China ; Death ; Humans ; Tissue and Organ Procurement

Evidence-based medicine emphasizes making project of diagnosis and therapy on the basis of the most objective research results. The current condition in which domestic medicine is dominant in hepatobiliary surgery and teaching needs to be changed urgently. The procedure of application of evidence-based medicine in teaching of hepatobiliary surgery is explained by an actual example. Evidence-based medicine plays an important role in teaching and quick progress in all of the hepatobiliary surgery.

AIM: To study the protective effect of bone marrow stromal cells (MSCs) on ischemia /reperfusion hippocampal slices. METHODS: Ischemia/reperfusion models of hippocampal slices from newborn rats were established. MSCs obtained from adult bone marrow were cultured, isolated and purified. Cell death was assessed using propidium iodide fluorescence. And brain-derived neurotrophic factor (BDNF) expression in MSCs was determined by immunocytochemistry and Western blot. RESULTS: Maximal dead cells appeared in hippocampal slices 3 to 7 days after reperfusion. When the slices were co-cultured with MSCs, only a few cells were dead. The protective effect of MSCs on the slices was diminished significantly when anti-BDNF antibody was added to the medium. The protein of BDNF was faintly expressed in MSCs under normal conditions. When MSCs were co-cultured with ischemia /reperfusion hippocampal slices, the expression of BDNF in MSCs was increased gradually especially when co-cultured for 3 to 7 days. However, MSCs co-cultured with normal hippocampal slices expressed BDNF at a lower level at any times of co-culture. CONCLUSIONS: In an in vitro model of simulated ischemia, MSCs reduce cell death. Ischemia/reperfusion hippocampal slices co-cultured with MSCs promote the expression of BDNF in MSCs, which in turn protect the ischemic neurons.

Aerenchyrna formation has been described in depth in a number of species at a histological level. But large gaps remain in our understanding of its regulation as a developmental process. It is attempted to analyse essential mineral elements like K, Mg, Cu, Zn, Ca and P in the cell wall of aerenchyma cells in petioles ofS. trifolia at five different developmental stages by CSEM-EDX technique. At early stage, K and Cl concentrations in cell wall were high up to 36% and 4.3% of dry weight, respectively. It supported the hypotheses that aerenchyma spaces are filled with liquid at early developmental stages of aerenchyma in S. trifolia petiole. Mg concentration was high at stage 2, up to 0.86% of dry weight. Zinc and Cu were detected only at rapid expansion stages, during which the concentrations were up to 1.5% and 2.5%, respectively. Calcium was detected in the cell wall only at mature stages, the concentration was high up to 1.3% of dry weight at stages 4 and 5. These results confirmed that the element concentration of aerenehyma cell wall undergoes dynamic changes during different developmental stages, and a low Ca with high Zn and Cu concentration are needed for cell expansion. Copper and Zn deposition in the cell wall showed a significant positive linear correlation, suggesting that these two elements share same or similar uptake and transport mechanism in plants.

Objective To explore the significance of serum cystatin C (Cys C)and β2-microglobulin (β2-MG) levels in blood and urine samples in hypertension grading and risk stratifying. Methods One hundred and thirty six cases with primary hypertension were enrolled into the study and classified into three grades and four risk stratifications. The serum Cys C levels were determined by ELISA assay. The blood and urine β2-MG were measured by radioimmunoassay. The serum BUN, Cr concentration were measured by the automatic biochemical analyzer. Results The positive rates of urine β2-MG were the highest index in patients with grade 1 (32%) and low risk hypertension( 8% ) ,followed by serum Cys C levels( grade 1 hypertension 24% ) ,compared with other indices( Ps ＜ 0. 05 ). With the blood pressure elevating, as well as the risk stratification increasing,serum Cys C level and the blood, urine β2-MG levels increased gradually by grading and stratifications (Ps ＜0. 05 or Ps ＜0. 01 ). We also found linear regression relationship between serum Cys C ,urine β2-MG levels and the risk stratifications of hypertension( r =0. 851 and r =0. 469 respectively,Ps ＜0. 01 ). The significant changes of serum BUN,Cr were only found in patients with grade 3 or very high-risk hypertension. Conclusion Joint detection of serum Cys C and urine β2-MG may help to detect early glomerular and tubular dysfunction in primary hypertension patients. Serum Cys C and blood, urine β2-MG levels are also related with the occurrence and development of hypertension,which show clinical significance in hypertension prognosis.

Objective: To discuss the way of early nutritional support in the patients after the liver transplantation. Methods: The nutritional support was used in 28 patients who had suffered the orthopetic liver transplantation (OLT).Parenteral nutrition was started as soon as possible after the operation. On the fourth day after the operation, enteral nutrition was also used. Results: 5 patients died from the postoperative complications. 23 patients survived and had been in better nutrition. Conclusion: The early nutrition support can play an important role in the patients recovery after OLT. EN should be administrated immediately when the gut functions.

Objective To investigate the role of survivin and P53 in apoptosis of gastric adeno- carcinoma,as well as its relationship with the clinicopathologic features and the prognosis.Methods The gas- tric tissue microarrays were composed of those from 100 cases of gastric cancer and 30 controls.At these tissue microarrays,expressions of survivin and P53 were investigated immunohistochemically,and tumor cell apoptosis index was examined by TUNEL method.Of the 100 cases,47 cases were followed-up from 14 months to 13 years,in which the survival was analyzed.Results Two paraffin-embedded gastric carcinoma tissue micro- arrays were successfully constructed,including 114 and 116 tissue spots,respectively.Immunohistochemical analysis showed that survivin was expressed in 78 cases (78%).No expression of survivin was detected in control tissue (P0.05).In the 47 cases with followed-up data,univariant analysis revealed that the survival was correlated with invading of vessel and nerve,TNM stages,and expression of survivin.The histological grades and expression of P53 were not related to prognosis.However,Cox stepwise proportional hazards analysis showed that only TNM staging and survivin status retained significant independently in prospecting prognosis.Conclusions The expression of survivin was associated with the pathologic features,TNM stages and prognosis in gastric carcinoma,indicating that overex- pression of survivin may be a poor prognosis factor for gastric carcinoma.

ObejectiveTo evaluate the efficacyofacupointthread embedding in easing painafterMilligan-Morgan(M-M)for mixed hemorrhoids.MethodSixty patients undergone M-M for mixed hemorrhoids were randomized into a treatment group of 30 cases and a control group of 30 cases. After M-M, patients in the treatment group received thread embedding at Changqiang (GV1) and bilateral Zhibian (BL54), while the control groupdidn’treceive any intervention. The onset time of post-operative pain, average pain index within a week, and pain index after defecation, electromyogram (EMG), change of anal canal pressure, patients’ satisfaction, and adverse-event rate were observed.ResultThe average pain index and pain index after defecation in the treatment group were significantly lower than that in the control group (P<0.05), and the onset of pain in the treatment group was significantly later than that in the control group (P<0.01); after surgery, the anal canal resting pressure in the treatment group was markedly lower than that in the control group (P<0.05); there wasno significant difference in comparing the squeeze pressure of anal canal between the two groups (P>0.05). According to the motor unit potential (MUP) analysis, there were significant differences in comparing the amplitude (Ampl) and Ar/Am of the restingphase between the two groups (P<0.05), while there were no significant differences in comparingthe Ampl, Area, Ar/Am, and Freq of the contraction phase between the two groups (P>0.05). There were significant differences in comparing the patients’satisfaction, adverse-event rate, and use of analgesics between the two groups (P<0.05). ConclusionAcupoint thread embedding can produce a content analgesic effect, and it’s safe and reliable.

Objective To outline the research fronts of ten major sub-specialties in internal medicine.Methods Based on their impact factor scores and the proportion of the journals of 10 subspecialties (endocrinology & metabolism,cardiac & cardiovascular systems,hematology,infectious diseases,nephrology,gastroenterology & hepatology,respiratory system,rheumatology,critical care medicine,clinical neurology) in Journal Citation Report (JCR),and careful consulation of expert clinicians,we identified 50 journals.Their bibliographic records (including references) published in 2011 were downloaded,and the frequency of the references (citations) in each sub-specialty was counted and the highly cited records were extracted.We performed a clustering analysis according to the co-cited times among any pairs of the highly cited records.To tag each cluster of highly cited records,we browsed the titles and abstracts of all highly cited records in the same cluster,and concluded the main topics of each cluster.Finally,we extracted the current published papers devoted to particular cluster by some clustering analysis indicators.The clusters of highly cited records were considered as the intelligence base,and the main topics in current papers which citing these highly cited papers were considered as research fronts.Results Totally 50 journals on 10 sub-specialties in internal medicine were identified.A total of 202 highly cited papers,38 clusters (knowledge bases),and 152 corresponding current citing papers presenting the research fronts were selected.Conclusions We confirm and present research fronts in 10 major sub-specialties of internal medicine.This study provides a synchronic structure of contemporary research activities in internal medicine sub-specialties.

Objective To screen the mimic epitopes of Rh(D)blood group antigens and identify their immunity from phage display peptide library.Methods A twelve mer phage peptide library was biopanned with anti-Rh(D)monoclonal antibody immobilized on plastic surface.After three round panning,thirty-five clones were randomly selected and positive clones were identified by ELISA and cross-reaction,followed by antibody competition inhibition assay and DNA sequencing to obtain the mimic epitopes of Rh (D)blood type antigens.The target phage clones were characterized and the antigenicity was analyzed by Western blot.Results After the third round screening,phages were enriched,and eleven positive clones were obtained.According to sequencing and competition inhibition analysis,the same"-WP-Q-"structure existed in seven of the eleven clones,and they had more than 40%inhibition ratio.The other clones had no same characteristics with low inhibition ratio possibly due to non-specific binding.Western blot analysis indicated that these phage clones could be specifically recognized by the anti-Rh(D)serum and they shared the same antigenicity of Rh(D)protein.Conclusions Rh(D)mimotope of"-WP-Q-"structure is successfully obtained by phage peptide library screening with anti-Rh(D)monoelonal antibody.The results lay the foundation for further exploration of pathogenesis and vaccine development of Rh(D)hemolytic diseases of newborn.