Objective To analyze and evaluate the effect addition of albumin to the extracorporeal circulation (CPB) in patients undergoing valve replacement. Methods 62 patients under 60 years of age, with the blood level of albumin nearly normal, undergoing mitral valve replacement or aortic valve replacement were randomly divided into two groups. In 34 patients albumin was added to the priming fluid of extraporeal circulation, and in 28 patients it was not. The pre-operative and postoperative serum albumin levels, the duration of assisting ventilation, and the amount of albumin needed between the time of operation to 7 am of the first postoperative day were compared. In both groups the primary priming fluid consisted of balanced electrolyte solution, hydroxyethyl starch, 5% sodium bicarbonate, and 25% mannitol. Results All the indexes, including the preoperative level of albumin, the amount of albumin needed from operation to 7 am of the first postoperative day, and the albumin level at 7 am of the first postoperative day showed no notable differences. Conclusion For patients with no hypoalbuminemia, mitral valve replacement or aortic valve replacement is safe to withhold the addition of albumin to the priming fluid for CPB.

Objective To explore the mechanism of six-segment classification of femur intertrochanteric fracture in a three-dimensional finite element model of upper thigh-bone and its clinical relevance.Methods The left upper thigh-bone of a normal male volunteer of 60 years old was scanned using 64-slice CT.After the images were stored in the format of JPG,they were input into photoshop 7.0 for three-dimensional creation.The three-dimensional images were used to make a three-dimensional finite element model of upper thigh-bone using software Super 93.The model consisted of 764 nodes and 531 units (including 306 compact bone units and 225 cancellous bone units).In this model,the stress distribution at the trochanter during human tumbling was analyzed by imitating adduction,abduction,adduction-intemal rotation and abduction-external rotation of the hip,as well as intense muscular contraction of gluteus medius,piriformis and iliopsoas during adduction-internal rotation of the hip.Results Analysis of stress nephogram showed that the stress was distributed mainly at the exterior cortical bone and spread to the inter-trochanteric part in simple hip adduction (two-part fracture) and distributed mainly at the interior cortical bone and spread to the inter-trochanteric part in simple hip abduction (two-part fracture).In adduction-internal rotation or abduction-external rotation of the hip,the stress was focused on the anterior and posterior walls of the greater trochanter and trochanteric part and spread to the exterior and interior cortical bone and the inter-trochanteric part (three-or four-part fracture).During intense muscular contraction of gluteus medius,piriformis and iliopsoas during adduction-internal rotation of the hip,the stress was focused on the anterior and posterior walls of the greater trochanter,lesser trochanter and trochanteric part and spread to the exterior and interior cortical bone and the inter-trochanteric part (five-or six-part fracture).Conclusions The six-segment classification of femur intertrochanteric fracture explains complex stress distributions after human falling.When combined with three-dimensional CT reconstruction,it is more intuitive than other classifications so that it can provide more definite surgical advice for different types of fracture.

Objective: Our aim was to observe the protective effect of propofol in clinical relevant concentration on the peroxidative injured erythrocyte. Methods: Intravenous blood samples taken from 20 healthy adults were prepared for red blood cell (RBC) suspensions and divided equally into 5 groups: groupⅠfor control, group Ⅱ with hydrogen peroxide (H2O2, 100 mmol/L) -induced injury, and group Ⅲ, Ⅳ, Ⅴ with the same injury as the group Ⅱ but being pretreated with 3 different concentrations of propofol (25, 50, 75 μmol/L), respectively. The concentrations of potassium and malondialdehyde (MDA) in RBC suspensions and hemolytic degree after incubation were measured. Results: After 60-minute incubation, the extracellular potassium concentrations (0.16, 0.14, 0.14 mmol/L), MDA concentrations (5.66, 5.57, 6.20 nmol/L), and hemolytic degree (76.89%, 59.84%, 64.22%) decreased significantly in the groups that were pretreated with propofol as compared with the group Ⅱ (0.26 mmol/L, 9.19 nmol/L, and 100%), but no difference has been seen within the groups pretreated with 3 different concentrations of propofol and between the propofol-treated groups and the group Ⅰ(0.10 mmol/L, 4.13 nmol/L, 52.73%). Conclusion: Propofol in clinical relevant concentrations may decrease MDA production, hemolytic degree, and potassium exflux from erythrocyte in response to in vitro oxidative challenge with hydrogen peroxide and enhance erythrocyte antioxidant capacity. The protective effect is not related with concentrations.

Objective:To investigate the effect on proliferation and apoptosis of T-cell leukemia cells by silencing NRP-1 ( Jurkat cells).Methods:The lentivirus plasmid which expresses NRP1 gene specific shRNA was constructed in our preliminary ex-perimental.We transfected the lentivirus plasmid to human T-cell Lymphoma cells.The proliferation of Jurkat cells different groups and effect on cell proliferation after chemotherapy drug EPI-treated were found by CCK-8 kit.The proliferation level and apoptosis rate of the cells were detected by flow cytometry and Annexin-V-FITC/PI method.Results:The proliferation level of NRP-1 /shRNA interference group was decreased significantly in 48 h,72 h,96 h,which was compared with the control groups.The apoptosis rate of the NRP-1/shRNA interference group was increased compared with control groups.The chemotherapy drug sensitivity of epirubicin ( EPI ) test results showed that EPI concentration was 0.025,0.05,0.1,0.2,0.4 μg/ml,the NRP-1/shRNA interference group of cell growth inhibition rate was increased,the corresponding control group difference had statistical significance(P<0.05).We choose the drug con-centration of the EPI IC50 for next experiments.NRP-1/shRNA interference group cell apoptosis rate increased significantly after induction,compared with the control groups difference was statistically significant ( P<0.05 ).Compared with control group, the expression level of Bcl-2 protein was decreased and the expression level of bax protein was increased significantly after EPI induction.The percentage of cells at G0/G1 phase increased significantly,while those at S phase decreased significantly.Conclusion:Plasmid shRNA-NRP1 inhibited the expression of NRP1 in Jurkat cells and decreased the proliferation level of Jurkat cells and promote their apoptosis and enhance their drug sensitivity;the molecular mechanism may relate to down-regulation of Bcl-2 and up-regulation of Bax.and arrested the cell cycle at G0/G1 phase.

Objective To compare the clinical results of surgical and conservative treatment of acute patellar dislocations.Methods Retrospective analyzed the clinical data of 35 patients with acute patellar dislocations from June 2004 to October 2009,and divided the patients into 2 groups.One group with 18 patients underwent surgical treatments,and the other group with 17 patients underwent conservative treatments,record the number of relapses cases of both the two groups.A radiographic examination was performed in the evaluation of the patients,and the Kujala questionnaire was applied with the intention of analyzing the improvement of pain and quality of life.Results All patients were followed up for more than 12 months.(1) The conservative treatment group exhibited a higher number of recurrent dislocations (7 patients) (41.2％) than the surgical treatment group,which did not have any relapses (x2 =9.265,P =0.002).(2) The patellar tilt returned to normal in the surgical group,while 8 patients returned to normal in the conservative group,with statistical difference between groups (x2 =10.980,P =0.001).And the lateral shift ratio returned to normal in the surgical group,while 6 patients returned to normal in the conservative group,with statistical difference between groups(x2 =7.667,P =0.006).(3)The surgical treatment group obtained a significantly better mean score on the Kujala test than preoperative ((90 ± 5) vs.(58 ± 6),t =16.465,P ＜ 0.01) ; The conservative treatment group,compared with the preoperative,is not improved obviously ((72 ± 6) vs.(62 ± 8),t =0.943,P ＞ 0.05) ;Postoperative group comparison,surgical group was higher than that in conservative group,there was significant difference between two groups (t =12.256,P ＜ 0.01).Conclusion For acute patellar dislocation,surgical treatment can significantly restore patellar stability,improve the function of knee joint.

BACKGROUND:Extreme lateral lumbar disc herniation is a rare type of lumbar disc herniation, there are a variety of treatment methods, but the therapeutic efficacy and recurrence rate are controversial.
OBJECTIVE:To investigate the availability of lumbar pedicle screw fixation combined with interbody fusion cage for treating extreme lateral lumbar disc herniation.
METHODWe retrospectively analyzed 19 patients with extreme lateral lumbar disc herniation after treatment with lumbar pedicle screw fixation combining with interbody fusion cage from March 2006 to January 2009. The outcomes were evaluated depending on VAS scoring standard and Macnab scoring standard, lumbar stability were observed postoperatively. We analyzed the spinal stability in recurrent lumbar disc herniation patients after lumbar pedicle screw fixation combined with interbody fusion cage depending on literature search.
RESULTS AND CONCLUSION:Al the 19 patients were fol owed up for 13 months to 3 years, the leg and lumbar pain of al the patients were relieved to varying degrees. Preoperative VAS score was 7.3±1.28 points and postoperative VAS score was 2.1±0.8 points, showing significant difference between two groups (P<0.05). The excellent and good rate was up to 95%with 15 excellent results, 3 good results and 1 acceptable result depending on Macnab evaluation standard. There was no pedicle screw loosening, broken, non-fusion phenomenon. Al the lumbar interbody fusions were good. No one occurred secondary lumbar spinal stenosis. Experimental findings indicate that, lumbar pedicle screw fixation combined with interbody fusion cage for extremely lateral lumbar disc herniation, is characterized as fast symptom relief, strong fixation and good lumbar stability.

Objective To investigate the expression of miR-520d-3p in 2 and 4 Gy X-ray irradiated A549 cells, serum samples of non-small cell lung cancer (NSCLC) patients and its significance. Methods Real time quantitative PCR (RT-qPCR) was employed to detect the expression miR-520d-3p in 2 and 4 Gy X-ray irradiated A549 cells in vitro. Besides, 0, 2 and 4 Gy X-ray irradiated A549 cells were used to prepare animal model of nude mice lung metastasis through mainline. The expressions of miR-520d-3p and lung tissue of nude mice were detected, and the serum samples of NSCLC patients were collected to test the expression of miR-520d-3p . Results Compared with the control group ( 0 Gy ) , the expression of miR-520d-3p was up-regulated significantly in 2 and 4 Gy X-ray irradiated A549 cells after 48 hours (1.00±0.03, 1.47±0.10, 1.84 ±0.09 respectively), and there was a significant difference (F= 94.350, P= 0.000). Furthermore, compared the control group with injection after 10 weeks, the expressions of miR-520d-3p in nude mice lung tissue in 0, 2 and 4 Gy X-ray irradiated groups were increased (2.33 ±0.13, 8.24 ±0.25, 3.46 ±0.14, respectively) (F=1.787, P= 0.227), and the expressions in serum were increased (11.43±2.30, 10.22±4.62, 8.99 ±3.67, respectively) (F= 1.547, P= 0.246). Out of 20 serum samples of NSCLC patients (including 10 cases of adenocarcinoma, 10 cases of squamous carcinoma ), 11 cases (55%) were detected with up-regulated miR-520d-3p expression. Conclusions 2 and 4 Gy X-ray could increase the expression of miR-520d-3p of A549 cells in vitro and in vivo, which might be correlated with the enhanced invasion and metastasis of A549 cells induced by X-ray in vitro and in vivo. Furthermore, the expressions of miR-520d-3p were increased significantly in over 50%serum samples of NSCLC patients, which might be a new marker for the diagnosis of NSCLC.

Objective · To explore influencing factors associated with the hydration status in peritoneal dialysis (PD) patients.Methods · Eligible PD patients treated in Renji Hospital affiliated to Shanghai Jiao Tong University School of Medicine from September 2016 to January 2017 were enrolled.Demographic data of patients were collected and biochemical indexes were measured.Their peritoneal transport characteristics and dialysis adequacy were evaluated.Hydration status index overhydration (OH) value was measured with bioimpedance spectroscopy.Multivariate linear regression was used to analyze the independent factors associated with the OH.Results · A total of 147 PD patients with a median age of 58.52 years and a median PD duration of 43.03 months were enrolled.Of them,90 (61.2％) were male,21(14.3％) were accompanied by diabetes mellitus,and 107 (72.8％)were overhydrated (OH＞1.1L).Compared to those with normal hydration status (OH ≤ 1.1 L),the overhydrated patients had higher proportion of diabetes,BSA,Charlson comorbidity score,brain natriuretic peptide (BNP),4 h D/Pcr,and 24 h dialysate protein,and lower tKt/V,serum albumin than the normal hydrated patients (all P＜0.05).Multivariate linear regression showed that comorbid diabetes mellitus (P=0.000),higher 4h D/Pcr (P=0.000),and lower serum albumin level (P=0.001) were independent relevant factors for the increase of OH.Conclusion· Overhydration is common in PD patients.Comorbid diabetes mellitus,higher 4 h D/Pcr,and lower serum albumin are independent relevant factors for the hydration status in PD patients.

Objective To explore the analgesic effect of intra-articular botulinum neurotoxin type A (BoNTA) injection in rats with adjuvant-arthritis pain,to quantify the expression of calcitonin gene-related peptide (CGRP) in the dorsal root ganglia (DRG) associated with arthritis pain,and to investigate the retrograde axonal transport of BoNT-A into the DRG after peripheral injection.Methods Ninety Sprague-Dawley rats were randomly divided into groups A,B,C,D and E,each of 18.A murine model of adjuvant-arthritis pain was established by injecting 50 μL of complete Freund's adjuvant into the left ankle in all the mice except those in group A.The control group A was treated with intra-articular injection of 50 μL of saline solution.Three weeks later,groups A and B were treated with a 20 μL intra-articular saline injection,while groups C,D and E received an intra-articular injection of BoNT-A at 1 U/20 μL,3 U/20 μL or 10 U/20 μL respectively.Pain threshold and muscle strength were graded before and 1,5,15 and 21 days after the modelling,as well as at 1,3,5 and 14 days after the BoNT-A treatments.Protein expression and the CGRP-positive cell number were observed,as well as any BoNT-A-cleaved synaptosomal-associated 25 kDa protein (cl-SNAP-25) in the DRG using Western blotting and immunofluorescence.Results Compared with group A,there was a significant decrease in the average mechanical withdrawal threshold and muscle strength and a significant increase in the protein expression and the CGRP-positive cell number in the other 4 groups.Compared with group B,the mechanical withdrawal threshold had increased significantly more in groups D and E at 5 days after the BoNT-A injection and in group C at 14 days after the treatment.Compared with group B,the protein expression and the number of CGRP-positive cells were significantly lower in groups D and E at 3 days after the BoNT-A injection.The decrease in group C was significant after 14 days.No significant differences were found between groups D and E in any measurement at any time point.There was no significant difference among groups B,C and D in terms of muscle strength.Five days after the BoNT-A injection,significantly decreased muscle strength was observed in group E.In addition,BoNT-A cleaved-SNAP-25 was detected in the DRG.Conclusion BoNT-A can reduce arthritis pain through inhibiting the expression of CGRP in the DRG.Its analgesic effect has a dose response.A peripheral injection of BoNT-A can arrive at the DRG through retrograde axonal transport.

Objective To investigate the effect of Zingiber corallinum oil ( ZCO ) on apoptosis and proliferation of cervical carcinoma cell line HeLa. Methods HeLa cells were treated with different concentrations of ZCO(5-80 mg·L-1)in vitro. Cytotoxicity rate was determined by CCK-8 assay. The morphological changes was observed using inverted microscope after AO/EB staining. Caspase-3 activities were measured with a colorimetric method. Protein level of hsp-70 were detected by Western blotting. Cell cycle and apoptosis were analyzed by flow cytometer ( FCM ) . Results ZCO exhibited effect of proliferation inhibition and apoptosis-inducing on the growth of HeLa cells in a dose-dependent manner. Caspase-3 activities increased in a dose-dependent manner while the expression of hsp-70 decreased. Cell cycle was arrested in G2/M phase. Conclusion ZCO exhibites a marked effect of proliferation inhibition and apoptosis-inducing on HeLa cells. The mechanism of ZCO might be activating the key enzyme in apoptotic pathway, so that the expression of hsp-70 is down-regulated, and cell cycle is arrested in G2/M phase.