Objective To evaluate the effect of dexmedetomidine on brain injury in the patients undergoing cardiac surgery with cardiopulmonary bypass (CPB).Methods Eighty patients of both sexes, aged 18-64 yr, with body surface area of 1.6-2.0 m2, with left ventricular ejection fraction＞30％, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ (New York Heart Association Ⅱ or Ⅲ), scheduled for elective cardiac surgery with CPB, were equally and randomly divided into control group (group C) and dexmedetomidine group (group D) using a random number table.Before induction of anesthesia, dexmedetomidine was given as a bolus of 1 μg/kg over 10 min followed by an infusion of 0.5 μg · kg-1 · h-1 throughout the surgery in group D, and the equal volume of normal saline was given in group C.After induction and before skin incision (T0) , at 30 min after beginning of CBP (T1) , at 30 min after the end of CBP (T2) , at the end of surgery (T3) , and at 24 and 72 h after surgery (T4.5) , blood samples from jugular bulb were drawn for determination of serum concentrations of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), IL-10, S-100β protein and neuron-specific enolase (NSE).Results Compared with group C, the serum concentrations of TNF-α and S100β at T1-3 and IL-6 and NSE at T1.4 were significantly decreased, and the serum concentrations of IL-10 at T1-4 were increased in group D (P＜0.05).Conclusion Dexmedetomidine given as a bolus of 1 μg/kg over 10 min followed by an infusion of 0.5 μg · kg-1 · h-1 throughout the surgery can reduce the brain injury in the patients undergoing cardiac surgery with CPB, and the mechanism is related to inhibited inflammatory responses.

BACKGROUND:In treatment of lumbar diseases, lumbar fusion therapy fails in 20%of cases and may lead to a series of complications such as pain, intervertebral space col apse, and delayed kyphosis deformity.
OBJECTIVE:To observe the effect of nucleus pulposus on interbody fusion after removing the anterior column disc of rabbit lumbar vertebra.
METHODS:A total of 36 healthy Japanese white rabbits were randomly and equal y divided into three groups, with 12 rabbits in each group. (1) Group of anterior longitudinal ligament+bone grafting:The L3 intercalated disc were wel exposed and anterior longitudinal ligament was stripped, obtaining a space to L3 intercalated disc, then the iliac bone was implanted. (2) Group of excising anterior 1/3 disc+bone grafting:After the anterior 1/3 disc tissue was excised, the iliac bone was implanted and sutured as Group of anterior longitudinal ligament+bone grafting. (3) Group of excising anterior 1/3 disc+fixation:After the anterior 1/3 disc tissue was excised, the iliac bone was implanted and the anterior column fixation was performed.
RESULTS AND CONCLUSION:Biomechanical testing showed that, at 12 weeks, the verticality tensile force in the group of anterior longitudinal ligament+bone grafting was obviously higher than other two groups, and have better fusion rate and could bear stronger force. Lateral position lumbar radiography showed that, the bone graft was absorbed and no new bone grew into the intervertebral space in the group of excising anterior 1/3 disc+bone grafting at 12 weeks;the formation of osseous bridge was found in the group of excising anterior 1/3 disc+fixation;complete bony fusion was found in the group of anterior longitudinal ligament+bone grafting. Histological examinations showed that, at 12 weeks, no bone tissue formed in the group of excising anterior 1/3 disc+bone grafting;a smal amount of bone trabecula and osteocytes were observed in the group of excising anterior 1/3 disc+fixation;a great quantity of newborn bone trabecula and osteocytes, remodeling lamel ar bone and canalis haversi structure were observed in the group of anterior longitudinal ligament+bone grafting. The stability of anterior column has notable effect on interbody fusion, after the anterior column disc is destroyed, the free nucleus pulposus may affect spinal fusion, so restoring the stability of the anterior column may promote interbody fusion, but stil cannot get solid spinal fusion.

Purpose To study the status of EGFR mutations and the expression of excision repair cross-complementation group 1 ( ER-CC1) and Ki-67 protein in patients with non-small cell lung cancer (NSCLC) and to examine the relationship between their expression and clinicopathologic features. Methods EGFR mutations were analyzed with DNA sequencing, and the expression of ERCC1 and Ki-67 protein was examined by immunohistochemistry EnVision. The relationship of EGFR mutations with the expression of ERCC1and Ki-67 and the clinicopathological features were analyzed. Results EGFR mutations were detected in 143 (143/291, 49. 1%) of the 291 specimens. EGFR mutations were found more frequently in women, non-smokers and adenocarcinoma. The difference of EGFR muta-tion rate between the histological subtypes according to the IASLC/ATS/ERS classification of lung adenocarcinoma was significantly ( P=0. 008). The mean tumor diameter was smaller in patients with EGFR mutations than in those with wild-type EGFR (P=0. 020). EGFR mutations were not related to age, lymph node metastasis. However, EGFR mutations were not related to the expression of ER-CC1 and Ki-67 protein (P>0. 050). Conclusions EGFR mutation is closely linked to several clinicopathological factors, such as gender, differentiation, and histological subtype. There is heterogeneity of EGFR mutation in patients with NSCLC. EGFR mutations were not related to the expression of ERCC1 and Ki-67 protein.

Objective To evaluate the role of Janus kinase 2-signal transducer and activator of transcription 3 (JAK2-STAT3) signaling pathway in sevoflurane postconditioning-induced inhibition of mitochondrial permeability transition pore (mPTP) opening during myocardial ischemia-reperfusion (I/R)in rats.Methods Sixty pathogen-free healthy male Sprague-Dawley rats,weighing 250-300 g,were divided into 4 groups (n=15 each) using a random number table:I/R group,sevoflurane postconditioning group (group SP),AG-490 group (group AG) and sevoflurane postconditioning plus AG-490 group (group SP+AG).Myocardial I/R was induced by 30 min ligation of the left anterior descending branch of coronary artery followed by 120 min reperfusion.In group SP,2.8％ sevoflurane was inhaled for 15 min starting from 2 min before reperfusion.JAK2 inhibitor AG-490 3 mg/kg was intravenously injected at 10 min before reperfusion in group AG.In group SP+AG,AG-490 3 mg/kg was intravenously injected at 10 min before reperfusion,and 2.8％ sevoflurane was inhaled for 15 min starting from 2 min before reperfusion.At 15 min of reperfusion,5 rats were sacrificed and myocardial specimens were obtained for determination of the expression of JAK2,phosphorylated JAK2 (p-JAK2),STAT3 and phosphorylated STAT3 (p-STAT3)in myocardial tissues by Western blot.The ratios of p-JAK2 to JAK2 expression (p-JAK2/JAK2) and pSTAT3 to STAT3 expression (p-STAT3/STAT3) were calculated.Five rats were sacrificed at the end of reperfusion for measurement of myocardial infarct size.The left 5 rats were selected and sacrificed,myocardial specimens were obtained,and the opening of mPTP was detected by a calcein-cobalt quenching method.Results Compared with group I/R,the myocardial infarct size and mPTP opening were significantly decreased,and JAK2/p-JAK2 and STAT3/p-STAT3 were increased in group SP (P＜0.05),and no significant change was found in the parameters mentioned above in SP+AG and AG groups (P＞0.05).Compared with group SP,the myocardial infarct size was significantly enlarged,the extent of mnPTP opening was aggravated,and JAK2/p-JAK2 and STAT3/p-STAT3 were decreased in SP+AG and AG groups (P＜0.05).Conclusion The mechanism by which sevoflurane postconditioning inhibits the opening of mPTP during myocardial I/R is related to activation of JAK2-STAT3 signaling pathway in rats.

Objective To establish and identify the induced pluripotent stem cell(iPSC) line reprogrammed from human umbilical cord mesenchymal cells(HuMSCs).Methods HuMSCs were cultured by adhesion method,and OCT4,SOX2,KLF4,c-Myc,NANOG,LIN-28 were transfected into HuMSCs with lentiviral victor to reprogramme HuMSCs into iPSC.Morphological observation,pluripotency genes (SOX2,TDGF1,THY-1,OCT4,REX1 and TERF1) expression,alkaline phosphatase detection,karyotype analysis,embryonic stem cells (ESC) specific proteins (NANOG,OCT4,SSEA-4,TRA-1-81) immunofluorescence staining,differentiated into teratomas in vivo(inject the iPSC into SCID mice) and embryniod bodies in vitro were performed to exam the pluripotency of the iPSC.Results Four days after being infected by lentivirus,the HuMSCs became round-shape; 10 days after infection,some embryonic stem(ESC)-like colonies appeared.Fourteen days after infection,picked up the regularly shaped colonies and cultured several passages.About 1.25％ HuMSCs were reprogrammed into iPSC.The iPSC presented clone-like growth like ESC.All the cells were positive to alkaline phosphatase staining and expressed the pluripotency genes.The iPSC also expressed the ESC specific proteins,and karyotype analysis showed normal chromosome caryotype (46,XY).Furthermore,the iPSC could form embryoid bodies in vitro,expressed alpha fetoprotein(AFP),smooth muscle actin(SMA) and β-tubulin.The iPSC could alsoform teratomas in vivo.Conclusion OCT4,SOX2,KLF4,c-Myc,NANOG,LIN-28 can reprogram HuMSCs into iPSC efficiently.

Objective To investigate the clinical efficacy of percutaneous transhepatic insertion of biliary stent (PTIBS) combined with radioactive seed implantation in treating malignant biliary obstruction. Methods A total of 38 patients with malignant biliary obstruction were enrolled in this study. Radioactive 125I seed was used, and each 125I seed was 4.5 mm in length and 0.8 mm in diameter. The 125I seeds were placed in a catheter to prepare the 125I seed- strip. PTCD was carried out first, then percutaneous catheterization was performed and a guide- wire was inserted through the catheter until it passed the obstructed biliary segment. The obstructed segment was dilated by a balloon - catheter, which was followed by PTIBS. An 8 - 10 F drainage - catheter was placed into the biliary duct through the stent. Finally, guided by fluoroscopy the catheter with the 125I seed- strip was inserted via the drainage- catheter to the area that was planned to be radiated. The external drainage- catheter was wrapped and fixed to the skin, or was imbedded under the skin. Results Of the 38 patients with malignant biliary obstruction, successful PTIBS combined with radioactive seed implantation was accomplished in 36 patients. After the treatment, the serum bilirubin level fell to normal or near normal range in all patients (P < 0.05). No obvious side effects were observed. Conclusion For the treatment of malignant biliary obstruction, percutaneous transhepatic insertion of biliary stent combined with radioactive 125I seed - strip implantation is a safe and effective method.

E2 is an envelope glycoprotein of Classical swine fever virus (CSFV) and contains sequential neutralizing epitopes to induce virus-neutralizing antibodies and mount protective immunity in the natural host. In this study, four antigen domains (ABCD) of the E2 gene was cloned from CSFV Shimen strain into the retroviral vector pBABE puro and expressed in eukaryotic cell (PK15) by an retroviral gene expression system, and the activity of recombinant E2 protein to induce immune responses was evaluated in rabbits. The results indicated that recombinant E2 protein can be recognized by fluorescence antibodies of CSFV and CSFV positive serum (Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China) using Western blot, indirect immunofluorescence antibody test (IFAT) and ELISA, Furthermore, anti-CSFV specific antibodies and lymphocyte proliferation were elicited and increased by recombinant protein after vaccination. In the challenge test, all of rabbits vaccinated with recombinant protein and Chinese vaccine strain (C-strain) were fully protected from a rabbit spleen virus challenge. These results indicated that a retroviral-based epitope-vaccine carrying the major antigen domains of E2 is able to induce high level of epitope-specific antibodies and exhibits similar protective capability with that induced by the C-strain, and encourages further work towards the development of a vaccine against CSFV infection.

Objective To find out risk factors affecting the prognosis of adult cardiogenic shock patients treated with extracorporeal membrane oxygenation.Methods From January 2003 to December 2010,patients with cardiogenic shock required veno-arterial ECMO after failure of conventional therapy and intra-aortic balloon pump counterpulsation therapy were retrospectively studied. Patients with severe traumatic brain injury,advanced malignancies and multiple organ failure were excluded.All patients were divided into survival group and death group.The risk factors were found out using one-way ANOVA and a multivariate logistic regression analysis was used to determine independent factors associated with survival.Results Thirty-one patients successfully weaned from ECMO. Twenty-two patients were successfully discharged.The average duration of ECMO was 41.56 ± 43.07 hours.Factors associated with failure of hospital discharge were age,pre-ECMO levels of ejection fraction,pre-ECMO levels of lactate,disseminated intravascular coagulation,renal failure and multiorgan failure (P ＜ 0.05). Conclusions Irreversible heart failure and the complications are significantly correlated with survival,and the early use of ECMO for cardiogenic shock and recognize the factors are key to the success of ECMO treatment.

Objective To measure vitamin D levels in newborn cord blood inorder to ascertain appropriate supplementation regimes.Methods A total of 6420 newborn umbilical cordblood 25-hydroxyvitamin D [ 25-( OH ) D ] concentrations were measured by enzyme linked immunosorbent assay, and the correlation between 25-( OH ) D and gestational or birth weight or season was retrospectively analyzed.Results There were 5358(83.5℅)of the 6420,had umbilical cord blood concentrations of 25-(OH)D <50. 0 nmol/L. The 25-(OH)D levels M(Q1,Q3)increased from very preterm births, moderately preterm, later preterm, full-term infants to post-term infants [ 29. 0 ( 22. 5, 38.9),33.4(26.3,41.6),35.1(26.9,43.3),35.7(28.1,45.0),43.3(33.5,52.8)nmol/L, P <0. 001]. The 25-(OH) D levels M(Q1,Q3) increased from very low birth weight infants, low birth weight, normal birth weight infants to macrosomia [29. 0(22. 4,38. 8),34. 6(27. 5,44. 2),35. 1(28. 1, 44. 7),35. 7(28. 0,47. 5), P<0. 001]. The 25- (OH)D levels were positively correlated respectively in gestational ages and body weights ( r =0. 619 , 0. 180 , P <0. 05 ) . Newborn umbilical cord blood concentration of 25- ( OH ) D levels varied with season ( P all <0. 001 ) , the lowest in spring [ 30. 4 (24.1,38.3)]and highest in autumn[39.3(31.6,50.9)].Conclusions Premature and low birth weight infants are especially at high risk of vitamin D deficiency and should receive appropriate vitamin D supplementation. In addition, there should be an ongoing promotion of vitamin D supplements to pregnant women and the awareness of sun exposure to achieve vitamin D sufficiency.

BACKGROUND:There is no effective drug for idiopathic pulmonary fibrosis (IPF), because of a lack of the animal model imitating the complete pathogenesis of human IPF. Therefore, it is critical to establish an ideal animal IPF model used for investigating the underlying pathogenesis and developing a kind of effective drug. OBJECTIVE:To establish an animal model that can mimic more characters of human IPF. METHODS:Seventy male C57BL/6 mice were randomly divided into two groups, fol owed by subjected to the intraperitoneal injection of bleomycin (35 mg/kg) on days 1, 4, 8, 11, 15, 18, 22, and 25, twice (group A) or once (group B) a week. Mice were sacrificed at 2, 4, 6, 8, and 10 weeks after the eighth injection, and the lung tissues were moved used for hematoxylin-eosin, Masson and immunohistochemical stainings. RESULTS AND CONCLUSION:There were various degrees of alveolitis and pulmonary fibrosis in the two groups at different time points after the last injection. The scores of alveolitis and pulmonary fibrosis in the group A began to gradual y increase from the 2nd week and reached the highest level at the 6th-8th weeks until the 10th week. In contrast, the scores of alveolitis and pulmonary fibrosis in the group B peaked at the 2nd week, then fluctuately decreased, and were significantly lower than those in the group A at the 6th week (P<0.05). Immunohistochemistry showed that type I col agen deposition was mainly distributed in the subpleural region, peri-vascular region and alveolar septa, which was consistent with Masson staining findings. The expression levels of transforming growth factorβ1 (TGF-β1) andα-smooth muscle actin (α-SMA) in the regions developing alveolitis and pulmonary fibrosis were significantly increased. In the group A, the expression levels of type I col agen, TGF-β1,α-SMA, and the hydroxyproline content in the lung tissues reached the peak level at 6-8 weeks. However, in the group B, al above indicators reached the highest level at the 2nd week, but gradual y decreased thereafter. At the 4th week, the expression Levels of TGF-β1 andα-SMA in the group B were significantly lower than those in the group A (P<0.05). At the 6th week, the hydroxyproline and type I col agen levels in the group B were significantly lower than those in the group A (P<0.05). In conclusion, the mouse model of pulmonary fibrosis induced by intraperitoneal injection of 35 mg/kg bleomycin twice weekly can be used to mimic the repetitive wound healing process, pathological morphology and cytokine changes of human IPF, which is prone to administration, with better stability and repeatability. This model is of great significance for the study on IPF. Subject headings:Disease Models, Animal;Pulmonary Fibrosis;Bleomycin