BACKGROUND: Rat model of orthotopic liver transplantation is a very valuable model for experimental study in liver transplantation including organ preservation, tissue ischemia-reperfusion injury, allograft rejection and immune tolerance mechanism. Stable liver transplantation animal model is the basis of the related experimental studies. However, its experimental operation is long and boring, especially performed by a single operator under direct vision. OBJECTIVE: To investigate the operation techniques to establish a stable rat model of orthotopic liver transplantation by a single operator under direct vision. METHODS: The orthotopic liver transplantation was performed using two-cuff method in 50 pairs of rats. We exposed the abdominal cavity fully, perfused the donor liver through abdominal aorta without flipping donor liver; suprahepatic inferior vena cava was in vivo cut down using one-step method, without diaphragm ring; the suprahepatic inferior vena cava was anastomosed with single-row suture, and the cuff of portal vein was installed by fixing the blood vessel forceps on rubber. Hepatic artery was not reconstructed. Fluid replacement was administered to maintain hemodynamic stability in rats after operation. RESULTS AND CONCLUSION: The donor operative time was (36.2± 2.5) minutes, donor liver trimming time was (12.2± 1.5) minutes, receptor operative time was (45.6 ± 3.5) minutes, suprahepatic inferior vena cava anastomosis time was (10.1 ± 2.1) minutes, portal vein cuff time was (1.5 ±0.9) minutes, infrahepatic inferior vena cave cuff time was (1.1 ± 0.6) minutes, anhepatic phase was (15.1 ± 2.2) minutes. The success ratio of the operation was 100% and the survival rates within 1 week and 1 month were all 100%. It is indicated that the key factors of a successful model were stable anesthesia, good donor liver perfusion, adequate exposure, skilled microsurgical technology and vascular anastomosis technique.

Objective To explore the effect of ghrelin on insulin release of mouse pancreatic islet ?-cell line(NIT-1 cells) and its probable mechanism.Methods NIT-1 cells were incubated in high-glucose DMEM with ghrelin.Then,the media was sampled for the assay of insulin by RIA.The(mRNA) expressions of glucose transporter 2(GluT2),pancreatic-duodenal homeobox-1(PDX-1),inwardly rectifying potassium channel with two transmembrane regions(Kir6.2) and sulphonylurea receptor 1(SUR-1) in the cells were detected by using RT-PCR.The cell proliferation was determined by MTT assay.Results(1) 10~(-9)mol/L to 10~(-7)mol/L of ghrelin inhibited dose-dependently the high-glucose challenged insulin release of the NIT-1 cells.(2) The mRNA expression of Kir6.2,but not GluT2,PDX-1and SUR-1,was down-regulated by 10~(-7)mol/L of ghrelin.(3) Ghrelin had no effect on proliferation of the cells.Conclusions Ghrelin inhibits high-glucose induced insulin secretion of the islet ?-cells.This effect may be secondary to the down-regulation for the expression of Kir6.2,(a component) of ATP-sensitive potassium channel.

Objective To observe the effects of baicalin on forms of hepatic tissue, liver apoptosis, mRNA expressions of iNOS, NF-κB and protein expression of Caspase-3 in rats with ischemia reperfusion injury; To discuss its mechanism of action.Methods The rat models of liver ischemia reperfusion were performed according to the Pringle's method. Rats were randomly divided into sham-operation group, model group and baicalin group. Sham-operation group and model group were given normal saline for gavage, while baicalin group was given baicalin for gavage. Morphological characteristic was observed by HE staining. Hepatocyte apoptosis was determined by TUNEL. The mRNA expressions of iNOS and NF-κB were determined by RT-PCR. The protein expression of Caspase-3 was determined by Western blot.Results Compared with the sham-operation group, mRNA expressions of iNOS and NF-κB and the protein expression of Caspase-3 in the model group increased, as well as liver apoptosis rate (P<0.05,P<0.01); compared with the model group, mRNA expressions of iNOS and NF-κB and the protein expression of Caspase-3 in the baicalin group decreased, as well as liver apoptosis rate (P<0.05), and the hepatic lesion significantly improved in the baicalin group.Conclusion Baicalin can restrain Caspase-3 induced apoptosis by reducing the expressions of iNOS and NF-κB, with a purpose to realize the hepatoprotective effect for liver of rats with ischemia reperfusion injury.

BACKGROUND:Exploration on nonlinear acoustic response of the contrast agent microbubble contained in microvessel under ultrasound excitation is of great significance to maximizing ultrasonic energy deposition, promoting the development of quantitative imaging algorithm, revealing the damage mechanism or evaluating the targeted therapy, and overcoming the limitations of the traditional methods that are mainly used in large-size vessels, and measuring microvessel elasticity.
OBJECTIVE:To build a microvessel containing an ultrasound microbubble, revealing the internal mechanism among ultrasound, microbubble, blood flow and microvessel.
METHODS:Based on the finite element analysis and the lumped parameter model, three-dimensional microvessel containing microbubble model was built and simulated on Comsol Multiphysics 4.4 platform.
RESULTS AND CONCLUSION:Microbubble exhibited slower radial motion compared with axial motion due to vascular wal limitation, but maximum displacement and stress were found near the microbubble center because of the oscil ation coupling of the microbubble with the vascular wal . Under the same ultrasound pressure, the excitation frequency increased, accompanied by decreased and stabilized microvessl constriction and dilation;under the same frequency, with the enhancement of ultrasound pressure, the local microbubble oscil ation lasted longer. With the increase of Young’s modulus of the microvessel wal , the frequency of microbubble oscil ation was reduced, while the amplitude increased. Al these findings indicate that the frequency of microbubble oscil ation increased with the reduction of microvessel size, while its amplitude decreased. The frequency of microbubble oscil ation increased with the enhancement of ultrasound excitation, while the amplitude decreased. On the contrary, ultrasound pressure affected the dynamic characteristics of microbubble and microvessel. In particular, it was the first to demonstrate that the elasticity of microvessel has approximate linear positive correlation with the amplitude of microbubble oscil ation, which reveals the relationship between microvessel elasticity and microbubble response so as to provide theoretical basis for indirect measurement of microvessel elasticity.

We created the multi-media network-based teaching platform in emergency and critical care medicine teaching and unified the advantages of the network technique,multimedia technique and information commons,to build up a new place for all kinds of persons to learn the emergency and critical care medicine in any time or any places,and to build up a teaching re-source library of emergency and critical care medicine by the digital image processing technique, streaming media technique and database technique.

To meet the requirement of curriculum design about medical imaging field to undergraduate in medical college,the course of medical imaging radiation protection was developed by compiling a new textbook,establishing curriculum planning,implementing and evaluating teaching system.The teaching system of “one aim and two follows” was set up by use of three stages and three cycle feedbacks research and the course construction was promoted and developed by its teaching assessment,summary in time and the innovation of the teaching method.

Objective To evaluate the clinical efficacy after implantation of preloaded aspheric intraocular lens.Design Retrospective case series.Participants 74 patients(82 eyes)with age-related cataract:38 patients(43 eyes)in group A(control group),36 patients(39 eyes)in group B(case group).Methods 74 patients(82 eyes)were randomly selected to receive phacoemulsification with KS-3(group A)and KS-3Ai(group B)IOL implantation.The wavefront aberrations and contract sensitivity were measured 3 months post-operatively.Main Outcome Measures Wavefront aberrations and contract sensitivity.Results No complications occurred in both gruops.In 1.0deg,0.7deg,the mean contract sensitivity in group A were lower than those in group B(t =3.69,2.71;P

Objective:To investigate the safety and efficacy of endoscopic treatment for sporadic non-ampullary descending duodenal adenoma, and to analyze high-risk endoscopic features of malignant adenoma.Methods:Data of 54 patients diagnosed as having non-ampullary descending duodenal adenoma in Nanjing Drum Tower Hospital from November 2012 to September 2019 were retrospectively studied. The patients were divided into two groups, the high-grade intraepithelial neoplasia/adenocarcinoma (HGIN/AC) group and the low-grade intraepithelial neoplasia (LGIN) group according to pathological grade. Clinical features including gender, age, size and color of lesions, therapeutic methods, complications and postoperative follow-up results were analyzed.Results:A total of 54 patients were divided into the HGIN/AC group ( n=12) and the LGIN group ( n=42). There were significant differences in size or color of lesions between the two groups (both P<0.05). All 54 patients received endoscopic treatment. Biopsy, endoscopic mucosal resection and endoscopic submucosal dissection were performed on 8, 32 and 14 cases, respectively. A small perforation was found and clipped during operation without any complications. There were 2 cases of delayed hemorrhage, and the bleeding stopped under endoscopic treatment. The mean follow-up time was 2-58 months with no recurrence. Conclusion:Endoscopic treatment is safe and effective for non-ampullary descending duodenal adenoma. Lesions of size larger than 10 mm and those with a red surface have higher malignant tendency.

Objective To compare the curative effects and safety of mirtazapine and fluoxetine in treatment of elderly depressive patients with insomnia.Methods 92 cases of elderly depressive patients with insomnia were randomly divided into two groups: the mirtazapine treatment group and the fluoxetine treatment group. The period of treatment was six weeks. The antidepressant effect was assessed with the drop rate of Hamilton Depression Scale (HAMD),the effect of improving sleep was assessed with HAMD sleep disturbance factor and the Pittsburgh Sleep Index (PSQI), and the administration of security was assessed with vice Treatment Emergent Symptom Scale (TESS).Results After treatment, the effective rate of the mirtazapine group was 90.9% (40/44), that of the fluoxetine group was 84.1% (37/44). In the end of 1st, 2nd, and 4th weeks after treatment, the difference between the two groups were significant (P<0.001). At the end of 6th week, the difference was not significant (P>0.05) in HAMD; the difference was significant in HAMD sleep disturbance factor and PSQI score (P<0.05).Conclusion The clinical effects of mirtazapine in treatment of depression are similar to that of fluoxetine, but mirtazapine takes effects fast, can improve the symptoms of insomnia, has higher safety and better compliance, and is more appropriate for the depressive elderly patients with insomnia than fluoxetine.

AIM: To investigate the effect of 5 - fluorouracil ( 5 - FU ) on the expression of the stem cell marker CD133 on colon cancer stem cells. METHODS:CD133 expression on several colon cancer cell lines was detected by flow cytometry. The CD133 positive cells from DLD1 cells were separated by the method of magnetic activated cell separation. Colony assay was used to measure self - renew ability and MTS assay was used to detect the sensitivity to 5 - FU after separation. After 5 - FU treatment, the change of CD133 mRNA level was measured by qPCR. RESULTS: CD133 expression on the surface of colon cacner cell lines DLD1, HT29, SW480, HCT116, Lovo, RKO was 30.20% , 82.00% , 0.34% , 91.80% , 85.30% , 0.28% respectively. DLD1 cells had two obvious populations according to CD133 expression. CD133 positive cells were separated from DLD1 cells, the positive purity was 87.21% ±5.33% and the negative purity was 84.30% ±4.65%. CD133 positive cells formed more colonies with limited dilution colony assay (46.33% ±4.44% vs 31.00% ±2.00% , P <0.05). CD133 positive cells were less sensitive to 5 - FU compared to CD133 negative cells(20% less, P <0.01). 5 - FU at concentration of 1 mg/L upregulated CD133 mRNA expression in both DLD1 and HT29 cells, the relative quantity was increased from 1 to 1.684 ±0.012(P <0.01 )and 30.702 ±0.280 to 49.379 ±0.460(P <0.01) in HT29 and DLD1, respectively. CONCLUSION: Compared to CD133 negative cells, CD133 positive cells show more ability to form colonies in vitro, and are less sensitive to 5 - FU. 5 - FU upregulats the mRNA expression of CD133, resulting in the CD133 colon cancer stem cells enrichment during 5 - FU treatment.