BACKGROUND: Property of artificial liver reactor is generally evaluated by using an enclosed experimental device, which is constructed through simulating bioartificial liver supporting system. Moreover, the enclosed experimental device is also comprehensively evaluated biological function of hepatocytes and biological response efficiency. In addition, it is significance for primarily evaluating the properties of polysulfone membrane hollow fiber reactor to optimize bioartificial liver supporting system. OBJECTIVE: To construct polysulfone membrane bioreactor experimental system, understand the effects on plasma of patients with severe hepatitis, and observe the feasibility of hollow fiber reactor regarded as bioartificial liver reactor. DESIGN: Repeated measurement.SETTING: General Infectious Disease Institute, Southwest Hospital, the Third Military Medical University of Chinese PLA. MATERIALS: Seven Chinese mini-pigs with 1-7 days old and of either gender were provided by Experimental Animal Center, the Third Military Medical University (certification: F99017). The animal disposal accorded to the ethical standard. Tumor necrosis factor-α (TNF-α) and transforming growth factor-β1 (TGF-β1) kits were purchased from Jingmei Bioengineering Company, China; polysulfone membrane hollow fiber reactor by Shanghai Dehong Biomaterial Institute, China; Cellco culture-circular artificial capillary culture system by Spectrum Company, USA; seven plasma exponents were taken from admission patients with chronic severe hepatitis during plasma exchange. All patients provided the informed consent, and the animal experiment was conducted with confirmed consent by the local ethics committee.METHODS: This study was performed at the General Infectious Disease Institute, Southwest Hospital, the Third Military Medical University of Chinese PLA from January 2004 to July 2005. ① Experimental procedure: The experimental pigs underwent ablactation at 12 hours before experiment, and then hepatocytes were separated after cleaning their fur. An enclosed system was composed of polysulfone membrane hollow fiber reactor and Cellco culture-circular artificial capillary culture system, which were connected with oxygen-carbon dioxide diffusion tube and media holding pond. Interface of external cavity was blocked with clean rubber tampon. The separated hepatocytes underwent spheroid culture by using magnetic stirring method, and then they were inoculated in the external cavity of polysulfone membrane hollow fiber reactor. Next, 200 mL plasma from severe hepatitis patients was added in media holding pond and circled from internal cavity of reactor to media holding pond at the speed of 80 mL/min. ② Experimental evaluation: 2 mL liquid circulation separately collected from internal cavity of reactor at 0, 2, 4 and 6 hours after circulation was used to measure level of ammonia in supernatant by using glutamic dehydrogenase-violet method. In addition, content of total bilirubin was detected by using automatic biochemistry analyzer, prothrombin time by using automatic blood coagulometer, and TNF-α and TGF-β1 were detected according to the kits. MAIN OUTCOME MEASURES: Effects of polysulfone membrane bioreactor on ammonia, bilirubin, prothrombin time, TNF-α and TGF-β1 in plasma of patients with severe hepatitis.RESULTS: ① Measurement of ammonia, total bilirubin and prothrombin time in patients with severe hepatitis: Level of ammonia decreased persistently, in particularly, the decrease was obvious from 0 to 2 hours, and then, it was decreased slowly. While, level of total bilirubin was also decreased persistently, and it was significantly lower at 6 hours than that at 0 hour (P < 0.05). Moreover, prothrombin time was decreased persistently, and it was significantly lower at 6 hours than that at 0 hour (P < 0.05). ② Measurement of TNF-α and TGF-β1 in patients with severe hepatitis: Contents of both TNF-α and TGF-β1 decreased persistently, and they were significantly lower at 6 hours than those at 0 hour (P < 0.05). CONCLUSION:Polysulfone membrane bioreactor experimental system can clear noxious substance of small molecules in plasma of patients with severe hepatitis, supply beneficial components, and decrease levels of cytokines. Therefore, it can be regarded as the bioartificial liver reactor.

Objective To observe the injuries of sodium citrate plasma(scP) on the growth and function of HepG2 cells.Methods The HepG2 cells were cultured.The viability,cell cycle and apoptosis,the leakage of LDH,total protein,glutathione and the changes on morphology of hepatocytes exposured to scP were investigated.Results The viability of HepG2 cells was inhibited when the cells were cultured in scP for 24h(F=37.108,P=0.001).After 48h,nearly all cells died except cells in 10% scP group.After the cells were exposed to scP for 24h,the percentage of S phase of the cell cycle and the rate of apoptosis were significantly increased compared to those of the control.The leakages of LDH were increased in the HepG2 following exposure to scP for 5h(P

Objective To summarize the clinical and pathological features of glycogen storage disease (GSD) type Ⅱ. Methods The clinical and pathological data of the 20 GSD type Ⅱ patients were reviewed. Results One patient with infantile-onset mainly presented hypotonia, muscle weakness, feeding difficulties, pulmonary infection and cardiomyopathy insufficiency and increase of serum creatine kinase (778 IU/L) and echographic evidence of hypertrophic cardiomyopathy were detected. Electromyography studies indicated a definite myopathy. Nineteen cases were late-onset, presenting a slowly progressive proximal myopathy with truncal involvement or with symptoms dominated by respiratory insufficiency. Not all muscles were equally affected. Increase of serum creatine kinase (208-2600 IU/L) was detected in 14 patients and normal level in 1 patient. Electromyography studies indicated a definite myopathy in 9 patients,with abnormal irritability in 1 patient and susceptible in 4 patients and myotonic discharge in 1 patient and no abnormalities in 2 patients. Echographic evidence of thickening of the interventricular septum and pulmonary hypertension were detected in 2 patients respectively. The common light microscopic feature of all case was a vacuolar myopathy with high glycogen content and acid phosphatase activity in the vacuoles. Conclusions GSD type Ⅱ often presents slowly progressive myopathy which often affect the toro and respiratory muscles.In most patients the serum creatine kinase level is elevated slightly. Muscle biopsy is of use to make the definite diagnosis of this disease.

BACKGROUND:Matrix metal oproteinase-13 is most active in the degradation of col agen type II in the extracel ular matrix of cartilage. Interleukin-1 (IL-1) is thought to be the inducer of matrix metal oproteinases, and participates in the degradation and degeneration of articular cartilage. OBJECTIVE:To study the influence of IL-1βon microRNA-27b (miR-27b) and matrix metal oproteinase-13 expression of chondrocytes in rats. METHODS:Chondrocytes isolated from seven male Wistar rats were cultured and divided into IL-1βstimulation group and control group. No stimulus was given in the control group;10μg/L of serum free medium was used to culture rat chondrocytes in the IL-1βstimulation group. Cel growth was observed at 0, 24, and 48 hours under an inverted microscope. miR-27b and matrix metal oproteinase-13 expression in the cultured chondrocytes were detected. RESULTS AND CONCLUSION:The relative expression of matrix metal oproteinase-13 in rat chondrocytes was gradual y increased when induced by IL-1βat 0, 24, and 48 hours (P<0.05). Expression of miR-27b and miR-31 in rat chondrocytes at 24 and 48 hours induced by IL-1βgradual y decreased (P<0.05);conversely, expression of MiR-26a, miR-26b, miR-23, and miR-204 gradual y increased (P<0.05). After 48 hours of IL-1βinduction, expression of miR-27b was the lowest in rat chondrocytes (P<0.05). These findings suggest that IL-1βinhibits miR-27b expression, strengthens the expression of matrix metal oproteinase-13, and damages chondrocytes, contributing to both the onset and progression of osteoarthritis.

Objective Through the introduction and implementation of the tutor system to explore nursing practice of cultivating and management methods in operating room. Methods The theoretical knowledge,operation ability,comprehensive ability,and quality of work and so on before and after the implementation of tutor system for new nurse training were compared. Results Tutor system has obviously im-proved the comprehensive quality of new nurses,such as the interpersonal and communication skills and the ability to analyze and solve prob-lem independently. Conclusion The tutor system is beneficial to the interaction between teachers and students,thus enhancing the profes-sional identity of the operating room nurses,reducing the loss of the specialized nursing talents,improving the quality of nursing and setting up a new adapted teacher-and-students mode for teaching and training in the operating room. So it is worthy of extending application.

Objective　To study E-cadherin associated proteins α-、β-、γ-catenin expression and their significance in invasive lobular carcinoma (ILC) and invasive ductal carcinoma (IDC) of breast. Methods　Immunohistochemistry staining (labeled streptavidin-biotin method) was used to detect α-、β-、γ-catenin expression in invasive breast carcinoma (19 cases of ILC and 32 cases of IDC ). Results　The loss and reduction rate of α-、β-、γ-catenin expression in ILC was 78.9% (15 cases)，52.6%(10 cases) and 84.2%(16 cases), respectively. The rate of α-、β-、γ-catenin expression showing loss and reduction in IDC was 75.0%(24 cases)，43.8%(14 cases) and 81.3%(26 cases), respectively. The staining intensity of α-、β-、γ-catenin expression in invasive carcinoma of breast was weaker than that in foci of carcinoma in situ (semiquantitative grading). There was a positive relationship between the expression of α-catenin and β-catenin in invasive breast carcinoma. No significant association was seen between reduced protein expression of α-、β-、γ-catenin and the development of lymph node metastasis. Conclusion　α-、β-、γ-catenin expression was almost identical in ILC and IDC of breast, showing significant loss and reduction of protein expression in the carcinoma cells of invasive breast carcinoma, suggesting that α-、β-、γ-catenin may lose their normal adherent ability in the pathogenesis of invasive breast carcinoma.

As an exclusive Miao medicine of Honwing Pharma （Guizhou） Co. Ltd.， Yifei Zhike capsules are both a prescription drug and an over-the-counter （OTC） drug. Its main ingredients include Ranunculus ternatus and Panax notoginseng. With the effects of nourishing Yin and moistening the lungs， as well as relieving cough and reducing phlegm， Yifei Zhike capsules are often used in the treatment of acute and chronic bronchitis， pulmonary tuberculosis， and other diseases. However， there is insufficient understanding of their efficacy， suitable syndromes， and safety in clinical practice， with a lack of relevant expert consensus on clinical application. To standardize their clinical application， 30 experts from the fields of respiratory medicine， pharmacy， and evidence-based medicine were invited to develop an Expert Consensus on the Clinical Application of Yifei Zhike Capsules （Consensus for short） through evidence-based medicine methods. The Consensus clarified the syndrome characteristics， disease stages， dosages， treatment courses， combined medication， and other norms in the treatment of acute/chronic bronchitis and pulmonary tuberculosis and could be applicable to clinical physicians and pharmacists in medical and health institutions at all levels. In disease diagnosis， it provided diagnostic criteria for traditional Chinese medicine and Western medicine and clarified that the suitable traditional Chinese medicine syndrome was the syndrome of Qi-Yin deficiency with intermingled phlegm-blood stasis. Clinical studies have confirmed that Yifei Zhike capsules combined with standard anti-tuberculosis therapy can effectively improve the symptoms of pulmonary tuberculosis patients， increase the sputum smear conversion rate， and promote the absorption of lesions. When treating acute cough caused by respiratory tract infections， Yifei Zhike capsules can increase the markedly effective rate and the seven-day disappearance rate of cough symptoms. Meanwhile， recommendations for specific usage， dosages， and treatment courses were given for different diseases， and it was pointed out that long-term medication required key monitoring of adverse reactions. In safety， the adverse reactions of Yifei Zhike capsules involved multiple aspects such as the digestive system and allergic reactions， and pregnant women and women during menstruation were prohibited from using it. In addition， modern research has shown that Yifei Zhike capsules have an adjuvant therapeutic effect on tuberculous pleurisy and may be effective for inflammatory and benign pulmonary nodules. However， further research should be conducted on the toxicological safety of long-term medication. The formulation of the Consensus provides a scientific basis for the rational clinical application of Yifei Zhike capsules， which helps to improve clinical efficacy and reduce medication risks.

As an exclusive Miao medicine of Honwing Pharma （Guizhou） Co. Ltd.， Yifei Zhike capsules are both a prescription drug and an over-the-counter （OTC） drug. Its main ingredients include Ranunculus ternatus and Panax notoginseng. With the effects of nourishing Yin and moistening the lungs， as well as relieving cough and reducing phlegm， Yifei Zhike capsules are often used in the treatment of acute and chronic bronchitis， pulmonary tuberculosis， and other diseases. However， there is insufficient understanding of their efficacy， suitable syndromes， and safety in clinical practice， with a lack of relevant expert consensus on clinical application. To standardize their clinical application， 30 experts from the fields of respiratory medicine， pharmacy， and evidence-based medicine were invited to develop an Expert Consensus on the Clinical Application of Yifei Zhike Capsules （Consensus for short） through evidence-based medicine methods. The Consensus clarified the syndrome characteristics， disease stages， dosages， treatment courses， combined medication， and other norms in the treatment of acute/chronic bronchitis and pulmonary tuberculosis and could be applicable to clinical physicians and pharmacists in medical and health institutions at all levels. In disease diagnosis， it provided diagnostic criteria for traditional Chinese medicine and Western medicine and clarified that the suitable traditional Chinese medicine syndrome was the syndrome of Qi-Yin deficiency with intermingled phlegm-blood stasis. Clinical studies have confirmed that Yifei Zhike capsules combined with standard anti-tuberculosis therapy can effectively improve the symptoms of pulmonary tuberculosis patients， increase the sputum smear conversion rate， and promote the absorption of lesions. When treating acute cough caused by respiratory tract infections， Yifei Zhike capsules can increase the markedly effective rate and the seven-day disappearance rate of cough symptoms. Meanwhile， recommendations for specific usage， dosages， and treatment courses were given for different diseases， and it was pointed out that long-term medication required key monitoring of adverse reactions. In safety， the adverse reactions of Yifei Zhike capsules involved multiple aspects such as the digestive system and allergic reactions， and pregnant women and women during menstruation were prohibited from using it. In addition， modern research has shown that Yifei Zhike capsules have an adjuvant therapeutic effect on tuberculous pleurisy and may be effective for inflammatory and benign pulmonary nodules. However， further research should be conducted on the toxicological safety of long-term medication. The formulation of the Consensus provides a scientific basis for the rational clinical application of Yifei Zhike capsules， which helps to improve clinical efficacy and reduce medication risks.