Anastomotic leak after aortic dissection surgery is a common and critical complication.Interventional therapy is less invasive and effective.This case reported that anastomotic leak was found after surgery for type A aortic dissection.The risk of reoperation was high.The minimally invasive method was used to release the ocduder to the anastomotic leak.The effect was accurate.

Objective: To investigate the inhibitory effect of Green Tea Polyphenols(GTP) on H2O2-induced lens epithelial cell apoptosis and relevant mechanism.Methods: Separated and cultivated lens epithelial cell,disposed that with GTP,then detected the inhibitory effect of GTP by electron transmission microscopy,flow cytometry and DNA fragmentation assay.The bcl-2,Bax and caspase-3 protein expression were measured with Western-blot in various groups.Results: The apoptosis cells and G1 phase cells increased in the group treated with sodium chloride solution,and the DNA "ladder" was found.In the group treated with GTP,the apoptosis cells and G1 phase cells decreased,and no DNA "ladder".The apoptosis protein bcl-2 increased,however,the Bax and caspase-3 protein decreased.Conclusion: The GTP can protect lens epithelial cells from the oxidative injury and restrain the apoptosis rate of lens epithelial cells and the mechanism was nearly correlated with bcl-2,Bax and caspase-3 protein.

Apoptosis ; Fatty Liver, Alcoholic ; Humans ; Lipid Metabolism

Objective To estimate the effect of low molecular weight heparin (LMWH) combined with conventional treatment on patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods Literature on randomized control trials( RCTs) with AECOPD treated by LMWH combined with conventional methods was collected in PubMed.The studies were selected according to inclusive and exclusive criteria.The data were extracted,the quality was assessed, and meta-analysis was conducted with RevMan 5.2 software.Results There were twelve RCTs including 879 patients with AECOPD in the current study.The results of meta-analysis showed that:①LMWH could obviously improve PaO2 and PaCO2 of patients with AECOPD as compared with the control group.②There was no statistically significant difference between the LMWH-treated group and control group in the improvement of FEV1 or hematocrit.Conclusion LMWH can significantly improve arterial blood gas analysis in AECOPD, but does not improve FEV1 or hematocrit.

QT dispersion(QTd,equals maximal minus minimal QT interval on a standard ECG) has been shown to reflect inhomogeneity of myocardial repolarization and cardial electrical instability, hence,been proposed to be associated with ventricular arrhythmias.But the intrinsical mechanism of QTd is incompletely understood. Contributing to QTd are differences of action potential duration(APD) in the three-dimensional structure of ventricular myocardium, which is identified to own three cell subtypes:endocardial, midmyocardial(M cells) and epicardial cells.And findings suggest that regional differences in the duration of the M cell action potential may lead transmural and spatial dispersion of repolarization. Autonomic nerves by combining receptors on the myocardial cells,especially M cells affect significantly the APD.Concordance between heterogeneity of ventricular myocardium and heterogeneity of autonomic innervation in heart provide support for the role of autonomic nerve in the generation of the QT dispersion.

Background Cell immunologic therapy for retinoblastoma(RB)is becoming a hot research topic.Cancer-testis antigen is a human immunogenic protein and is used to treat some tumors.However,its effect on RB has not been investigated.Objective The present study was to discuss the antigen specific anti-tumor effect of cytotoxic T lymphocytes(CTL)induced by the cancer-testis antigen,NY-ESO-1-sensitized dendritic cells(DCs),on human RB.Methods PCR was performed to amplify target gene fragments from the NY-ESO-1 plasmids,and then the target gene fragments were digested with the restriction enzymes SalI and EcoRI.Harvested fragments were inserted into the pDC316 plasmid to construct the recombinant plasmid pDC316/NY-ESO-1.The expression of NY-ESO-1 protein in human RB cells strain,HXO-RB44,was detected by immunofluorescence and Western blot.Monocytes were isolated from 60 ml of peripheral blood from a healthy donor using Ficoll density-gradient centrifugation with a cell density of 1 × 107/ml.DCs isolated from blood were stimulated with recombinant human granulocyte-macrophage colony stimulating factor(rhGM-CSF)and recombinant human interleukin-4(rhIL-4).The recombinant plasmid pDC316/NY-ESO-1 was transfected into DCs and the DCs were co-cultured with T lymphocytes.The resultant CTL were used as effector cells.The growth of the CTL was detected by MTT assay.The CTL were then added into the growth medium used for culturing HXO-RB44 cells and the vitality of the HXO-RB44 cells was assayed by MTT assay.Results The sequence of the cloned DNA fragment of the recombinant plasmid pDC316/NY-ESO-1 was conforms with the sequence of the NY-ESO-1 gene.The expression of the NY-ESO-1 protein in HXO-RB44 cells was tested by immunofluorescence and Western blot.DCs were successfully induced with rhIL-4 and rhGM-CSF from PBMC.The recombinant expression plasmid pDC316/NY-ESO-1 was successfully transferred into DCs.These DCs had high expression of surface molecules such as HLA-DR(42.1％),CD80(54.2％),CD83(39.7％)and CD86 (94.8％).The CTL that was induced by DCs-sensitized with NY-ESO-1 specifically killed HXO-RB44 cells.CTL induced by the sensitized DCs had a stronger cytotoxic effect against HXO-RB44 cells compared with un-sensitized DCs and CTL un-induced with DCs,as shown by MTT asssay(P＜0.05).The anti-tumor activity was highest when the ratio of effector to target was 75∶1(P＜0.05).Conclusions DCs transfected by the recombinant plasmid pDC316/NY-ESO-1 can induce the proliferation of allogenic CTLs,which showed a specific anti-tumor effect against HXO-RB44 cells.These results present a new type of immunotherapy for the treatment of RB.

Objective To evaluate the clinical value of selective intra-arterial calcium stimulated venous sampling ( ASVS) for the localization of pancreatic insulinoma preoperatively.Methods The clinical data of 28 insulinoma patients admitted from May 2000 to June 2010 in Ruijin Hospital undergoing selective intra-arterial calcium stimulated venous sampling with diagnosis of insulinomas before surgery were analyzed retrospectively.Results There were 12 males and 16 females.All the patients had Whipple's triad, and with proved insulinomas by postoperative pathology.There were 26 cases of single insulinoma and 2 cases of multiple insulinomas with altogether 32 insulinomas resected.78.1% of insulinomas were less than 20 mm.All patient were examined by selective intra-arterial calcium stimulated venous sampling.The peak ratio of insulin to the baseline after calcium stimulation appeared at the superior mensenteric artery (SMA) in 6 cases, and the peak ratio of insulin to the baseline after calcium stimulation appeared at gastroduodenal artery(GDA), proximal splenic artery (SAP) and distal splenic artery (SAD) in 9 cases, 6 cases and 6 cases respectively; Selective intra-arterial calcium stimulated venous sampling accurately located 25 cases, and selective intra-arterial calcium stimulated venous sampling located 2 cases wrongly.In one patient, the selective intra-arterial calcium stimulated venous sampling was falsely negative.The mean and median peak ratio of insulin to the baseline after calcium stimulation were 8.8 folds and 14.8 folds respectively.Accurate rate of selective intra-arterial calcium stimulated venous sampling was 89.3% (25/28) and it was higher than that of computed tomography (CT) (56.5% ) , magnetic resonance imaging (MRI) (60.0%).Sensitivity of selective intra-arterial calcium stimulated venous sampling was 96.2%, which was higher than that of computed tomography ( 69.6% ) , magnetic resonance imaging (75.0% ).Conclusion Selective intra-arterial calcium stimulated venous sampling is superior to computed tomography, or magnetic resonance imaging as a preoperative localizing tool for insulinomas, since this procedure is invasive it should be used when other preoperative morphologic studies (computed tomography or magnetic resonance imaging) failed.

Objective To observe the clinical efficacy of the early activity on preventing deep vein thrombosis after joint replacement. Methods A total of 90 patients who undergone skeleton and knee joint replacement from January 2014 to January 2015 were randomly divid-ed into the observation group and the control group (with 45 cases in each group)according to the random number table method.The control group were given routine nursing care to prevent thrombosis,while the observation group were given intervention nursing,namely implementa-tion of early activities.The related symptoms of deep venous thrombosis and D-dimer level of high blood coagulation state of plasma of the two groups were observed and compared before and after treatment.Results The symptoms of deep vein thrombosis of the observation group in the early postoperative period were less than that of the control group,and the difference was significant(P <0.05).The D-dimer level of the observation group was lower than that of the control group 7 days after the operation with a significant difference (P <0.05).Conclusion Systematic nursing intervention of early activities can significantly reduce the related symptoms of forming deep vein thrombosis after joint re-placement.In addition,it has an apparent effect on lowing the high blood coagulation state and preventing deep vein thrombosis.

Objective To explore the replantation method of upper limb's biplane mutilation in conjunction with soft tissue defect.Methods From January 2003 to January 2013,29 patients with upper limb's biplane mutilation in conjunction with soft tissue defect were treated.There were 21 males and 8 females with the average age of 28.6 years.The youngest one was 1 year old and the oldest one was 70 years old.All the cases underwent different replantation order and transplantation by using vascular and nerve and flap according to the lesion they suffered,including the defected plane and soft tissue.Results All replantation limbs were survived besides 2 cases with infection and 3 cases of delaying healed due to the part of tissue necrosis.Among all 29 cases,9 cases got excellent recovery,14 cases were in good condition,4 cases were poor and 2 cases were bad.The totally excellent and good rate of upper limb function was 79.3％ according to the limb reattachment function evaluation criteria of Hand Surgery of the Chinese Medical Association.Conclusion It can obtain higher survival rate due to our different replantations and method of tissue replantation to cure double plane mutilation in conjunction with soft tissue defect of upper limb.

Objective To study the improvement of sleep and life quality in chronic insomina patients with abdominal acupuncture. Methods Ninety patients were randomly divided into study group and control group. The study group were treated with abdominal acupuncture combined with hypnotics, and control group of with pure hypnotics. Ten treatments formed a course. The therapeutical effect was assessed with Pittsburgh Sleep Quality Index (PSQI) and Questionnaire SF-36 before and after treatment and 2 weeks after treatment respectively. Results The significant improvement was obtained in aspects of general effective rate right after the treatment, general score of PSQI and score of Questionnaire SF-36, and very significant improvement two weeks after the treatment not only in PSQI scores in sleep quality, sleep efficiency, daytime function and hypnotics but in SF-36 score. Conclusions Abdominal acupuncture can treat chronic insomnia through regulating body environment so as to improve sleep and life quality, and eliminate the hypnotic side effects.