Objective To investigate the result of local injection of growth differentiation factor-5 (GDF-5) and fibrin gel for treatment of lumbar disc injury in rabbits.Methods Lumbar puncture with a 20-gauge needle was performed at L3/4,L4/5,and L5/6 discs of 40 New Zealand white rabbits.After needle puncture,L3/4 discs were injected with GDF-5 and fibrin gel (compound group) ; L4/5 discs fibrin gel (fibrin gel group) ; L5/6 discs nothing (blank control group).Two weeks later,intervertebral disc degeneration in each group was observed via radiography,MRI and nucleus proteoglycan content detection and histological examination.Results At postoperative 2-,4-,8-,and 12-weeks,X-ray films revealed a gradual decrease in disc height index (DHI) among the three groups,but the decreasing velocity was lower in compound group than in other two groups (P ＜ 0.05).On MRI,the signal of intervebral discs among the three groups diminished progressively with time,but a relatively lower decreasing was observed in compound group (P ＜ 0.05).At postoperative 4-week,proteoglycan content of the nucleus pulposus was (6.3-± 0.4) in compound group,higher than (5.9-0.4) in blank control group and (5.8-± 0.3)in fibrin gel group (P ＜0.05).At postoperative 2-week,histological evaluation showed (5.28 ±0.41)points in compound group,lower than (7.54 ± 0.53) points in blank control group and (7.21 ± 0.44)points in fibrin gel group (P ＜ 0.05).Conclusion Local injection of GDF-5 and fibrin gel facilitates the restoration of the injured discs and delays further disc degeneration.

Objective To investigate the effects of the frozen embryo transplantation for patients with poor outcome of endometrial growth by using growth hormone (GH) intrauterine perfusion combined with replacement cycle in the treatment of thin endometrium.Methods This was a prospective study and study participants were consecutively recruited between Jun 2014 and September 2015.A total of 88 frozen thawed embryo transfer cycles was divided into two groups from the Reproductive Center of Hunan Provincial Maternal and Child Health Hospital.Group A were 63 hormone replacement therapy (HRT) cycles and Group B were 25 GH intrauterine perfusion combined HRT cycles.Results The endometrial thickness of 22 thin endometrium patients from Group B were increased above 7 mm on progesterone day.The endometrial thickness on transplant day of Group A was (9.28 ± 1.64) mm,which was significantly higher than Group B (7.9 ± 0.86) mm (P ＜ 0.05).The clinical pregnancy rate (50.79％ vs 52.0％),implantation rate 31.1％ vs 47.17％),miscarriage rate (9.38％ vs 15.38％) had no significant difference between Groups A and B.The endometrial thickness from 7 mm to 7.9 mm on transplant day,the clinical pregnancy rate (30.76％ vs 54.54％) had no significant difference in two groups (P ＞0.05),but the implantation rate of group A was significantly lower than that of group B (20％ vs 52.17％) (P ＜0.05).When the endometrial thickness was above 8 mm on transplant day,the clinical pregnancy rate (58.33％ vs 63.63％),implantation rate (36.36％ vs 50％) had no significant difference between groups A and B (P ＞ 0.05).Conclusions GH uterine cavity perfusion was a useful method for treatment of thin endometrium,and was helpful for improvement of endometrial thickness and receptivity,improved embryo implantation environment by assistance for HRT under the high estrogen levels.

Objective To investigate the correlation between apolipoprotein E (protein:apoE;gene:APOE) polymorphisms and intracellular Ca2 + concentration in the early stage after astrocyte injury.Methods ( 1 ) The CDS region of three APOE alleles was obtained by using reverse transcription polymerase chain reaction (RT-PCR). Then, the recombinant plasmid pEGFP-N1-APOE was constructed and identified by sequencing. (2) Astrocytes were separated from APOE gene-knockout mice for immunocytochemical identification. The recombinant plasmid was transfected into the astrocytes with liposome-mediated method to screen the cell lines that could stably express APOE information. (3) Cell injury models were set up by scarification. Laser scanning confocal microscope (LCSM) was used to detect the dynamic changes of intracellular Ca2+ at 12, 24, 48 and 72 hours postinjury. Results Compared with the control group ( before injury ), every allele showed significant changes of fluorescence intensity of Ca2 + ( P ＜0.05). At 12 hours after injury, the fluorescence intensity of Ca2+ was weak, with no statistical difference between three groups ( P ＞ 0. 05 ). At 24,48 and 72 hours postinjury, the fluorescence intensity was increased progressively, with significant higher intensity in ε4 group than the other two groups (P ＜0.05 ). Conclusions The concentration of intracellular Ca2+ in the astrocytes carrying APOEε4 allele is higher than that of those carrying APOEε2 and ε3 alleles, indicating that APOEε4 carriers may activate Ca2+ channel and lead to aggravation and poor prognosis of acute injury.

Objective To study the severity of acute pancreatitis (AP) by using MRI and the acute physiology and chronic healthy evaluation Ⅲ (APACHE Ⅲ ) score, and the correlation between corresponding MRI findings and APACHE Ⅲ scores.Methods One hundred patients with AP undergoing abdominal MRI were recruited in the study. The MRI features of acute pancreatitis were recorded. The severity of AP on MRI was graded by MR severity index (MRSI) as mild (0 to 2 points),moderate ( 3 to 6 points) and severe (7 to 10 points).APACHE Ⅲ score was denoted for AP was as mild ( ＜35 points)and severe ( ≥ 35 points).The local and systematic complications,mortality,need to intense care unit (ICU),and hospitalization time were recorded and compared with MRSI and APACHE Ⅲ score.Nonparametric Spearman correlation was calculated for testing the correlation between the MRSI,the APACHE Ⅲ and hospitalization time.The correlation of clinical results with MRSI and APACHE Ⅲ was calculated by x2 test.Results In the 100 patients with AP,there were respectively 80 and 20 patients with edematous and necrotic pancreatitis on MRI.According to MRSI,34,59 and 7 patients had mild,moderate,and severe acute pancreatitis,respectively.The APACHE Ⅲ score was (24.9 ± 12.2) points.Seventy-seven patients had less than 35 points and 23 patients had more than 35 point of APACHE Ⅲ score.There were significant differences in the local complication,systematic complication,need to ICU among the three groups in MRSI score,respectively( x2 =9.161,19.118,54.767;P ＜ 0.01 ).There was difference in the systematic complication between mild and severe AP in APACHE Ⅲ score(x2 =13.120,P =0.000),but there were no differences (x2 =0.245,x2 =2.568;P ＞ 0.05) in the local complication,need to ICU between mild and severe AP in APACHE Ⅲ score.There was weak correlation ( r =0.235,P =0.019 )between MRSI score and hospitalization time,and no difference (r =0.168,0.105; P ＞ 0.05)between APACHE Ⅲ and MRSI,APACHE Ⅲ and hospitalization time,respectively.Conclusions Both MRSI and APACHE Ⅲ score may predict systematic complications. However,MRSI is superior to APACHE Ⅲ in predicting the local complications,need to ICU,and hospitalization time in patients with acute pancreatitis.

Objective To study MRI findings of pancreatic ducts of piglets with chronic pancreatitis (CP) induced by pancreatic duct ligation and analyze the relationship between pancreatic duct changes in piglets with CP and the pathological severity of CP. Methods Thirty healthy piglets were included in this study. Five piglets were randomly selected as normal control group, and the remaining 25 piglets were served as the experimental group. The duct ligation operations were performed on experimental group. After 2 to 18 weeks, pancreas and pancreatic ducts were observed on MRI. Then the pancreas was removed and graded into three types by histopathology. The relationship between the diameter of pancreatic duct or the pancreatic branch displaying rate and the severity of CP was analyzed by Spearman correlation coefficient. Results CP was found in 21 piglets( 84. 0% ) in the experimental group including mild ( n = 7 ), moderate ( n = 8 ) and severe( n = 6) pancreatitis. Pancreatic ducts were shown in mild CP and the edge of pancreatic ducts was irregular in three cases. The dilated RPD, LPD and MPD constituted the "person" form in moderate and severe CP. The diameter of pancreatic ducts was(0. 9 ±0. 3)mm, (2. 9 ± 1.4)mm and (4. 8 ± 1.2)mm in mild, moderate, and severe CP respectively. The expansion extent of pancreatic ducts was correlated with the severity of CP of piglets (r = 0. 837, P ＜ 0. 05). The pancreatic branch displaying rate increased with the increase of the severity of CP ( r = 0. 990, P ＜ 0. 05 ); the displaying rate was 0/7 for mild, 3/8 for moderate, and 5/6 for severe CP. Conclusions The dilated pancreatic ducts with "person" form in piglets with obstructive CP created by pancreatic duct ligation. The pancreatic duct changes on MRI reflect the severity of CP of piglets.

Objective To compare the clinical efficacy of percutaneous transforaminal endoscopic discectomy (PTED) and Quadrant minimally invasive system in treatment of lumbar disc herniation (LDH). Methods 59 single-level LDH patients were randomly divided into PTED group (n = 31) and Quadrant group (n = 28). Then compare the operative time, incision length, blood loss, length of hospital stay, and the return-to-work time between the two groups. In addition, visual analogue scale (VAS), Japanese Orthopedic Association (JOA), Oswestry disability index (ODI), and modified MacNab criteria were used for surgical efficacy evaluation. Results In PTED group, compared with Quadrant group, we observed, shorter incision length, less blood loss, shorter hospital stay, and shorter time of returning to work (P < 0.05), postoperative VAS, JOA and ODI scores had been improved in both groups (P < 0.05). The PTED group had lower VAS scores of lumbago at 3 days and 1, 3 months postoperatively (P < 0.05). As for postoperative JOA and ODI score, no notable difference was found between the two groups at each corresponding follow-up time point (P > 0.05). According to the improved MacNab criteria, there was no significant difference in excellent or good rate between the two groups (P > 0.05). Conclusion The clinical results of PTED and Quadrant minimally invasive system in treatment of lumbar disc herniation were satisfactory, and PTED were less traumatic method with rapid recovery.

OBJECTIVETo explore the role of P38 signaling pathway in neonatal rat astrocyte swelling and the expression of aquaporin-4 (AQP4) after oxygen-glucose deprivation (OGD) and recovery (OGD/R).

METHODSPrimarily cultured neonatal rat astrocytes were subject to OGD for 5 h followed by oxygen-glucose recovery in the presence or absence of the P38 inhibitor SB203580 (10 µmol/L). The astrocytes were investigated at 0.5, 2, 8 and 24 h after oxygen-glucose recovery for morphological changes and cell injuries using lactate dehydrogenase (LDH) assay. The expressions of P38, P-P38, and AQP4 mRNAs and proteins in the astrocytes were detected using RT-PCR and Western blotting.

RESULTSOGD/R caused significantly enhanced expression of P-P38 protein, and this effect was blocked by SB203580. AQP4 mRNA and protein expression declined transiently at 0.5 h after OGD and increased gradually to reach the peak level at 8 h (P<0.05). Application of the SB203580 significantly lowered OGD-induced AQP4 mRNA and protein up-regulation (P<0.05). Astrocyte swelling occurred after OGD/R but was obviously lessened by SB203580. LDH release increased markedly after OGD/R, and was attenuated by treatment with SB203580 (P<0.01).

CONCLUSIONP38 signaling pathway participates in astrocyte swelling after OGD/R, and blocking this pathway can attenuate AQP4 up-regulation and ameliorate the cell swelling.

Animals ; Animals, Newborn ; Aquaporin 4 ; metabolism ; Astrocytes ; metabolism ; pathology ; Brain Edema ; metabolism ; pathology ; Cell Hypoxia ; Glucose ; pharmacology ; MAP Kinase Signaling System ; physiology ; Oxygen ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; metabolism

OBJECTIVETo explore the role of p38 signal pathway in regulating matrix metalloproteinase-9 (MMP-9) expression and brain edema formation in a rat model of traumatic brain injury (TBI).

METHODSA total of 130 adult male Sprague Dawley rats were randomly divided into 4 groups, namely the normal group (n=10), sham-operated group (n=40), TBI (induced by Feeney free falling methods) group (n=40), and SB group with intraperitoneal SB203580 treatment (10 µmol/L) 15 min before TBI (n=40). The rats were sacrificed 2 h and 2 days after TBI. The expressions of p38, p-p38, and MMP-9 mRNA and protein were detected by RT-PCR and Western blotting. The blood brain barrier permeability was detected by Evans Blue (EB) test, and the brain water content (BWC) was determined using a gravimetric technique.

RESULTSThe expression of p-p38 protein increased markedly 2 h after TBI (P<0.05), and was suppressed by SB203580 treatment (P<0.05). MMP-9 mRNA and protein showed no obvious increase at 2 h after TBI, but significantly increased at 2 days as compared with those in the sham-operated group (P<0.05). MMP-9 mRNA and protein were much lower in SB group than in TBI group 2 days after TBI (P<0.05). The blood brain barrier permeability significantly increased 2 h after TBI (P<0.05) and kept increasing until 2 days (P<0.05), but was reduced significantly by SB203580 (P<0.05). BWC increased obviously 2 days after TBI (P<0.05) and was lessened by SB203580 (P<0.05).

CONCLUSIONBlocking p38 signal pathway can attenuate MMP-9 upregulation and brain edema after TBI, suggesting the important role of p38 in regulating MMP-9 expression to affect traumatic brain edema.

Animals ; Brain Edema ; pathology ; Brain Injuries ; metabolism ; Enzyme Inhibitors ; pharmacology ; Imidazoles ; pharmacology ; MAP Kinase Signaling System ; Male ; Matrix Metalloproteinase 9 ; metabolism ; Pyridines ; pharmacology ; Rats ; Rats, Sprague-Dawley

Objective To assess the effects of artificial cycle after long-acting gonadotropin-releasing hormone (GnRH) agonist down regulation scheme and artificial cycle only scheme in preparation of endometrium before frozen embryo transfer in polycystic ovary syndrome (PCOS) patients on pregnancy outcome.Methods A retrospective analysis was made on the frozen embryo transfer of 132 PCOS patients in the reproductive center of Hunan Maternal and Child Health Hospital from November 2016 to October 2017.The patients were divided into GnRH-a down regulation + artificial cycle group (n =66) and simple artificial cycle group (n =66) according to the different endometrial preparation schemes before frozen embryo transplantation.The transplantation cycle and pregnancy outcome of the two groups were compared.Results (1) There was no statistically significant difference in age,primary infertility rate,infertility years and body mass index (BMI) between the two groups (P ＞ 0.05).(2) In the artificial cycle group,4 cases in which the transplantation was cancelled,including 2 cases who were cancelled due to breakthrough bleeding and 2 cases due to endometrial thickness that were less than 7 mm.There was a statistically significant difference in the cancellation rate between the two groups (x2 =4.13,P =0.04).There were no statistically significant difference in embryo frozen storage time,retrieved oocytes in fresh embryo cycle,frozen thawed embryos in the survival rate,graftage embryonic number,high-quality embryonic rate,endometrium thickness in conversion day (P ＞ 0.05).Estrogen level,luteinizing hormone (LH) levels on endometrium conversion day in GnRH-a down regulation plus artificial cycle group and artificial cycle group were respectively as [(1 439.38 ± 357.43) nmoL/ml vs (1 580.54 ± 479.69) nmol/ml and (2.32 ± 0.94) mIU/ml vs (9.46 ±1.52) mIU/ml],with statistically significant difference (x2 =53.64,P ＜ 0.001;x2 =14.32,P ＜ 0.001).(3) The biochemical pregnancy rates of the patients in the GnRH-a down regulation plus artificial cycle group and artificial cycle group were 72.73％ and 53.23％ respectively,with statistically significant difference (x2 =5.23,P =0.036).The clinical pregnancy rate (65.15％) in GnRH-a down regulation plus artificial cycle group was higher than that of the artificial cycle group (46.77％),with statistically significant difference (x2 =4.39,P =0.022).There was no statistically significant difference in early abortion rate and ectopic pregnancy rate between the two groups.Conclusions In frozen embryo transplantation cycle,long-term GnRH-a down regulation after artificial cycle scheme is superior to simple artificial cycle scheme with significantly reduced cycle cancellation rate,low estrogen and LH levels in endometrium transformation day and higher biochemical pregnancy rate and clinical pregnancy rate.

Objective:To construct a simple model of arteriovenous fistula classification,and to achieve the classification of arteriovenous fistula in hemodialysis patients.Methods:The study was a retrospective analysis, a total of 304 hemodialysis patients with internal fistula in People′s Hospital of Deyang City from January 2016 to January 2021 were selected by convenience sampling method,depending on whether the internal fistula was dysfunctional, patients were divided into 64 in the internal fistula failure group and 240 in the internal fistula patency group. Independent influence factors and their regression coefficient were obtained by single-factor analysis and logistic regression analysis, The risk score formula was established based on the regression coefficient to form a simple model of internal fistula classification.The model was evaluated by receiver operating characteristic curve and the scoring criteria for internal fistula classification was determined.Results:Logistic regression analysis showed that diabetes mellitus, hypotension, age≥60 years old, compression time≥30 min, blood phosphorus>1.78 mmol/L, triglyceride>1.71 mmol/L and fibrinogen>4 g/L were independent influencing factors of internal fistula failure (all P<0.05).The area under the receiver operating characteristic curve was 0.858(95% CI 0.789-0.928, P<0.01), and the best critical value of the internal fistula classification was 7.5, the sensitivity was 80.4% and the specificity was 84.8%. Conclusions:By obtaining the predictors of internal fistula failure, conducted the risk score, and constructed a simple model of internal fistula classification, which can effectively predicted the risk of internal fistula failure. It is conducive to the implementation of internal fistula classification management and the puncture of corresponding grade, to ensure the pathway safety of patients.