OBJECTIVETo evaluate the protective effects of punicosides on alcohol induced acute liver injury in mice and its possible mechanisms as well.

METHODThe 60 mice were randomly divided into normal control, model group, three dose groups of punicosides with low, medium and high, then there is silibinin group. Three dose groups of punicosides and silibinin were given in advance by gavage for 4 weeks, then the mouse model of alcoholic acute liver injury was established. The serum levels of ALT, AST and TG were determined, and the mice were killed to calculate somatic index of liver, thymus as well as spleen. MDA, SOD, GSH-Px and GSH-ST were detected in the liver homogenate. Histopathological changes of the liver were observed by HE staining. The expression of MCP-1 and NF-kappaB in the liver tissues were detected by immunohistochemistry.

RESULTMid and high dose of punicosides reduced the liver index in mice significantly, improved liver steatosis, decreased the level of ALT, AST and TG in serum and the content of MDA in liver homogenate, furthermore the two dose groups increased the activity of SOD, GSH-Px and GSH-ST, inhibited the expression of MCP-1 and NF-kappaB in liver tissue.

CONCLUSIONPunicosides can protect the acute liver damage induced by alcohol.

Alcohols ; adverse effects ; Animals ; Chemical and Drug Induced Liver Injury ; blood ; drug therapy ; metabolism ; pathology ; Chemokine CCL2 ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; Gene Expression Regulation ; drug effects ; Liver ; drug effects ; enzymology ; pathology ; Male ; Malondialdehyde ; metabolism ; Mice ; NF-kappa B ; metabolism

Objective To investigate the effects of enhanced external counterpulsation on coronary heart diseas epatients who suffer from insomnia .Methods Ninety-two cases of coronary heart disease patients with insomnia were divided into observation group and control group randomly ,46 cases in each group .The cases in control group were given routine drug treatment and nursing for coronary heart disease and insomnia .On this base ,the cases in observation group were given EECP .Use the pittsburgh sleep quality index (PSQI) to evaluate the sleep quality of two groups on day of admission and 30d after treatment .The dimensions score and total score of two groups in each time were compared and analyzed .Results After the intervention of 30 d ,PSQI scores in the observation group were lower than those before intervention ,and lower than that of control group ,and there was statistical signifi-cance(P<0 .05) .Conclusion The EECP can relieve the insomnia of coronary heart disease patients ,and improve there sleep quali-ty .

Objective To investigate and assess the clinical effect of treatment of children′s fractures at distal radial or radial-ulna through incision and Kirschner wire′s interior fixation without coursing epiphysis.Methods The treatment of children′s fractures at distal radial or radial-ulna in our hospital between 1996 and 2005 were reviewed,91 cases via Kirsehner-wire′s internal fixation were dealt.According to the way of placing Kirschner wire,the patients were divided into 2 groups.Group A of 53 cases eschewing epiphysis and passed bone-cortex.Group B of 38 cases got intramedullary fixation and passed epiphysis for 38 cases.After 6-100 months′ follow-up investigation,the 2 groups were comporred by analyzing statistics and the number of cases which involved repeatedly setting of Kirschner wire during operation,anatomical restoration,replacement,Kirschner-wire moving,infection,wrist′s dysfunction and bridge between the epiphysis.Results The fractures in both groups were recovering well.Besides,both were at the low rate of repeated replacement,Kirschner wire moving and infection.However,there were significant differences on repeated setting of Kirschner wire during operation,wrist′s dysfunction and bridge between the epiphysis,of which group B were higher than those in group A.Conclusions While the children′s fractures at distal radial or radial-ulna will be reduced by incision and fixing with Kirschner wire,the way of eschewing epiphyses and passing bone-cortex is better because it accords with anatomic character of children.It can not only fix reliably and bring satisfying clinical treatment effect,but also cause little complication.Thus,it is superior to the way of intramedullary fixation and passed epihysis.

BACKGROUND: Removal of immunosuppressants in patients with recurrent tumor in long-term following organ transplantation is always a hot controversial point in academic circles. To further elevate clinical efficiency, people began to invent new immunosuppressant and studied immune efficiency of various immunosuppressant component. They tried to reduce the application of cyclosporin A (CsA).OBJECTIVE: To analyze the CsA safe withdrawal of a case of kidney recipients, at 18 years after renal transplantation, who developed bladder carcinoma and renal pelvic carcinoma at 11 years and 18 years after transplantation, respectively. METHODS: After identified diagnosis, we performed transurethral resection of bladder tumor (TURBt) and total nephroureterectomy merobladder excision. Pathologic examination revealed grade Ⅰ-Ⅱ of bladder and renal pelvic transitional cell carcinoma. After the operation, patient was treated with immune suppression program of CsA withdrawal gradually in 12 days.Within 12 days, 5 mg CsA was decreased every 3 days, and complete withdrawal was done at 12 days. The dosage of azathioprine tablets and prednisone acetate tablets was not changed. Serum creatinine levels were rechecked every 3 days during drug withdrawal, and blood pressure, urine volume, physical symptom of patients and ultrasound of transplanted kidney were observed.RESULTS AND CONCLUSION: During the three months of CsA withdrawal, the blood creatinine levels were from 65 to indicated that the CsA gradually withdrawal of a case of kidney recipients after renal transplantation, who developed transitional cell carcinoma and was performed transurethral resection of bladder tumor (TURBt) and total nephro- ureterectomy merobladder excision, was safe. No tumor relapse or diversion was found.

OBJECTIVETo discuss the clinical effects of external fixator combined with limited internal fixation in the treatment of pediatric distal femur fractures.

METHODSFrom January 2008 to June 2014, 17 children of distal femur fractures were treated by external fixator combined with limited internal fixation. There were 12 males and 5 females, aged from 6 to 13 years old with an average of 10.2 years, ranged in the course of disease from 1 h to 2 d. Preoperative diagnoses were confirmed by X-ray films in all children. There were 11 patients with supracondylar fracture , and 6 patients with intercondylar comminuted fracture. According to AO/ASIF classification, 9 fractures were type A1, 5 cases were type A2,and 3 cases were type C1. The intraoperative and postoperative complications, postoperative radiological examination, lower limbs length and motion of knee joints were observed. Knee joint function was assessed by KSS score.

RESULTSAll the patients were followed up from 6 to 38 months with an average of 24.4 months. No nerve or blood vessel injury was found. One case complicated with the external fixation loosening, 2 cases with the infection of pin hole and 3 cases with the leg length discrepancy. Knee joint mobility and length measurement (compared with the contralateral), the average limited inflexion was 10 degrees (0 degrees to 20 degrees), the average limited straight was 4 degrees (0 degrees to 10), the average varus or valgus angle was 3 degrees (0 degrees to 5 degrees). KSS of the injured side was (96.4 +/- 5.0) points at final follow-up, 16 cases got excellent results and 1 good. All fractures obtained healing and no epiphyseal closed early was found.

CONCLUSIONExternal fixator combined with limited internal fixation has advantages of simple operation, reliable fixation, early functional exercise in treating pediatric distal femurs fractures.

Adolescent ; Child ; External Fixators ; Female ; Femoral Fractures ; surgery ; Femur ; injuries ; surgery ; Fracture Fixation, Internal ; Humans ; Internal Fixators ; Male

Objective To investigate antimicrobial resistance and ceftriaxone resistance mechanisms in clinically isolated nontyphoidal Salmonella(NTS),and provide evidence for the prevention and control of NTS infection and rational use of antimicrobial agents.Methods 108 NTS isolates were isolated from stool specimens of outpatients with acute diarrhea in the Second Hospital of Tianjin Medical University and Tianjin Medical University General Hospital from May to October of 2014,NTS were performed antimicrobial susceptibility testing;non-ceftriaxone-susceptible isolates were typed by serological,multilocus sequence (MLST),and pulsed-field gel electrophoresis (PFGE)methods,extended-spectrumβ-lactamase (ESBL)detection and AmpC genes were detection.Results Among 108 NTS isolates,mono-drug resistance rate to 11 antimicrobial agents was 49.07% (n= 53),multidrug resistance rate was17.59% . Susceptibility rates to nalidixic acid,levofloxacin,ciprofloxacin,ceftriaxone,and ertapenem were 61.11% ,66.67% ,68.52% ,97.22% ,and 100.00% respectively. Three non-ceftriaxone-susceptible NTS isolates were detected,2 were ST11 Salmonellaenterica serotype (Sa8709,Sa8771),1 was ST34 Salmonellatyphimurium serotype(Sa8763). Cluster analysis of PFGE revealed that Sa8709 was highly similar to Sa8771 strains(91 .70% ), but the similarity to Sa8763 was low(55.80% );Sa8709 strain carried CTX-M gene,Sa8771 strain carried CTX-M and TEM genes,Sa8763 strain carried OXA gene. Conclusion Clinically isolated NTS in this area are low resistant to fluoroquinolones,multidrug resistant strains carrying ESBLs have emerged.

Objective To investigate the effect of different Chinese herbs on cell proliferation and cartilage oligomeric matrix protein(COMP)expression in chondrocyte culture.Methods Chondrocytes isolated from rabbit knee cartilage were cultured for 3 generations with the density of 2?10~4/cm~2 and were verified by collagenⅡimmunohistochemical staining.Rabbit sera containing herbs were obtained after animals orally ad- ministrated herbs at the dosage equivalent to human.At 5% and 10% serum density,cells were cultured in the medium that contained liver-softening herbal compound sera.Subgroups setting at 1,3 and 5 hours after herb intervention were observed.Rabbit and bovine sera were control groups.Seven days after intervention,chon- drocytes proliferation was observed using the MTT assay kit.For the study of COMP expression,chondrocytes were isolated from human knee cartilage supematant.Superuatant COMP level was tested by enzyme-linked immunoabsorbent assays(ELISA)after directly adding compound and extract from liver-softening herbs to the culture at the final concentration of 10 mg/ml for 3 days.Results Liver-softening herbal compound group had significant effect on cell proliferation compared to control,of which,3-hour subgroup was more significant than 1-and 5-hour subgroups(P

A total of 1 100 patients underwent renal transplantation in the Organ Transplantation Center,Second Affiliated Department of General Hospital of Chinese PLA between 1988 and 2008 were collected,and retrospective analysis was performed in five female patients with malignant tumor,which appeared at 68 months (20-132 months) following renal transplantation,including 2 with renipelvic and uretal cancer and 3 with bladder cancer. Two of the 3 patients with bladder cancer presented homolateral renipelvic and uretal metastasis. Three cases and 1 case of upper uretal cacer were observed at the homolateral or heterolateral of kidney grafts respectively. The main characteristic of sign was iterative and painless gross hematuria. The 5 patients underwent renal transplantation with intravesical instillation therapy and nephrectomy. All patients were survived without rejection in the 1-62 months follow-up. The incidence of malignancy in renal allograft recipients is much higher than that in normal ones,which is related to the long term use of immunosuppressants. Urinary epithelial cancer is the main complicating carcinoma and the first choice of treatment is surgical operation. Based on the normal renal grafts function,the dose of immunosuppressants should be as low as possible,Moreover,radiotherapy or chemiotherapy should be adopted according to the types and stages of tumor complicating renal transplantation.

Objective To assess the risk factors of the in-hospital mortality of acute type A aortic dissection after operation. Method From January 2003 to June 2008,185 patients, 144 males and 41 females, with acute type A aortic dissection operated on were enrolled. The average age of patients was (49.46 ± 11.04 ) years old.The patients' demographics, history, clinical features, and some laboratory examinations were reviewed. Univariate and multivariate analysis followed by logistic regression analysis were carried out to identify the predictors of inhospital mortality. Results The in-hospital mortality rate was 9.1%. The results of univariate and multivariate analyses as follows: pre-operation positive neurological symptom (Univariate OR = 5.084,95%CI:1.792 -14.426, P = 0.002; Multivariate OR = 5.538,95%CI: 1.834 - 16.721, P = 0.002, respectively), hypotension (Univariate OR = 6.986,95%CI:1.510- 32.323,P =0.013; multivariate OR = 1.998,95%CI:0.315-12.679,P = 0.463, respectively) and renal failure (Univariate OR = 3.594,95%CI:1.237 - 10.438,P =0.019; Multivariate OR = 3.254,95%CI:1.034- 10.242, P= 0.044, respectively). Conclusions There are two predictors, pre-operation positive neurological symptom and renal failure, of pre-hospital mortality found in current analyses. Our results may improve the regimen made by cardiac surgeons and emergency doctors so as to help patients and their relatives to make correct decision.

Objective To analyze the clinical techniques of renal artery control in laparoscopic donor nephrectomy.Methods 211 relative living renal transplantations were performed from June 2003 to June 2012,and 136 donors underwent laparoscopic donor living nephrectomy (LDN) since 2007.Forty donors were subjected to the Hem-o-lock clips for renal artery control by open surgery,87 donors to the Hem-o-lock clips for renal artery control by laparoscope,5 donors to the Endo GIA stapler for renal artery control by laparoscope,and 4 donors to the Hem-o-lock clips by laparoscope combined with hand-assisted suture transfixion for renal artery control.Results The warm ischemia time of renal artery control was shortest (1.1 ± 0.3 min) by Hem-o-lock clips in open surgery,and longest (3.2 ± 0.8) min by the Hem-o-lock clips with laparoscope.There was significant difference in the warm ischemia time of renal artery between open group and other groups,the differences (P＜0.05).The comparison of prognostic factors in the transplant renal outcome showed no significant difference among groups.The renal arterial stump-rrhexis-caused massive secondary bleeding occurred in 1 case subject to Hem-o-lock clips for renal artery control by laparoscope,with conversion to open surgery urgently,the operation was successful at last.Other renal artery control ways were all safe without any adverse reaction.Conclusion The warm ischemia time of renal artery control by Hem-o-lock clips in open surgery was shortest in laparoscopic donor nephrectomy.The renal artery control way by Endo GIA stapler in laparoscope or by Hem-o-lock clips with hand-assisted suture transfixion is safest.The utilization of Hem-o-lock clips should be careful in high risk population such as severe atherosclerosis etc.