Gastrointestinal bleeding is a common acute and critical illness that may result in hemorrhagic shock.In conventional concept, sufficient blood transfusion to ensure volume resuscitation was necessary for this emergency condition.With the propose and application of restrictive transfusion strategy in clinical practice, the new concept has been applied in patients with gastrointestinal bleeding.Restrictive transfusion strategy could maintain the perfusion of vital organs with a minimized blood transfusion, and avoiding the coagulopathy and acidosis caused by massive transfusion.This article reviewed the advances in study on gastrointestinal bleeding and restrictive transfusion strategy.

Objective:The characteristics and changes of the three-dimensional micro structure of human placenta in Early-onset severe preeclampsia (EOSP) were quantified, and the relationship of morphologic features and the poor fetal prognosis was explored. Methods:10 patients were recruited in EOSP group, 10 normal blood pressure premature pregnancy were as control group. Ultrathin sections were observed by elec-tron microscope. The Vv,Sv,Nv of plancenta were measured by stereology method. These parameters were compared between the two groups. Results:①In EOSP group, the miorovillus at the bottom of syncytial was sparse and swollen. The mitochondria and endoplasmic reticulum were swollen and dilated. The deposition of lipid granules were increased.②The Vv, Sv of mitochondrial and endoplasmic reticulum in EOSP group were significant augmented than control groups( P<0.01 ). There was no significant difference of Nv in mitochon-drion and endoplasmic reticulum between two groups ( P >0.05). ③The Vv,Sv, Nv of microvilli in EOSP group were smaller than those in control group ( P < 0.01 ). Conclusions. In EOSP, the microstructure of placenta is impaired, thus the synthesis and transportation function of placenta were affected, so fetus could be injured subsequently.

OBJECTIVE To investigate the carrier state of lid margins after eyes area disinfection by 75% alcohol and 0.5% iodine and to compare the effect of different disinfectants,so we will know whether 0.5% iodine can be used for eyes area disinfection. METHODS Thirty eight patients(76 eyes) from our hospital in March-May 2005 were analyzed.The operated eyes area as control group were disinfected by 75% alcohol-the traditional disinfection method.The contralateral eyes area without operation as experimental group were disinfected by 0.5% iodine.Lid margins samples were obtained for culture after 3 minutes. RESULTS The qualification rate was 81.58% in the experimental group whereas 60.53% in the control group(P

Objective To observe the expression changes of microRNA-124(miRNA-124) following traumatic brain injury (TBI) in mice and investigate the correlation of miRNA-124 with neural axon regeneration.Methods Ninety-one C57BL/6 mice were assigned into TBI group (n =63) and control group (n =28) according to the random number table.Mice in TBI group were subjected to controlled cortical impact and euthanized at 12 hours and 1,3,7,14,21,28 days postinjury for the collection of brain tissue in the trauma zone.Mice in control group underwent craniectomy only.Trauma zone observation was done using the HE staining.Expression of miRNA-124 was detected using the real-time PCR.Levels of Nrp-1,Gap-43 and Tau were detected using the Western blot and immunohistochemical staining.Results After injtury,study of mice behavior and HE staining indicated the establishment of experimental model was successful.Expression of miRNA-124 reached the peak at 3 days postinjury (3.80 ± 0.22),expression of Nrp-1 reached the peak at 7 days postinjury (2.006 ±0.179),expression of Tau reached the peak at 14 days postinjury (2.063 ±0.172),and expression of Gap-43 sustained high level since 12 hours after injury(1.355 ± 0.093) (P ＜ 0.05).Count of axon marker positive cells in TBI group was the lowest at 1 day postinjury due to the direct damage and edema,and then slowly recovered.There was no significant difference in the count of axon marker positive cells between the two groups at 14,21 and 28 days postinjury (P ＞ 0.05),but the morphology in TBI group changed obviously.Although the positive cells of axon marker decreased at 1 day postinjury,expressions of miRNA-124,Nrp-1,Tau and Gap-43 in TBI group were significantly increased compared to the detections in control group (P ＜ 0.05).Conclusion Increased expression of miRNA-124 in trauma zone may closely related to axon regeneration after TBI in mice.

ObjectiveTo explore the effects of comprehensive rehabilitation on life quality of patients with stroke in recovery phase.Methods83 patients with stroke in recovery phase (over 3 months) accepted comprehensive rehabilitation. Their extremity motor function and activity of daily living (ADL) were compared before and after rehabilitation.ResultsThere were statistically significant difference on Brunnstrom scores and ADL scores before and after rehabilitation(P<0.01).ConclusionComprehensive rehabilitation can improve motor function and quality of life in post-stroke patients.

Ginko biloba extract is an active compound with broad biological function.This review summarizes the immuomodulatory effect of Ginko biloba extract on immune organ development, monocyte macrophage, natural killer cell, humoral immunity, cellular immunity, cytokines, red cell immunity and mucosal immunity.

Objective:To explore the expression and clinical significance of late autophagy in per-ipheral blood mononuclear cells (PBMCs) of patients with primary gouty arthritis (GA).Methods:Peripheral blood, clinical data, and laboratory tests were collected from 30 patients with acute gout (AG), 30 patients with intermittent gout (IG), and 50 healthy controls (HC). Quantitative polymerase chain reaction (RT-qPCR) was used to detect mRNA expression levels of autophagy-related genes (ATG5, ATG12, ATG16, ATG3, ATG7, ATG10, ATG4B, LC3-2/LC3B). Measurement data conformed to normal distribution were tested using t test or analysis of variance (ANOVA), and non-normal distribution data were tested using Mann-Whitney test or Kruskal-Wallis H test. SNK was used for pairwise comparison among the three groups. Correlation between variables was tested by Spearman correlation analysis. Results:① The expression level of ATG5 mRNA,ATG12 mRNA, ATG16 mRNA, ATG10 mRNA and LC3-2 mRNA in the AG group was lower than that of the IG group and the HC group, and the expression level of the IG group was lower than that of the HC group[9.16×10 -3(6.04×10 -3, 15.00×10 -3) vs 14.48×10 -3(9.95×10 -3, 21.38×10 -3) vs 0.08×10 -3(12.21×10 -3, 42.79×10 -3), H=19.377, P<0.001; 18.89×10 -3(13.85×10 -3, 24.92×10 -3) vs 21.13×10 -3(12.11×10 -3, 28.06×10 -3) vs 33.57×10 -3(13.11×10 -3, 49.89×10 -3), H=7.545, P=0.023; 8.72×10 -3(4.96×10 -3, 13.74×10 -3) vs 10.62×10 -3(7.48×10 -3, 24.71×10 -3) vs 20.07×10 -3(11.99×10 -3, 39.56×10 -3), H=20.962, P<0.001; 1.05×10 -3(0.73×10 -3, 1.84×10 -3) vs 1.60×10 -3(0.93×10 -3, 2.58×10 -3) vs 1.69×10 -3(1.05×10 -3, 3.54×10 -3), H=8.193, P=0.017; 2.31×10 -3(1.22×10 -3, 3.53×10 -3) vs 2.78×10 -3(1.68×10 -3, 5.96×10 -3) vs 3.68×10 -3(2.00×10 -3, 5.67×10 -3) , H=7.135, P=0.028]. The expression level of ATG4B mRNA in the AG and IG group was higher than that in HC group, and there was significant difference between IG group and AG group, IG group and HC group[9.95×10 -3(6.32×10 -3, 12.23×10 -3) vs 10.86×10 -3 (8.80×10 -3, 17.03×10 -3) vs 8.07×10 -3(5.52×10 -3, 11.63×10 -3), H=8.531, P=0.014]. There was no significant difference between the ATG3 mRNA and ATG7 mRNA groups ( H=0.539, 3.739, bothall P values >0.05). ② The results of Spearman correlation analysis suggested that in patients with acute gout, ATG3 was negatively correlated with PDW and MPV ( r=-0.499, P=0.006; r=-0.463, P=0.011); ATG4B was positively correlated with HDL-C ( r=0.408, P=0.048); ATG7 was negatively correlated with GLOB ( r=-0.554, P=0.001); ATG10 was positively correlated with ALB ( r=0.412, P=0.024) and negatively correlated with Crea and hsCRP ( r=-0.459, P=0.011; r=-0.375, P=0.045); ATG12 was negatively correlated with MO ( r=-0.434, P=0.017); ATG16 was negatively correlated with ALT and AST ( r=-0.389, P=0.034; r=-0.366, P=0.047); LC3-2 was positively correlated with UA ( r=0.381, P=0.041) and negatively correlated with MPV and PDW ( r=-0.413, P=0.026; r=-0.449, P=0.015). In patients with intermittent gout, ATG3 and ATG4B were negatively correlated with apoB100 ( r=-0.555, P=0.011; r=-0.462, P=0.040); ATG5 was negatively correlated with Crea ( r=-0.456, P=0.011); ATG10 was negatively correlated with TC, LDL-C, and apoB100 ( r=-0.526, P=0.017; r=-0.556, P=0.011; r=-0.515, P=0.020). Conclusion:Autophagy is involved in the development of gout, and is correlated with ibflammatory and metabolic indicators, suggesting that autophagy is an important feature in the pathogenesis of GA.

Objective: Invasion and metastasis are the main causes of carcinoma mortality; hence, the timely blocking of the invasion and metastasis of carcinoma has become a research hotspot. The present study aims to investigate the expression levels of Tiam-1 mRNA and HPA-1 mRNA and their correlation with the invasion and metastasis of hepatocellular carcinoma. Methods: From May 2009 to Jan 2012, 65 hepatocellular carcinoma patients admitted consecutively in our hospital for surgical treatment were included in this study. Real-time fluorescent quantitative reverse transcriptase polymerase chain reaction (RT-PCR) was used to investigate the expression levels of Tiam-1 mRNA and HPA-1 mRNA in hepatocellular carcinoma, paired adjacent hepatocellular carcinoma (2 cm from the carcinoma), and surgical marginal normal hepato mucosa tissues (5 cm from the carcinoma). RT-PCR was also used to analyze their correlation with the clinicopathological characteristics of hepatocellular carcinoma. Results: The expression level of HPA-1 mRNA was significantly higher in hepatocellular carcinoma (43.83±11.62) than in paired adjacent hepatocellular carcinoma (14.82±8.16) and normal hepato mucosa tissues (6.02±5.36) (P<0.001). The expression level of HPA-1 mRNA was higher in paired adjacent hepatocellular carcinoma than in normal hepato mucosa tissues (P<0.05). The expression of Tiam-1 mRNA was higher in hepatocellular carcinoma (35.28±11.81) than in paired adjacent hepatocellular carcinoma (12.94±6.25) and normal hepato mucosa tissues (4.17±3.49) (P<0.05). The expression level of Tiam-1 mRNA was higher in paired adjacent hepatocellular carcinoma than in normal hepato mucosa tissues (P<0.05). The expression levels of Tiam-1 mRNA and HPA-1 mRNA were closely associated with the degree of differentiation, depth of infiltration, lymph node metastasis, vessel metastasis, and TNM (Tumor, Node, Metastasis)staging of gastric carcinoma (P<0.05). Spearman rank correlation analysis demonstrated a significant correlation between Tiam-1 and HPA-1 (OR=0.523, P<0.05). Conclusion: The expression levels of Tiam-1 mRNA and HPA-1 mRNA were high in hepatocellular carcinoma. Meanwhile, the increased ex-pression levels of Tiam-1 and HPA-1 can promote the invasion and metastasis of hepatocellular carcinoma. Moreover, the determination of Tiam-1 and HPA-1 may be valuable for the treatment and prognosis of hepatocellular carcinoma.

Objective To investigate the imaging features of pancreatic acinar cell carcinoma (PACC),and to assess the role of CT and MRI in the diagnosis of the disease.Methods CT and MRI data of 7 cases with PACC confirmed by surgery and pathology were reviewed retrospectively.Plan and dynamic contrast-enhanced CT were performed in 4 cases.MRI with T1 WI,T2 WI,and dy-namic contrast-enhanced series were performed in 3 cases.Results All of the PACC lesions were manifested as a single solitary mass.1 lesion was located in the pancreatic head,and the other 6 in the pancreatic body-tail.On plan CT,all of the 4 lesions ap-peared hypodense and 3 lesions had irregular more hypodense region in the lesions.On the contrast-enhanced CT,the tumor paren-chyma showed mild to moderate enhancement with non-enhanced hypodense region in the arterial phase,and lower enhancement than that of the surrounding normal pancreatic tissue in the portal and delayed phase.All of the 3 cases were heterogeneous hypointensity on T1 WI and hyperintensity on T2 WI.The manifestations of the tumors on contrast-enhanced MRI were similar with that on the contrast-enhanced CT.Dilation of the pancreatic duct was seen in 4 cases.Liver metastasis was seen in 1 case.Surrounding tissues were invaded in 4 cases.Conclusion CT and MRI can display the features of PACC and help to improve the diagnostic accuracy.

BACKGROUND:Currently, human umbilical cord derived-mesenchymal stem cel s are mainly for local transplantation, which has some shortcomings, such as large trauma, bleeding, complications, that limit its widespread application in clinical practice. OBJECTIVE:To investigate the feasibility of intravenous transplantation of human umbilical cord derived-mesenchymal stem cel s for repair of spinal cord injury. METHODS:Eighty Wistar rats with spinal cord hitting were divided into five groups:blank control group with no transplantation (n=10), DMEM local transplantation group (n=15), DMEM intravenous transplantation group (n=15), cel local transplantation group (n=20), cel intravenous transplantation group (n=20). The functional recovery of spinal cord injury was observed with Basso, Beattie and Bresnahan scores at regular time as wel as hematoxylin-eosin staining and immunohistochemistry staining. RESULTS AND CONCLUSION:During 1 day to 2 weeks after transplantation, there was no significant difference in the Basso, Beattie and Bresnahan scores between the five groups;within 4-12 weeks after transplantation, the Basso, Beattie and Bresnahan scores were significantly higher in the two cel transplantation groups than the other three groups, but there was no difference between these two cel transplantation groups (P>0.05). Histological observation showed that the number of voids and glial scars was less in the cel local transplantation group and cel intravenous transplantation group compared with the other three groups, and there was also no difference between the two cel transplantation groups. These results indicate that the intravenous transplantation of human umbilical cord derived-mesenchymal stem cel s is similar to the local transplantation in the repair of acute spinal cord injury, which is simple and avoids secondary injuries and various complications. It is recommended that this method provide a new approach for cel transplantation.