Objective To investigate the curative effect and safety of percutaneous intradiscal injection of ozone combined with epidural injection of collagenase for the treatment of prominent lumbar disc protrusion.Methods A total of 541 patients with lumbar disc protrusion were included in this study.All the patients fulfilled the following criteria:the fibrous ring was broken,the protruded extent of nucleus pulposus was less than 10 mm and the dura sac and/or nerve root was compressed.The intradiscal injection of ozone combined with epidural injection of collagenase was performed in all patients.The patients were followed up through further consultation,letters,telephone or other ways.Five hundred and forty-one cases were followed up for 2-3 months(short-term),312 cases for 4-12 months(medium-term)and 115 cases for 13-18 months(ling-term).The short-term,medium-term and long-term curative effects were evaluated with unified curative criteria,and the results were compared with that obtained with the treatment of epidural injection of collagenase only. Results The short-term, medium-term and long-term effective rate of selected cases was 95.9%(519/541),90.4%(489/541)and 87.2%(472/541),respectively.When combined application of two methods was performed,different degree of shrinkage of the protruded nucleus pulposus was obviously observed,with a mean shrinkage degree of 30.5%.The short-term,medium-term and long-term effective rate of simple collagenase chemonucleolysis was 89.5%,82.4%and 80.4%,respectively.Conclusion Intradiscal injection of ozone combined with epidural injection of collagenase is an effective treatment for lumbar disc protrusion when the fibrous ring is broken,the protruded extent of nucleus pulposus is less than 10 mm and the dura sac and/or nerve root is compressed. Its curative effect is superior to simple collagenase chemonucleolysis. Ozone is of clinical significance for producing the shrinkage of the nucleus pulposus.

Objective To investigate the curative effect and safety of percutaneous intradiscal injection of ozone combined with epidural injection of collagenase for the treatment of prominent lumbar disc protrusion.Methods A total of 541 patients with lumbar disc protrusion were included in this study.All the patients fulfilled the following criteria:the fibrous ring was broken,the protruded extent of nucleus pulposus was less than 10 mm and the dura sac and/or nerve root was compressed.The intradiscal injection of ozone combined with epidural injection of collagenase was performed in all patients.The patients were followed up through further consultation,letters,telephone or other ways.Five hundred and forty-one cases were followed up for 2-3 months(short-term),312 cases for 4-12 months(medium-term)and 115 cases for 13-18 months(long-term).The short-term,medium-term and long-term curative effects were evaluated with unified curative criteria,and the results were compared with that obtained with the treatment of epidural injection of collagenase only.Results The short-term,medium-term and long-term effective rate of selected cases was 95.9%(519/541),90.4%(489/541)and 87.2%(472/541),respectively.When combined application of two methods was performed,different degree of shrinkage of the protruded nucleus pulposus was obviously observed,with a mean shrinkage degree of 30.5%.The short-term,medium-term and long-term effective rate of simple collagenase chemonucleolysis was 89.5%,82.4%and 80.4%,respectively.Conclusion Intradiscal injection of ozone combined with epidural injection of collagenase is an effective treatment for lumbar disc protrusion when the fibrous ring is broken,the protruded extent of nucleus pulposus is less than 10 mm and the dura sac and/or nerve root is compressed.Its curative effect is superior to simple collagenase chemonucleolysis.Ozone is of clinical significance for producing the shrinkage of the nucleus pulposus.

Objective To investigate the predictive value of bedside echocardiographic assessment of the inferior vena cava variability ( ΔIVC ) in the weaning of patients with mechanical ventilation before spontaneous breathing test ( SBT ) . Methods Eighty-two mechanical ventilation patients admitted to the department of critical care medicine in our hospital from June to December 2017 and ready to wean from the mechanical ventilation were successively included . SBT was performed by T-tube mode after screening and the success of weaning is defined that the spontaneous breathing time exceeds 48 h after extubated . According to the outcomes of weaning ,the patients were divided into the weaning success group( 61 cases) and the weaning failure group(21 cases) ,the successful rate of weaning was 76 .1％ . The basic clinical characteristics of the patients ,including age ,sex ,acute physiology and chronic health score II ,heart rate , respiratory rate ,mean arterial pressure ,central venous pressure ( CVP) and the level of lactic acid were recorded ,and the inferior vena cava variability ( ΔIVC ) were measured before SBT with bedside echocardiography . The ΔIVC differences between the patients in the weaning success group and the weaning failure group were compared ,and the predicted value of ΔIVC for the weaning results was evaluated by ROC curve ,expressed as the area under the curve ( AUC) . Results The CVP of the weaning failure group was higherthanthatintheweaningsuccessgroup[(10.0±3.2)mmHgvs(7.2±2.8)mmHg(1mmHg =0 .133 kPa) , P =0 .01] . There was no significant difference in other basic clinical characteristics( all P >0 .05) . The ΔIVC of the weaning success group was significantly higher than that of the weaning failure group[(67.1±25.8)％ vs(33.8±23.2)％ ,P =0.001].TheAUCofthe ΔIVC predicted the weaning result before SBT was 0 .76 . The sensitivity of ΔIVC>50％ predicting successful weaning was 81 .8％ and the specificity was 79 .2％ . Conclusions Echocardiographic assessment of the inferior vena cava variability in patients with mechanical ventilation before SBT can predict the weaning outcome and guide fluid management clinically .

To optimize program of bovine somatic nuclear transfer, we used two different enucleation procedures (by Spindle-view system & Hoechst 33342 staining), two different procedures to introduce donor nuclei (by ooplasm microinjection & electrofusion), and three different group electrofusion parameters (group 1: 1.9 kV/cm, 10 micros, two; group 2: 1.5 kV/cm, 25 micros, two; group 3: 0.6 kV/cm, 100 micros, one) to reconstruct bovine cloned embryos. The cleavation rates and blastocyst development rates of cloned embryos were used to assess the efficiency of different operational procedure. Finally, the best combination of operational procedure, that the spindle-viewer system was used for oocytes enucleating, and donor cell was electrofused into ooplasm by electrical pulse (1.9 kV/cm, 10 micros, two) to reconstruct bovine cloned embryos. Then the excellent blastocysts were transferred to fosters for producing cloned cattle 80 high-quality cloned blastocysts were transferred into 33 fosters, two cloned calves were produced. According to the results, the optimized program could be used to produce cloned cattle.
Animals ; Cattle ; Cell Nucleus ; physiology ; Cloning, Organism ; veterinary ; Embryo Transfer ; methods ; Embryo, Mammalian ; cytology ; physiology ; Female ; Microinjections ; Nuclear Transfer Techniques ; veterinary ; Oocytes ; cytology ; physiology

Morulaes and blastocysts obtained from Guanzhong dairy goats 6-7 days after mating were treated with whole embryo cultivaton, enzymatic digestion and immunosurgery separately. The goat embryonic stem cells (ESC) were isolated and cultured on a feeder layer of mitomycin-inactivated mouse embryo fibroblasts (MEF). The characteristics of goat ESCs were analyzed by immunohistochemisty, RT-PCR and inducing differentiation in vitro. The results indicated that the embryos were easier to attach the culture dish and form primary colonies with whole embryo method. There were colonies that maintained undifferentiated for 18 passages. The ESCs expressed the protein of Nanog, Oct4 and SSEA-3, whereas the protein of SSEA-4 was absent and the protein of SSEA-1 was weakly expressed. In addition, the genes of Nanog, Oct4, TERT and CD117 were expressed in goat ESCs. The cells also could differentiate to myocardial cells when induced in vitro by DMSO. These results suggest that the goat ESCs have characteristics of ESCs.
Animals ; Blastocyst ; cytology ; Cell Differentiation ; physiology ; Cell Separation ; methods ; Cells, Cultured ; Embryo Culture Techniques ; Embryo, Mammalian ; cytology ; Embryonic Stem Cells ; cytology ; metabolism ; Female ; Goats ; Male ; Mice ; Myocytes, Cardiac ; cytology ; Rabbits

Objective To systematically evaluate the effect of different administration methods of hydrocortisone on blood glucose in patients with septic shock. Methods The Cochrane Library, PubMed, Web of Science, Embase, CNKI, CBM, Wanfang, and VIP databases were searched from foundation to December 31st, 2017 for the randomized controlled trials (RCTs) about hydrocortisone on blood glucose of different drug-deliver ways in patients with septic shock. In addition, the citation retrievals were performed by the literature references. Then the quality evaluation and data extraction was conducted by two researchers independently according to the Cochrane systematic review methods. RevMan 5.3 software was utilized to perform meta-analysis on the influences of the two different administration methods of the continuously pumping hydrocortisone group (experimental group) vs. the intermittently dripping hydrocortisone group (control group) on the mean blood glucose (MBG), largest amplitude of glycemic excursion (LAGE), glucose variability (GV), hyperglycemia time window in patients with septic shock. Results 1 203 relevant articles were preliminarily searched. Then the duplications were removed, reviews, and non-RCTs and articles evidently not accordant with the inclusion criteria were excluded by titles and abstracts. Eventually a total of 5 well-designed RCTs (404 cases) were incorporated, including 201 cases in the experimental group and 203 cases in the control group. The results of meta-analysis showed that compared with the control group, MBG was significantly decreased in the experimental group [mean difference (MD) = -0.99, 95% confidence interval (95%CI) = -1.53 to -0.45, P < 0.05], LAGE was decreased (MD = -5.66, 95%CI =-6.92 to -4.41, P < 0.05), GV was reduced (MD = -0.67, 95%CI = -0.82 to -0.53, P < 0.05), and hyperglycemia time window was shortened (MD = -7.68, 95%CI = -9.03 to -6.33, P < 0.05). The funnel chart revealed that there was publication bias in the MBG, hyperglycemia time window of the articles, and the publication bias was lower in the LAGE and GV. Conclusion Compared with intermittent administration method, the continuous pumping hydrocortisone method can stabilize the blood glucose of septic shock patients, shorten the duration of hyperglycemia and reduce the peak value of blood glucose.

Objective:To investigate the correlation of 25-hydroxyvitamin D [25(OH)D], parathyroid hormone(PTH)and bone turnover markers with the glomerular filtration rate(GFR)in elderly male patients with type 2 diabetes mellitus.Methods:The study included a total of 426 non-dialyzed male T2DM patients with a disease course of more than 10 years, of whom 206 aged 60-86 years(the elderly group, 69.8±5.7 years old)and 220 aged 40-59 years(the middle-aged group, 50.1±5.3 years old). According to the estimated GFR(eGFR)calculated using the CKD-EPI formula, patients in each group were divided into four subgroups: Group 1(at CKD1 stage), Group 2(at CKD2 stage), Group 3(at CKD3 stage)and Group 4(at CKD4/5 stage). Levels of 25(OH)D, parathyroid hormone(PTH), procollagen type 1 N-terminal propeptide(P1NP), and C-terminal telopeptide of type Ⅰ collagen(β-CTX)in each group were measured.Results:The median level of 25(OH)D was 17.10(11.30-21.60) μg/L in 426 patients, of whom 292(68.5%)showed vitamin D deficiency.The level of 25(OH)D decreased significantly in the elderly group compared with the middle-aged group(15.10 μg/L vs. 17.15 μg/L, Z=-2.165, P=0.030), while the proportions of patients with vitamin D deficiency were similar in the two groups(68.4% vs. 68.6%, χ2=0.002, P=0.966). With decreasing eGFR, the proportion of patients with vitamin D deficiency gradually increased in the elderly.In the elderly cases, compared with the Group 1 and Group 2, the level of 25(OH)D in Group 3 dropped significantly (10.85 μg/L vs. 16.80 μg/L, Z=-2.808, P=0.005; 10.85 μg/L vs. 15.60 μg/L, Z=-2.099, P=0.044), and Group 4 showed an even more pronounced decrease than Group 3(6.65 μg/L vs. 10.85 μg/L, Z=-1.956, P=0.048). The level of 25(OH)D decreased significantly in the middle-aged patients at the CKD4/5 stage.The levels of PTH and β-CTX were negatively correlated with the 25(OH)D level( r=-0.348 and -0.263, P<0.001), and the level of negative correlation was affected by eGFR. Conclusions:In non-dialysis elderly male patients with T2DM, PTH and bone turnover marker β-CTX levels are negatively correlated with the 25(OH)D level, and the negative correlations are affected by eGFR.

Brain Injuries, Traumatic ; China ; Critical Care ; Cross-Sectional Studies ; Female ; Humans ; Intensive Care Units ; Male ; Renal Insufficiency