For the problems that 3 first-class ternary hospitals which are not directly affiliated to medical universities are facing in cultivating high-educated staff's scientific abilities,analyze the importance to carry out scientific work in clinic and discuss how to improve their scientific abilities from hospitals,departments and high-educated staff themselves.

To explore the protective effect of sodium tanshinone IIA sulfonate (STS) on microcirculatory disturbance of small intestine in rats with sepsis, and the possible mechanism, a rat model of sepsis was induced by cecal ligation and puncture (CLP). Rats were randomly divided into 3 groups: sham operated group (S), sepsis group (CLP) and STS treatment group (STS). STS (1 mg/kg) was slowly injected through the right external jugular vein after CLP. The histopathologic changes in the intestinal tissue and changes of mesenteric microcirculation were observed. The levels of tumor necrosis factor-α (TNF-α) in the intestinal tissue were determined by using enzyme-linked immunoabsorbent assay (ELISA). The expression of intercellular adhesion molecule-1 (ICAM-1) in the intestinal tissue was detected by using immunohistochemisty and Western blot, that of nuclear factor κB (NF-κB) and tissue factor (TF) by using Western blot, and the levels of NF-κB mRNA expression by using RT-PCR respectively. The microcirculatory disturbance of the intestine was aggravated after CLP. The injury of the intestinal tissues was obviously aggravated in CLP group as compared with S group. The expression levels of NF-κB p65, ICAM-1, TF and TNF-α were upregulaed after CLP (P<0.01). STS post-treatment could ameliorate the microcirculatory disturbance, attenuate the injury of the intestinal tissues induced by CLP, and decrease the levels of NF-κB, ICAM-1, TF and TNF-α (P<0.01). It is suggested that STS can ameliorate the microcirculatory disturbance of the small intestine in rats with sepsis, and the mechanism may be associated with the inhibition of inflammatory responses and amelioration of coagulation abnormality.

BACKGROUND: Renin-angiotensin-aldosterone system existed in bone tissue. Recent studies on antihypertensive drugs found that angiotensin converting enzyme inhibitor type antihypertensive drug was possibly effective for osteoporosis. Perindopril is one of the commonly used antihypertensive drugs. Whether perindopril affected bone metabolism or could be used in anti-osteoporosis has not been reported.
OBJECTIVE: To observe effects of perindopril on bone metabolism in a rat model of osteoporosis induced by retinoic acid.
METHODS: Fifty Sprague-Dawley rats were randomly divided into five groups, with ten in each group. In the model group and each perindopril groups, rats were intragastricaly administered retinoic acid solution 80 mg/kg per day. After successful model establishment, rats in different perindopril groups were intragastrical y administered perindopril 2, 4 and 8 mg/kg per day, once a day, for 42 consecutive days. In the normal control and model groups, rats were given an equal volume of distil ed water. Serum calcium, phosphorus, alkaline phosphatase, bone mass and bone mineral density were detected in each group. Expression of bone specific alkaline phosphatase and tartrate-resistant acid phosphatase mRNA in bone tissue was determined.
RESULTS AND CONCLUSION: Compared with the model group, after treatment with perindopril, serum calcium and phosphorus levels were increased, alkaline phosphatase activities were significantly decreased, bone mass and bone mineral density were obviously increased in rats with retinoic acid-induced osteoporosis. Expression of bone specific alkaline phosphatase mRNA was higher in the perindopril 8 mg/kg group than in the perindopril 2 and 4 mg/kg groups and model group. Tartrate-resistant acid phosphatase mRNA expression was higher in the perindopril 8 mg/kg group than in the model group. These results indicated that perindopril could improve partial bone metabolic biochemical markers in osteoporosis rats, promoted bone formation by up-regulating bone specific alkaline phosphatase mRNA expression, and had a certain preventive effect on retinoic acid-induced osteoporosis.

Objective To investigate the impact of alterations within the space of Disse micro- environment on the migration of hepatic stellate cells(HSC) during the process of liver fibrosis,and to ex plore the novel mechanism of liver fibrosis from the view of cell migration.Methods A modified in vitro Boyden chamber system to partially mimic in vivo microenvironment of Disse space of normal and liver fibrosis was employed.The effects of fibrogenetic growth factors on the migration of HSC in liver fibrosis were observed via cell migration and cell proliferation experiments.Results Enhanced platelet-derived growth factor(PDGF)-BB,transforming growth factor(TGF)-?1 and/or epithelial growth factor(EGF) in liver fibrosis resulted in an increase in migratory capacity of activated HSC.The enhanced migration of HSCs induced by PDGF-BB was partially associated with their increased proliferation,while,TGF-?1 or EGF-induced migration was proliferation independent.The elevation of basic fibroblast growth factor (bFGF) or vascular endothelial growth factor(VEGF)during liver fibrosis had no effect on the migration of HSCs.Conclusions The study provides valuable insights into the role of space of Disse microenvironment in regulating HSC migratory behavior.TGF-?1,PDGF-BB and EGF,which increased in liver fibrosis, could induce the migration of activated HSC.However,bFGF or VEGF has no such kind of effect,al- though they also increased during liver fibrosis.

Objective To evaluate the sensitivity of sleep-deprivation electroencephalography(EEG) examination in diagnosis of partial seizures of children.Methods One hundred and six normal children (male 57,female 49, 3-12 years old)and 102 children suspected of epilepsy but with normal in standard EEG examination were selected at random(male 63,female 39,3-12 years old). Sleep-deprivation EEG was performed individually.Periods of sleep-deprivation were 18-20 hours for children below 7 years old and 24 hours for the older ones.Results The EEG showed slowing of background electric activity. In addition, 57 cases showed spindle/sharp-slow wave complex.The rate of EEG abnormality was 55.88%.The rates of EEG abnormality for partial seizures and generalized seizure were 76.32% and 43.8%,respectively(?~2=8.98 P

Objective To compare the sensitivity of sleep-deprivation electroencephalography(EEG)examination on children suffered with nonepileptic seizures in normal and suspected epileptic in children.Methods Thirty -eight children with nonepileptic seizures (male 13,female 25,age 4-12 years, mean 8.1 years) had induced a person to make a confession. One hundred and six normal children (male 57, female 49, age 3-12 years,mean 7.6 years) and 102 children(male 63,female 39,age 3-12 years,mean 7.3 years)suspected of epilepsy clinically but with normal standard EEG examination were selected at random as controls.Sleep-deprivation EEG was performed individually.Results The sleep deprivation EEG showed slow background electric activity in all 3 groups. In addition, the rates of EEG abnorma lity for nonepileptic seizures group were zero,no statistics were computed because F was a constant. Fifty-seven cases showed spindle/sharp-slow wave complex in suspected epileptic children.The rate of EEG abnormality was 55.9%.The rate of EEG abnormality for normal control group was 1.9 %.There were significant difference among 3 groups (?2=97.3 P

Objective To report the clinical effect of primary percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI).Methods A retrospective study was accomplished on the clinical data of 13 AMI patients who underwent PCI from March 2004 to April 2006.Results The infarct-related artery (IRA)was successfully recanalized by primary PCI for 12 AMI patients,without major complications occurred in these cases during hospitalization.Conclusion Primary PCI should be firstly chosen for treatment of AMI in the hospitals which could carry out PCI.

OBJECTIVETo evaluate the effects of ketamine on perioperative serum cytokine levels in patients undergoing orthotopic liver transplantation (OLT).

METHODSTwenty patients undergoing OLT were randomly divided into ketamine group (n=10) and control group (n=10). Patients in ketamine group were given intravenous bolus injection of ketamine at 0.25 mg/kg followed by ketamine infusion at 0.5 mg.kg(-1).h(-1) until the end of operation except in the anhepatic phase, whereas the control group received saline of the same amount. Arterial blood samples were obtained at the start of surgery (T(1)), 5 min before the anhepatic phase (T(2)), 5 min before recirculation (T(3)), 15 and 60 min after recirculation (T(4), T(5)), and 0, 4 and 24 h after operation (T(6), T(7), T(8)). Serum levels of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6) and IL-10 were measured by ELISA.

RESULTSSerum TNF-alpha, IL-6 and IL-10 levels increased significantly during anhepatic phase as compared with the baseline level (T(1)) (P<0.05), and the changes were especially obvious in IL-6 and IL-10. The levels of the cytokines kept rising after recirculation and reached the peak level at T(5)(P<0.05), followed then by rapid decline and still maintaining higher levels than the preoperative ones 24 h after operation. The levels of TNF-alpha in ketamine group between T(2) and T(7) were significantly lower than that in the control group, and the IL-6 level between T(2) and T(5) were also significantly lower in ketamine group. Serum IL-10 level did not show any significant difference between the two groups.

CONCLUSIONIschemia and reperfusion injury of the liver and surgical stress induce pro- and anti-inflammatory cytokine responses during liver transplantation, in which event IL-6 and IL-10 are more sensitive than TNF-alpha. Ketamine can inhibit the production of TNF-alpha and IL-6 but not IL-10.

Anesthetics, Dissociative ; administration & dosage ; Female ; Humans ; Interleukin-6 ; blood ; Ketamine ; administration & dosage ; Liver Cirrhosis ; blood ; surgery ; Liver Neoplasms ; blood ; surgery ; Liver Transplantation ; methods ; Male ; Perioperative Care ; Tumor Necrosis Factor-alpha ; blood

Background Diabetic retinopathy (DR) leads to blindness because of the retinal angiogenesis caused by the ischemia of retina.Vascular endothelial growth inhibitor (VEGI) is a recently identified anti-angiogenic cytokine,which can suppress endothelial cell proliferation and angiogenesis.Objective The aim of this study was to detect the change of serum and vitreous VEGI/TL1A and its relative cytokines in patients with DR.Methods A non-randomized controlled clinical trial was performed.Fifty-five DR patients were enrolled in Tianjin Medical University General Hospital from November 2012 to March 2013 with the informed consent.The patients were divided into non-proliferative DR (NPDR) group (20 cases) and PDR group (35 cases).Eleven cataract patients served as normal control group,and 15 patients with diabetic mellitus (DM) were included as DM group.The demography was matched among the groups,but the course of DM and the blood glucose level were elevated in the PDR group and the DM group compared with DR group (all at P＜0.05).We collected the serum of all the patients above.Another 23 PDR patients (25 eyes) were enrolled in Tianjin Medical University General Hospital from November 2012 to March 2013 with the informed consent and served as PDR group,healthy corpse's eyes (n=7) as control group,the patients were assigned to the retinal photocoagulation group,surgery group and photocoagulation +surgery group according to different treatment procedures.Vitreous samples were collected during the progress of vitrectomy.TL1A/VEGI 251,VEGF,TNF-α,IL-1β and NF-κB p65 concentrations in the serum and vitreous specimens were detected using ELISA.The differences of serum and vitreous TL1A/VEGI 251,VEGF,TNF-α,IL-1β and NF-κB p65 in various groups were statistically analyzed by ANOVA and independent sample t test,respectively.The correlation between TL1A/VEGI 251 and VEGF,TNF-α,IL-1β,NF-κB p65 were calculated by Pearson correlation analysis.Results TL1A/VEGI 251 concentration was elevated in the DM group,NPDR group and PDR group compared with the normal control group,with significant difference among the 4 group (F =27.431,P =0.009),and TL1A/VEGI 251 concentration was higher in the PDR group than that in the DM group or the NPDR group (P＜0.05).VEGF,TNF-α,IL-1 β and NF-κB p65 concentrations in serum were increased in the PDR group in comparison with the DM group,NPDR group and the normal control group (P＜0.05).However,no significant difference among the DM group,NPDR group and the normal control group (P＞0.05).Serum TL1A/VEGI 251 concentration was significant correlated with VEGF,TNF-α,IL-1β and NF-κB p65 concentration (r=0.951,0.951,0.851,0.944,all at P＜0.01).Vitreous TL1A/VEGI 251,VEGF,TNF-α,IL-1 β concentrations were ascended in the PDR group compared with the normal control group (P =0.024,0.001,0.000,0.037),but there was no significantly difference in vitreous NF-κB p65 concentration between the two groups (P =0.073).Vitreous TL1A/VEGI 251 concentrations declined in the retinal photocoagulation group and the surgery group compared with the normal group (all at P＜ 0.05),and significant positive correlations were found between vitreous TL1A/VEGI 251 concentration and VEGF or TNF-α concentration (r =0.675,0.950,P ＜ 0.01) ;while Pearson correlation coefficient was not statistically significant between vitreous TL1A/VEGI 251 concentration and IL-1β or NF-κB p65 concentration (r=0.233,0.318,P＞0.05).Conclusions VEGI is involved in the pathogenesis of DR,and it interacts with VEGF,TNF-α,IL-1β and NF-κB to affect the development of DR.These results provide a new clue for the further study of DR.

Objective To discuss the optimal timing of fixation for femoral shaft fractures with concomitant head injuries. MethodsEarly and delayed complications,mortality rate,interval of ICU and duration of hospital stay were compared among 137 patients with head injuries,so as to evaluate the curative effect of early fixation of femoral shaft fracture(n=56) and delayed fixation(n=81).Results Early fixation group enjoyed advantages in the interval of ICU,duration of hospital stay,associated shock and infection rate over the delayed fixation group(P