Objective To explore the therapeutic effect of a chitosan-collagen-salvianolic acid slow-release composite mem-brane on lumbar spine and epidural scar tissue after lumbar laminectomy in rabbits.Methods Chitosan,type Ⅰ collagen,and salvianol-ic acid were used to prepare the composite membrane material in a specific ratio.After constructing a lumbar laminectomy animal model in New Zealand white rabbits,the material was implanted.The animals were sacrificed at 4 and 8 weeks after surgery,L1,L2 and T12 lumbar spine and epidural scar tissue were collected.Hematoxylin-eosin staining and Masson staining were used to detect pathological changes in lumbar spine bone tissue,and a biochemical kit was used to measure the hydroxyproline(HYP)content in scar tissue.Results At 4 and 8 weeks after surgery,the model group showed tight adhesion between the dura mater and scar tissue,with inability to separate blunt-ly.The model group had reduced trabecular number and thickness compared to the sham group,with trabecular fractures,disordered ar-rangement,disrupted collagen continuity,and increased HYP content.After implantation of different materials,the adhesion between the dura mater and scar tissue decreased,trabecular arrangement improved,trabecular number increased,bone collagen staining area signifi-cantly increased,collagen structure was restored,and HYP content at 4 weeks was significantly lower than the model group(P＜0.05).At 8 weeks,HYP content showed no significant difference compared to the model group,with only the model+CC group showed a signifi-cant decrease(P＜0.05).Conclusion The chitosan-collagen-salvianolic acid slow-release composite membrane promotes the heal-ing and repair of tissues after lumbar laminectomy in rabbits.

Objective To explore the therapeutic effect of a chitosan-collagen-salvianolic acid slow-release composite mem-brane on lumbar spine and epidural scar tissue after lumbar laminectomy in rabbits.Methods Chitosan,type Ⅰ collagen,and salvianol-ic acid were used to prepare the composite membrane material in a specific ratio.After constructing a lumbar laminectomy animal model in New Zealand white rabbits,the material was implanted.The animals were sacrificed at 4 and 8 weeks after surgery,L1,L2 and T12 lumbar spine and epidural scar tissue were collected.Hematoxylin-eosin staining and Masson staining were used to detect pathological changes in lumbar spine bone tissue,and a biochemical kit was used to measure the hydroxyproline(HYP)content in scar tissue.Results At 4 and 8 weeks after surgery,the model group showed tight adhesion between the dura mater and scar tissue,with inability to separate blunt-ly.The model group had reduced trabecular number and thickness compared to the sham group,with trabecular fractures,disordered ar-rangement,disrupted collagen continuity,and increased HYP content.After implantation of different materials,the adhesion between the dura mater and scar tissue decreased,trabecular arrangement improved,trabecular number increased,bone collagen staining area signifi-cantly increased,collagen structure was restored,and HYP content at 4 weeks was significantly lower than the model group(P＜0.05).At 8 weeks,HYP content showed no significant difference compared to the model group,with only the model+CC group showed a signifi-cant decrease(P＜0.05).Conclusion The chitosan-collagen-salvianolic acid slow-release composite membrane promotes the heal-ing and repair of tissues after lumbar laminectomy in rabbits.

Feces and intestinal contents of pigs suspected with porcine epidemic diarrhea virus were collected from a farm in Minqin County,Gansu Province,China.After the suspected positive sam-ples were detected by RT-PCR,Vero cells were used to isolate and culture them in vitro.The suc-cessfully isolated virus was identified in the laboratory,and its whole genome sequence was ana-lyzed for genetic evolution.The pathogenicity was evaluated by animal regression test.The results showed that typical syncytial lesions could be observed when the PEDV-positive treatment solu-tion was inoculated with Vero cells in the 4th generation,and the virus titer in the 6th generation reached 10-4 75TCID50/mL.PEDV-like virions with a diameter of about 100 nm and a round shape with obvious capsular membranes and spikes were observed by electron microscopy.Whole genome sequencing analysis showed that the total length of this strain was 28 085 bp,which was far from the G1 subtype represented by the classical strain CV777(96.6％),and had a high homology with the G2b strains BC-2011-1,IA1,USA/Colorado/2013 and WELL(98.6％).This indicated that the strain belonged to the G2b epidemic strain.The animal regression test showed that the 5-day-old piglets developed vomiting,acute watery diarrhea,emaciation and mental depression within 12 h after the attack,and the symptoms worsened and died within 24 h.After autopsy,the infected piglets could be observed with stomach swelling,high intestinal heave,thin and transparent intesti-nal wall,and undigested milk clots inside.In summary,a PEDV G2b epidemic strain was success-fully isolated and identified in this study,and its whole genome sequence and pathogenicity were analyzed,providing research materials for future studies on PEDV gene function,pathogenic mech-anism and vaccine development.

It is a new attempt to interpret the essence of doctor-patient relationship and reveal the mechanism of doctor-patient conflict by using game theory. According to James Cass’s philosophy theory of finite and infinite games, this paper applies the four elements of finite and infinite games: "goal-actor-rule-boundary". Combined with the four elements of game theory, the doctor-patient relationship was systematically interpreted, and the evolution model of finite games and infinite games was constructed. This paper held that the essence of doctor-patient relationship is an infinite game in theory, the nature of doctor-patient relationship is a finite game in reality, and doctor-patient conflict is the result of the evolution of the finite game of doctor-patient relationship. Based on the finite game evolution model, this paper analyzed the causes of doctor-patient conflict in the specific narrative of doctor-patient conflict, and pointed out that the doctor-patient relationship can only be resolved by changing their "game view", so as to achieve the transcendence of the doctor-patient relationship from finite game to infinite game.

Objective:To summarize the patient profiles and therapeutic efficacies of ABO-incompatible living-related kidney transplantations at 19 domestic transplant centers and provide rationales for clinical application of ABOi-KT.Methods:Clinical cases of ABO-incompatible/compatible kidney transplantation (ABOi-KT/ABOc-KT) from December 2006 to December 2009 were collected. Then, statistical analyses were conducted from the aspects of tissue matching, perioperative managements, complications and survival rates of renal allograft or recipients.Results:Clinical data of 342 ABOi-KT and 779 ABOc-KT indicated that (1) no inter-group differences existed in age, body mass index (BMI), donor-recipient relationship or waiting time of pre-operative dialysis; (2) ABO blood type: blood type O recipients had the longest waiting list and transplantations from blood type A to blood type O accounted for the largest proportion; (3) HLA matching: no statistical significance existed in mismatch rate or positive rate of PRA I/II between two types of surgery; (4) CD20 should be properly used on the basis of different phrases; (5) hemorrhage was a common complication during an early postoperative period and microthrombosis appeared later; (6) no difference existed in postoperative incidence of complications or survival rate of renal allograft and recipients at 1/3/5/10 years between ABOi-KT and ABOc-KT. The acute rejection rate and serum creatinine levels of ABOi-KT recipients were comparable to those of ABOc-KT recipients within 1 year.Conclusions:ABOi-KT is both safe and effective so that it may be applied at all transplant centers as needed.

Objective To explore the efficacy of renal transplantation plus hematopoietic stem cell transplantation on inducing immune tolerance and summarize its long-term follow-up outcomes . Methods From 2009 to 2018 ,a total of 11 cases of living related donor kidney transplantation plus hematopoietic stem cell transplantation were performed .Two of them were HLA-matched and the remainder were mismatched for one HLA haplotype . The donor hematopoietic stem cells were mobilized using granulocyte colony-stimulating factor at 5 days pre-transplantation and collected at 1 day pre-operation .The recipients received total lymphoid irradiation for 3 days pre-transplantation and received anti-thymocyte globulin induction during transplantation .The donor hematopoietic stem cells were infused at 2 ,4 and 6 postoperative day .Postoperative regulatory T cells ,chimerism ,B cell activating factor and mixed lymphocyte culture and other parameters were detected and long-term follow-up outcomes tracked .Results The immune tolerance-inducible recipients had a significant increase in activated Treg .One HLA-matched recipient achieved 30％-50％ of chimerism and lost after 6 months .However ,other recipients did not achieve mixed chimerism .The BAFF of recipient spiked sharply after transplantation .Mixed lymphocyte culture indicated that a donor-specific low response was induced .The recipients were followed up for 717 to 3612 days .The first recipient lost renal function and another ten recipients had stable renal function . None of the recipients had myelosuppression or graft-versus-host disease .Allograft biopsy confirmed only one case of mild acute rejection . The dose of immunosuppressive agents was lowered in 5 patients .Conclusions Hematopoietic stem cell transplantation for inducing tolerance is safe during renal transplantation . And chimerism is essential for inducing immune tolerance .

OBJECTIVEStudy on the promoter effects of sodium butyrate in high or low dosages on carcinogenesis process, based on the immortalization of human fetal esophageal epithelium induced by human papillomavirus (HPV) 18E(6)E(7) genes.

METHODSThe immortalized esophageal epithelium SHEE was treated with high concentration of the sodium butyrate (80 mmol/L) and then with low concentration (5 mmol/L) for 8 weeks respectively. The cells were cultured continuously without sodium butyrate for 14 weeks. The morphology, proliferation and apoptosis of the cells were studied by phase contrast microscopy, immunohistochemistry and flow cytometry. The dead and the viable cells were assayed by fluorescent microscopy with Hoechst 33342 and Propidium iodide staining. Tumorigenesis of the cells was assessed by soft agar colony formation and by transplantation of cells into nude mice and SCID mice.

RESULTSWhen cells were exposed to high concentration of sodium butyrate, cell death was increased leaving few live cells. When cells were cultured in the medium with low concentration of sodium butyrate, the first proliferative stage appeared. Removal of the butyrate caused the cell to enter a crisis stage with a long doubling time resembling senescent cells. After the crisis stage, the cells progressed to the second proliferation stage with continuous replication and atypical hyperplasia. At the end of the second proliferative stage, carcinogenesis of the cells appeared with large colonies in soft-agar and tumor formation in transplanted SCID mice and nude mice.

CONCLUSIONSThe malignant change of the immortalized epithelium by the effects of sodium butyrate is the consequence of a two-stage mortality mechanism: cells death by butyrate cytotoxicity and cell crisis by abrogation of sodium butyrate. These data reveal that in high dosage, sodium butyrate induces cell death and in low dosage, it induces cell proliferation, which emphasizes the importance of butyrate as a promotor of carcinogenesis.

Animals ; Butyrates ; toxicity ; Carcinogens ; toxicity ; Cell Death ; drug effects ; Cell Division ; drug effects ; Cell Line, Transformed ; Cell Transformation, Neoplastic ; chemically induced ; Esophageal Neoplasms ; etiology ; Esophagus ; pathology ; Humans ; Mice ; Mice, Inbred BALB C ; Papillomaviridae ; pathogenicity

AIM: To investigate the effects of granulocyte colony-stimulating factor (G-CSF)-mobilized bone marrow stem cells on treatment of the myocardial infarction in experimental rats. METHODS: Three hours after injected with isoprenaline(ISO) interaperitoneally to develop acute ischemic model, rats' bone marrow stem cells were mobilized by G-CSF and migrated to the site of myocardial infarction. The hearts were harvested from 24 hours to 2 weeks after administration of ISO for histopathological examination. RESULTS: 24 hours after administration of ISO , myocardial infarct zones scattered in the pallium of the control group ,there were a large amoumt of inflammatory cells infiltration around the infarct zones and majority of them were neutrophils. The infarction in the G-CSF treatment group was milder, majority of the infiltrative cells were monocytoid; 48 hours after administration of ISO, infarct zones expanded greatly in control group, while that of the G-CSF treatment group increased just mildly; 2 weeks after administration of ISO, there was no significant scar in the G-CSF treatment group. We also found the regeneration of myocytes in the pallium. CONCLUSION: G-CSF treatment protected the ischemic myocardium and it may be used to treat the acute myocardial infarction.