RT-PCR and in situ hybridization were observed during dialyzer reuse. Results Every plasma cytokine level was decreased during reuse compared with first use dialyzer, but no significant difference was found between them. The levels of gene expression of IL-1?、TNF-? and IL-6 were different from the first use significantly. Conclusion If effective dialysis volumn was maintained, formaldehyde as disinfectant on reprocessing the dialyzer may amilorate membrane bio-compatibility. It would be benificial to decrease appearance of long term hemodialysis -related complications.

Objective To study enhanced recovery after surgery (ERAS) in pancreaticoduodenectomy.Methods A case-control study was conducted on 56 patients who underwent pancreaticoduodenectomy in our hospital from May 2012 to December 2016.These patients were divided into two groups:25 patients received ERAS management (the ERAS group) and 31 patients traditional perioperative management (the control group).The data on postoperative pancreatic leakage,bile leakage,postoperative bleeding,delayed gastric emptying,postoperative intestinal function recovery,hospitalization stay,medical cost and readmission rate within 90 days between the two groups were compared.Results The rate of delayed gastric emptying,postoperative intestinal function recovery,hospitalization stay and medical cost were significantly better in the ERAS group than the control group (all P ＜ 0.05).There were no significant differences in the rates of pancreatic leakage,bile leakage,postoperative bleeding,and readmission within 90 days between the two groups (all P ＞ 0.05).Conclusions Perioperative ERAS in pancreaticoduodenectomy was safe and efficacious.It improved recovery of patients and reduced hospital stay and expenses.

Objective:To introduce a novel clinical classification that can be applied to osteoradionecrosis treatment in an easy and considerably acceptable manner through a retrospective analysis of patients with osteoradionecrosis of the mandible (ORNM). Methods:The clinical data of 99 ORNM patients admitted to shanghai Ninth People's Hospital between 2000 and 2013 were summa-rized. A novel classification was established based on bone necrosis and soft tissue lesions. The new staging system was developed based onBandSclassifications. Corresponding strategies and methods of ORNM treatment at different stages were also proposed. Results:A new staging system with four different stages (i.e., stage 0:8 cases;stageⅠ:14 cases;stageⅡ:65 cases;and stageⅢ:12 cases) was proposed. Conservative treatment was applied to stage 0 patients, whereas sequestrectomy was performed in stageⅠcases. Marginal or segmental resection of the mandible was selected for stageⅡpatients;osteocutaneous flap or just soft tissue flap was also reconstructed. Conclusion:This new classification and staging system is easier to use and more acceptable for clinical evaluation than other systems.

The 3T3-L1 preadipocytes were used as carriers in the investigation of total extract, n-butanol extract, CB-1 and CB-2 of Coreopsis tinctoria Nutt. on cell proliferation and differentiation. Three groups at different doses were set for each of the four extract regions of C. tinctoria Nutt., respectively. MTT assay was used to detect 3T3-L1cell proliferation by four extract regions of C. tinctoria Nutt. Oil Red O staining was used to analyze the formation and accumulation of cytoplasmic lipid during cell differentiation. The results showed that compared with the control group, there were significant inhibition on cell proliferation when thetotal extract of C. tinctoriaNutt. at 100 μg·mL-1, n-butanol extract at 0.5, 5, and 50 μg·mL-1, CB-1 and CB-2 at 50 μg·mL-1 (P< 0.01). N-butanol extract showed certain dose-dependent manner (r = -0.903). Oil Red O staining showed that compared with the control group, thetotal extract of C. tinctoria Nutt. at 1, 10, 100 μg·mL-1 can obviously inhibit cell differentiation, reduce the formation of cytoplasmic lipid (P< 0.01). N-butanol extract can inhibit cell differentiation in a dose-dependent manner (r= -0.779). CB-1 and CB-2 obviously inhibited cell differentiation at the concentration of 50 μg·mL-1 (P < 0.01). It was concluded that thetotal extract, n-butanol extract, CB-1 and CB-2 of C. tinctoria Nutt. can inhibit the proliferation and differentiation of 3T3-L1 preadipocytes and reduce the formation of cytoplasmic lipid.

Objective:To assess the effectiveness of free vascularized bone flap transfer for treatment of advanced osteoradionecrosis of the mandible (ORNM). Methods:We reviewed 53 patients who were treated for ORNM by radical resection and reconstruction with free vascularized bone flaps in our institute between January 2003 and January 2015. Results:Among the 53 vascularized bone flap patients, 48 (90.57%) had fibula osteocutaneous and 5 (9.43%) had deep circumflex iliac artery (DCIA). Postoperative complications occurred in 5 (10.42%) of the 48 fibula osteocutaneous patients (4 cases of vein thrombosis and 1 case of arterial crisis). In three of these patients, flap was salvaged back to normal in a timely manner by vascular exploratory surgery. However, pectoralis major myocutaneous flap was conducted as a second procedure for the other two patients. Meanwhile, complications occurred in 2 (40%) of the 5 DCIA transfer patients (1 case of vein thrombosis and 1 case of arterial crisis). None of these two flaps was salvaged back. Necrosis transfer bone was finally removed. No obvious donor site complications were noted. The mean follow-up time was 28 months. Our results showed that 88.57%of the patients with ORNM were stable, 85.71%of the patients can open their mouth at 2-3 figures, 85.72%of the patients can eat soft or semi-liquid food, and 80%patients can speak clearly and can be understood by others around them. No significant difference was found in mouth opening and face type of the patients with or without the intact condyle. However, the temporomandibular joint area discomfort of the patients with intact condyle was obviously less than that of patients with removed condyle. Conclusion:Radical resection, followed by vascularized bone flaps, especially fibula osteocutaneous, is still the best way to treat ORNM, as long as the indications are chosen appropriately, intraoperative work is conducted properly, and postoperative complications are controlled.

Objective To investigate the clinical effect of Shenfu injection in the treatment of patients with post - cardiac arrest syndrome(PCAS),to analyze the patients' blood C - reactive protein (CRP) and early mean arterial pressure. Methods From September 2013 to September 2016,80 patients with PCAS in the No. 98 Hospital of PLA were randomly divided into study group and control group according to the digital table,with 40 cases in each group. The study group was treated by Shenfu injection,the control group was treated by saline. The changes of CRP,mean arterial pressure and GCS score at 4h,12h,1d,2d and 3d after resuscitation and the 90d survival rate were observed. Results At 4h,12h,1d,2d and 3d after resuscitation,the peripheral blood CRP levels in the study group were (22. 01 ±2. 16)mg/ L,(34. 68 ± 4. 95)mg/ L,(62. 51 ± 3. 68)mg/ L,(98. 65 ± 6. 57)mg/ L,(100. 67 ± 10. 03)mg/ L, respectively,which in the control group were (25. 16 ± 3. 54)mg/ L,(41. 52 ± 5. 31)mg/ L,(75. 09 ± 4. 58)mg/ L, (120. 48 ± 10. 61)mg/ L,(128. 26 ± 9. 64)mg/ L,respectively,there were statistically significant differences between the two groups(t = 4. 804,5. 959,13. 542,11. 063,12. 543,all P < 0. 01). At 4h,12h,1d,2d and 3d after resuscita-tion,the mean arterial pressure in the study group were (78. 03 ± 8. 65)mmHg,(88. 34 ± 10. 20)mmHg,(97. 05 ± 9. 57)mmHg,(105. 29 ± 10. 45)mmHg,(112. 14 ± 9. 46) mmHg,respectively,which were higher than those in the control group [(68. 21 ± 8. 03)mmHg,(74. 01 ± 10. 59) mmHg,(83. 09 ± 11. 25) mmHg,(98. 25 ± 9. 17) mmHg, (104. 68 ± 3. 14)mmHg](t = 5. 262,6. 164,5. 978,3. 203,4. 733,all P < 0. 01). At 4h,12h,1d,2d and 3d after resuscitation,the GCS scores of the study group were (5. 21 ± 1. 12) points, (5. 78 ± 2. 05) points, (6. 85 ± 1. 68)points,(7. 91 ± 2. 57)points,(9. 98 ± 2. 07) points,respectively,which were higher than those of the control group [(4. 01 ± 2. 14) points, (4. 22 ± 3. 75) points, (4. 39 ± 3. 89) points, (4. 41 ± 2. 86) points, (5. 06 ± 4. 14)points](t = 3. 142,2. 309,3. 672,5. 757,6. 723,all P < 0. 05). The survival rate of the study group was 50％(20 / 40) at 90d after resuscitation,which was higher than that of the control group [23％ (9 / 40)](χ2 = 6. 545,P =0. 011). Conclusion Shenfu injection has protective effect on the function of patients with CRP after surgery,and can improve the prognosis of patients,it is worthy of clinical use.

Objective To detect the expression of miR-122 in hepatocellular carcinoma (HCC) cells and tissues,and to explore the role and the underlying mechanisms of miR-122 in HCC cells on invasion and migration.Methods Real-time quantitative polymerase chain reaction of analysis was used to examine the expression of miR-132 in HCC cell lines,a normal liver cell line,HCC tissues and adjacent non-tumor tissues.Over express or inhibit miR-122 by transfection.The invasion and migration of HCC cells were analyzed by Transwell assays.Meanwhile,related mechanism proteins were detected by western blot,including insulin like growth factor 1 receptor(IGF-1 R),E-cadherin,vimentin.Results The expression of miR-122 was decreased in HCC tissue samples compared with the adjacent non-tumor tissues[(20.5 ± 4.2) × 10-4 vs.(30.3 ± 5.6) × 10-4],especially in HCC tissue samples with HBV [(25.6 ± 3.5) × 10-4 vs.(19.1 ±3.2) × 10-4].The same results were observed in HCC cell lines.MHCC-97H cells exhibited lowest level of miR-122 expression[(33.7 ± 1.3) × 10-3],whereas SMMC-7721 exhibited the highest level of miR-122 expression [(65.3 ± 1.3) × 10-3].MiR-122 over-expression suppressed the invasion and migration of MHCC-97H[(218.7±24.0) vs.(418.0 ±23.4),(392.7±12.8) vs.(706.6±19.8)].Knocking down miR-122 promoted the invasion and migration of SMMC-7721 [(233.0 ± 14.4) vs.(145.0-±8.0),(561.3 ±9.6) vs.(218.0 ± 11.3)].Western blot revealed that miR-122 suppressed the expression of IGF-1R,Vimentin and facilitated the expression of E-cadherin.Conclusions The study indicates that miR-122 is downregulated in HCC,especially in HCC tissue samples with HBV.MiR-122 can suppress invasion and migration of hepatocellular carcinoma by regulating IGF-1R and epithelial mesenchymal transition,and may provide a new therapeutic option for HCC.

Angioplasty, Balloon, Coronary ; Heart Injuries ; drug therapy ; etiology ; Humans ; Thrombin ; administration & dosage

Objective: To summarize the clinical and electrophysiological characteristics of children with Wolff-Parkinson-White syndrome or ventricular pre-excitation. Methods: One hundred and seventy-nine consecutive children with Wolff-Parkinson-White syndrome or ventricular pre-excitation who were hospitalized at Beijing Anzhen Hospital Affiliated to Capital Medical University and planned to accept radiofrequency ablations were selected.Electrocardiogram and echocardiography were completed and detailed clinical data were collected before ablations.Anterograde refractory period of accessory pathways (ERPAPA) and retrograde ventriculoatrial conduction were measured during electrophysiology studies.The clinical and electrophysiological characteristics of these children were analyzed. Results: The ratio of left-sided to right-sided accessory pathways was 1.001.93(61 cases vs.118 cases). Six out of 61 patients with left-sided accessory pathways were verified by electrophysiology study.There was no statistical difference of P-R interval and QRS duration between patients with right-sided and left-sided accessory pathways(all P>0.05). Twelve patients were combined with congenital heart diseases.Fourteen patients with right-sided accessory pathways were of ventricular pre-excitation induced dilated cardiomyopathy.ERPAPA was measured successfully in 110 patients, ERPAPA less than 250 ms accounted for 32.7%(36/110 cases). Six children with two pathways were recognized.Antidromic atrioventricular reentrant tachycardia was induced in 3 children.One child had slow conduction pathway localized in right-sided septum. Conclusions Right-sided overt accessory pathways are more common in children with Wolff-Parkinson-White syndrome or ventricular pre-excitation.Organic heart diseases are not uncommon.Besides congenital heart disease, a small proportion of patients with right overt accessory pathways may develop ventricular pre-excitatory induced dilated cardiomyopathy resulting from ventricular wall dyskinesia.Most of the decremental retrograde ventriculoatrial conduction is the characteristic of ventricular muscles rather than the accessory pathways in nature.Two pathways are not uncommon in children with Wolff-Parkinson-White syndrome or ventricular pre-excitation.Before finishing radiofrequency ablation, the anterograde and retrograde function of the accessory pathway should be evaluated in detail again because it is easy to neglect the existence of another accessory pathway.

Objective To investigate whether the preoperative nutritional risk index(NRI) can predict the clinical out-comes of the patients underwent homologous orthotopic heart transplantation after 4 weeks.Methods With the use of continu-ous sampling method, a total of 168 adult patients who underwent homologous orthotopic heart transplantation from March 2013 to March 2015 were enrolled in this study.According to the cut-off points of the NRI, the patients were divided into 4 groups (high, moderate, mild and no nutritional risk).4 weeks after transplantation, the data about the length of stay in ICU, infec-tive and non-infective complications were collected , and the predictive value of the preoperative NRI for the clinical outcomes of the patients underwent homologous orthotopic heart transplantation were evaluated after 4 weeks of operation.In addition, the enrolled patients were divided into 2 groups according to their nutritional risk(with or without), and the differences between the two groups were compared.Results Among the patients, the prevalence of high, moderate, and low nutritional risk was 7. 1％, 32.7％ and 9.5％, respectively.The prevalence of infective complications for the 4 groups(from high risk to no risk) was 16.7％、7.3％、6.3％ and 3.5％, and the corresponding prevalence of non-infective complications was 16.7％、9.1％、6.3％ and 2.4％, respectively.In addition, the length of ICU stay of the 4 group was(10.9 ±1.0)days,(7.8 ±0.5)days, (6.7 ±0.7)days and(5.9 ±0.6)days, respectively.There were significant differences of length of ICU stay, infective and non-infective complications among the 4 groups(P<0.05 for all).Totally, there were significant differences of clinical out-comes between patients with and without nutritional risk(P <0.05 for all).Conclusion Preoperative NRI can predict the clinical outcomes regarding infective and no-infective complications as well as length of ICU stay for the adult patients under-went homologous orthotopic heart transplantation .