Abstract To analyse the mechanism of TECA bio-artificial liver support system(BALSS)to treat acute liver failure (ALF) canines. The blood of partial liver resection-induced ALF canines or RPMI1640 solution were circulated in the inner space of the hollow fibers (blood loop), and porcine hepatocytes were cultured in outer space of the hollow fibers (cell loop). The concentrations of lidocaine, albumine and urine in the RPMI1640 solution were measured. The compositions of proteins in cell loop and blood loop were analysed by polyacrylamide gel electrophoresis (PAGE). The ultrastructure of porcine hepatocytes in BALSS was observed with transmission electronic microscopy. There were not any proteins in RPMI1640 solution before BALSS circulation. After 6 hours of the BALSS circulation, the concentration of lidocaine in RPMI1640 solution decreased significantly,and concentration of albumine and urine nitrogen increased gradually. The ultrastructure of the porcine hepatocyte shown damaged after BALSS 6h. The results suggested that TECA BALSS could replace temporarily the functions of failure liver by the effects of biologic transform and synthesis of porcine hepatocytes.

To evaluate the inhibitory effect of recombinant adenoviruses p16 (Ad p16) combined with Ad p53 on human cholangiocarcinoma cell line QBC939 in vitro. Expression of p16 was low and p53 was negative in QBC939 cells. High level of p16 and p53 expressions were observed in QBC939 cell line transfected with Ad p16 and Ad p53. The growth rates of the Ad p16 infected combined with Ad p53 infected QBC939 cells were inhibited, which was higher than those of the Ad p53 or close to Ad p16 transfection. Colony formation in Ad p16 with Ad p53 transfected cells greatly decreased versus Ad p16 transfected or Ad p53 transfected cells. The Ad p16, Ad p53 and Ad p16 with Ad p53 transfected cells manifested apoptosis and G 1 arrest, which were confirmed by the flow cytometry. The suppression effects mediated by expression of the exogenous p16 with p53 in tumor cell resulted mainly from apoptosis and G 1 arrest, which is higher than exogenous p16 or p53.

Objective To investigate the cause and management of postsplenectomy fever in portal hypertensive patients . Methods The clinical data of 295 portal hypertension patients undergoing splenectomy from 1990 to 2003 were reviewed. Among these,80 patients suffered from a continuous fever higher than 38.5℃ for more than 2 weeks postoperatively. Results Except for two patients with unknown cause, 78 of 295 patients with continuous fever were caused by complications such as splenoportal thrombosis(35 cases), infection of hematocele or hydrops in splenic recess(20 cases), left subphrenic infection(7 cases), pneumonia and hydrothorax or empyema(5 cases), 3 cases each of postoperative abscess of tail of pancreas,winary tract infection and inteclion of surgical incision, 1 case of leakage of esophageal anastomosis and intraabdominal infection in 1 case. The lasting fever was related to the grade of liver function(P0.05). Conclusions Splenoportal thrombosis, and hematocele, hydrops or infection in the splenic recess were the main causes of persistent fever after splenectomy. Prevention and treatment of infection and amelioration of hepatic function will help to reduce the rate of postoperative continuous fever.

Objective To observe clinical significance、anatomy and variation of normal internal cerebral veins and their tributa-ries.Methods The studies included 284 sides in 142 patients.The patients were performed with 320-detector Row CT One-stop Scanning.Then,the anatomical features of internal cerebral veins and their tributaries were evaluated.Results The detection rate of internal cerebral veins(ICA)、thalamostriate veins(TSV)、septal veins(SV)、anterior caudate nucleus veins、posterior caudate nucleus veins and lateral direct veins was 100%、100%、98.9%、95.4%、93.7%、48.6%.Type of IA was seen frequently in four types of ICA,the parts of ICV and their tributaries were mirror symmetry,the majorities of ICA were located the same plane.Anterior cau-date nucleus veins were classified four types on basis of these different draining patterns,they were drained to TSV commonly.There was no significant difference between venous angle or false venous angle and type of their draining(P>0.05).There was significant difference between detection rate of lateral direct veins and development of posterior caudate nucleus veins(P<0.05).Conclusion 320-detector Row CT One-stop Scanning was an important method that internal cerebral veins were detected effectively and non-inva-sively,observed anatomy,course and morphological change of ICV.

Objective To explore the effect of damage control surgery (DCS) in the treatment of severe electric burn. Methods Retrospective analysis on clinical data of 45 patients with severe electric burn was con-ducted. According to implementing DCS or not , patients were separated into DCS group and control group. In DCS group, tangential excision and transplanted xenogenic acellular dermal matrix was conducted for severe electric burn cases with deep Ⅱ degree wound, and escharectomy and VSD dressing for Ⅲ~Ⅳ degree electric contact burn wound at the first stage then skin-grafting or skin flap-grafting on the secong stage was applied. For control group , debridement, tangential excision or escharectomy and skin-grafting or skin flap-grafting to close the wound were conducted. We compared the difference in terms of operation time, length of stay, disability rate, mortality and complications between 2 groups. Results The operation time, incidince of disability and complications in DCS Group obviously decreased but there was no difference in length of stay and mortality in both groups. Conclusion DCS is effective for reducing complications and optimizing therapeutic effect for severe electric burn patients.

By use of fractal analysis indexes-correlation dimension, fractal dimension and scaling exponent, the heart rate variability signals obtained from 38 subjects' ECG during anesthesia are analyzed. The results show that there is an obvious change of fractal characteristic of heart rate variability during anesthesia. The correlation dimension (P < 0.000001) during anesthesia is evidently less than that during consciousness, while the short-range scaling exponent a (P < 0.0001) during consciousness is evidently less than that during anesthesia. These illustrate that the difference in fractal characteristic between anesthesia and well-balanced state can be detected by the fractal analysis of heart rate variability. In the end, the paper poses that the analysis of heart rate variability is fit for monitoring the depth of anesthesia by detrended fluctuation analysis.
Anesthesia ; Electrocardiography ; Heart Rate ; physiology ; Humans ; Monitoring, Physiologic ; methods

Objective:To explore the correlation between defecation disorders and diet in patients undergoing sphincter-preserving surgery for rectal cancer.Methods:This study was a cross-sectional survey. From 2021 to 2023, convenience sampling was used to select 159 patients with rectal cancer who underwent sphincter-preserving surgery at Peking University Third Hospital as participants. The General Information Questionnaire, Food Frequency Questionnaire, and Defecation Questionnaire were used for the survey.Results:The incidence of defecation disorders in 159 patients with rectal cancer after sphincter-preserving surgery was 74.2% (118/159), and the types of defecation disorders with high to low incidence were "frequent defecation (96/159, 60.4%) " "constipation (37/159, 23.3%) " "diarrhea (33/159, 20.8%) " and "fecal incontinence" (24/159, 15.1%). Diets were clustered into 9 categories (vegetables and fruits, carbohydrate staple foods, red meat foods, gas producing foods, dairy products, white meat foods, dessert foods, high-fat foods, and spicy and stimulating foods). Binomial Logistic regression analysis showed that red meat foods and gas producing foods were the influencing factors of frequent defecation ( P<0.05), red meat foods was the influencing factor of diarrhea ( P<0.05), and carbohydrate staple foods was the influencing factor of fecal incontinence ( P<0.05) . Conclusions:The incidence of defecation disorders in patients with rectal cancer after sphincter-preserving surgery is relatively high, and the intake of red meat foods, gas producing foods, and carbohydrate staple foods should be appropriately controlled. Clinical medical and nursing staff should pay close attention to the diet of elderly patients.

Objective To analyze the correlations of D-dimer and the Global Registry of Acute Coronary Events (GRACE) score with long-term heart failure (HF) in patients with acute myocardial infarction (AMI). Methods A total of 398 patients with AMI were selected as research objects and divided into normal D-dimer group (n=309) and elevated D-dimer group (n=89) based on the D-dimer level. Cox proportional hazard model was used to analyze the risk factors for long-term HF in both groups. Time-dependent receiver operating characteristic (ROC) curve was used to analyze the values of D-dimer, GRACE score and their combination in predicting long-term HF. According to the GRACE score and D-dimer level, 398 patients were divided into low-value group (181 patients with normal D-dimerand low GRACE score), high-value group (70 patients with elevated D-dimer and high GRACE score), and middle-value group (147 patients did not meet the conditions of the low-value and high-value groups). Kaplan-Meier method was used to analyze the occurrence of long-term HF in the three groups. Point-biserial analysis was used to analyze the correlation between elevated D-dimer and the occurrence of long-term HF. Results The number of patients with long-term HF in the elevated D-dimer group was 2.3 times of the normal group. D-dimer and GRACE score were independent risk factors for long-term HF in patients with AMI (P < 0.05). Both D-dimer and GRACE score had certain predictive values for the occurrence of HF at 5 years after AMI, but the predictive efficiency of GRACE score was better. The incidence of long-term HF in the high-value group was significantly higher than that in the low-value group and the middle-value group (P < 0.01). D-dimer was significantly positively correlated with the occurrence of long-term HF after AMI (P < 0.001). Conclusion Both D-dimer and GRACE score are independent risk factors for long-term HF in patients with AMI, and the two indexes have certain predictive value for the occurrence of long-term HF. Patients with both elevated indicators are high-risk groups for long-term HF.

To study the attachment, proliferation and differentiation of neural stem cells (NSCs) on surface modified PHBHHx films and to establish the theory of PHBHHx application in NSCs-based brain tissue engineering. PHBHHx film was fabricated by a solution-casting method, and the morphology of the film was observed under scanning electron microscopy(SEM). The films were treated by NaOH or lipase, then the surface hydrophilic property was characterized using water contact angle measurement. NSCs were isolated from the cerebral cortex of rat embryos on embryonic day 14.5, and cultured on surface treated PHBHHx films. The morphology of NSCs attached on the film was visualized under SEM, and the survival and differentiation of NSCs were observed through immunocytochemical staining. Compared with the untreated PHBHHx films, the water contact angle of NaOH or lipase treated PHBHHx films decreased dramatically, and the number of NSCs attached significantly increased. NSCs survived well on treated PHBHHx films and differentiated into neurons and glial cells. The amelioration of hydrophilic property of PHBHHx film improved its biocompatibility with NSCs. PHBHHx can serve as a novel CNS tissue engineering biomaterial applied for NSCs transplantation, brain repairing and regeneration.
3-Hydroxybutyric Acid ; chemistry ; Animals ; Caproates ; chemistry ; Cell Adhesion ; physiology ; Cell Differentiation ; drug effects ; Cell Proliferation ; Cells, Cultured ; Cerebral Cortex ; cytology ; Coated Materials, Biocompatible ; chemistry ; Embryonic Stem Cells ; cytology ; Female ; Neural Stem Cells ; cytology ; Rats ; Surface Properties ; Tissue Engineering

Objective To retrieve,analyse and integrate the best evidences in perioperative fluid management for elderly patients with hip fracture,therefore to provide references for patient care.Methods Following the 6S evidence model,databases and websites were searched to collect the evidences on perioperative fluid management of elderly patients with hip fracture.The searched databases including BMJ Best Practice,UpToDate,AAOS Clinical Practice Guidelines,ASBMR,ANZHFR,ESTES,NICE,SIGN,JBI,Cochrane Library,CINAHL,Embase,PubMed,Web of Science,CNKI,Wanfang Data,VIP database,CEBM Database,Medive,China Science and Technology Journal Database,SinoMed,and other websites about orthopaedics.The searched literatures included guidelines,clinical decision-making,best practices,expert consensus and systematic reviews.The time span for the published literatures was from the inception of the databases and websites to August 2022.Two researchers independently completed quality evaluations of the retrieved literatures,as well as extraction,assessment and integration of the abstracted evidences.Results A total of 15 articles were included,they were 2 guidelines,3 clinical decision-makings,1 best practice,7 expert consensus,and 2 systematic reviews.Thirty pieces of evidence were summarised from 7 aspects,covering multidisciplinary team collaboration,dynamic assessment and monitoring of fluid status,fluid resuscitation,fluid management before and after the surgery and health education.Conclusions This study summarised the best evidences in perioperative fluid management for elderly patients with hip fracture.The evidences provide an evidence-based solution which will enable the healthcare workers to fully combine the clinical scenarios,evaluate changes in fluid volume status dynamically,develope personalised fluid management strategies and improve patient outcomes.