Objective To observe the effect of low molecular weight heparin in the treatment of patients with intrahepatic cholestasis pregnancy(ICP)and regulation of cytokines.Methods 124 patients with ICP were randomly divided into observation group and control group.The control group was treated with SAMe +UDCA therapy,the con-trol group was added low molecular weight heparin.All patients were treated for 10 days.Alanine aminotransferase (ALT),aspartate aminotransferase (AST),total bile acid (TBA),tumor necrosis factor alpha (TNF -α)and IL-18 were observed before and after treatment.Results After treatment,ALT,AST and TBA levels were lower in the two groups(t=64.48,110.14,45.75,40.76,62.54,24.67,all P=0.000),which of the observation group were higher(t=62.42,49.42,23.03,all P=0.000).After treatment,the TNF-αand IL-18 levels were lower in the two groups(t=13.14,25.07,all P=0.000),the TNF-αlevel in the observation group was lower than the control group(t=4.91,P=0.000).After treatment,the incidence rates of neonatal meconium,neonatal asphyxia of the observation group were significantly lower than those of the control group(7.14%vs.20.69%,χ2 =4.33,P=0.037;8.93% vs.24.14%,χ2 =4.75,P=0.029).The incidence rate of fetal and maternal hemorrhage between the two groups had no statistically significant differences (1.79% vs.1.72%,χ2 =0.00,P=0.980;5.17% vs.3.57%,χ2 =0.17,P=0.680).Conclusion The effect of low molecular weight heparin in the treatment of patients with intrahepatic cholestasis of pregnancy is exact,it can reduce the biochemical markers and inflammatory cytokine expression and improve perinatal outcome,which deserves to promote in the clinical treatment application.

Antineoplastic Agents ; adverse effects ; Humans ; Integrative Medicine ; Organoplatinum Compounds ; adverse effects ; Peripheral Nervous System Diseases ; chemically induced

Adult ; Cerebrospinal Fluid Rhinorrhea ; surgery ; Endoscopy ; adverse effects ; Humans ; Male ; Pneumocephalus ; etiology

Animals ; Disease Models, Animal ; Electric Stimulation ; Neurons ; metabolism ; Nitric Oxide Synthase ; metabolism ; Parkinson Disease ; metabolism ; Rats ; Subthalamic Nucleus ; metabolism

OBJECTIVETo promote development and utilization of Ophiocordyceps gracilis in xinjiang and provide basic data for researching and sustainable developing medicine fungus related to O. gracilis.

METHODA white strain SFYT002 isolated from the sclerotium of O. gracilis in Xinjiang was researched by morphological observation, ITS and 18SrDNA sequencing. The ITS and 18SrDNA sequences of the strain were determined, BLAST was compared with the other sequences of Tolypocladium in GenBank. The phylogenetic trees of ITS and 18SrDNA sequences were analyzed in Tolypocladium. In addition, the filter paper method was used to study the antibacterial effects.

RESULTThe main morphological characters of this strain were white cotton-like colonies, phialide with inflated base, drastically sharping with partially bending tips, small and transparent budding spores with being always assemble to spearhead and globular, subglobular or ellipse conidiospores. The phylogenetic trees of ITS and 18SrDNA sequences were constructed and analyzed in Tolypocladium. It was resulted that Tolypocladium was confirmed to be monophyletic, and the strain SFYT002 was the same as the systematic position of others of T. inflatum. Meanwhile, the antibacterial test was performed against the 4 common pathogenic bacteria. It was showed that both fermentation and its extracts of different polar from this strain possessed good anti-bacteria capacities.

CONCLUSIONThe strain SFYT02 was identified as T. inflatum, and inhibited effectively growth of bacteria.

Anti-Bacterial Agents ; isolation & purification ; pharmacology ; China ; DNA, Fungal ; genetics ; DNA, Intergenic ; genetics ; Hypocreales ; genetics ; isolation & purification ; physiology ; Medicine, Chinese Traditional ; methods ; Mycelium ; Phylogeny

Objective To conduct a systematic review on the safety and efficacy of enhanced recov -ery after surgery ( ERAS) in perioperative management of hepatectomy .Methods A literature search was conducted on databases which included the PubMed , Embase, Cochrane Library, Sinomed, Wangfang, VIP and CNKI for randomized controlled trials ( RCTs) on application of ERAS in patients after hepatectomy . The data collection ended in August 2015.A meta-analysis was performed using RevMan 5.3 software.Re-sults Eleven RCTs which included 1074 patients were selected into this study .There were 530 patients in the ERAS group and 544 patients in the control group .On Meta-analysis, when compared with the control group, the ERAS group had significantly shorter length of hospital day (WMD=-2.36, 95%CI: -3.19~-1.54 , P<0.05 ) , shorter time for functional recovery ( WMD=-2.30 , 95%CI: -3.77 ~-0.83 , P<0.05), lower total complication rate (RR=0.65, 95%CI:0.52~0.80, P<0.05), and significantly decreased rates of postoperative pulmonary infection (RR=0.36, 95%CI:0.14~0.91, P<0.05) and nausea and vomiting (RR=0.48, 95%CI:0.26~0.89, P<0.05).There were no significant differences between the two groups on the rates of postoperative bleeding , biliary fistula, abdominal infection, delayed incisional healing, wound infection and urinary tract infection (P>0.05).The ERAS group had significant-ly lower hospitalization cost (SMD=-1.61, 95%CI:-2.42~-0.80, P<0.05), but the differences between the two groups on mortality and re-admission rates were not significant (P>0.05).When compared with the control group , the drainage tube removal time ( WMD=-2.83 , 95% CI:-3.92~-1.76 , P<0.05), time to first mobilization (SMD=-2.34, 95%CI:-2.98~-1.70, P<0.05), time to first feeding ( SMD=-5.08 , 95%CI: -9.33~-0.83 , P<0.05) , time to passage of first flatus ( SMD=-3.60, 95%CI:-4.85~-2.34, P<0.05) in the ERAS group were significantly shorter , but there was no significant difference on the time to the first bowel motion ( P>0.05 ) .Conclusions ERAS in the peri-operative management of hepatectomy was safe and beneficial .

Objective To compare everolimus (EVR) with calcineurin inhibitor (CNI) minimization or withdrawal on renal function of liver transplant patients with standard CNI therapy.Methods A search was conducted on databases which included the PubMed,Embase and Cochrane library for randomized controlled trials (RCTs) comparing EVR with CNI with minimization or withdrawal (the EVR group) with standard CNI therapy (the standard CNIs group) on renal function of liver transplant patients.A metaanalysis was performed using RevMan 5.3 software.Results Five RCTs which included 1 264 patients were selected into this study.There were 790 patients in the EVR group and 474 patients in the standard CNIs group.On meta-analysis,the EVR group had significantly better renal function (SMD =0.36,95％ CI 0.09 ～ 0.64,P ＜ 0.05),but higher rates of infection (RR =1.37,95％ CI 1.08 ～ 1.74,P ＜ 0.05),dyslipidemia (RR =2.46,95％ CI 1.79 ～ 3.38) and leukopenia (RR =2.37,95％ CI 1.32 ～ 4.26).No significant differences were found on the mortality and the acute rejection rates between the two groups (all P ＜ 0.05).Conclusions EVR with CNI minimization or withdrawal after liver transplantation provided effective immunosuppression and improved patients' renal function.The treatment increased the rates of infection,dyslipidemia and leukopenia.

Objective:To investigate the prognostic value of preoperative inflammatory indicators for hepatocellular carcinoma (HCC).Methods:The retrospective cohort study was conducted. The clinicopathological data of 73 patients with primary HCC who underwent radical partial hepatectomy in the Beijing Tsinghua Changgung Hospital of Tsinghua University from December 2014 to July 2019 were collected. There were 57 males and 16 females, aged from 33 to 81 years, with a median age of 58 years. Results of blood examination indicators at the first time in hospital were determined for patients. Observation indicators: (1) the best cut-off values of?? preoperative inflammatory indicators calculated by the maximally selected rank statistics; (2) follow-up; (3) influencing factors for prognosis of HCC patients; (4) comparison of clinicopathological parameters of HCC patients; (5) comparison of predictive value for overall survival. Follow-up was conducted using outpatient examination and telephone interview to determine postoperative survival of patients up to September 2019. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M (range). The best cut-off values ??for continuous variables were obtained using the maximally selected rank statistics based on survival at endpoint of follow-up. Count data were represented as absolute numbers, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Kaplan-Meier method was used to calculate survival rates, and Log-rank test was used for survival analysis. Univariate analysis was performed using the Log-rank test. Multivariate analysis was performed using the COX proportional hazard model. The time-dependent receiver operating characteristic curve (ROC) was used to compare the predictive value of independent prognostic factors. Results:(1) The best cut-off values of?? preoperative inflammatory indicators calculated by the maximally selected rank statistics: the best cut-off values of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and prognostic nutrition index (PNI) were 3.46, 131.05, and 45.65. (2) Follow-up: 73 patients were followed up for 31 months (range, 2-57 months). Twenty patients died during the follow-up. (3) Influencing factors for prognosis of HCC patients: results of univariate analysis showed that NLR, PNI, tumor diameter, and tumor differentiation degree were related factors affecting prognosis of patients ( χ2=10.213, 4.434, 5.174, 4.306, P<0.05). Results of multivariate analysis showed that NLR and tumor differentiation degree were independent factors affecting prognosis of patients ( hazzard ratio=4.429, 13.278, 95% confidence interval as 1.662-11.779, 1.056-10.169, P<0.05). (4) Comparison of clinicopathological parameters of HCC patients: of 73 patients, 64 cases had NLR<3.46 and 9 cases had NLR≥3.46. Cases with tumor length >5 cm or ≤5 cm, neutrophils, lymphocytes were 23, 41, (2.9±1.2)×10 9/L, (1.7±0.6)×10 9/L for 64 patients with NLR<3.46, versus 8, 1, (5.8±2.9)×10 9/L, (1.0±0.3)×10 9/L for 9 patients with NLR≥3.46; there were significant differences in above indicators between the two groups ( χ2=7.017, t=2.982, -3.168, P<0.05). (5) Comparison of predictive value for overall survival: time-dependent ROC curves of NLR and tumor differentiation degree for 1-, 2-, 3-, 4-year survival rates had the area under curve of 0.735,0.611, 0.596, 0.574 and 0.554, 0.583, 0.572, 0.556, respectively. NLR had better predictive value for overall survival of patients than tumor differentiation degree. Conclusion:Preoperative NLR is an independent factor affecting prognosis patients, and its predictive efficacy is better than tumor differentiation degree.

AIM: To assess the differentiation of rat mesenchymal stem cell (MSC) in the microenvironment of retinitis pigmentosa(RP) induced by the administration of sodium iodate. METHODS: In vitro cultured Lewis rat MSC were injected into the subretinal space of NaIO3 induced RP rat eyes (30g/L NaIO3 100mg/kg). To observe the trace and differentiation of MSC by immuno-fluorescent method successively in 5 weeks after the surgery.RESULTS: The majority of the transplanted cells stay in retinal pigment epithelium(RPE) layer and cones and rods layer. From the 2nd week after transplantation, the engrafted MSC expressed PCK and rhodopsin under fluorescent microscope.CONCLUSION: MSC can survive mainly in the outer layer of retina in the microenvironment of RP and differentiate forward the RPE cell and photoreceptor.

Objective: To observe the effects of electroacupuncture (EA) with three frequencies (100 Hz, 2 Hz, and 2 Hz/100 Hz) on the apoptosis of neurons and c-Jun N-terminal kinase (JNK) signaling pathway in the hippocampus of rats with vascular dementia (VD), and explore the mechanism of EA intervention for VD. Methods: Fifty male Sprague-Dawley rats were randomly divided into a model group, a sham operation group, a 100 Hz EA group, a 2 Hz EA group, and a 2 Hz/100 Hz EA group, with ten rats in each group. The VD model rats were established by repeated ischemia-reperfusion of bilateral common carotid arteries. The rats in the EA groups received EA intervention at Baihui (GV20), Dazhui (GV14), Geshu (BL17) and Zusanli (ST36), once a day for 14 d. Afterward, Morris water maze was used to examine the learning and memory performances of the rats in each group, hematoxylin-eosin staining to observe the histomorphological changes in the hippocampal CA1 region, terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling to test the apoptosis of neurons in the hippocampal CA1 region, and Western blot to detect the protein expression levels of JNK, phosphorylated JNK (p-JNK), Caspase-8, and Caspase-3 in the hippocampus tissue. Results: Compared with the sham operation group, the escape latency of the model group in water maze test was prolonged; the number of crossing the original platform was decreased (P<0.01); the hippocampal neurons were severely damaged and the number of surviving neurons was decreased (P<0.01), whereas the number of apoptotic neurons was increased (P<0.01); the protein expression levels of JNK, p-JNK, Caspase-8, and Caspase-3 in the hippocampus were significantly increased (P<0.01). Compared with the model group, the escape latency of each EA group was significantly shortened; the number of crossing the original platform was significantly increased (P<0.01); the damage of hippocampal neurons was alleviated, the number of surviving neurons was increased (P<0.01), and the number of apoptotic neurons was decreased (P<0.01); the protein expression levels of JNK, p-JNK, Caspase-8, and Caspase-3 in the hippocampus were decreased (P<0.01). The results in the 2 Hz EA group and the 2 Hz/100 Hz EA group were superior to those in the 100 Hz EA group. Conclusion: EA with the three frequencies (100 Hz, 2 Hz, and 2 Hz/100 Hz) can improve the learning and memory performances in VD rats subjected to ischemia-reperfusion, its mechanism may be related to the inhibition of neuronal apoptosis and the regulation of the related protein expression of JNK signaling pathway, and the intervention effects of EA with 2 Hz and 2 Hz/100 Hz are more significant.