Objective To investigate the roles of cell apoptosis and the gene expressions of Fas, FasL, bcl-2 and bax in acute rejection of pancreaticoduodenal transplantation and to evaluate the function of duodenum biopsy for early detection of rejection in rats. Methods Wistar and SD rats were divided into two groups: ①Wistar rats that underwent allogenic pancreaticoduodenal transplantation from the organs of SD rats; ②Wistar rats that received homogenic transplantation. The grafts were then harvested on day 3, 5 and 7 after the transplantation, and all graft samples were observed with HE staining and TUNEL was also used to detect apoptotic cells. The expressions of Fas, FasL, bcl-2 and bax were measured by immunochemical method. According to Nakhleh’s score, pathologic features of transplanted pancreas and duodenum were ranged from one to three scores in order. Results The percentage of same or different scores between the pathological scores of pancreas and duodenum in allogenic pancreaticoduodenal transplantation group were 61.1% (11/18) and 38.9% (7/18) respectively, and there were 6 specimens of pancreatic tissue got higher scores with only one higher score for duodenum. There were significant differences of histopathologic rejection scores and apoptotic indices between the two groups, respectively (P＜0.05， P＜0.01). Apoptotic indices of pancreas and duodenum both showed positive correlations with histopathologic rejection scores (r=0.965， P＜0.01; r=0.942, P＜0.01). The rejection score and apoptotic index elevated, the expression of FasL increased, bcl-2 decreased, and Fas and bax changed over time after operation. Conclusion Apoptosis maybe significantly positive correlated with the degrees of damage of the acute pancreaticoduodenal allograft rejection, and the apoptotic index maybe valuable to estimate the damage. FasL and bcl-2 were significantly related to the impairment of acute pancreatic allograft rejection as well. Duodenum biopsy may contribute to the early diagnosis of the rejecting transplanted tissues.
Objective To explore the effect, operational essential, and clinical meaning of transilluminated powered phlebectomy for patients with varicose vein of the lower extremity. Methods In the study, 255 patients with 363 lower extremities of varicose vein in our hospital between May 2006 and November 2009 were treated by transilluminated powered phlebectomy. According to revised clinical etiology anatomic and pathophysiological classification system (CEAP), there were 104 limbs in C2, 53 limbs in C3, 155 limbs in C4, 34 limbs in C5, and 17 limbs in C6. The patients were followed up to observe postoperative complications. Results All varicose vein labeled before operation were resected. Surgical time was (100±20) min in unilateral lower extremity and (147±19) min in bilateral lower extremities. Total 221 patients (302 lower extremities) were followed up in 4 to 46 months, median follow up time was 24.5 months. Total 167 cases (247 lower extremities) had accepted the operation more than 1 year, 154 cases (229 lower extremities) in which were followed up. In the 229 lower extremities above, recurrences occurred in 11 extremities, small amounts of residual small varices were observed in 2 extremities, the recurrence rate was 5.68% （13/229）. Twenty-one limbs with ulcer were healing in 3 to 6 weeks after operation. Postoperative complications: there was paresthesias or pain of ankle area in 16 limbs, which was improved in 3 to 6 months after physical therapy; there was ecchymosis of skin of leg in 112 limbs, which disappeared in 3 to 5 weeks after operation; there was light edema in 37 limbs, which disappeared in 1 to 2 weeks after operation; there was local hematoma in 2 limbs, incision light infection in 5 limbs, skin and subcutaneous tissue necrosis above medial malleolus in one limb, and back of knee popliteal skin lesion in 2 limbs, which were all cured by the symptomatic treatment. Conclusions Surgical treatment of varicose veins is actually the combination of various surgical procedures. Varicose vein extraction using transilluminated powered phlebectomy is safe, efficacious, and cosmetically satisfactory.
Objective To research the methods and techniques of SD rat bone marrow stromal cells （MSCs）culture in vitro and to provide a large number of MSCs for cell therapy. Methods Bone marrow from the femur and tibia of the early age SD rats was taken to culture to the passage 1-4 （P1-P4）, its growth was observed and P3 cells were evaluated by HE staining and immunohistochemisty. Results The growing speed of P1-P3 was faster than that of P0, cells fusion was 85%-90% after 3-4 d and the cells were arranged in groups liked whirlpool shape or parallel; （3.4-3.6）×104/cm2 cells were gained and the total cell number of P1-P3 was 4.08×106, 2.44×107 and 2.85×108 respectively, the rate of trypan blue rejecting stained was 95%-97%. P4’s growing speed was slower than before, 1.42×109 in 3.0×104/cm2 cells were gained, and the rate of rejecting stained was 95%. P4-cell output was amplified nearly 2 000-fold higher than P0-cell. P3 immunohistochemical analysis indicated CD105+ cells 61.9%， CD44+ 45.4%， CD29+ 16.8%， CD45+ 8.2%， CD31+ 13.7%， CD34+ 8.3% and CD11b+ 1.5%, respectively. Conclusion The culture of whole bone marrow is suitable for a large number of MSCs provision in vitro, and can meet the needs of the cell therapy research.
ObjectiveTo evaluate the effectiveness and safety of the additional catheter-directed thrombolysis (CDT) and conventional treatment (CT) for treatment primary deep vein thrombosis. MethodsDatabases such as CNKI, WanFang Data, Pubmed, EMBASE.com, Medline, CBM, CSJD, CJFD, and the Cochrane Library were electronically searched from the date of their establishment to 30 June, 2013, and the relevant literatures and conference proceedings were also manually searched to include randomized controlled trials (RCTs) on comparison of additional CDT versus CT for primary deep vein thrombosis. Two reviewers independently screened studies according to the inclusion and exclusion criteria, extracted data, and accessed the methodological quality of the included studies. Then the meta-analysis was performed by using RevMan 5.1 software. Publication bias was assessed by STATA software. A meta-regression model was used to describe between study variability. ResultsTwo RCTs including 3 literatures contain 224 patients reporting data on safety and efficacy of CDT versus CT were included. There were no publication bias (Begg'S test, Z=1.02. P > 0.05;Egger'S test, t=0.98, P > 0.05). The results of meta-analysis showed that:in 6 months after surgery iliofemoral vein patency rate of CDT group was higher than that of CT group (OR=3.62, 95% CI:1.51-8.64, P=0.004), in 6 months after surgery CDT group with a lower rate than CT group of the iliofemoral vein occlusion and (or)venous reflux rate (OR=0.24, 95% CI:0.11-0.53, P=0.000), and the incidence rate of PTS in 24 months after surgery in CTD group was less than that of CT group (OR=0.55, 95% CI:0.31-0.96, P=0.040). There were no statistically significant of the major complications after surgery between CDT group and CT group (OR=1.34, 95% CI:0.12-15.69, P=0.810). But the incidence rates of minor complications and total complications after surgery in CT group were lower than those of CDT group (OR=13.67, 95% CI:4.08-45.83, P < 0.00 01 and OR=11.67, 95% CI:4.40-30.99, P < 0.000 01). ConclusionsCDT is a effective and positive way to treat early deep venous thrombosis especially in terms of the patency of vascular and prevent the occlusion and PTS. Due to the limitation of the included studies, large sample size, multicenter, and high quality studies are needed to verify the above conclusion, such as the ATTRACT Study. The intracavitary therapy could be applied to clinic combining individual conditions of patients.
Objective To summarize the mechanism and research progress of Kruppel-like factor 2 (KLF2) in various liver diseases and related drug development, providing theoretical basis for further mechanism exploration and clinical application. Method The literatures on the mechanism of KLF2 in liver diseases at home and abroad were collected and summarized. Results KLF2 was widely distributed and had various functions in human body, mainly regulating the growth, differentiation and function of endothelial cells, inhibiting pro-inflammatory and pro-thrombotic gene expression, and participating in important physiological processes such as liver inflammation, oxidative stress and thrombosis, and affecting the occurrence and development of various liver diseases. The regulation of KLF2 expression by statins had been widely used in the treatment of liver diseases. Conclusion KLF2 regulates the expression of related molecules through a variety of pathways and affects the functions of various cells in the liver, which is the focus of research on improving liver injury.
ObjectiveTo investigate the possible mechanism affecting liver cirrhosis by splenectomy. MethodsBy subcutaneous administration of 20% carbon tetrachloride(CCl4), liver cirrhosis models were established in splenectomy and nonsplenectomy groups. After HE staining, special staining and immunohistochemical staining, mast cell, Kupffer’s cell and Ito cell were counted under optical microscope. Liver pathological sections and the dynamic changes of these cells in mice were studied respectively in comparison with the normal group.ResultsThe incidence of liver cirrhosis in nonsplenectomy group was significantly higher than that in splenectomy group after the 16th injection of CCl4 (P＜0.05). The count of mast cell was much higher than that in splenectomy group after the 4th and the 8th injection (P＜0.05). Kupffer’s cell and Ito cell significantly increased after the 12th and the 16th injection in nonsplenectomy group compared with splenectomy group (P＜0.05). ConclusionSplenectomy may decline the incidence of hepatic cirrhosis caused by multifactors. In the early stage, splenectomy influences the migration, maturation and accumulation of mast cell. In the middle and late stage, it influences the proliferation of Kupper’s cell and cytokine secretion, thus the Ito cells are activated and proliferation is inhibited, in which extracellular matrix decreases in amount and the degree of hepatic fibrosis is reduced.
Objective More and more women without child and female adolescents are undergoing medical abortion (MA), MA effect on subsequent pregnancy has been brought into focus. This research will evaluate the effect of MA on subsequent pregnancy. Methods To searched Medline, Embase, Cochrane Library, Chinese Biomed-database, correlative websites and nine Chinese medical journals. The studies that were included in the reference list were additionally searched. Only RCTs (randomized control trials), CCTs (clinical control trials) and prospective cohort studies were included. Two researchers evaluated the quality of the literature and combined the evidence independently. Revman 4.1 was used for meta-analysis. Results Eight prospective cohort studies with 2 934 cases were included. The incidences of miscarriage, postpartum hemorrhage and placental abnormality occurred in MA group were significantly lower than those occurred in SA group, and their OR (with 95%CI) were 0.42 (0.22 to 0.83), 0.58 (0.39 to 0.85) and 0.68 (0.54 to 0.87), respectively. No other significant differences were observed between the two artificial abortions groups. Though the tendency indicates that medical abortion has a probable influence on subsequent pregnancy, there was no significant difference about subsequent pregnancy between MA and first pregnancy. Conclusion Unnecessary abortion should be avoided. MA is safer than SA on subsequent pregnancy, so MA is the preferred option for women without child and female adolescent to terminate their unwilling pregnancy. However, as all the studies included were prospective cohort studies, further high-quality RCTs should be conducted.
ObjectiveTo investigate the distribution of bacteria detected from blood culture of pediatric patients and to observe the blood culture contamination rate. MethodsA total of 6 530 blood samples, collected from January 2011 to December 2012 were detected by BacT/Alert 3D automated blood culture system. We found out the contamination bacteria according to clinical data, laboratory data and microbiology knowledge. ResultsA total of 314 bacteria strains were isolated from 6 530 blood samples, and the positive rate was 4.8%, 228 of which were gram-positive bacteria. The isolates were mainly coagulase-negative staphylococci (43.9%), followed by Staphylococcus aureus (2.9%). In addition, 86 cases were gram-negative bacteria, the majority of which were Escherichia coli (9.6%), followed by Klebsiella pneumonia (8.3%). The overall blood culture contamination rate was 49.7% (156 bacteria were identified). The top two were coagulase-negative staphylococci (31.2%), followed by Bacillus sp. (6.4%). ConclusionThe contamination rate is high in children's blood culture, and coagulase-negative staphylococci are the main bacteria. It's necessary to use clinical data and laboratory data to determine its clinical significance, and avoid unnecessary use of antibiotics.
Objective To systematically evaluate the effectiveness and safety of minimally invasive video-assisted thyroidectomy (MIVAT) and conventional open thyroidectomy (COT) in treatment of thyroid carcinoma without lymph node metastasis. Methods Databases including PubMed, EMbase, The Cochrane Library (Issue 3, 2015), WanFang, CBM, VIP and CNKI were searched to collect the randomized controlled trails (RCTs) and non-RCTs about MIVAT and COT in treatment of thyroid carcinoma without lymph node metastasis. The retrieval time was from inception to October 2015. The studies were screened according to the inclusion and exclusion criterias, and the data was extracted and the quality of studies was evaluated by 2 reviewers independently. Then the Meta-analysis was conducted by using RevMan 5.2 software. Results A total of 13 non-RCTs involving 3 083 cases were included. The results of Meta-analysis showed that: compared with COT group, operative time of MIVAT group was longer (MD=31.36, 95% CI: 27.68-35.03, P<0.05), hospital stay (MD=-0.16, 95% CI: -0.28--0.04, P=0.01) and length of scar (MD=-1.51, 95% CI: -1.63--1.39, P<0.05) of MIVAT group were shorter, but there was no significant difference in the incidences of transient hypocalcemia (OR=1.29, 95% CI: 0.93-1.78, P=0.13), transient laryngeal nerve palsy (OR=1.42, 95% CI: 0.93-2.17, P=0.11), hemotoma (OR=1.21, 95% CI: 0.64-2.29, P=0.56), recurrence (OR=0.61, 95% CI: 0.28-1.33, P=0.22), number of retrieved central lymph nodes (MD=-0.10, 95% CI: -0.98-0.78, P=0.82), and the size of tumors (MD=-0.02, 95% CI: -0.06-0.02, P=0.39) between the 2 groups. Conclusion MIVAT is safe and feasible in treatment of thyroid carcinoma without lymph node metastasis when its indications are strictly controlled.
Objective To investigate the application of abdominal aorta and bilateral abdominal perineal artery ligation in a hindlimb ischemia model of rats for research. Methods According to the random digits table, 38 SD rats were divided into 3 groups randomly, sham operation group (SO group, n=12), abdominal aorta ligation group (AAL group, n=12) and abdominal aorta and bilateral abdominal perineal artery ligation group (AAL+BAPA group, n=14). Rats were anesthetized by 6 mg/100 g ketamine via intraperitoneal injection. Blood vessels were ligated via laparotomy according to different procedures. Movement and pale skin color of rat’s hindlimb were observed on 2 and 4 weeks after operation, meanwhile venous blood from unilateral iliac vein was obtained for blood gas analysis and hindlimb skeletal muscle for HE stain. Results Two rats were dead during 3 d after operation in AAL+BAPA group, other rats survived. Rats in SO group had no obviously abnormal appearance. AAL group and AAL+BAPA group immediately presented hindlimbs pale, lower skin temperature, hypofrontality of limb motion after procedure. Symptoms above mentioned had improved gradually after 2 weeks and completely recuperated 4 weeks after operation in AAL group. Ischemia symptoms were still remained obviously such as cold, dried and thin on the 4th weekend in AAL+BAPA group. Each group had no hindlimbs necrosis. Two weeks after operation, pale limbs and muscle strength in AAL+BAPA group were more severe than those of SO group (Plt;0.05); Pale limbs was still worse than that of AAL group on 4 weeks after operation (Plt;0.05). There were no significant differences on different time in each group (Pgt;0.05). Venous blood partial pressure of oxygen of AAL+PABA group was significantly lower than that of the other two groups on 2 and 4 weeks after operation (Plt;0.05). Normal striated muscle structure was presented in SO group pathologically. AAL group revealed coloretur unevenness, swelling and distension, muscle cellular transverse striation elimination, skeletal muscle cell nucleolus deeply stained on the 2nd weekend and no difference with the SO group on the 4th weekend. AAL+BAPA group presented skeletal muscles decoration unevenness, cells swelling and distension, muscle cellular transverse striation elimination, skeletal muscle cell nucleolus stained deeply and intensively, intercellular space widening until the 4th weekend， but no obviously necrocytosis. Conclusion The method of ligating abdominal aorta and bilateral abdominal perineal artery can make a stable SD rat model of hindlimb ischemia