Objective To evaluate the diagnosis and treatment of aortic dissection combined with chronic renal failure.Methods Ten cases were retrospectively analyzed who were diagnosed as aortic dissection combined with chronic renal failure between January 2012 and December 2014.The history of chronic renal failure was 1-6 years.According to Standford classification,one case was type A dissection and the other nine were type B.Results Seven type B dissection had endovascular stent implantation.Perioperative renal function monitor and hemodialysis was given.The other two patients with type B dissection had conservative treatment.One patient with type A dissection died in the day of diagnosis.Follow-up data showed seven patients with stent implantation were in good condition and two others with conservative treatment died due to dissection rupture three and eight months after diagnosis respectively.Conclusions The mortality of aortic dissection combined with chronic renal failure is high.For Standford B dissection,endovascular stent implantation is a reliable treatment method.

Objective:To study the inhibitory effect of salidroside on the proliferation of fibroblast-like synoviocytes with rheumatoid arthritis in human(HFLS-RA) induced by tomor necrossi factor-α(TNF-α),and to clarify the molecular mechanism of its control effect on rheumatoid arthritis(RA).Methods:The HFLS-RA were cultured in vitro,then treated with TNF-α and different concentrations of salidroside.The cells were divided into normal control group(0 μg·L-1TNF-α),model control group(10.0 μg·L-1TNF-α)and 12.5,25.0,50.0,and 100.0 μmol·L-1 salidroside groups(10.0 μg·L-1TNF-α+salidroside).The proliferation activity was detected by MTT mehthod;the expression levels of β-catenin,matrix metalloproteinase-7(MMP-7),and Cyclin-D1 in supernatant of the cells were detected by ELISA method;the expression level of β-catenin protein in cells was detected by Western blotting method.Results:Compared with normal control group,the proliferation activity of the HFLS-RA in model control group was significantly increased (P<0.05);compared with model control group,the proliferation activities of the HFLS-RA in 12.5 and 25.0 μmol·L-1 salidroside groups were decreased but there were no significant differences(P>0.05),and the proliferation activities of the HFLS-RA in 50.0 and 100.0 μmol·L-1 salidroside groups were significantly decreased (P<0.05).Compared with normal control group,the expression levels of β-catenin,MMP-7,and Cyclin-D1 in the supernatant of the cells in model control group were increased(P<0.05).Compared with model control group,the expression levels of β-catenin,MMP-7,and Cyclin-D1 in the supernatant of the cells in 12.5 and 25.0 μmol·L-1 salidroside groups were decreased,but there were no significant differences(P>0.05);the expression levels of β-catenin,MMP-7,and Cyclin-D1 in the supernatant of the cells in 50.0 and 100.0 μmol·L-1 salidroside groups were decreased(P<0.05).The Western blotting results showed that the expression level of β-catenin protein in the cell in model control group was higher than that in normal control group(P<0.01);the expression levels of β-catenin protein in the cells in 12.5 and 25.0 μmol·L-1 salidroside groups were lower than that in model control group,but there were no significant differences(P>0.05);the expression levels of β-catenin protein in the cells in 50.0 and 100.0 μmol·L-1 salidroside groups were lower than that in model control group(P<0.05).Conclusion:Salidroside could inhibit the proliferation of HFLS-RA,and its control effect might be related to the regulation of Wnt/β-catenin single pathway.

To construct a system of genetic transformation suitable for Rhizopus oryzae, we constructed a single-exchange vector pBS-hygro carrying hygromycin B resistance gene (hph) as its selective marker using gene splicing by overlap extension PCR (SOE PCR) technique. We introduced this recombinant vector into Rhizopus oryzae AS 3.819 by PEG/CaCl2-mediated transformation of protoplast, electroporation of protoplast and germinated spores; and we studied the effects of hydrolysis time, field strength and spore germination time on transformation frequency. We conducted quantitative real-time PCR (qPCR) assay to determine the gene copy number of ldhA integrated in the genome of R. oryzae transformants and its effect on the stability of transformants. We successfully achieved R. oryzae transformants integrated with pBS-hygro-ldhA vector. The optimal hydrolysis time for protoplast production was 140 min, and the optimal field strength of electroporation pulse for protoplast was 13 kV/cm. The optimal germination time of spores for electroporation was 2.5 h, and the optimal field strength of electroporation pulse was 14 kV/cm. The transformation frequency of method based on germinated spores was generally higher than the methods based on protoplast. The qPCR test results suggested that transformants with high copy number of integration in a certain range were relatively stable. Our results provided basis and support for metabolic regulation and genetic engineering breeding of R. oryzae.
DNA, Recombinant ; Electroporation ; Genetic Engineering ; Genetic Vectors ; Hygromycin B ; Protoplasts ; Real-Time Polymerase Chain Reaction ; Rhizopus ; genetics ; Transformation, Genetic

We evaluated the patient in the early,advanced or healing phase of the disease by MRI in the treatment of chronic brucellosis spondylitis and to guide the clinical treatment.MRI images of 40 patients with clinically diagnosed chronic brucellosis spondylitis were analyzed retrospectively.The imaging findings of early,advanced and healing patients were summarized.MRI showed abnormal signals in the vertebral body,intervertebral disc,paraspinaI and psoas muscle.It is early stage if the intervertebral space was normal,and advanced stage if combined with interverbral space stenosis.It demonstrated short T1 and short T2 signal or similar to the normal vertebral body,combined with intervertebral space stenosis,for the healing stage.According to the specific imaging manifestations of chronic brucellar spondylitis in the course of disease development,it is possible to evaluate the clinical stage of the disease and guide the rational selection of clinical treatment.

Aged, 80 and over ; Heart Valve Prosthesis Implantation ; methods ; Humans ; Male ; Prosthesis Failure

OBJECTIVETo investigate the placement of a long tube into the small intestine under fluoroscopic guidance and to evaluate its decompression effect on early postoperative small bowel obstruction (EPSBO).

METHODSFifty-four patients with EPSBO requiring decompression between April 2010 and July 2014 were enrolled in the study. Insertion of a long tube was guided by fluoroscopy. We first used the guide wire to pass the pylorus and then used the 10 Fr feeding tube as an exchangeable tube to put the superstiff wire into the duodenum. Finally the long tube could be passed over the guide wire through the pylorus into the intestine. The total procedure time, the radiation exposure time, and the incidence of complications were evaluated.

RESULTSThe long tubes passed into the jejunum on initial insertion for all patients, so the success rate of this technique was 100%. The long tube was inserted into ileum in 18 patients. The mean total procedure time was 34.4 ± 8.6 minutes, and the mean radiation exposure time 18.9 ± 6.8 minutes. A total of 47 patients (87%) experienced full recovery following long-tube decompression and without the need for surgical intervention.

CONCLUSIONSUsing the wire-exchange technique, it is easy to place a long tube into the small bowel under fluoroscopic guidance. This decompression method is safe and effective for management of EPSBO.

Adult ; Aged ; Decompression, Surgical ; methods ; Female ; Fluoroscopy ; Humans ; Intestinal Obstruction ; surgery ; Male ; Middle Aged ; Postoperative Complications ; surgery ; Retrospective Studies

ObjectiveTo evaluate the effect of Rhubarb associated preparations (rhubarb or prescriptions of traditional Chinese medicine including rhubarb) on sepsis patients with acute gastrointestinal dysfunction (AGI).Methods The retrieval of databases from libraries including PubMed, Medline, Cochrane Central Register of Controlled Trials, CNKI, CBMdisc, Wan Fang Database, VIP database were searched to identify randomized controlled trials (RCTs) about Rhubarb associated preparations for treatment of sepsis patients with AGI from the foundation of the various databases to March 2016. And in the mean time, the references of the studies accepted were also retrieved. The retrieving and screening of literatures were performed independently by two researchers, the methodological quality and data extraction of the enrolled literatures were assessed by Jadad scale, and Cochrane Collaboration 5.3 software was used to perform Meta analyses to observe the effects of rhubarb associated preparations on gastrointestinal function score, acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score and 28-day mortality in sepsis patients with AGI; the bias of published literatures was evaluated by funnel plot.Results ① Finally, 16 studies involving 1 171 patients (610 in rhubarb preparation group and 561 in the control group) were identified and enrolled. 12 studies had a Jadad score ≥ 3 and 4 studies < 3. The random method was used in classification of groups in all the studies in which the intergroup baseline data being comparable was clearly indicated. The blind method was applied in 5 contained RCTs.② The results of Meta-analyses showed that rhubarb associated preparation could improve gastrointestinal function score [mean difference (MD) = -0.52, 95% confidence interval (95%CI) = -0.55 to -0.48, P < 0.000 01], reduce the APACHEⅡ score (MD = -3.66, 95%CI = -5.00 to -2.33,P < 0.000 01) and 28-day mortality [odds ratio (OR) = 0.46, 95%CI = 0.30 to 0.71,P < 0.000 01] compared with those in the control group, the differences being statistically significant. No publication bias was seen in 16 literatures containing RCTs from the funnel plot.Conclusions Compared with the control group, the rhubarb associated preparations combined with conventional theraph can significantly improve the gastrointestinal function score, reduce APACHE Ⅱ score and 28-day mortality of sepsis patients with AGI, which suggests the rhubarb associated preparations have better efficacy. In addition, the result of sensitivity analysis has not substantially changed the results of Meta-analysis.

Objective To prepare a innovative VP3 gene‐loaded ultrasound microbubble decorated with TATp and SDF‐1 , having the extracellular accumulation and intracellular permeation function ,and characterize their property .Methods VP3 gene‐loaded ultrasound microbubbles were prepared with the method of W/O/W double emulsion .SDF‐1 and TATp were covalently con‐gjugated to the surface of poly‐lactic/acid‐glycolic acid(PLGA) microbubble though thioether bonds to prepare gene‐loaded targeted ultrasound mirobubbles .Their particle size ,distribution and surface potential were determined by Malvern measuring instrument . The conjugation status of TATp and SDF‐1 were evaluated by flow cytometry and confocal microscopy .Their DNA protection were identified by digestion reaction test .The vitro targeting capacity was preliminarily assessed by light microscopy and flow cytometry , and the vitro ultrasound imaging was investigated under high frequency imaging condition .Results The gene‐loaded targeted ultra‐sound mirobubbles showed regularly sphericity .The diameter was (536 .00 ± 16 .55)nm ,and showed a narrow distribution .The zeta potential was(-0 .08 ± 0 .08)mV .The average gene loading was 0 .62% ,with the average rate of 36 .13% gene encapsulation effi‐ciency .The DNA protective effect sustained 60 min without damage .Connection rate of TATp and SDF‐1 coupled with PLGA mi‐crobubbles surface was 69 .84% .The vitro targeting study showed that more targeted microbubbles stably clustered together in the tongue SCC‐15 cell membranes with the connection rate of 91 .44% ,while non‐targeted microbubbles combination rate was 12 .96% .Moreover ,the vitro ultrasound imaging was tiny dot ,even high echo .Conclusion TATp‐SDF‐1‐VP3‐PEG‐PLGA micro‐bubbles were prepared successfully ,which can efficiently target to tongue SCC‐15 cells ,and pass through the cell membranes at a short time in company with outstanding ultrasound imagings in vitro .

Objective To evaluate the diagnostic and therapeutic strategy of traumatic pulmonary pseudocyst (TPP).Methods Fifteen patients who were diagnosed and treated as TPP between January 2000 and November 2011 were studied retrospectively.Results Nonpenetrating chest trauma was the underlying cause in all cases.A typical sign shown on chest radiograph was a thin-walled cavitary lesion in 9 patients,6 patients accompanied by traumatic wet lung,with or without an air-fluid level.Serial radiological images of CT showed high resolution of the above lesions.Single TPP lesion occurred in 9 patients,and multiple TPP lesions in 6 patients.The size of the lesions was 5 -75 (32 ± 17) mm.The pseudocyst was located in the left lung in 5 patients(33％),located in the right lung in 7 patients (47％),located in bilateral lung in 3 patients (20％).All TPP patients were treated conservatively with no occurrence of complications.Conclusions TPP is an uncommon benign lesion secondary to thoracic trauma.CT scan is an optimal option for diagnosis and evaluation of TPP.Uncomplicated cases can take conservative treatment.For complicated patients,theraneutic strategy should be made individually.

Objective To introduce the experience and analyze the clinical outcome of applica- tion of reinforced bar-ring hybrid external fixator combined with limited internal fixation for complex frac- turcs of tibia plateau in patients.Methods From Aug.2002 to Feb.2005,21 patients with complex fractures of tibial plateau were treated with reinforced bar-ring hybrid external fixatar combined with lim- ited internal fixation.According to Schatzker classification,there were 13 patients with typeⅤfracture and 8 with typeⅥfracture.Voluntary and non-weight beating knee joint motion to partially weight bear- ing was taken one week after operation.Progressive loading was taken continuously until there was clinical evidence of fracture stability and then full weight bearing was done.Results The mean follow-up peri- od was 15.9 months (10-24 months).All the fractures got united and the mean union time was 4.2 months(3-8 months).All the injured knees could extend to less than 5 degrees and flex to more than 90 degrees after rehabilitation.Evaluated by Merchant score system for knee joint,81% of patients achieved excellent healing (7 cases) and good healing (10 cases).Conclusion Operation by using reinforced bar-ring hybrid external fixator combined with limited internal fixation can reduce complications and avoid stiffness of the knee joint.It is an effective method for complex fractures of tibial plateau.