Objective To investigate the morphological changes of peritoneum during peritoneal dialysis (PD) and elucidate the possible mechanism of its functional deterioration. Methods Peritoneal biopsies were obtained from normal subjects( n = 10), uremic predialysis patients( n = 12) at catheter insertion and PD patients ( n = 10) at the time of catheter remove or reinsertion or renal transplantation, peritoneal morphology was studied by light microscopy, scanning electron microscopy and transmission electron microscopy. Results Normal peritoneal membrane consisted of a monolayer of mesothelial cells on a basement membrane, and a layer of connective tissue containing cells, blood vessels, lymphatic vessels and so on. Mesothelial cells were polygonal, often elongated, and had numerous microvilli on their luminal surface. Sometimes the microvilli ended with roundish formation or resembled a corona. There were lots of oval or roundish pinocytotic vesicles in the cytoplasm of mesothelial cell. Submesothelial connective tissue contained many collagen and elastic fibers. The peritoneal morphology of uremic predialysis patients was similar to that of normal subjects. But significant abnormalities of peritoneal morphology were observed in PD patients and the changes were progressive. Microvilli were the first site of damage, including microvilli shortening, gradual reduction in number and following total disappearance. Then mesolhelial cell detachment from basement membrane and total disappearances were found. Finally the peritoneal membrane only consisted of submesothelial connective tissue denudation of cells. Conclusions PD can modify peritoneal morphology and structure. The morphological change is progressive and might be one of the important causes of peritoneal failure. Peritoneal biopsy can provide lots of valuable informations about the impact of PD, and thus further study on the relationship between peritoneal structure and its function is very useful for understanding of the physiopathology of peritoneum during PD.

Objective To summarize the characteristics of nosocomial infections in the patients treated in intensive care unit (ICU).Methods The incidence of nosocomial infections was monitored in ICU from March 2012 to August 2012.The incidence rate of infection was adjusted with Average Severity of Illness Score (ASIS)score and analyzed in relation to three invasive pro-cedures.Pathogen distribution of nosocomial infections in ICU was also analyzed.Results Nosocomial infection was identified in 357 of the 3 700 ICU patients (9.65%).The overall daily infection rate was 30.34‰,specifically,49.10‰ for ventilator asso-ciated pneumonia (VAP),13.86‰ for catheter-related bloodstream infections (CRBSI),and 1.09‰ for catheter-associated urinary tract infections (CAUTI).Of the 688 bacterial isolates,gram negative bacteria accounted for 82.70%.The top three bacterial species were Acinetobacter baumanii ,Pseudomonas aeruginosa ,and Klebsiella pneumoniae .Conclusions ICU is the focus for surveillance of nosocomial infections.Objective investigation is critical for nosocomial infection surveillance.

Objective To investigate the effects of preconditioning with different concentrations of sevoflurane on the expression of Toll-like receptor 4 (TLR4) in rats with acute lung injury (ALI) induced by lipopolysaccharide (LPS).Methods Thirty adult male Sprague-Dawlcy rats,wcighing 200-250 g,were randomly divided into 5 groups (n =6 each):normal saline group (group NS),group ALI,and preconditioning with different concentrations of sevoflurane groups (groups S1-3).ALI was induced by intratracheal instillation of LPS 5 mg/kg.Groups S1-3 inhaled 1.2％,2.4 ％ and 4.8 ％ sevoflurane for 30 min respectively,and ALI was induced 30 min later.The rats were sacrificed at 12 h after administration of LPS or normal saline and lungs were removed for microscopic examination and for determination of TLR4 mRNA and protein expression in lung tissues and concentrations of TNF-α and IL-1β in broncho-alveolar lavage fluid (BALF).W/D lung weight ratio was calculated.Results Compared with group NS,W/D lung weight ratio and concentrations of TNF-a and IL-1β in BALF were significantly increased and the expression of TLR4 mRNA and protein was up-regulated in groups ALI and S1-3 (P ＜ 0.01).Compared with group ALI,the parameters mentioned above were significantly decreased in groups S2 and S3,and the concentrations of TNF-α and IL-1 β in BALF were significantly decreased and the expression of TLR4 mRNA was down-regulated in group S1 (P ＜ 0.05 or 0.01).The parameters mentioned above were significantly lower in groups S2 and S3 than in group S1 (P ＜ 0.05).The pathologic changes were significantly attenuated in groups S1-3 compared with group ALI.Conclusion Preconditioning with sevoflurane can concentration-dependently reduce LPS-induced ALI in rats through inhibiting the up-regulation of TLR4 expression in lung tissues and reducing the inflammatory response.

To examine the effects of ischemia and anoxia on cell activation and cell cycle of astrocytes in vitro, the cell cycles and the proliferation of astrocytes in different time points after ischemia and anoxia were studied by flow cytometry and BrdU labeling and the expression of GFAP and cyclin D1 was detected by the fluorescence immunochemistry. After ischemia and anoxia in vitro, the astrocytes in S phase were significantly increased as compared with those in the normal group and the proliferating ability of the astrocytes was highest 6 h after the treatment as revealed by BrdU pulse labeling, but the astrocytes in S phase and proliferating ability were decreased after 6 h. At the early stages of ischemia and anoxia, the positive staining intensity of GFAP was increased, peaked at 6th h, while 12 h after the ischemia and anoxia, the positive staining intensity of GFAP became weak, and the expression of cyclin D1 was gradually increased after the ischemic and anoxic damage. It is concluded that astrocytes are activated to proliferate and enter new cycle events by ischemia and anoxia, and cyclin D1 is implicated in the proliferation and repair of astrocytes. The cell cycle events are closely associated with the proliferation and activation of astrocytes.
Animals, Newborn ; Astrocytes/*cytology ; Cell Cycle ; Cell Hypoxia ; Cell Proliferation ; Cells, Cultured ; Cyclin D1/biosynthesis ; Cyclin D1/genetics ; Glial Fibrillary Acidic Protein/*biosynthesis ; Glial Fibrillary Acidic Protein/genetics ; Rats, Wistar

Objective To establish the HPLC fingerprint of Disporum cantoniense. Methods HPLC analysis was performed on Agilent Zorbax SB-C18 chromatographic column ( 250 mm × 4. 6 mm, 5 μm) with the mobile phase consisting of methanol-0.05% phosphoric acid in gradient mode.The flow rate was 1.0 mL·min-1, the detection wavelength was 256 nm and the column temperature was 30 ℃. Results The HPLC fingerprint of 15 batches of Disporum cantoniense was established. Thirteen common peaks in the fingerprint were demarcated, four of which were identified by reference substances. Chemical pattern recognition of fingerprint was performed by hierarchical cluster analysis and principal component analysis. Conclusion The method is simple, accurate and has a good repeatability, and can be used for quality control of Disporum cantoniense.

Objective To explore the feasibility of nasolabial sulcus flap transfer with autologous free skin graft to repair the alar defects after malignant tumor resection.Methods From January 2012 to January 2015,9 patients with malignant tumor were treated in the hospital.After complete tumor removal,the defect area being reconstructed was 1.5 cm × 1.3 cm to 2.5 cm × 2.5 cm.The defects of 9 patients were all restored with nasolabial sulcus flap combined with autologous free skin graft.Results The 9 patients were followed up for 6-18 months postoperatively.The nasolabial sulcus flap and autologous free skin graft were survived completely in all cases.Symmetrical alae were noted with slight edema within nasal cavity but without difficult ventilation.Scar was repaired in phase-two surgery.Conclusions Nasolabial sulcus flap combined with autologous free skin graft is an optional way in alar defects restoration.Further with secondary morphologic plasty,satisfactory surgical outcome can be achieved.

Objective To investigate the protective effect of edaravone against ischemiareperfusion injury in small-for-size rat liver grafts and its possible mechanisms. Methods 40 % small-for-size rat liver transplantation model was established by using modified two-cuff technique, adult male SD rats were used as donors and recipients, and 16 recipient rats were randomly divided into two groups (8 cases in each group), saline control group (control group) and edaravone treatment group (ED group). In the ED group, 3 mg/kg edaravone was given intravenously via penile vein 30 min before transplantation in the recipients. The same amount of saline was given in the control group at the same time points. Serum hepatic function (AST and ALT) and histopathological changes were analyzed; the contents of MDA and SOD, and hepatic myeloperoxidase (MPO) activity in liver grafts after 6 h were determined; and TNF-α levels at 6th h after reperfusion were measured by using enzyme-linked immunosorbent assay (ELISA method). Results As compared with control group,serum AST and ALT levels were significantly reduced at the 6th h after reperfusion in ED group (AST: 825. 50 5±72. 87 vs 1188. 03 ± 124. 04; ALT. 687. 40 5±72. 21 vs 988. 66 ± 91.07, P<0. 01 ).The content of MDA was lower and SOD level was higher in ED group significantly than in control group (P<0. 01). As compared with control group, hepatic TNF-α levels and MPO activity at the 6th h after reperfusion were significantly decreased in ED group (P<0. 01 ). Histopathological analysis revealed disruption of lobular architecture, apparent hepatocelluar degeneration accompanied by focal necrosis, significant edema, congestion and inflammatory cell infiltration in periportal area at the 6th h after reperfusion in control group, but minimal liver damage was observed in ED group. Conclusion Edaravone could ameliorate early ischemia-reperfusion injury in small-for-size liver grafts significantly.The protective mechanisms were mediated in part by increasing antioxidant ability, inhibiting lipid peroxidation, and down-regulating inflammatory reaction.

ObjectiveTo assess the clinical efficacy and safety of donepezil in treating the mild to moderate cognitive impairment of vascular dementia.Methods60 patients with vascular dementia were randomly divided into therapy group (donepezil 5 mg/d for 4 weeks, and then increased to 10 mg/d) and control group (piracetan 800 mg,3/d). All patients were assessed with Mini Mental State Examination (MMSE), Wechsler Adult Intelligence Revised in China (WAIS-RC), Activities of daily living (ADL), and Clinical Global Impression (CGI), before and 12 weeks after treatment. ResultsMMSE scores improved significantly in both groups after the treatment. The therapy group produced significantly better scores than the control groups on the MMSE(P<0.05). WAIS-RC scores improved significantly in the therapy groups(P<0.01), but there was no significant difference for control groups(P>0.05), before and after treatment. Severity Improvement(SI) score of ADL and CGI in the both groups decreased. The total efficiencies of donepezil and piracetan groups were 86% and 56% respectively. There was no significant difference in adverse effects between two groups. ConclusionDonepezil can improve the cognitive function of patients with vascular dementia, which seems better than that of piracetan, and it is fairly safe for vascular dementia patients to take donepezil 10 mg a day.

ObjectiveTo investigate the effect of arsenic trioxide (As2O3) on the metastasis capability of Ewing's sarcoma ceils. MethodsMTT assays were performed to choose appropriate concentrations of As2O3 (＜ 2 μmol/L) for the experiments.Migration and invasion assays were performed to assess the effect of As2O3 on the metastasis of Ewing's sarcoma cells. Changes in matrix metalloproteinase(MMP)-9 expressions were detected by gel zymography assay and the phosphoinositide 3-kinase/AKT(PI3K-AKT)pathway was investigated using Western blot. ResultsThe amount of Ewing's sarcoma cells across basal membrane of Transwell in migration and invasion assay decreased gradually with the increase in As2O3 concentration. The average quantities of A-673 across the membrane after treatment by gradual concentrations accounted for 54.3 ％,49.0 ％ and 17.0 ％ of that of untreated group respectively in migration assay (F=112.78,P ＜ 0.01), while 52.7 ％, 32.3 ％ and 10.3 ％ in invasion assay(F =183.76, P ＜ 0.01). Similarly, the percentage of RD-ES was 46.0 ％,39.0 ％ and 8.0 ％ in migration assay (F =408.25,P ＜ 0.01) and 58.7 ％,22.3 ％ and 9.0 ％ in invasion assay (F =373.25, P ＜ 0.01)respectively. The difference had statistics significance.The expression of MMP-9 was suppressed by As2O3 treatment according to gel zymography assay.Western blot assay showed that PI3K-AKT pathway was inhibited and nuclear factor kappa B(NF-κB)was inactivated.ConclusionLow-concentration As2O3 may inhibit metastasis capability of Ewing's sarcoma cells.

Objective To evaluate the outcome of surgical treatment of tricuspid valve regurgitation after valve replacement.Methods Twenty one patients with tricuspid valve insufficiency after valve replacement were performed surgical treatment.Tricuspid valve-plasty was performed in 17 patients and tricuspid valve replacement was done in 4 patients.Three patients underwent edge-to-edge tricuspid valveplasty.DeVega procedure was performed in 5 patients.Cosgrove-Edward annuloplasty ring was used in 15 patients.Four patients' valve were replaced by SJM bileallet mechanical prostheses.Results There was 3 patients dead early after operation with a mortality of 14.3％(3/21).The causes of death including multiple organ failure,cardiac arrest and low cardiac output syndrome.The rate of early postoperative complications was 33.3％ (7/21),including pulmonary edema,arrhythmia,acute renal failure and low cardiac output syndrome.The patients were followed up 9-60 months.The rate of readmission was 23.8％ (5/21).Two patients went to hospital again for pleural effusion,1 patient for left ventricular dysfunction and 2 patients for right ventricular dysfunction.The other patients recovered well.Conclusions Surgical therapy is effective on severe tricuspid valve regurgitation after valve replacement.Preoperative aggressive treatment of heart failure,a reasonable grasp of surgical indications and timing of surgery,strict perioperative management are the keys to guarantee patients a smooth recovery.