Objective To explore an improved technique of mouse ventral heterotopic heart transplantation and construct an animal model for the study of transplantation immunity.Methods The donor heart aorta and the recipient ventral aorta, the donor pulmonary artery and the recipient inferior caval vein, were anastomosed by using the end-to-side suture technique respectively. At the same time, important anatomical structures of transplantation-related sites were measured.Results The diameter of recipient inferior caval vein and ventral aorta was (1.9?0.2)mm and (0.9?0.1)mm respectively. The average length of ventral blood vessels which can be used was (6.0?1.0)mm. The model construction success rate was 92%. The average time of donor operation and recipient operation was (8.0?1.0)min and (40.2?3.0)min respectively. The time of artery anastomosis and vena cava anastomosis was (9.3?1.2)min and (7.8?1.7)min respectively. Conclusions The animal model is stable and can be used for the study of transplantation immunity.

Objective To study the relationship between Th1/Th2 cytokine profiles and the survival time of cardiac allografts in mice.Methods The ventral heterotopic cardiac transplantation models were divided into three groups: rejection group, treated group, isograft group, each group with 20 recipients. Mean survival time(MST), pathologic histological changes, the mRNA expression of IFN-?,IL-2,IL-4 and IL-10 were measured.Results MST of heart allografts in rejection and treated group was (7.8?0.77)d, and (14.80?1.01)d respectively. The survival time of grafts in isograft group were all more than 28d. The difference among the three groups was significant. In rejection group, the number of infiltrating cells was much more than that in the other groups, and also, the extent of pathologic histological changes was more severe. The mRNA expression of IFN-? and IL-10 in graft and spleen in rejection group was much stronger than that in the others. There was no obvious mRNA expression of IL-2 and IL-4 in grafts of all three groups. The mRNA expression of IL-2 in the spleens of rejection group was the strongest, while the mRNA expression of IL-4 in the spleens of treated group was the strongest.Conclusions The dynamic equilibrium of Th1/Th2 cytokines plays an important role in the survival time prolongation of cardiac allografts in mice. IL-10 can also participate in the process of graft rejection.

Objective To investigate the value of the three-dimensional endorectal ultrasonography (3D-ERUS) in the tumor staging before transanal endoscopic microsurgery (TEM).Methods The clinical data of 30 patients with rectal cancer who underwent 3D-ERUS before TEM at the Nanjing Hospital of Traditional Chinese Medicine from April 2012 to December 2013 were retrospectively analyzed.The accuracy,sensitivity and specificity of the 3D-ERUS were evaluated according to the results of the postoperative pathological examination.The consistency of the results of the 3D-ERUS and postoperative pathological examination were compared by Kappa consistency test.Results Of 30 patients,25 patients in stage T0,3 in stage T1 and 2 in stage T2 were diagnosed by preoperative 3D-ERUS.There were 2 patients (stage pT0) with inflammatory polyp by postoperative pathological diagnosis,6 patients (stage pT0) with tubular adenoma,16 patients (stage pT0) with villioustublar adenoma,2 patients (stage pTis) with carcinoma in situ,2 patients (stage pT1) with tectal adenoma and 2 patients (stage pT2) with rectal adenoma.There were 2 patients with excessive tumor staging by 3D-ERUS,1 patient in stage pT0 was misdiagnosed in stage T1,1 in stage pT1 was misdiagnosed in stage T2 and 1 in stage pT2 was misdiagnosed in stage T1 with insufficient tumor staging.The accuracy of 3D-ERUS in the preoperative tumors staging of TEM was 90.0％ compared with the resuls of postoperative pathological examination.The accuracy,sensitivity and specificity of 3D-ERUS in stage pT0,pTl,and pT2 of TEM were 96.7％,90.0％,93.3％ and 96.2％,50.0％,50.0％ and 100.0％,92.8％,96.4％,respectively.There was a significant difference in the consistency between preoperative 3D-ERUS and postoperative pathological examination (κ =0.685,P ＜ 0.05).Conclusion 3D-ERUS is an accurate clinical method in the preoperative tumors staging of TEM,and can be used as the preoperative assessment for TEM.

Objective To assess the relationship between gastric carcinoma perfusion imaging parameters with the multislice spi-ral CT (MSCT)and the tumor angiogenesis(MVD,VEGF).Methods (1)33 patients with gastric cancer were carried on perfusion CT scanning in the suspected lesions,and compared with operation and histological result.MSCT perfusion parameters tumor,such as local blood flow (BF),blood volume (BV),mean transit time of contrast agent (MTT),permeability surface (PS),were recor-ded,and compared with clinical pathological data.(2)27 patients of 33 cases which CT perfusion plane matching with operation pa-thology specimens performed with tumor microvessel density (MVD),vascular endothelial growth factor (VEGF)monoclonal anti-body immunohistochemical examination of MVD,the most intensive areas of high power (×200 HP)field counted,and VEGF stai-ning positive judged.Results Achievement ratio of gastric carcinoma MSCT perfusion imaging was 84.85% (28/33).The average value of BF,BV,MTT and PS were 63.658 ± 18.305,7.5 1 1 ± 2.427,1 1.952 ± 4.325 and 31.81 7 ± 13.533,respectively,and MVD was 37.7 ± 11.1/200 HP (range:13-60).VEGF was positive in 16 cases,negative in 11 cases.Gastric carcinoma undifferentiated group perfusion parameter PS value (35.1 5 ± 12.74 )and MVD (40.53 ± 10.66 )were higher than the differentiation group (23.90 ± 12.71 and 31.13 ± 9.82 )(P < 0.05 ),but BF,BV,MTT not statistically significant;Differences of CT perfusion parameters and MVD were not significant statistically between invasive serosa and noninvasive ;PS value (36.65± 12.80)of lymph node metastasis was greater than without metastasis(22.70 ± 1 1.1 5 )(P <0.01 ),the other was no significant difference;TNM staging Ⅲ,Ⅳ phase group of BF value (69.56 ± 1 6.49),PS value (34.90 ± 12.80)and MVD value (40.74 ± 10.53)were higher than Ⅰ,Ⅱ Group (49.63 ± 1 5.04),(24.50 ± 13.13)and (30.63 ± 9.61)(P <0.01).Spearman correla-tion analysis in confidence (two tails)of 0.01 was statistically significant between MVD in tumor tissues and gastric cancer MSCT perfusion parameters of BF (r=0.404)and MTT (r=0.371),whereas BV and PS were no significance.The regression equation of MVD with BF and MTT:MVD =1 6.602+0.1 50XBF +0.967XMTT,model checking of F values was 6.62,P =0.003.Conclusion The gastric carcinoma multi-slice CT perfusion imaging parameters BF,MTT and MVD,VEGF(+)was positive correlation, MSCT perfusion imaging parameters reflects tumor VEGF positive expression of gastric carcinoma.

Objective:To discuss the effect of sarcopenia (Sa) on the prognosis of transjugular intrahepatic portosystemic shunt (TIPS) in patients with portal hypertension (PHT).Methods:Totally 131 PHT patients treated with TIPS were retrospectively collected from August 2013 to December 2017 in the First Affiliated Hospital of USTC, and were divided into the Sa group [maximum transverse diameter of the psoas major muscle/height (TPMT/H) ≤16.8 mm/m, n=60] and the control group (TPMT/H>16.8 mm/m, n=71). The patients were followed up with a median time of 42 months. The Kaplan-Meier method was used to calculate the incidence of hepatic encephalopathy, recurrence rate of PHT-related complications and survival rate of PHT patients after TIPS, and the differences were compared by Log-rank test. Results:The incidences of hepatic encephalopathy within 6 months after TIPS and severe hepatic encephalopathy requiring hospitalization in the Sa group [36.7% (95%CI 24.5%-48.8%) and 15.0% (95%CI 6.0%-24.0%)] were higher than those of the control group [15.7% (95%CI 7.3%-24.1%) and 2.8% (95%CI 0-6.7%)], with statistically significant differences (χ2=7.843, 16.442, P=0.005, 0.001). The 5-year overall recurrence rate of PHT-related complications of the Sa group after TIPS [15.8% (95%CI 6.4%-25.2%)] was higher than that of the control group [5.7% (95%CI 0.2%-11.2%)], with a statistically significant difference (χ2=4.431, P =0.035. The 1, 3 and 5-year survival rates in the Sa group were 88.3% (95%CI 80.3%-96.3%), 86.7% (95%CI 78.1%-95.3%) and 77.8% (95%CI 65.1%-90.5%) respectively, which were all lower than those of the control group [97.2% (95%CI 93.3%-100%), 95.8% (95%CI 91.1%-100.0%) and 93.7% (95%CI 87.6%-99.87%) respectively], and the difference was statistically significant (χ2=5.055, P=0.025). Conclusion:Sa has a higher incidence in PHT patients, which can increase the incidence of hepatic encephalopathy and recurrence rate of PHT-related complications, and can decrease the survival rate in PHT patients after TIPS. Hence, the Sa is an indicator of the poor prognosis in PHT patients with TIPS.

Aim To investigate the effect of Ding''s herb enema prescription on intestinal tissue related target in rat colitis induced by dextran sulfate sodium(DSS), and to elucidate the mechanism of Ding''s herb enema prescription in improving the intestinal inflammation and intestinal fibrosis.Methods Rats were fed with 3.5％ DSS.The rats were randomly divided into positive drug group, model group, Control group, and Ding''s herb enema prescription group.The positive drug group was treated with mesalazine enema, and Ding''s herb enema prescription group was treated with Ding''s herb enema prescription.The colon mucosa was taken once a day for 6 weeks.The changes of intestinal inflammatory response and intestinal fibrosis related proteins were detected by GSR-CAA-67 antibody protein array, and the differentially expressed proteins were screened out.Results Eight proteins showed statistical differences, including IFN-γ, erythropoietin(EPO), TIMP-2, TIM-1, IL-6, TIMP-1, TNF-α, IL-22 (P<0.05).On the other hand, Ding''s herb enema prescription and mesalazine significantly antagonized the effect of IL-6 and TIMP-1 (P<0.05).The antagonized effect of Ding''s embolization enema on TNF-α and IL-22 was also significant(P<0.05), but mesalazine had no similar effect (P>0.05).Conclusions Ding''s herb enema prescription has the effect of multiple targets, which may improve the intestinal inflammatory response and intestinal fibrosis to achieve the purpose of treatment of ulcerative colitis(UC).

BACKGROUNDPulmonary hypertension (PH) is a common complication of chronic obstructive pulmonary disease (COPD). Although alveolar hypoxia is considered as a main cause of PH in COPD, structural and functional changes of pulmonary circulation are apparent at the initial stage of COPD. We hypothesized that an inflammatory response and oxidative stress might contribute to the formation of PH in COPD.

METHODSWe measured the levels of interleukin-6 (IL-6) and 8-iso-prostaglandin (8-iso-PSG) in exhaled breath condensate (EBC) and serum in 40 patients with COPD only or in 45 patients with COPD combined with PH. Pulmonary arterial systolic pressure (PASP) was assessed by Doppler echocardiography and defined as PH when the value of systolic pressure was greater than 40 mmHg.

RESULTSCompared with the COPD only group, the level of IL-6 in EBC was significantly increased in all 45 patients with COPD combined with PH ((8.27±2.14) ng/L vs. (4.95±1.19) ng/L, P < 0.01). The level of IL-6 in serum was also elevated in patients with COPD combined with PH compared with the COPD only group ((72.8±21.6) ng/L vs. (43.58±13.38) ng/L, P < 0.01). Similarly, we also observed a significant increase in the level of 8-iso-PSG in both EBC and serum in the COPD with PH group, compared with the COPD only group (EBC: (9.00±2.49) ng/L vs. (5.96±2.31) ng/L, P < 0.01 and serum: (41.87±9.75) ng/L vs. (27.79±11.09) ng/L, P < 0.01). Additionally, the value of PASP in the PH group was confirmed to be positively correlated with the increase in the levels of IL-6 and 8-iso-PSG in both EBC and serum (r = 0.477-0.589, P < 0.05).

CONCLUSIONThe increase in the levels of IL-6 and 8-iso-PSG in EBC and serum correlates with the pathogenesis of PH in COPD.

Aged ; Breath Tests ; Female ; Humans ; Hypertension, Pulmonary ; blood ; metabolism ; Interleukin-6 ; blood ; metabolism ; Male ; Middle Aged ; Prostaglandins A ; blood ; metabolism ; Pulmonary Disease, Chronic Obstructive ; blood ; metabolism