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Objective To explore the potential biomarkers for the diagnosis of primary brain stem injury （PBSI） by using metabonomics method to observe the changes of metabolites in rats with PBSI caused death. Methods PBSI, non-brain stem brain injury and decapitation rat models were established, and metabolic maps of brain stem were obtained by LC-MS metabonomics method and annotated to the HMDB database. Partial least square-discriminant analysis （PLS-DA） and random forest methods were used to screen potential biomarkers associated with PBSI diagnosis. Results Eighty-six potential metabolic markers associated with PBSI were screened by PLS-DA. They were modeled and predicted by random forest algorithm with an accuracy rate of 83.3%. The 818 metabolic markers annotated to HMDB database were used for random forest modeling and prediction, and the accuracy rate was 88.9%. According to the importance in the identification of cause of death, the most important metabolic markers that were significantly up-regulated in PBSI group were HMDB0038126 （genipinic acid, GA）, HMDB0013272 （N-lauroylglycine）, HMDB0005199 [（R）-salsolinol] and HMDB0013645 （N,N-dimethylsphingosine）. Conclusion GA, N-lauroylglycine, （R）-salsolinol and N,N-dimethylsphingosine are expected to be important metabolite indicators in the diagnosis of PBSI caused death, thus providing clues for forensic medicine practice.

Objective To investigate the effect of astragaloside Ⅳ on the injury of SK⁃N⁃SH cell in Parkinson's disease (PD) induced by 1 ⁃ methy ⁃ 4 ⁃ phenylpyridine (MPP＋) and its mechanism. Methods Human neuroblastoma cell line SK ⁃N ⁃SH was cultured to logarithmic growth stage, which were randomized to routine culture (control group), MPP＋ induction (MPP＋ group), astragaloside Ⅳ 10 mg/ml + MPP＋ induction (astragaloside Ⅳ 10 mg/ml group), astragaloside Ⅳ 30 mg/ml + MPP＋ induction (astragaloside Ⅳ 30 mg/ml group), astragaloside Ⅳ 30 mg/ml + MPP＋ induction + Janus kinase 2 (JAK2) inhibitor AG490 (JAK2 inhibitor group). Cell survival was detected by methyl thiazolyl tetrazolium (MTT) assay, cell apoptosis was detected by flow cytometry, reactive oxygen species (ROS) level was detected by DCFH ⁃ DA fluorescence probe, lactate dehydrogenase (LDH) and superoxide dismutase (SOD) activities were detected by enzyme method. And the relative expression levels of phosphorylated Janus kinase 2 (pJAK2) and phosphorylated signal transducer and activator of transcription 3 (pSTAT3) proteins in JAK2 ⁃ STAT3 signal transducer pathway were detected by Western blotting. Results There were significant differences in cell survival rate (P = 0.000), apoptosis rate (P = 0.000), ROS content (P = 0.000), LDH activity (P = 0.000), SOD activity (P = 0.003), pJAK2 (P = 0.000) and pSTAT3 (P = 0.000) proteins relative expression levels among different SK ⁃ N ⁃ SH groups. Further pairwise comparison showed that compared with the control group, the cell survival rate (P = 0.000, 0.001, 0.049, 0.000), SOD activity (P = 0.000, 0.002, 0.012, 0.000), relative expression levels of pJAK2 (P = 0.003, 0.006, 0.036, 0.002) and pSTAT3 (P = 0.001, 0.002, 0.024, 0.001) proteins were decreased in MPP＋ group, astragaloside Ⅳ 10 mg/ml and 30 mg/ml groups, JAK2 inhibitor group, but the cell apoptosis rate (P = 0.001, 0.001, 0.001, 0.000), ROS content (P = 0.000, 0.001, 0.002, 0.000) and LDH activity (P = 0.000, 0.002, 0.038, 0.000) were increased. Compared with MPP＋ group, the survival rate (P = 0.016, 0.000), SOD activity (P = 0.003, 0.001), relative expression of pJAK2 (P = 0.013, 0.002) and pSTAT3 (P = 0.018, 0.002) proteins increased in astragaloside Ⅳ 10 mg/ml and 30 mg/ml groups, which the apoptosis rate (P = 0.021, 0.008), ROS content (P = 0.031, 0.003) and LDH activity (P = 0.001, 0.000) decreased. Compared with astragaloside Ⅳ 10 mg/ml group, the cell survival rate (P = 0.002), SOD activity (P = 0.027), relative expression of pJAK2 (P = 0.007) and pSTAT3 (P = 0.006) proteins were increased in astragaloside Ⅳ 30 mg/ml group, but ROS content (P = 0.019) and LDH activity (P = 0.011) decreased, while apoptosis rate (P = 0.016), ROS content (P = 0.030) and LDH activity (P = 0.004) increased in JAK2 inhibitor group, and SOD activity (P = 0.004), the relative expression of pJAK2 (P = 0.001) and pSTAT3 (P = 0.005) proteins were decreased. Compared with astragaloside Ⅳ 30 mg/ml group, cell survival rate (P = 0.001), SOD activity (P = 0.001), the relative expression of pJAK2 (P = 0.000) and pSTAT3 (P = 0.001) proteins in JAK2 inhibitor group were decreased, but the apoptosis rate (P = 0.004), ROS content (P = 0.002) and LDH activity (P = 0.001) were increased. Conclusions Astragaloside Ⅳ can reduce MPP＋ induced SK ⁃ N ⁃ SH cell injury in PD, which may be related to the activation of JAK2 ⁃ STAT3 signal transducer pathway.

There is no uniform standard for determining the drainage effective radius of CO2 phase transition fracturing in view of the fact, we analyze the traditional measurement for drainage effective radius, clarify definition of drainage radius. The time-source method is established based on SF6 tracer method and test data, and it was tested in coal mine. The research shows there is time effect between drainage influence radius and drainage effective radius, and the drainage time is the key factor to distinguish them; the time-source method divides the drainage time into drainage effective time and drainage compensation time. The drainage effective radius under a certain time is obtained through SF6 tracer method and analysis of the field data. It can reflect the drainage situation of boreholes more accurately; the test-in-place experimented at main haulage roadway in No.3 coal seam of Daping Coal Mine. The result shows that the drainage effective radius after CO2 phase transition fracturing is 12 m when the drainage time is 120 d and drainage effective radius is 16 m when the drainage time is 148 d.

Taking the bund stampede in December 31th,2014 as an example,the urgent problems of the population surveillance and trend alert analysis in mass gatherings were proposed:population statistics and the flow density in the scenic,flow and velocity analysis,the judgments of stop-and-go or head-on walking phenomenon inside the local area.In order to provide support for population situation judgment and early warning,emergency response and evacuation in future mass gatherings,the intrinsic defects of the current three principal techniques analysis and the corresponding suggestions were put forward.

Objective To investigate the effect of astragaloside IV on the injury of SK-N-SH cell in Parkinson's disease (PD) induced by 1 - methy - 4 - phenylpyridine (MPP+) and its mechanism. Methods Human neuroblastoma cell line SK-N-SH was cultured to logarithmic growth stage, which were randomized to routine culture (control group), MPP+ induction (MPP+ group), astragaloside IV 10 mg/ml + MPP+ induction (astragaloside IV 10 mg/ml group), astragaloside IV 30 mg/ml + MPP+ induction (astragaloside IV 30 mg/ml group), astragaloside IV 30 mg/ml + MPP+ induction + Janus kinase 2 (JAK2) inhibitor AG490 (JAK2 inhibitor group). Cell survival was detected by methyl thiazolyl tetrazolium (MTT) assay, cell apoptosis was detected by flow cytometry, reactive oxygen species (ROS) level was detected by DCFH-DA fluorescence probe, lactate dehydrogenase (LDH) and superoxide dismutase (SOD) activities were detected by enzyme method. And the relative expression levels of phosphorylated Janus kinase 2 (pJAK2) and phosphorylated signal transducer and activator of transcription 3 (pSTAT3) proteins in JAK2 - STAT3 signal transducer pathway were detected by Western blotting. Results There were significant differences in cell survival rate (P = 0.000), apoptosis rate (P = 0.000), ROS content (P = 0.000), LDH activity (P = 0.000), SOD activity (P = 0.003), pJAK2 (P = 0.000) and pSTAT3 (P = 0.000) proteins relative expression levels among different SK - N - SH groups. Further pairwise comparison showed that compared with the control group, the cell survival rate (P = 0.000, 0.001, 0.049, 0.000), SOD activity (P = 0.000, 0.002, 0.012, 0.000), relative expression levels of pJAK2 (P = 0.003, 0.006, 0.036, 0.002) and pSTAT3 (P = 0.001, 0.002, 0.024, 0.001) proteins were decreased in MPP+ group, astragaloside IV 10 mg/ml and 30 mg/ml groups, JAK2 inhibitor group, but the cell apoptosis rate (P = 0.001, 0.001, 0.001, 0.000), ROS content (P = 0.000, 0.001, 0.002, 0.000) and LDH activity (P = 0.000, 0.002, 0.038, 0.000) were increased. Compared with MPP+ group, the survival rate (P = 0.016, 0.000), SOD activity (P = 0.003, 0.001), relative expression of pJAK2 (P = 0.013, 0.002) and pSTAT3 (P = 0.018, 0.002) proteins increased in astragaloside IV 10 mg/ml and 30 mg/ml groups, which the apoptosis rate (P = 0.021, 0.008), ROS content (P = 0.031, 0.003) and LDH activity (P = 0.001, 0.000) decreased. Compared with astragaloside IV 10 mg/ml group, the cell survival rate (P = 0.002), SOD activity (P = 0.027), relative expression of pJAK2 (P = 0.007) and pSTAT3 (P = 0.006) proteins were increased in astragaloside IV 30 mg/ml group, but ROS content (P = 0.019) and LDH activity (P = 0.011) decreased, while apoptosis rate (P = 0.016), ROS content (P = 0.030) and LDH activity (P = 0.004) increased in JAK2 inhibitor group, and SOD activity (P = 0.004), the relative expression of pJAK2 (P = 0.001) and pSTAT3 (P = 0.005) proteins were decreased. Compared with astragaloside IV 30 mg/ml group, cell survival rate (P = 0.001), SOD activity (P = 0.001), the relative expression of pJAK2 (P = 0.000) and pSTAT3 (P = 0.001) proteins in JAK2 inhibitor group were decreased, but the apoptosis rate (P = 0.004), ROS content (P = 0.002) and LDH activity (P = 0.001) were increased. Conclusions Astragaloside IV can reduce MPP+ induced SK - N - SH cell injury in PD, which may be related to the activation of JAK2 - STAT3 signal transducer pathway. [ABSTRACT FROM AUTHOR]

High speed cutting is an effective technique to achieve high efficiency and high quality machining of titanium alloy and other difficult materials. The high speed cutting process of titanium alloy has the nonlinear dynamic characteristics of high temperature, high strain and high strain rate. In order to accurately describe the dynamic mechanical behavior of titanium alloy in high speed cutting, the research on dynamic constitutive model of titanium alloy is reviewed. The application conditions, advantages and disadvantages of Johnson-Cook model, Zerilli-Armstrong model and Bammann model are analyzed from the perspective of phenomenological model and physical model with Ti-6Al-4V as the research object. After comprehensive comparison, the Johnson-Cook model is selected for further exploration, and the Johnson-Cook modified model is classified based on the influence of temperature and competition mechanism. The prediction accuracy of the Johnson-Cook modified model is improved compared with that of the classical model. At the same time, it is proposed that the construction of phenomenology-physics composite constitutive model can be taken as the key direction to explore the dynamic constitutive model of titanium alloy, and the method of experiment and computer synchronization can be used to obtain the optimal solution of constitutive model parameters, so as to improve the prediction accuracy of dynamic constitutive model.

Gear transmission characteristics are the most important research contents in gear transmission, and contact characteristics are important factors that affect gear transmission performance. The establishment of tooth surface contact analysis (TCA) model of a gear pair plays a guiding role in analyzing its contact characteristics. The rotary surface equation of the variable hyperbolic circular-arc-tooth-trace (VH-CATT) cylindrical gear cutter is obtained with the large cutter forming principle, and the mathematical model of the gear tooth surface is established based on the gear meshing conditions. With the influence of installation error on gear contact performance considered, a TCA model with installation error was established. The influence of different installation errors and different design parameters on the geometric contact characteristics and sensitivity of the gear pair is analyzed. The analysis results show that the central distance error may affect the contact ratio of the VH-CATT cylindrical gear pair and that the shaft parallelism error has a great influence on its transmission characteristics, greatly changing the size and position of the gear pair contact area. The design parameters also affect the size and location of the contact area to various degrees.

The abnormal expression of clock genes is closely related to the circadian rhythm of blood pressure and to the occurrence and development of hypertension. This article summarizes the relationship between the clock gene period (PER) and the circadian rhythm of blood pressure, the influence of abnormal expression of PER in peripheral tissues and organs related to blood pressure regulation on blood pressure, and the research progress in the field of hypertension chronotherapy. The author hopes to provide new ideas for the clinical diagnosis, treatment and prognosis of hypertension.

This paper studies transverse grain-cooling ventilation technology applied to 24m long-span warehouse in high temperature and humidity area. Application effect of transverse grain-cooling ventilation technology was evaluated by adopting district cooling ventilation mode. The results showed that the transverse grain-cooling ventilation by sub region in large-span warehouse had the advantages of faster cooling rate, better ventilation uniformity, remarkable water retention effect and lower consuming power. The temperature gradient along the cool air direction was less than 0.22 ℃/m. The ventilation water loss rate was 0.1% and consuming power rate was 0.10 kw·h/(t·℃). The consuming power rate is only 20% of the maximum consuming power rate index of 0.5 kw·h/(t·℃) which is defined in the “Grain and oil storage—Technology regulation of application of grain chiller”, (GB/T 29374—2012).

In order to solve the problem of No. 2 coal seam water hazards during the roadway tunneling process of the water-rich coal seam in northern Yuheng Mining Area, taking Balasu Coal Mine as an example, and combining the previous mining experience, firstly, the advanced drilling engineering （short drill + long drill） and the hydrochemical analysis in the rock roadway are carried out, and then the drainage water exploration ideas for the tunneling of the special coal seam water hazards in this area is proposed. The results show that the water drainage effect of the drilling project of No.2 coal seam in the early stage is remarkable, and the water volume and water pressure attenuation of each drill hole are obvious, indicating that the water recharge condition of No.2 coal seam is poor, and the whole coal seam belongs to the state of static water occurrence. Through the full analysis test of coal seam water, it is found that the water quality type of No.2 coal seam is basically SO4-Na·（Ｃａ） type water, with the pH value between 7.63-8.04 and a total salinity of 5 820.88 mg/L to 6 202.99 mg/L. It is believed that the water runoff and discharge conditions are limited and the water is in a closed state for a long time, which is conducive to the development of water drainage. Therefore, the ideas of drainage water exploration suitable for the roadway tunneling of No.2 coal seam in this area is proposed, including drilling technical schemes such as “double funnel mode”, “advance screen mode”, “lower coal drainagemode” and “bilateral feather mode”.

During in-situ exploitation of the oil shale, the connectivity of the pore structure of the reservoir directly affects not only the flow behavior and heat transfer efficiency of the heat-carrying medium, but also the diffusion and flow behaviors of the oil and gas. In this study, the T2 spectra of saturated water and bound water in samples from the Fushun oil shale were measured with low-field nuclear magnetic resonance at different final pyrolysis temperatures (23~650℃). NMR pore parameters, including T2 cutoff value of movable fluid, bound fluid porosity, saturated fluid porosity and permeability, were analyzed. The evolution of pore connectivity of the oil shale with final pyrolysis temperature was studied quantitatively. The results demonstrated that final pyrolysis temperature affected the variations of pore connectivity and the permeability of oil shale. The increase of total porosity could be attributed mainly to the increments of movable fluid. These results indicated that increases in final pyrolysis temperature enhanced the permeability and transport of oil and gas, providing a basis for further understanding of the evolution of pore structure in oil shale in-situ pyrolysis.

In order to explore the pressure relief effect of mining under protective seam on overlying strata in Jincheng Mining Area, the engineering background of mining 9# coal seam as the protective seam of 3# coal seam was studied. The effect of pressure relief of overlying coal and rock mass and the law of swelling deformation of coal mass in protected seam after mining of lower protective seam are studied by numerical simulation, and the effective protection scope is determined. The results show that after the mining of protective seam, the pressure relief effect of overlying coal and rock mass appears in different zones, and the pressure relief effect decreases with the increase of vertical distance from the working face. The inclined pressure relief angle of the protected seam is 63 degrees and the strike pressure relief angle is 60 degrees. The swelling deformation rate of the protected seam in the middle of the goaf is about 4‰, which is a stable pressure relief area. After field test, it was found by borehole television that coal of the protected seam appears separation fissure affected by mining. The coal seam gas parameters shows that the gas content and gas pressure of the protected seam are reduced to 50% and 60% before mining, respectively.

Based on the high attitude platform of building slabstone-installing robot with independent development,research was carried out about multi-DIM vibration. The paper firstly constructs the system with two degrees of freedom parallel mechanism as the main body and rotating MR damper as actuator. The dynamics equation of the vibration system is established by using Lagrange equation. The paper analyzes the vibration characteristics and designs a kind of rotary MR damper based on a shear mode of magneto rheological fluid. The mechanical characteristics of MR damper is analyzed. The kinematics and kinetic analysis of parallel mechanism is done. The multi-DIM vibration suppression works quickly based on the position of platform according to the kinematics equation. Finally the simulation experiment of this system of multi-DIM vibration suppression is introduced with the aid of to calculate and analysis whether the model is effective and feasible.

Objective To investigate the root canal numbers of maxillary second primary molars. Methods 216 maxillary second primary molars from 204 children aged 3⁃8 years old were selected. All the teeth need to do the root canal therapy. After opening the pulp chamber, the root canal were examined and determined with small size K file and 17％ethylene diaminetetraacetic acid (EDTA). Hand instruments were used for root canal preparation and then zinc⁃oxide iodoform paste was used for filling. Results 216 maxillary second primary molars, 122 teeth had three root canals (56.5%), and 94 teeth had four root canals (43.5%). The incidence of second mesiobuccal canal (MB2) was 41.2%. There was no correlation between the incidence of the MB2 canal and gender and tooth position. Conclusion The root canals of maxillary second primary molars had more variations, and there was a high incidence of the second mesiobuccal canal.

For problem that hydraulic support controller was operated manually in most coal mines at present, which led to low working efficiency and poor operation safety, a hardware design scheme of hydraulic support controller for automatic working face was introduced, and realization schemes of centralized control function and self-diagnosis function of the controller were expounded. The controller, which adopts dual controlling cores and communication mode of dual RS485 buses, can monitor, process and upload information real-timely including roof pressure of hydraulic support, pushing displacement and position of shearer, and realize automatic shearer tracking, support pulling and support pushing according to technical command from terminal controller. The controller also realizes self-diagnosis function by use of communication mode of I2C bus, which can real-timely monitor and correct fault action signals of hydraulic support. The results of industrial test on the ground and fault simulation experiment verify correctness of design scheme of the controller.

Thorium in geological samples, digested by mixed acid system of HNO3-HCl-HClO4-HF, is measured by using Inductively Coupled Plasma-Atomic Emission Spectrometry (ICP-AES). In the practical analysis, the stability of the results is poor when the content of thorium, moreover, the content of thorium cannot be detected with high matrix effect. In this work, a new method is described for the determination of thorium using ICP-AES. The pretreatment process is optimized by digestion with Na2O2, filtration separated with 10 g/L NaOH and resolved with 40% hot HCl acid. The best analytical line of thorium is 401.913 nm by studying the working conditions of ICP-AES. The method detection limit is 0.21 μg/g, the relative standard deviation (n=7) are from 7.7% to 15.9%, the relative error (n=6) are from 7.0% to 10.0%, and the standard addition recovery are from 92.0% to 104.0%. Furthermore, this method can be used to determine accurately the content of thorium, which is higher than 0.21 μg/g based on verification of certified reference materials. Compared with conventional methods, this method is simple, fast, and highly accurate and has a lower detection limit. It is suitable for practical determination of a large amount of samples.

For problems of few expandable IO of DSP and complex circuit design of microcomputer-based protection device for power system by use of DSP and single chip microcomputer, CPLD chip EPM7128 was used to design logic circuits of expanded digital IO, handshaking signal, data communication, and frequency measurement of the device, and design and implementation of CPLD in communication between dual CPUs were introduced emphatically. The simulation result verified correctness of the CPLD logic circuits. The application of the circuits in the microcomputer-based protection device also showed their flexibility and stability.

A design scheme of temperature monitoring node of real-time temperature monitoring system for high-voltage electrical equipments based on wireless sensor network was introduced. The node is consisted of microprocessor MSP430F2012, temperature sensor DS18B20 and wireless transceiver controller nRF24L01. In process of temperature monitoring, the temperature sensor collects temperature data regularly and sends the data to the microprocessor for processing, then the node sends real-time temperature data to base station through the wireless transceiver controller. The node achieves real-time monitoring of high-voltage electrical equipment, satisfies the demand on low power consumption, and improves stability of the equipments and reliability of the monitoring system.

The paper introduced a design scheme of motor protection device based on dual-CPU of DSP56F807 and W78E516B, and analyzed circuit designs of main control board and man-machine interaction board and protection algorithm of the device. The device uses DSP56F807 to realize functions of multi-channel AD conversion, electricity-quantity calculation, kinds of protection algorithm, real-time clock control, data storage, CAN communication and output control of switching value of relay, uses W78E516B to realize function of man-machine interaction, and uses Fourier algorithm that can compensate any decaying time constant and filtrate decaying DC component to improve precision and correctness of motor protection algorithm. The experimental result showed that over-current protection algorithm of the device is good in sensibility and reliability with better running effect.

A new experimental equipment MCQ-II for supercritical CO2-ECBM recovery test with large size specimen was designed. The equipment can measure the specimen swelling during the supercritical CO2-ECBM recovery test. With the equipment, series of experiments for supercritical CO2 seepage and CH4 recovery with supercritical CO2 displacement were carried out. It is found that, under the conditions of 50 °C and constant volumetric stress, supercritical CO2 permeability is positively related to the infiltrating pressure, while it is negatively related to the confined volumetric stress. It turns out that supercritical CO2 permeability in the coal is higher than CO2 in general condition. The rise of volumetric stress and pore pressure will increase the supercritical CO2 adsorption. Under 48 MPa and 60 MPa volumetric stress, 10. 82 to 17. 52 and 16. 12 to 20. 40 units of carbon dioxide can be stored in per unit of coal, respectively. During the process of CH4 adsorption, CO2 adsorption and CH4 displacement by CO2, coal swelling volumetric percentage is recorded. In the experiment of CH4 displacement by supercritical CO2, more CH4 and CO2 were injected to specimen No. 1 (weakly caking coal) than specimen No. 2 (coking coal),but the replacement ratio of carbon dioxide to methane and the CO2 storage rate are almost equal, 4.01/4.16, 20.05%/20.09% Respectively. [ABSTRACT FROM AUTHOR]

Objective: To analyze the relationship between initial (within 24 hours) postoperative hemoglobin (Hb) value and prognosis in non-cardiac surgery patients receiving intraoperative blood transfusion, and to provide support for sensible blood use in surgery., Methods: A retrospective analysis was performed on all patients aged 18 or older who underwent non-cardiac surgeries and who received intraoperative blood transfusion at West China Hospital, Sichuan University from 2012 to 2018. According to their initial postoperative Hb levels, the patients were divided into 6 groups, including Hb<75 g/L, 75 g/L≤Hb<85 g/L, 85 g/L≤Hb<95 g/L, 95 g/L≤Hb<105 g/L, 105 g/L≤Hb<115 g/L, and Hb≥115 g/L goups. Multivariate linear regression was performed to examine the differences in the length-of-stay between the groups and binary logistic regression analysis was conducted to examine the differences between the groups in inpatient mortality, the rate of patient voluntary discharge against medical advice, incidence of acute ischemic injury, including acute kidney injury, myocardial infarction, and cerebral infarction, and length-of-stay longer than 28 days. In addition, the effects of multiple interactions between initial postoperative Hb and the types of surgery, the amount of intraoperative red blood cell infusion (red blood cell<8 U vs. red blood cell≥8 U), and preoperative anemia status (Hb<100 g/L vs. Hb≥100 g/L) on postoperative length-of-stay were analyzed., Results: A total of 7528 patients were included in this study. Compared to those of the reference group, the 95 g/L≤Hb<105 g/L group, the length-of-stay of patients with initial postoperative Hb<75 g/L increased and the mortality (odds ratio [ OR ]=2.562) and the rate of voluntary discharge against medical advice ( OR =1.681) increased significantly. Patients in the 75 g/L≤Hb<85 g/L group had increased length-of-stay and increased incidence of acute ischemic injury ( OR =1.778) relative to the reference group. The interaction analysis showed that there was significant interaction between initial postoperative Hb and the types of surgery, which influenced the postoperative length-of-stay., Conclusion: In non-cardiac surgery patients who have receive blood transfusion, initial postoperative Hb<85 g/L is associated with poorer prognosis. However, those patients with higher initial postoperative Hb did not gain more benefits, suggesting that 85 g/L≤Hb<95 g/L may be the target Hb value for sensible intraoperative transfusion., (Copyright© by Editorial Board of Journal of Sichuan University (Medical Sciences).)

Objective: To study the effect of bone morphogenetic protein (BMP) antagonist Gremlin 1 (GREM1) on the function of stem cells from apical papilla (SCAPs) and explore its mechanism., Methods: After isolation and culturing of stem cells from apical papilla in vitro , immunofluorescent staining was done to examine the subcellular localization of GREM1 in SCAPs. Transfection with lentiviral GREM 1 shRNA was done to knock-down the GREM 1. The SCAPs were subjected to osteogenic induction in both the GREM 1 knockdown group and the control group, and the knockdown effect of GREM 1 was examined using real time-PCR and Western blot. Two groups of cells were collected and the alkaline phosphatase (ALP) activity was measured 7 d after osteogenic induction. Alizarin red staining was done 3 weeks after osteogenic/odontogenic induction and real time-PCR was done after 0, 1, 2, 3 weeks of osteogenic induction to examine the expression of osteogenic/odontogenic marker genes, including osteocalcin ( OCN ), osteopontin ( OPN ), bone sialoprotein ( BSP ), dentin matrix protein 1 ( DMP 1), dentin sialophosphoprotein ( DSPP ) and and the critical transcription factor osterix ( OSX ), Runt-related transcription factor 2 ( RUNX 2), and distal-less homebox 2 ( DLX 2). Two groups of cells were collected, and CCK-8 and CFSE assay were used to evaluate changes in cell proliferation. In addition, real time-PCR was used to examine the expression of senescence-related genes p 53 and wide-type activated factor 1 ( Waf 1), a regulatory factor of the cell cycle, stemness associated gene krupple-like factor 4 ( KLF 4), and SRY related HMG box-2 ( SOX 2), and the expression of bone morphogenetic protein ( BMP ) 2, 4, 5, 6, 7, 9 after GREM 1 knockdown., Results: Immunofluorescence staining showed that the expression of GREM1 in the nucleus was higher than that in the cytoplasm. Real time-PCR and Western blot affirmed that GREM 1 was knocked down steadily. The ALP activity of the GREM 1 knockdown group was higher than that of the control group ( P <0.05), and the alizarin red staining was lighter than that of the control group. The expression of OCN and DMP 1 increased in the first, second and third week, OPN was increased in the second week, BSP increased in the third week, DSPP increased in the first week, and the difference was statistically significant ( P <0.05). The key osteogenic transcription factors RUNX 2, OSX , and DLX 2 all increased at different stages, and the difference was statistically significant ( P <0.05). CCK-8 and CFSE assay showed that the proliferation ability of the GREM 1 knockdown group decreased ( P <0.05). In the GREM 1 knockdown group, the expression of BMP 2, 6, and 7 increased, the expression of SOX 2 and KLF 4 increased, while the expression of p 53 and Waf 1 decreased ( P <0.05)., Conclusions: The knockdown of GREM 1 enhanced the osteogenic/odontogenic differentiation and stemness of SCAPs and inhibited the proliferation and senescence of SCAPs. Effects of GREM1 on the function of SCAPs maybe achieved through regulating the gene expression of BMP 2, BMP 6, and BMP 7 at the mRNA level., (Copyright© by Editorial Board of Journal of Sichuan University (Medical Sciences).)

Objective: To investigate the activity of pyramidal neurons in the medial prefrontal cortex (mPFC) of normal and 6-OHDA-lesioned rats and the responses of the neurons to 5-hydroxytryptamine-7 (5-HT(7)) receptor stimulation., Methods: The changes in spontaneous firing of the pyramidal neurons in the mPFC in response to 5-HT(7) receptor stimulation were observed by extracellular recording in normal and 6-OHDA-lesioned rats., Results: Both systemic and local administration of 5-HT(7) receptor agonist AS 19 resulted in 3 response patterns (excitation, inhibition and no change) of the pyramidal neurons in the mPFC of normal and 6-OHDA-lesioned rats. In normal rats, the predominant response of the pyramidal neurons to AS 19 stimulation was excitatory, and the inhibitory effect of systemically administered AS 19 was reversed by GABAA receptor antagonist picrotoxinin. In the lesioned rats, systemic administration of AS 19 also increased the mean firing rate of the pyramidal neurons, but the cumulative dose for producing excitation was higher than that in normal rats. Systemic administration of AS 19 produced an inhibitory effect in the lesioned rats, which was partially reversed by picrotoxinin. Local administration of AS 19 at the same dose did not change the ?ring rate of the neurons in the lesioned rats., Conclusion: The activity of mPFC pyramidal neurons is directly or indirectly regulated by 5-HT7 receptor, and degeneration of the nigrostriatal pathway leads to decreased response of these neurons to AS 19.

Objective: To observe the effectiveness of conscious sedation with dexmedetomidine and sufentanil in patients for plastic surgery., Methods: Forty patients scheduled for elective plastic surgery under conscious sedation were infused 1 µg/kg intravenously within 15 minutes as loading dose followed by a continuous infusion of dexmedetomidine (0.5 µg·kg⁻¹·h⁻¹) and sufentanil (0.07 µg·kg⁻¹·h⁻¹) respectively. Sufentanil 0.05 µg/kg and midazolam 0.025 mg/kg were administrated intravenously 5 minutes before local infiltration, and then a bolus of sufentanil or midazolam was given as needed to maintain OAA/S score of 11 during the procedure. The drug infusion was discontinued at 5 to 10 min before the end of the surgical procedure. The complications (i.e. anoxemia, apnea, bradycardia, restlessness, nausea, vomiting, crying and excitation), if any, anesthesia duration and drug consumption were recorded. On the first postoperative day, patients were asked to rate their satisfaction with the anesthetic management and whether they would choose to receive the same sedative analgesic medications and should they require a similar surgical procedure in the future., Results: The OAA/S score decreased from 20.0 ± 0 to 11.5 ± 2.5 after patients being infused the loading dose of dexmedetomidine, and was maintained 10.5-11.1 during the procedure. At the end of the procedure, the OAA/S score return to 16.1 ± 2.8. The induction of sedation produced a significant decrease in HR (P < 0.05) and no significant changes in SBP, DBP and RR values (P > 0.05). There were 38 patients completed their procedures under conscious sedation, and there were incident of crying and bradycardia in 5 and 2 patients respectively. The anesthesia duration and consumption of dexmedetomidine, sufentanil and midazolam were (128 ± 47) min, (116 ± 43) µg, (10 ± 5) µg and (2 ± 1) mg respectively. In an interview on the first postoperative day, there were 13 patients complaining no memory, 17 patients complaining fuzzy memory and 8 patients complaining awake during the procedure, respectively. There were 92% of the patients willing to receive the same anesthetic technique again in the future., Conclusion: Conscious sedation with dexmedetomidine and sufentanil is an effective anesthetic technique in patients for plastic surgery.

Objective: To explore the phenotypes and genotypes of Staphylococcus aureus (S. aureus) hetero-resistant to erythromycin and clindamycin and compare their detection methods so as to report results accurately to guide clinical rational use of antibiotics., Methods: D test was used to detect the phenotypes of S. aureus hetero-resistant to erythromycin. And then the results of two methods (automated instrument and disk diffusion) were analyzed. All strains were continuously passaged for 50 generations to verify the phenotypic and genotypic stability of hetero-resistance. ErmA, ermC and msrA genes were amplified by multiplex polymerase chain reaction (PCR)., Results: Among 95 erythromycin-sensitive strains, there were 70 strains hetero-resistant to erythromycin (73.7%). The primary 70 strains were all susceptive to erythromycin (MIC ≤ 0.25 µg/ml) and clindamycin (MIC ≤ 0.25 µg/ml) with the cards of GP-67 of VITEK2 Compact. With D tests, the results were difficult to observe. The passaged 70 strains were all resistant to erythromycin (MIC >8 µg/ml) and susceptible to clindamycin (MIC ≤ 0.25 µg/ml) and D test positive with the cards of GP-67 of VITEK2 Compact. The primary and 50(th) generation of herero-erythromycin resistant strains were stable in susceptibility test results. The primary and the 50(th)th generation strains were all ermA gene positive, ermC and msrA negative with PCR results., Conclusions: The phenotypes and genotypes of hetreo-erythromycin resistant S. aureus strains were stable. Missed detection with VITEK2 Compact may affect the proper use of erythromycin and clindamycin. Laboratory technicians should identify the erythromycin-susceptible strains by disk diffusion method.

Objective: To explore the effects of left renal vein division (LRVD) on postoperative renal function and examine the overall prognosis in patients undergoing open repair of abdominal aortic aneurysm (AAA)., Methods: Retrospective analyses were conducted for the clinical data of AAA patients with open repair at our hospital from January 2000 to December 2011. They were divided into LRVD (n = 35) and non-LRVD (n = 141) groups. The 30-day mortality, cardio-cerebrovascular complications, pulmonary complications, preoperative and postoperative levels of creatinine and glomerular rate filtration (GFR), aortic cross-clamping time, blood loss volume, intensive care duration and dialysis or continuous renal replacement therapy (CRRT) rate were compared between two groups., Results: A total of 189 AAA repair were performed. And 13 patients with suprarenal clamping were excluded. The LRVD group had a significant higher proportion of ruptured AAA (48.6% vs 27.7%, P < 0.01), higher 3-day postoperative creatinine (P < 0.01), longer intensive duration (P < 0.05) and decreased 3-day postoperative GFR (P < 0.01). No significant difference existed in 30-day mortality, incidence of major complications, creatinine or GFR at discharge (P > 0.05)., Conclusions: LRVD during open surgery of AAA has no effect on the postoperative mortality and renal function.

Objective: To explore the treatment and prognosis of critical limb ischemia during perioperative period of open surgery for ruptured abdominal aortic aneurysm (AAA)., Methods: Retrospective reviews were conducted for the clinical data of unstable ruptured AAA patients with open repair at our hospital from June 2002 to June 2012 to examine the characteristics and treatment regimens for associated critical limb ischemia., Results: A total of 46 unstable AAAs were enrolled. There were 37 males and 9 females with an average age of 69 years. All AAAs were repaired by a bifurcated polytetrafluoroethylene graft via a transperitoneal midline incision. Critical limb ischemia was found in 8 patients during or after the procedure. Treatments included additional graft-distal iliac artery bypass (n = 2), anastomotic stoma stenting (n = 2), Fogarty catheter embolectomy plus local thrombolysis (n = 2), Fogarty catheter embolectomy (n = 1) and venous thrombolysis (n = 1). Lower limb necrosis developed in 5 patients (4 unilateral, 1 bilateral) and all of them died., Conclusion: Open repair of ruptured AAA may be associated with a considerate morbidity of critical limb ischemia. Early reconstruction of blood flow improves the prognosis.

Objective: To explore the expression of hypoxia-inducible factor 1 alpha (HIF-1a) in rat lower limb skeletal muscle with acute ischemia., Methods: Acute lower limb ischemia was established in 25 male or female SD rats of 200-250 g by ligating left iliac artery with microsurgical techniques. Gastrocnemius of lower limb was harvest at the time points of sham (0h), 4, 8, 12 and 24 h respectively. Immunohistochemistry, Western blot and real-time polymerase chain reaction (PCR) were used to detect the expression of HIF-1a in lower limb gastrocnemius., Results: There was a low expression of HIF-1a in normal gastrocnemius, but it was highly expressed in lower limb ischemia. With the elongation of ischemia time, its expression increased (P < 0.05), peaked at 4 h and 8 h (P < 0.05) and then declined gradually., Conclusion: With a characteristic trend during acute limb ischemia, HIF-1a may play an important role in the adaptive response to acute limb ischemia.

Objective: To evaluate the impact of surgical modality for gastric cancer on operational trauma., Methods: A total of 1499 cases of gastric cancer undergoing surgical procedures were divided into the groups of radical resection (RR, n = 1344) and palliative resection group (NRR, n = 155) according to their surgical modalities. And they were further divided into sub-groups according to the profiles of gastrectomy, extent of lymphadenectomy and multi organic resection. The extent of operational trauma (as evaluated by operative duration, transfusion volume, postoperative hospital day and incidence of complications) was compared in different groups and subgroups., Results: In RR and NRR groups, median transfusion volume (Q(1), Q(3)) was 0 (0, 600) vs 400 (0, 800) ml respectively. There was significant difference (P < 0.05). No significant difference existed in operative duration, postoperative hospital day or incidence of complications between two groups (all P > 0.05). In cases of distal gastrectomy, median transfusion volume was 0 (0, 400) vs 400 (200, 800) ml in RR and NRR groups (P < 0.05). No significant difference existed in operative duration, postoperative hospital day or incidence of complications between two groups (all P > 0.05). In cases of total gastrectomy, no significant difference existed in operative duration, postoperative hospital day, median transfusion volume or incidence of complications between two groups (all P > 0.05). In RR group, for the cases treated by D1, D2, D3 and paraaortic lymph node dissection (PAND), there were significant differences in operative duration ((248 ± 71), (271 ± 72), (309 ± 96), (351 ± 103) min), postoperative hospital day ((13 ± 4), (16 ± 12), (18 ± 11), (20 ± 19) days), median transfusion volume (0(0, 500), 0(0, 600), 400(0, 800), 600(200, 1000) ml) (all P < 0.05). But no significant difference existed in incidence of complications (P > 0.05). In RR group, operative duration, postoperative hospital day, median transfusion volume was (315 ± 96) vs (264 ± 66) min, (19 ± 15) vs (15 ± 11) days, 400 (0, 800) vs 0 (0, 400) ml in the patients with and without combined organic resection (all P < 0.05). But no significant difference existed in incidence of complications (P > 0.05)., Conclusions: As compared with palliative resection, radical resection will not increase surgical trauma. For the cases of radical resection, extent of lymphadenectomy and organic resection increase surgical trauma.

Objective: To compare Borrmann type IV gastric cancer with other types of cancer and explore their clinicopathological features and prognostic factors., Methods: We retrospectively reviewed the medical records of 893 consecutive advanced gastric cancer patients. They were divided into 2 groups: Borrmann type IV (n = 139) and other macroscopic Borrmann types of cancer (n = 754). Their clinicopathologic characteristics and overall survival data were analyzed., Results: Borrmann type IV gastric cancer was found to be associated with more advanced and unfavorable clinicopathological features. The incidence of preoperative biopsy-negative rate of Borrmann type IV gastric cancer was much higher (15.9%) than other Borrmann types of gastric cancer. The 5-year survival rate of Borrmann type IV cancer patients was 9.9% and it was significantly lower than that of other types. Moreover, the 5-year survival rate was higher in the patients with curative resection (18.7%) (P < 0.05). Stratified analysis revealed that when the tumor TNM stages were of II, III, the survival data of Borrmann type IV cancer were worse than others. Multivariate analyses revealed distant metastasis and curability were independent prognostic factors for Borrmann type IV gastric cancer., Conclusions: Borrmann type IV carcinoma has poor clinicopathological features and survival rate compared with other types. An early detection and curative resection may improve the prognosis for the patients with Borrmann type IV cancer.

Objective: To explore the effects of fast-track surgery on postoperative humoral immune function in patients undergoing elective colorectal resection., Methods: Seventy patients with colorectal carcinoma requiring colorectal resection were randomized into fast-track group (n = 35) and conventional care group (n = 35). The clinical parameters and markers of humeral immune function were evaluated in both groups postoperatively., Results: Sixty-two patients finally completed the study, including 32 in the fast-track group and 30 in the conventional care group. There was a significantly faster recovery of postoperative humoral immunity: blood levels of globulin (24.1 ± 2.4 vs 22.1 ± 3.3 g/L, P = 0.025), immunoglobulin G (10.79 ± 2.39 vs 8.66 ± 2.09 g/L, P = 0.007) and complement 4 (0.24 ± 0.09 vs 0.17 ± 0.05 g/L, P = 0.035) at Day 3 postoperation were higher in the fast-track group than in the conventional care group. And there was also a significantly shorter length of postoperative stay (6.0 ± 1.0 vs 11.7 ± 3.8 d, P < 0.001) in patients undergoing fast-track rehabilitation., Conclusion: Fast-track surgery accelerates the recovery of postoperative humoral immune function in elective surgery for colorectal carcinoma with a shorter length of postoperative hospital stay.

Objective: To compare the reconstructing safety of pancreaticogastrostomy (PG) versus pancreaticojejunostomy (PJ) after pancreaticoduodenectomy (PD)., Methods: The articles of prospectively controlled trials published until late December 2010 comparing PJ and PG after PD were searched by the means of MEDLINE, EMBASE, Cochrane Controlled Trials Register databases and Chinese Biomedical Database. After quality assessment of all included prospective controlled trials, a meta-analysis was performed with Review Manager 5.0 for statistic analysis., Results: A total of 6 prospective controlled trials were included. Among 867 patients analyzed, 440 underwent PG and 426 PJ. A meta-analysis of 6 prospective controlled trials (including randomized control trial (RCT) and non-randomized prospective trial) revealed significant differences between PJ and PG regarding the overall postoperative complication rates [OR 0.53, 95%CI (0.30, 0.95), P = 0.03], pancreatic fistula [OR 0.47, 95%CI (0.22, 0.97), P = 0.04] and intra-abdominal fluid collection [OR 0.42, 95%CI (0.25, 0.72), P = 0.001]. The differences in biliary fistula, intra-abdominal (IAC) complications and mortality were of no significance. Meta-analysis of 4 RCTs revealed significant differences between PJ and PG regarding intra-abdominal fluid collection [OR 0.46, 95%CI (0.26, 0.79), P = 0.005]. The differences in pancreatic fistula, overall postoperative complications, biliary fistula, intra-abdominal complications and mortality were of no statistical significance., Conclusion: Through a meta-analysis of 6 prospective controlled trials, there are significant differences between PJ and PG regarding overall postoperative complications, pancreatic fistula and intra-abdominal fluid collection. Significant differences exist between PJ and PG regarding intra-abdominal fluid collection. The safety profiles of PG and PJ are comparable.

Objective: To report the initial urological applications of single trocar laparoscopic surgery., Methods: From April to December 2010, a total of 45 urologic patients underwent single trocar laparoscopic surgery. The procedures included high ligations of spermatics vessels (n = 17), unroofing of renal cysts (n = 24) and ureterolithotomy (n = 4). Transperitoneal approach: A 15 mm incision was made in umbilicus and CO(2) pneumoperitoneum created. A 10-mm trocar was inserted into enterocoelia. After the installation of single punch laparoscope (STROZ), the operating instruments were guided through integrated working channel to complete operative procedures. Retroperitoneal approach: A 15 mm incision was made above the diseased-side crista iliaca for around 4 cm. Retroperitoneal cavity was prepared for retroperitoneoscopy with the IUPU (Institute of Urology, Peking University) technique. In the same way, a 10-mm trocar was inserted. And the single punch laparoscope was installed to complete operative procedures., Results: The procedures were successful in 41 cases. But the others (renal cysts, n = 2; ureteral calculus, n = 2) were successfully managed by adding a 5 mm trocar. Operation time: transperitoneal approach, 23 - 70 min; retroperitoneal approach, 45 - 175 min. The intra-operative volume of blood loss was minimal. And the hospital stay was 1 - 5 days. No significant postoperative complication occurred., Conclusion: For some relatively simple procedures, a new and more minimally invasive approach of single trocar laparoscopic surgery may be attempted.

Objective: To detect the cartilage changes of hip joint with osteonecrosis of femoral head (ONFH) in stages II and III and provide evidence for understanding cartilage changes of femoral head of osteonecrosis before collapse., Methods: The cartilage changes of ONFH were determined by delayed gadolinium enhanced magnetic resonance imaging of cartilage (dGEMRIC). According to ARCO classification of ONFH, the samples were divided into three groups: Group A, 11 hips, stageII; Group B, 13 hips, stage III; Group C, 10 hips, normal. All participates underwent the tests by dGEMRIC. And the data of T1Gd were collected and analyzed., Results: The values of T1Gd were 420 ± 60 (Group A), 361 ± 54(Group B) and 538 ± 26 (Group C) respectively. There was a significant difference among three groups. The values of T1Gd in the ONFH patients were lower than their healthy counterparts. The values of TIGd of Group B was 14% lower than those of Group A. And the difference was significant statistically., Conclusion: Cartilage of the femoral head undergoes abnormal metabolic changes before collapse. There is a loss of GAG in the cartilage and it aggravates with the worsening of ONFH.

Objective: To explore the relationships between serum levels of adiponectin, leptin, TNF-alpha and CRP (c-reactive protein) versus insulin resistance in early pregnancy., Methods: A total of 342 pregnant women delivering at our hospital were recruited from October 2007 to July 2008. Their clinical data were collected and analyzed. According to the 50-g 1-hour oral glucose screening test, they were divided into 3 groups: gestational diabetes, gestational impaired glucose tolerance and normal pregnancy. The serum levels of adiponectin, leptin, TNF-alpha and CRP were determined by ELISA (enzyme-linked immunosorbent assay) and multivariate correlation analysis was used to analyze their relationships with the indices of insulin resistance., Results: Among them, there were gestational diabetes (n = 13) and gestational impaired glucose tolerance (n = 19). Thirty-five normal pregnant women were selected as the control group. The result of analysis of variance indicted that adiponectin, leptin and TNF-alpha had significant statistical differences among three groups. Through the multivariate correlation analysis, adiponectin had a adverse correlation with the indices of insulin resistance. Leptin, CRP, TNF-alpha and BMI (body mass index) had positive correlations with the indices of insulin resistance., Conclusion: Adiponectin, leptin, TNF-alpha and CRP are correlated with the indices of insulin resistance. And TNF-alpha may become an important predictor of gestational diabetes in early pregnancy.

Objective: To study the expression of cell cycle related factor Gli2 in autogenous vein graft and its relation with neointima formation., Method: Autogenous vein graft model were established in 36 male wistar rats of 8 weeks old, 140 g, by transplanting the left jugular vein to intra renal abdominal aorta with microsurgical technique. Graft veins were harvest at 14, 28 days after transplantation. The IF and W-B were used to detect the protein expression in the vein graft. At the same time Gli2- mRNA was measured by RT-PCR., Results: Immunofluorescent staining showed that the Gli2+ cells was only 3.2% ± 0.4% in the normal vein, but was much more in the vein graft after surgery, was 41.3% ± 0.6%, 58.3 ± 0.6% respectively; The expression of Gli2 and PCNA were both elevated in the vein graft. There is a positive correlation between them which indicated by W-B, the relation index was 0.826; the Gli2 mRNA content was also increased in vein graft, was 8.9, 13.6 fold compared with normal vein as 1 respectively., Conclusion: Gli2 is upregulated in autogenous vein grafts and may correlated with the proliferation of vascular smooth muscle cells.

Objective: To study the effects of gonadotroph-releasing hormone (GnRH) agonist (GnRH-a) and GnRH antagonist (GnRH-ant) on cyclophosphamide (CTX)-induced follicle apoptosis in female rats., Methods: Thirty-six female Sprague- Dawley rats were randomized into 6 groups, namely normal saline (NS), CTX, GnRH-a+NS, GnRH-a+CTX, GnRH-ant+NS, and GnRH-ant+CTX groups. The rats were sacrificed between the first and second week after the treatments., and the follicle apoptosis was investigated using TUNEL assay and transmission electron microscopy., Results: The apoptosis rate of the granulose cells in the follicles in late development was significantly higher than that in early follicles, and the apoptosis rate of the oocytes and granulose cells in rats with CTX treatment was significantly higher than that in rats without CTX treatment (P<0.05). The apoptosis rate of the granulose cells in GnRH-a groups (ranging from 33.40 - or + 4.59 to 73.25 - or + 5.35) was significantly higher than that in GnRH-ant groups (27.46 - or + 4.52 to 49.38 - or + 5.02, P<0.05), but there was no significant difference in the oocytes of early follicles between GnRH-a groups (23.48 - or + 4.25 to 36.15 - or + 4.23) and GnRH-ant groups (21.47 - or + 3.81 to 34.04 - or + 5.54, P>0.05). Electron microscopy revealed characteristic apoptotic changes of the oocytes in early follicles and granulose cells in early and late follicles. The apoptotic changes were especially typical in the granulose cells showing the formation of the apoptotic bodies, and the oocytes only showed chromatin condensation and aggregation., Conclusion: In the rat mode, GnRH-a promotes while GnRH-ant suppressed follicle apoptosis induced by CTX. GnRH analogues regulates mainly granulose cell apoptosis, but have little effect on oocyte apoptosis.

Objective: To study the effect of gonadotroph-releasing hormone (GnRH) agonist (GnRH-a) and GnRH antagonist (GnRH-ant) against cyclophosphamide (CTX)-induced gonadotoxicity in female rats., Methods: Thirty-six female SD rats were divided randomly into 6 groups to receive treatment with normal saline (NS), CTX, GnRH-a+NS, GnRH-a+CTX, GnRH-ant+NS, GnRH-ant+CTX, respectively. The rats were sacrificed between the first and second week after termination of the medication to compare the weight of the ovaries, the number of the primordial follicles and the follicle growth. The expressions of bcl-2 and bax mRNA in the ovaries were examined using RT-PCR., Results: The number of the primordial follicles was significantly greater and that of the growing follicles significantly lower in GnRH-a+NS and GnRH-a+CTX groups than in the GnRH-ant+CTX and CTX groups (P<0.05). The rats in GnRH-a+NS and GnRH-a+CTX groups had the lowest ovarian weight among 6 the groups (P<0.05). The bcl-2 mRNA level in the GnRH-ant+NS group was significantly higher than that in the other groups (P<0.05). The Bax mRNA in the GnRH-a+NS and GnRH-a+CTX groups was significantly higher than that in the NS group (P<0.05), but close to that in the CTX group (P>0.05); bax mRNA expression in the GnRH-ant+NS group was significantly lower than that in the NS group (P<0.05), but in GnRH-ant+CTX group, its expression was close to that in the NS group (P>0.05)., Conclusions: In female rats exposed to CTX, the GnRH analogs provides ovarian protection against CTX-induced gonadotoxicity by regulating the expression of the Bax mRNA in the ovary. GnRH-a may decrease the sensitivity of the follicles to CTX-induced gonadotoxicity by promoting follicle apoptosis and inhibiting follicle proliferation, and GnRH-ant increases the sensitivity to the CTX through a reverse effect on the follicles.

Objective: To explore the role of interferon (IFN)-alpha/beta receptor beta subunit (IFNAR2) in the patients' response to IFN-alpha therapy as influenced by the grade of chronic hepatic inflammation, and understand the relation of IFNAR2 expression in the peripheral blood mononuclear cells (PBMCs) with HBV infection., Methods: Liver tissue specimens were obtained from 21 patients with chronic hepatitis B for examination of the hepatic inflammation, and PBMCs were isolated from another 16 patients with chronic hepatitis B and 15 health control subjects. Both the hepatic tissues and PBMCs were examined for IFNAR2 expression using immunohistochemistry., Results: The 21 patients with chronic hepatitis B were divided into 3 groups according to the severity of hepatic inflammation, namely G(1) (n=3), G(2) (n=7) and G(3) (n=11) groups. The patients in G(3) group showed had significantly higher IFNAR2 expressions in liver (25.1307-/+7.0700) than those of the G(1) (5.6913-/+1.8422) and G(2) (7.4706-/+5.3572) groups (P=0.000). The IFNAR2 levels in the PBMCs, however, did not show significant difference between patients with chronic hepatitis B and the healthy control subjects., Conclusion: In patients with chronic hepatitis B, IFNAR2 expression level is positively correlated to the severity of hepatic inflammation, and increased IFNAR2 expression in severe hepatic inflammation is therefore likely to result in increased response rate to INF-alpha therapy. The expression of IFNAR2 in the PBMCs is not associated with HBV infection.

Objective: To sum up the experience in diagnosis and treatment of isolated superior mesenteric artery (SMA) dissection and determine the best management for this disease., Methods: We retrospectively reviewed clinical data of two patients with isolated SMA dissection admitted in the first hospital of China medical university from October to December 2006 and 69 cases reported in the literature., Results: SMA dissection without aortic involvement is a rare event. Most diagnoses were established by CT and arteriography. Therapeutic option has not yet been established, however, conservative and interventional treatments have been reported more frequently. In our two cases, CT angiography allowed the rapid diagnoses. They were treated by conservative method and interventional stent separately, and have been followed-up for seven months. The managements were successful., Conclusion: Early diagnosis and management directly influence the prognosis. The strategy of management should be determined by symptoms, blood supply of SMA, peritonitis et al.

Objective: To investigate ovarian follicular damage induced by chemotherapeutic agents and gonadotropin- releasing hormone receptor (GnRHR) expression in the damaged ovaries in rats., Methods: Two groups of adult SD rats were subjected to intraperitoneal injection of a single-dose cyclophosphamide and saline, respectively, and 8 weeks later, the ovaries were taken for observing the ovarian damages. The distribution of GnRHR was detected with immunohistochemistry, and RT-PCR was used to determine the expression of GnRHR mRNA in the rat ovaries., Results: Massive primordial follicular loss occurred in the ovaries of rats exposed to cyclophosphamide with also evident stromal ovarian blood vessel damages and focal fibrosis. Both the protein and mRNA expressions of GnRHR were detected in normal rat ovaries, but in rats exposed to cyclophosphamide, the expressions were significantly lowered in the ovaries (P<0.05)., Conclusion: Low-level GnRHR expressions in the ovaries of rats with cyclophosphamide exposure suggest microenvironment disturbances in the damaged rat ovaries in advanced stage of chemotherapy.

Objective: To investigate the possible pathways for ovarian injury after administration of cyclophosphamide in rats., Methods: Adult SD rats received a single injection of saline vehicle or chemotherapeutic agent cyclophosphamide, and 8 weeks later, the ovaries were removed, fixed and serially sectioned for pathological examination and ovarian follicle counting. The expression of stem cell factor (SCF) protein was evaluated by immunohistochemistry and immunoreactive score, and SCF mRNA expression determined by RT-PCR in rat ovaries., Results: Cyclophosphamide had a detrimental effect on ovarian stromal function and lead to primordial follicle loss. Immunoreactive SCF antigens were expressed on the oocytes in the primordial and primary follicles of rat ovaries, and also in the granulosa cells of the secondary follicles and early antral follicles. There was a higher granulosa SCF, lower oocyte SCF and higher SCF mRNA level in the ovaries of the rats exposed to cyclophosphamide as compared with those in control rat ovaries (P <0.05)., Conclusion: Altered SCF expression in the ovaries of rats exposed to cyclophosphamide can be helpful for understanding the mechanisms for chemotherapeutic drug-induced ovarian damage.

Objective: To investigate the clinical benefits and the impacts on distribution and antibiotic resistance of pathogenic bacterium associated with fluoroquinolone prophylaxis during neutropenia in patients with acute leukemia., Methods: A total of 309 infection episodes occurred in patients with acute leukemia were retrospectively analyzed. The patients admitted in ward A (group A, n = 149) received oral ofloxacin as antibacterial prophylaxis during the neutropenia phase; no antibacterial prophylaxis was administered to the patients in ward B (group B, n = 160). The influences of prophylactic ofloxacin were determined by comparative evaluation on the clinical characteristics and the microbiological profile in both groups' patients., Results: Almost all enrolled patients experienced severe neutropenia. The median durations of ANC (absolute neutrophil count, ANC) < 0.2 x 10(9)/L were 11 (range 0 - 43) days. The median persistence time of fever was 8(range 1 - 46) days. Prophylaxis of ofloxacin decreased the proportion of normal flora (P = 0.00). The frequency of Escherichia coli was higher in group A than group B (23.9%, 12.5%, respectively, P = 0.00). Exposure to ofloxacin didn't affect the distributions of other pathogenic bacteria. No difference in the rate of ESBL (+) Escherichia coli was discovered between ofloxacin and no ofloxacin prophylaxis groups (31.9%, 35.4%, respectively, P = 0.61). Commonly used antibiotics had similar activity against the major strains isolated from two groups. Patients who received antibacterial prophylaxis showed a lower incidence (10.7%) of upper respiratory infections/tonsillitis and a relative higher incidence (14.4%) of gastrointestinal tract infections than those without intervention measure. The prophylactic use of ofloxacin couldn't cut down the risk of septicemia. Ofloxacin prophylaxis did not display negative effect on initial clinical response (65.8% in group A, 60.6% in group B, respectively, P = 0.35) and final efficacy (96.0% in group A, 91.9% in group A, P = 0.14) to the same empirical antimicrobial treatment schemes., Conclusion: The fluoroquinolone prophylaxis induces diminishing proportion of normal flora and increasing frequency of Escherichia coli in severely neutropenic patients with acute leukemia, may not influence the distribution of other bacteria. The susceptibility of main pathogens may not be affected by antibiotic prophylaxis. The fluoroquinolone don't decrease the incidence of septicemia and infection in gastrointestinal tract. Our data suggest that more prudent use of antibiotic prophylaxis may be reasonable even in patients at high-risk for developing infection.