Objective To summary the experience of management for orthotopic homologous heart transplantation,heart-lung co-transplantation and to discuss the postoperative treatment of short-term complications.Methods Orthotopic homologous heart transplantation and heart-lung co- transplantation on 9 cases were performed from May 2004 to February 2006.The patients were traced closely and all complications were treated in time.Results During hospital stay,hypertension oc- curred in one case,right heart insufficiency in one case,infection of mycetes and cytomegalovirus in 2 cases after the heart transplantation,and in the patient undergoing heart-lung co-transplantation,renal inadequacy,bronchial anastomosis stenosis and fungus infection occurred.All patients obtained symp- tomatic relief before discharge.Conclusion Proper perioperative management,immunosuppressive therapy and management of postoperative complications could reduce mortality and obtain satisfactory therapeutic effect in the near future.

Objective To discuss the operative technical details in reducing complications after thyroid diseases reoperation, especially how to choose operative method and preserve laryngeal recurrent nerve and parathyroid gland. Methods The study protocols of 183 patients undergoing reoperation for thyroid disease from Jan. 2000 to Mar. 2009 were reviewed. There were 115 cases of benign and 68 cases of malignant thyroid diseases to observe the postoperative complications. Results The rates of temporary and permanent laryngeal recurrent nerve injury were 4.92% (9/183) and 1.64% (3/183), respectively. The rates of temporary and permanent hypocalcemia were 4.37% (8/183) and 0.55% (1/183), respectively. The rate of postoperative internal hemorrhage was 0.55%(1/183). Conclusions The thyroid reoperation was more difficult and can seduced a high rate surgical complication. The thyroid reoperation can be successfully performed if the operators could pay attention to the operative skill.

Objective To construct an expression system to produce the virus-like particles containing a part of the sequence of PSA mRNA, which are ribonuclease-resistant due to the encapsulation of the mRNA by bacteriophage MS2 coat proteins. Methods The PCR products of PSA cDNA fragments were cloned to TA vector pBS-T, then the targeted segments could be obtained when the pBS-T-PSA were digested by restriction endonuclease Hind Ⅲ and cloned to prokaryocytic expression vector pNCCL1. The recombinant plasmids named PNCCL1-PSA were transfected into E. Coli BL21-DE3 and induced to express with IPTG. Results The recombinant plasmids were successfully constructed. The bacteriophage MS2 coat protein which expressed in BL21 can self- assemble to form ribonuclease resistant virus-like particles and the PSA mRNA was encapsulated into virus-like particles. Conclusions The virus-like particle containing PSA mRNA can be expressed in prokaryocyte and it can be used as standard and control in detecting PSA mRNA. It provides a new, stable and ribonuclease-resistant RNA standard in RNA detection.

OBJECTIVETo investigate diagnosis and therapeutic effects of knee joint synovial chondromatosis with arthroscopic.

METHODSFrom March 1995 to July 2011, 28 patients with knee joint synovial chondromatosis were treated. Among them, 18 males and 10 females ranging age from 25 to 81 (mean 55.2) years,the course of disease ranged from 0.5 to 15 (mean 5.6) years. Clinical manifestation mainly included pain, swell and functional limitation of knee joint. Knee open surgery (17 cases) and laparoscopic surgery (10 cases) were respectively used. Clinical symptom,image data,pathological manifestation and effects under arthroscopy were observed, Lysholm scoring was used to evaluate effects.

RESULTSAll patients were followed up except one lost, the duration ranging from 6 to 24 months. Lysholm score in knee open surgery was increased from (41.89 +/- 6.81) preoperatively to (67.73 +/- 7.62) postoperatively;while in laparoscopic surgery it was increased from (40.78 +/- 7.54) preoperatively to (77.46 +/- 8.43) postoperatively.

CONCLUSIONArthroscopic surgery, which has no risk of rupture of incision, nonunion, earlier to exercise, is a good method to diagnosis and treat knee joint synovial chondromatosis.

Adult ; Aged ; Aged, 80 and over ; Chondromatosis, Synovial ; diagnosis ; surgery ; Female ; Follow-Up Studies ; Humans ; Knee Joint ; surgery ; Laparoscopy ; Male ; Middle Aged ; Treatment Outcome

OBJECTIVETo investigate the efficiency and safety of different regimens by intravesical instillation of epirubicin, a derivative of adriamycin, for the prevention of primary superficial bladder carcinoma from recurrence.

METHODSNinety patients supplemented with intravesical epirubicin instillation after operation were randomly divided into three groups: Group A--80 mg in one dose; Group B--repeated epirubicin 40 mg q wk x 4-8 sessions followed by q month to the end of the second year; or Group C--50 mg q month to the same duration. All patients were followed up for two years by observing the recurrence rates and side effects.

RESULTSThe recurrence rate of groups A, B and C at one year was 16.7%, 13.3% and 16.7%, respectively, without any significant difference observed. However, it was 50.0%, 36.7% and 36.7% at two years, at which time the recurrence rate of group A was significantly higher than those of groups B and C. The side effects rate was 23.3%, 40.0% and 33.3% for groups A, B and C, respectively. The more instillations the patients had, the more severe side effects were.

CONCLUSIONEarly postoperative single high dose intravesical instillation of epirubicin combined with repeated lower doses of the same drug every month may be an efficient and safe regimen to prevent the primary superficial bladder carcinoma from recurrence.

Administration, Intravesical ; Adult ; Aged ; Antibiotics, Antineoplastic ; administration & dosage ; adverse effects ; Combined Modality Therapy ; Epirubicin ; administration & dosage ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; prevention & control ; Postoperative Period ; Prospective Studies ; Urinary Bladder Neoplasms ; prevention & control ; surgery

ObjectiveTo explore the inductive action of docosapentenoic acid(DPA) on neurite outgrowth in PC12 cells in vitro.MethodsNeurite outgrowth in PC12 cells was examined after the treatment with different concentration of DPA using Motic Zamges Plus software mapping cell image system.Western blot was performed to detect the expression of β Ⅲ-tubulin regulated protein kinase,a neuronal marker as well as ERK and protein kinase B (Akt) phosphorylation.ResultsPC12 cell neurite formation rate was increased in a concentration dependent manner in the induction of DPA,increased by 2.4% (DPA 10 μg/ml,P>0.05),18.6% (DPA 30 μg/ml,P<0.05) and 25.0% (DPA 50 μg/ml,P<0.05) compared with that in the control group.DPA promoted the expression of β Ⅲ-tubulin (P<0.05) and the phosphorylation level of ERK and Akt (P<0.05,P<0.01).ConclusionDPA promotes PC12 cell neurites growth and its mechanism may be related to the activation of ERK and Akt signaling pathways.

Objective To investigate the effect of adenoviral-mediated exogenous HGF(Ad-HGF)gene transfer on lung angiogenesis in the rabbit lung in rabbits with hyperkinetic pulmonary artery hypertension.Methods A thoracotomy wag performed through a midsternal incision in 1-month-old immature rabbit and an anastomosis between the left inominate artery and the pulmonary trunk was made to establish a chronic patent left to right shunt.Three mortths later,animals were randomly assigned to receive either Ad-HGF(2×109Pfu in 0.2 ml PBS,H1 group),repeated administration of Ad-HGF after one week (H 2 group),Ad-GFP(2×109 Pfu in 0.2 ml PBS,G group),or PBS(0.2 ml,C group)by the intratraeheal method of gene transfection.After two weeks,reverse transcription-polymerase chain reaction (RT-PCR)and immunohistochemical examination was performed to identify HGFmRNA and HGF protein expression.The capillary density and small pulmonary artery density were determined by immunostained with antibodies against factor Ⅷ and a-SMA.After 1 month,the collateral vessels were evaluated by angiogram under digital subtraction angiography(DSA).Results Two weeks after Ad-HGF transfection,484 bp bands could be found by RT-PCR in H l and H2 groups,but not in other groups.The expression of HGF protein could be detected on alveolag epithelium and pulmonary vessel endothelium by immunohistochemistry examination.The number of factor Ⅷ-positive pulmonary capillaries was also significantly increased in the H1 and H2 groups compared with the C and G groups(P<0.05).The capillary density reached(17.0±3.3)mm2 and (19.7±2.8)mm2 in the H1 and H2 group,respectively,whereas it remained(13.2±3.2)mm2 in the C group and(13.5±2.4)mm2 in the G group(P<0.05).One month after Ad-HGF transfeetion.the numbeT of small pulmonary arteries was significantly increased in Hl and H2 group compared with control groups(P<0.05).The collateral vessels were more abundant in HGF transfection groups than that in the two control groups reviewed by angiogram under digital subtraction angiography (DSA).Conclusion In vivo gene transfection with HGF by means of the intra-tracheal injection could induce pulmonary angiogensis in the early stage and small pulmonary arterial angiogensis in later stage.

Objective To explore the effect of urine neutrophil gelatinase-associated lipocalin(uNGAL) and urine interleukin-18(uIL-18) on the ill condition and prognosis in critically ill patients with acute kidney injury (AKI) at inception of continuous veno-venous hemofiltration (CVVH).Methods Children came from Department of Nephrology,PICU and health examination center in Guangzhou Women and Children's Medical Center were divided into 4 groups:critically ill patients with AKI receiving CVVH group(group A),critically ill patients with non-AKI receiving CVVH group(group B),critically ill patients with AKI didn't recevie CVVH group(group C),and healthy control group(group D).Serum creatinine(SCr),uNGAL and uIL-18 in all patients were analyzed.Results The uNGAL in group A and group C [(161.56 ± 71.44) μg/L,(153.69 ±51.33) μg/L] increased obviously when compared with group B and group D [(33.50 ± l 0.76) μg/L,(16.37 ± 6.20) μg/L] (all P ＜ 0.05).The uIL-18 in group A and group C[(4.16 ±1.13) μg/L,(3.81 ± 1.05) μg/L] was higher than that in group B and group D [(0.25 ± 0.04) μg/L,(0.19 ± 0.15) μg/L] (all P ＜ 0.05).There was no significance of uNGAL and uIL-18 between group B and group D(all P ＞ 0.05).The peak level of uNGAL[(241.76 ± 53.60) μg/L vs (196.32 ± 39.28) μg/L] and uIL-18[(5.15 ±0.78) μg/L vs (4.30 ±0.89) μg/L] in critically ill patients with AKI was higher in renal recoveries than in renal non-recoveries(P ＜0.05).The levels of uNGAL and uIL-18 critically ill patients at initiation of CVVH were higher in non-survivors when compared with survivors [(213.50 ± 104.78) μg/L vs (79.91 ± 55.81) μg/L,P ＜ 0.05],[(4.48 ± 2.32) μg/L vs (1.94 ± 1.88) μg/L,P ＜ 0.05].The levels of uNGAL and uIL-18 of critically ill patients with AKI at initiation of CVVH were higher in non-survivors than in survivors [(256.99 ± 49.33) μg/Lvs (127.11 ±38.99) μg/L,P＜0.05],[(5.48±0.67) μg/Lvs (3.65 ±0.98) μg/L,P＜0.05].The levels of uNGAL and uIL-18 at the first diagnosis time of AKI were higher in non-survivors than in survivors (P ＜ 0.05).Conclusions uNGAL and urine IL-18 at commencement of CVVH predicts short-term prognosis in critically ill patients with AKI.uNGAL and urine IL-18 can be as a prognostic value in the prediction of the need for renal replacement therapy initiation or mortality in critically ill patients with AKI.

AIM:To investigate the role of microRNA-486-5p (miR-486-5p) in the apoptosis of human bone marrow mesenchymal stem cells (hMSCs) induced by hydrogen peroxide (H2O2).METHODS: The hMSCs were cul-tured in vitro and exposed to serum-free medium and H2O2(10 mmol/L).The changes of miR-486-5p expression in oxida-tive stress-related apoptosis of hMSCs were measured by real-time PCR.The hMSCs were transfected with miR-486-5p mimic or inhibitor at concentration of 30 nmol/L by Lipofectamine RNAiMAX.The effect of miR-486-5p on H2 O2-induced decrease in cell viability was evaluated by MTT assay.Hoechst 33342 staining and flow cytometry were applied to determine the role of miR-486-5p in the apoptosis of hMSCs.The protein expression was evaluated by Western blotting.Caspase-3 ac-tivity was determined using a caspase-3 activity kit.RESULTS:Compared with control group, the expression of miR-486-5p significantly decreased after treated with H2O2(P<0.05).In addition, over-expression of miR-486-5p in the hMSCs reduced the cell viability, accelerated apoptosis, down-regulated Bcl-2/Bax ratio, caspase-3 enzyme precursor content and phosphorylation of Akt, and activated caspase-3 activity.Conversely, down-regulation of miR-486-5p significantly inhibited H2 O2-induced cell apoptosis and the caspase-3 activity, increased cell viability and up-regulated Bcl-2/Bax ratio and phos-phorylation level of Akt.CONCLUSION:Over-expression of miR-486-5p promotes H2 O2-induced hMSCs apoptosis, and repression of miR-486-5p protects hMSCs from H2 O2-induced cellular apoptosis, which may be mediated by regulating Akt signaling pathway.

Objective To explore the modulatory effect of 5-HT2A receptors on the discharge activities of inspiratory neurons in medial region of nucleus retrofacialis of neonatal rats. Methods Experiments were performed in vitro brainstem slice preparations from neonatal rats. These preparations included the medial region of nucleus retrofacialis with the hypoglossal nerve rootlets retained. The rhythmic discharges of the inspiratory neurons and activities of the hypoglossal nerve rootlets were simultaneously recorded by using microelectrodes and suction electrodes, respectively. Roles of 5-HT2A receptors in modulation of the discharge activities of inspiratory neurons were investigated by administration of the 5-HT2A receptor agonist 1-(2,5-dimethoxy-4-iodopbenyl)-2-aminopropane (DOI), and its specific antagonist ketanserine dissolved in modified Kreb's solution for perfused slices. Results In DOI group, the inspiratory time (TI) was (0.864±0.07)s, expiratory time (TE) was (10.78±1.06)s, respiratory cycle (RC) was (11.79±1.64)s, integral amplitude (IA) was (357.98±37.21)(μV·s) and the peak discharge frequency (PF) was (37.83±3.66)Hz. In control group, they were (0.68±0.06)s, (13.89±2.14)s, (14.77±1.92)s, (273.57±24.39)(μV·s), and (29.92±4.50)Hz, there were significant differences between the 2 groups (Pa<0.01). In ketanserine group, TI was (0.55±0.07)s, TE and RC were (18.43±3.28)s and (20.17+2.91)s respectively, IA and PF were (214.37±33.52)(μV·s) and (22.17±3.92)Hz, there were significant differences between ketanserine group and DOI, control group (Pa<0.01). Conclusion 5-HT2A receptors take part in modulate the discharge activities of inspiratory neurons in neonatal rat brainstem slices.