in 21 cases ,Ⅲ grade in 2 case ,no case of Ⅳgrade .Conclusion fMRI ,DTI ,neuronavigation ,IOUS and EcoG for guiding the operation of low grade gliomas located near the eloquent brain regions can resect the lesion to the largest extent and simultaneously deal with epileptogenic focus , effectively protect the neurological function of the functional region ,greatly reduce the side-injury of the normal brain tissues in the functional region ,at the same time increase the curative effect of symptomatic epilepsy .

Objective To evaluate the potential activity ofSaccharomyces boulardii as an adjuvant to triple therapy for Helicobacter pylori infection,so as to forecast the probable effectiveness of Saccharomyces boulardii in the eradication of Helicobacter pylori and the adverse reaction.Methods A total of 120 patients who received gastroscopy and tested positive for Helicobacter pylori infection were divided into standard triple therapy group and Saccharomyces boulardii group with 60 cases each by random digits table method.Patients were randomized to receive one week standard triple therapy,supplemented with Saccharomyces boulardii in Saccharomyces boulardii group.Saccharomyces boulardii was taken 500 mg per day for one week.All adverse reactions were recorded during the treatment period.13C or 14C urea breath test was performed at four weeks after the end of triple therapy to evaluate the situation of Helicobacter pylori eradication.Results Helicobacter pylori eradication rate in Saccharomyces boulardii group was higher than that in standard triple therapy group [80.00％ (48/60) vs.73.33％ (44/60)],but there was no significant difference (P =0.542).Five adverse reactions including epigastric discomfort,nausea,diarrhea,taste disorder and liver injury were recorded during the treatment period.The incidence of adverse reactions such as epigastric discomfort and diarrhea in Saccharomyces boulardii group was significantly lower than that in standard triple therapy group [13.33％ (8/60)vs.43.33％(26/60),3.33％(2/60) vs.26.67％(16/60)],and there was significant difference (P ＜ 0.05).Conclusion Saccharomyces boulardii as an adjuvant to triple therapy can not improve Helicobacter pylori eradication rate,but can decrease the incidence of adverse reactions during the treatment period and improve the complicance of Helicobacter pylori eradication treatment.