乙型肝炎相关慢加急性肝衰竭的免疫学特征及治疗策略

全球约有3.5亿人为乙型肝炎病毒（HBV）慢性感染者,而中国有近1亿人为慢性乙型肝炎患者,有15%~40%未经抗病毒治疗的患者将进展为终末期肝病,如肝硬化、肝衰竭及肝癌等[1-3]。在中国,HBV感染相关的慢加急性肝衰竭（acute-on-chronicliver failure,HBV-ACLF）患者约占肝衰竭患者总数的80％。     

Xenogeneic hepatic progenitor cell transplantation ameliorate CCl4/partial hepatectomy-induced rat acute liver failure

Objective： Hepatic progenitor cell transplantation has shed light on the treatment of liver failure. The present study was designed to evaluate whether xenogeneic liver epithelial progenitor cells （LEPCs） transplantation could promote liver recovery in a rat model of acute liver failure. The engraftment and hepatocytic differentiation of transplanted hepatic progenitor cells in the rat spleen was also investigated. Methods： LEPCs were propagated in vitro for long and transduced with lentiviral vector carrying mCherry gene. Intraperitoneal injection of CC14 followed by 2/3 partial hepatectomy three days later were used to establish rat models of acute liver failure. Rats were intrasplenically injected with mCherry modified LEPCs （n=20, 1× 107 cells/0.5 mL） or the same volume of medium （n=20）. Serum liver enzymes （ALT, AST） and liver histology were evaluated for 21 days after transplantation. The engraftment of transplanted LEPCs in the spleens was tested by polymerase chain reaction （PCR） amplification targeting mCherry gene. The differentiation into hepatocytic lineage of transplanted LEPCs was investigated usingimmunohistochemistry staining against Alb. Results： LEPCs were effectively transduced with lentiviral vector showing a transduction efficiency of 90%. Compared with control, cell-injected group displayed significantly lower levels of ALT and AST （P〈0.05） and better histological features including less swelling change and hepatocyte death. PCR amplification of mCherry sequences confirmed the engraftment of LEPCs in the spleens. Alb-positive cells first appeared 5 days after cell transplantation and the number of Alb-positive cells increased substantially （P〈0.05）, which revealed the hepatocytic differentiation process Conclusion： Xenogeneic hepatic progenitor cells can engraft and differentiate into hepatocytes in the splenic parenchyma. Intrasplenic delivery of hepatic progenitor cells ameliorates CCh/partial hepatectomy-induced liver injury in rats     

Renoprotective effect of alprostadil in combination with statins in patients with mild to moderate renal failure undergoing coronary angiography

Background The role of alprostadil and statins in contrast-induced acute kidney injury (CI-AKI) is controversial.The purpose of this study was to explore the efficacy of combined therapy with alprostad...     

Isolated non-compaction of ventricular myocardium in a victim of the Wenchuan earthquake with crush syndrome and acute renal failure

Non-compaction of the ventricular myocardium （NVM） is a rare congenital genetic heart defect that was initially reported 17 years ago by means of autopsy; few cases have been published since then. It has been classified as the primary inherited cardiomyopathy by the American Heart Association Scientific Statement in 2006 under contemporary definitions and classification of cardiomyopathies. It is caused by an arrested development of muscle fiber compaction, a process that normally takes place dunng early embryogenesls, which is characterized by numerous sinusoids or trabeculae that are excessive in number and abnormal in prominence and by deep intratrabecular recesses covered by endothelium that exhibits continuity with ventricular endocardium. It usually involves one and/or more segments of the left ventricle, while the clinical manifestations are highly variable,     

Febuxostat, a nonpurine selective inhibitor of xanthine oxidase: a promising medical therapy for chronic heart failure?

Heart failure is currently one of the most common and most cost-intensive of the chronic diseases The main cause of chronic heart failure （CHF） is the abnormalities of both cardiac contractile performance and myocardial energy metabolism. Elevated levels of reactive oxygen species （ROS） have been proposed to contribute to both of them. Xanthine oxidoreductase （XO） is a major source of ROS in the cardiovascular system. XO inhibitors （XOIs） have been the cornerstone of the clinical management of gout and conditions associated with hyperuricemia for several decades.     

晚期非小细胞肺癌EGFR-TKI治疗失败的临床模型及其后续治疗

1文献来源 Yang JJ, Chen HJ, Yan HH, et al. Clinicalmodes of EGFR tyrosine kinase inhibitor failure and subsequent management in advanced non-small cell lung cancer[J]. Lung Cancer, 2013,79（ 1 ）： 33-39. 2 证据水平     

Isoniazid-induced rhabdomyolysis in a patient with chronic heart failure: a case report

Rhabdomyolysis is one of the identified uncommon .but potentially lethal complications of isoniazidintoxication, which can be secondary to severe muscle exertion due to generalized seizures or can be caused by direct toxicity of either the drug or one of its metabolites on muscles.1＇2 ^However, as widely used anti-tuberculosis drug in China, isoniazid induced rhabdomyolysis appears to be very rare. To our knowledge, there is no report indicating association between rhabdomyolysis and isoniazid intoxication in Chinese population. We presented herein a case report of isoniazid-induced rhabdomyolysis in a Chinese man with chronic heart failure.     

Current state of myocardial tissue engineering

Ischemic heart disease and dilated cardiomyopathy followed by heart failure are a worldwide problem,which seriously challenge clinical outcomes and quality of life of patients. Heart failure is one of the major causes of morbility and mortality. The human heart cannot regenerate significantly because adult cardiomyocytes are terminally differentiated and cannot replicate after injury. The loss of cardiomyocytes accounts for a decrease in myocardial function, which leads to heart failure. Conservative treatment for cardiac conditions has focused on the reduction of workload, and protection from risk factors and has little therapeutic effect on patients in end-stage heart failure. Heart transplantation represents a life-saving and life-extending treatment modality for end-stage heart failure. In spite of advances in surgical techniques, the shortage of availability of donor organs has limited this treatment modality and has prompted researchers to develop alternative approaches. Cardiomyocyte regeneration is a prospective treatment modality, of which, in vitro engineering of myocardial tissue has had promising outcomes that should help cope with failing hearts in the future. Over the past years, much progress has been made to replace infarcted, non-functioning myocardium with newly formed tissue by means of cell-grafting techniques. Our country has made substantial progress in this field and promises a bright future for clinical management of heart failure.     

Advances in diagnosis and management of chronic heart failure in China: reference limits of N-terminal-pro-B-type natriuretic peptide, pharmacal management, and community care

Heart failure,the final outcome of various heart diseases,has an increasingly high prevalence in China.Diagnosis,medical treatments,and community managements of heart failure are substantial clinical challenges.N-terminal-pro-B-type natriuretic peptide （NT-proBNP） is a useful biomarker for diagnostic and prognostic predictions in heart failure patients;however,the levels of reference value in normal Chinese populations are lacking.The usage of classic Western medicines has greatly improved;furthermore,the treatment pattem of the integration of Western treatments and traditional Chinese medicine （TCM） is also widely explored.Moreover,community managements of heart failure have been paid more attention and the long-term mechanism is being built.Here,we summarize the range of reference values of NT-proBNP in normal Chinese subjects,current therapies including Western treatments and especially TCM,as well as community care among people with chronic heart failure patients in China.Keywords：chronic heart failure; N-terminal-pro-B-type natriuretic peptide; pharmacology; community care     

Two successful neonatal extracorporeal membrane oxygenation treatment for severe heart failure after cardiac surgery

Extracorporeal membrane oxygenation （ECMO） can play an important role by providing short-term circulatory support to enable myocardial recovery in patients with life-threatening heart failure. Currently, over 4000 children who received ECMO for cardiac support have been reported to the Extracorporeal Life Support Registry, with the majority1 of patients placed on ECMO following cardiac surgery. It has been recently reported that the overall survival rate of approximately 40% in children requiring ECMO after repair of congenital heart lesions.1-3 The risk of mortality was significantly increased in boys, patients younger than 1 month old,     

Effect of Acupuncture on CXCL8 Receptors in Rats Suffering from Embryo Implantation Failure简

To observe the effect of acupuncture on CXCL8 receptors（CXCR1 and CXCR2） in rat endometrium experiencing embryo implantation failure, 72 pregnant rats were randomly divided into four groups： normal group（N）, embryo implantation failure group（M）, acupuncture treatment group（A）, and progestin treatment group（W）. Then the rats in each group were equally randomized into a day-6（D6） group, a day-8（D8） group, and a day-10（D10） group. The rats in group M, group A, and group W were treated with mifepristone-sesame oil solution on day 1, while the rats in group N were injected with the same amount of sesame oil. Meanwhile, ＂Housanli＂ and ＂Sanyinjiao＂ were selected for acupuncture. From day 1 to the time of death, the rats in group A were fastened up and then acupuncture was administered while the rats in group N and group M were only fixed, and the rats in group W were given progestin. The number of implanted embryos was calculated. The expression of CXCR1 and CXCR2 in rat endometrium was detected by immunohistochemistry, Western blotting and real-time PCR. Compared to group N, the average number of implanted embryos, the protein and mRNA expression of CXCR1（D6, D8 and D10）, and the protein and mRNA expression of CXCR2（D8 and D10） in rat endometrium were significantly decreased in group M. Compared to group M, there was significant elevation in the average number of implanted embryos, the protein expression（D6, D8 and D10） and mRNA expression（D8） of CXCR1 in rat endometrium of group A, and the protein expression（D8 and D10） and mRNA expression（D8） of CXCR2 in rat endometrium of group W. These findings indicated that acupuncture can increase the number of implanted embryos in rats of embryo implantation failure, which may be relevant with up-regulation the expression of CXCR1 and CXCR2 at maternal-fetal interface of rats with embryo implantation failure.     

Severe crush syndrome complicated with acute pancreatitis: a case report and review of the literatures

Earthquake is one of the most catastrophic natural disasters. As we know, crush syndrome is the secondmost frequent cause of mortality after the direct impact of trauma.1-3 It is a serious clinical case that develops among casualties of earthquakes or other catastrophic events that may also result in a variety of ensuing uncommon complications. Cases of crush syndrome complicated with acute pancreatitis （AP） following the earthquakes are seldom reported.     

增强BEACOPP方案治疗晚期霍奇金淋巴瘤患者的远期疗效及安全性

1文献来源 Engert A, Diehl V, Escalated-dose BEACOPP patients with advanced-stage Franklin J, et al. in the treatment of Hodgkin＇ s lymphoma ：10 years of follow-up of the GHSG HD9 study [J]. J Clin Oncol, 2009, 27（27） ： 4548-4554.     

小儿心室辅助装置能显著提高心力衰竭患儿的生存率

1文献来源 Fraser CD Jr, Jaquiss RD, Rosenthal DN, et al. Prospective trial of a pediatric ventricular assist deviceIJl. N Engl J Med, 2012,367（6）：532-541.     

Effects of shensongyangxin capsule on heart rate turbulence and heart rate variability in chronic heart failure

Sudden cardiac death （SCD）, caused mainly by ventricular tachycardia and ventricular fibrillation, still remains a big clinical challenge in chronic heart failure （CHF）. Owing mainly to their strong prognostic efficiency and easy detection, heart rate variability （HRV） and heart rate turbulence （HRT） are widely used in recent years as the predictors for the risk of SCD.     

Angiotensin II vaccine promising for patients with chronic heart failure

Chronic heart failure （CHF）, as the end-stage presentation of all kinds of heart diseases, is a major public health problem as well issue. There are more than 5 as a pressing public policy million patients diagnosed with CHF in USA alone and approximately 550 000 new cases appear per year. About 0.4%-2% of the European population is affected by symptomatic heart failure. Hence heart failure is the leading cause of hospitalization especially in older people around the world.     

中药泡足联合足底按摩治疗肾衰患者失眠的护理探讨

[目的]分析中药泡足联合足底按摩在治疗肾衰患者失眠症状的疗效观察。[方法]选择本院肾衰住院患者80例,随机分成常规组和治疗组各40例,分别采用基础护理措施与中药泡足联合足底按摩法,观察并比较这两组患者的失眠治疗状况。[结果]治疗组疗效明显优于常规组(P<0.05)。[结论]中药泡足联合足底按摩能有效治疗肾衰患者的失眠症状,改善患者的睡眠质量。     

Relationship between heart rate and failure of biological valve： slowing the heart rate could delay the failure of biological valve？

For the patients with a relatively slow heart rate, the frequency of opening and closing of biological valves and the number ot impact ot mecnamcai stress upon biological valves were relatively less, so the mechanical wear was reduced. The question is whether this can slow the failure and calcification of the biological valve. A retrospective analysis replacement （MVR） cases was carried out. of 92 biological mitral valve during the period of 1996-2003     

Dioscin-induced Apoptosis of Human LNCaP Prostate Carcinoma Cells through Activation of Caspase-3 and Modulation of Bcl-2 Protein Family简

Dioscin is a natural steroid saponin derived from several plants, showing potent anti-cancer effect against a variety of tumor cell lines. In the present study, we investigated the anti-cancer activity of dioscin against human LNCaP cells, and evaluated the possible mechanism involved in its antineoplastic action. It was found that dioscin（1, 2 and 4 μmol/L） could significantly inhibit the viability of LNCaP cells in a time- and concentration-dependent manner. Flow cytometry revealed that the apoptosis rate was increased after treatment of LNCaP cells with dioscin for 24 h, indicating that apoptosis was an important mechanism by which dioscin inhibited cancer. Western blotting was employed to detect the expression of caspase-3, Bcl-2 and Bax in LNCaP cells. The expression of cleaved caspase-3 was significantly increased, and meanwhile procaspase-3 was markedly decreased. The expression of anti-apoptotic protein Bcl-2 was down-regulated, whereas the pro-apoptotic protein Bax was up-regulated. Moreover, the Bcl-2/Bax ratio was drastically decreased. These results suggested that dioscin possessed potential anti-tumor activity in human LNCaP cells through the apoptosis pathway, which might be associated with caspase-3 and Bcl-2 protein family.     

Cbl-b and PI3K/Akt pathway are differently involved in oxygen-glucose deprivation preconditioning in PC12 cells

Background Transient sublethal ischemia is known as ischemic preconditioning, which enables cells and tissues to survive subsequent prolonged lethal ischemic injury. Ischemic preconditioning exerts neuroprotection through phosphatidylinositol 3-kinase （PI3K）/Akt pathway. Cbl-b belongs to the Casitas B-lineage lymphoma （Cbl） family, and it can regulate the cell signal transduction.The roles of ubiquitin ligase Cbl-b and PI3K/Akt pathway and the relationship between them in oxygen-glucose deprivation preconditioninq （OGDPC） in PC12 cells were investiaated in the ore.~e.nt study