Effect of short-term high-dose atorvastatin on systemic inflammatory response and myocardial ischemic injury in patients with unstable angina pectoris undergoing percutaneous coronary intervention

Background Percutaneous coronary intervention （PCI） could develop periprocedural myocardial infarction and inflammatory response and statins can modify inflammatory responses property.The aim of this study was to evaluate whether short-term high-dose atorvastatin therapy can reduce inflammatory response and myocardial ischemic injury elicited by PCI.Methods From March 2012 to May 2014,one hundred and sixty-five statin-naive patients with unstable angina referred for PCI at Department of Cardiology of the 306th Hospital,were enrolled and randomized to 7-day pretreatment with atorvastatin 80 mg/d as high dose group （HD group,n=56） or 20 mg/d as normal dose group （ND group,n=57） or an additional single high loading dose （80 mg） followed 6-day atorvastatin 20 mg/d as loading dose group （LD group,n=52）.Plasma C-reactive protein （CRP） and interleukin-6 （IL-6） levels were determined before intervention and at 5 minutes,24 hours,48 hours,72 hours,and 7 days after intervention.Creatine kinase-myocardial isoenzyme （CK-MB） and cardiac troponin I （cTnl） were measured at baseline and then 24 hours following PCI.Results Plasma CRP and IL-6 levels increased from baseline after PCI in all groups.CRP reached a maximum at 48 hours and IL-6 level reached a maximum at 24 hours after PCI.Plasma CRP levels at 24 hours after PCI were significantly lower in the HD group （（9.14±3.02） mg/L） than in the LD group （（11.06±3.06） mg/L） and ND group （（12.36±3.08） mg/L,P ＜0.01）; this effect persisted for 72 hours.IL-6 levels at 24 hours and 48 hours showed a statistically significant decrease in the HD group （（16.19±5.39） ng/L and （14.26±4.12） ng/L,respectively）） than in the LD group （（19.26±6.34） ng/L and （16.03±4.08） ng/L,respectively,both P ＜0.05） and ND group （（22.24±6.98） ng/L and （17.24±4.84） ng/L,respectively）.IL-6 levels at 72 hours and 7 days showed no statistically significant difference among the study groups.Although PCI cau     

Intravitreal bevacizumab with or without triamcinolone acetonide for diabetic macular edema: a meta-analysis of randomized controlled trials

Background Intravitreal anti-vascular endothelial growth factor （anti-VEGF） drugs and corticosteroids are being widely used to treat diabetic macular edema （DME）. The purpose of this study was to evaluate further the efficacy and safety of intravitreal bevacizumab （IVB） alone in comparison with intravitreal bevacizumab combined with triamcinolone acetonide （IVB/IVT） in the treatment of DME. Methods Pertinent publications were identified through CNKI, PubMed, Medline, EMBASE, and the Cochrane Controlled Trials Register up to November 30, 2013. Two investigators independently assessed the quality of the trials, and changes in central macular thickness （CMT） and best-corrected visual acuity （BCVA） were extracted at 6 weeks and 3, 6, 12, and 24 months after the initial treatment. A meta-analysis was carried out to compare the results between the groups receiving IVB and IVB/IVT using the software RevMan 5.0. Results A total of six randomized controlled trials （RCTs） were identified and included. The meta-analysis revealed that a significant reduction of the CMT was observed at 3 months after the initial treatment in the IVB/IVT group compared to the IVB group （P=-0.001）. Also, changes in CMT at 6 weeks and 6, 12, and 24 months did not vary significantly between the IVB and IVB/IVT groups （P=0.53, 0.76, 0.34, and 0.09, respectively）. Similarly, changes in BCVA at 6 weeks and 3, 6, 12, and 24 months also did not vary significantly between the two groups （P=-0.66, 0.98, 0.81, 0.07, and 0.80, respectively）. The results were robust to sensitivity analyses. However, the rate of intraocular pressure （IOP） rise after intravitreal injections varied significantly between the IVB and IVB/IV＇r groups （P 〈0.01）. A publication bias was not detected by funnel plots, the Egger method, or the Begg method. Conclusions Results of this meta-analysis showed that the treatments with IVB alone and combined IVB/IVT were similarly effective in improving the visual acuity, and, to some degre     

Hydrogen sulfide defends against the cardiovascular risk of Nw-nitro-L-argininemethyl ester-induced hypertension in rats via the nitric oxide/endothelial nitric oxide synthase pathway

Background Dyslipidemia caused by liver injury is a significant risk factor for cardiovascular complications.Previous studies have shown that hydrogen sulfide （H2S） protects against multiple cardiovascular disease states in a similar manner as nitric oxide （NO）,and NO/endothelial nitric oxide synthase （eNOS） pathway is the key route of NO production.The purpose of this study was to investigate whether H2S can ameliorate the high blood pressure and plasma lipid profile in Nw-nitro-L-argininemethyl ester （L-NAME）-induced hypertensive rats by NO/eNOS pathway.Methods Thirty-six 4-week old Sprague-Dawley （SD） male rats were randomly assigned to 6 groups （n=6）：control group,L-NAME group,control ＋ glibenclamide group,control ＋ NaHS group,L-NAME ＋ NaHS group,and L-NAME ＋ NaHS ＋ glibenclamide group.Measurements were made of plasma triglycerides （TG）,low-density lipoprotein （LDL）,high-density lipoprotein （HDL）,total cholesterol （CHO）,glutamic-pyruvic transaminase （ALT） levels after 5 weeks.Then measurements of NO level and proteins expression of eNOS,P-eNOS,AKT,P-AKT were made in liver tissue.Results After 5 weeks of L-NAME treatment,the blood pressure,plasma TG （（1.22±0.12） mmol/L in L-NAME group vs.（0.68±0.09） mmol/L in control group; P ＜0.05） and LDL （（0.54±0.04） mmol/L in L-NAME group vs.（0.28±0.02） mmol/L in control group; P ＜0.05） concentration were significantly increased,and the plasma HDL （（0.26±0.02） mmol/L in L-NAME group vs.（0.69±0.07） mmol/L in control group; P ＜0.05） concentration significantly decreased.Meanwhile the rats treated with L-NAME exhibit dysfunctional eNOS,diminished NO levels （（1.36±0.09） mmol/g protein in L-NAME group vs.（2.34±0.06） mmol/g protein in control group; P ＜0.05） and pathological changes of the liver.H2S therapy can markedly decrease the blood pressure （（37.25±4.46） mmHg at the fifth week; P ＜0.05）,and ameliorate the plasma TG （（0.59±0.06） mmHg）,     

Kinetics of serum HBsAg in Chinese patients with chronic HBV infection with long-term adefovir dipivoxil treatment

Background Knowledge on Hepatitis B surface antigen （HBsAg） kinetics in chronic hepatitis B （CHB） patients with longterm adefovir dipivoxil （ADV） treatment is limited.The aims of this study were to investigate HBsAg kinetics in patients with chronic hepatitis B virus （HBV） infection treated with long-term ADV and to evaluate different characteristics between patients with and without HBsAg loss.Methods We retrospectively evaluated HBsAg kinetics in 24 Chinese patients with chronic HBV infection who achieved continuous virologic suppression during ADV therapy.HBV genotype was determined at baseline.Liver biochemistry,hepatitis B e antigen status,serum HBV DNA,and HBsAg levels were measured at baseline,6 months,and once every year thereafter.Results Of these 24 patients,3,1,and 20 patients were followed up for 3,5,and 6 years,respectively.Baseline serum HBsAg level had a moderate correlation with baseline HBV DNA level （r=0.52,P=0.01）.The median rate of HBsAg reduction during the therapy period was 0.08 Ig IU·ml-1·y-1.Baseline serum HBsAg level was significantly higher than other time points （P ranges from 0.046 to 0.002）.The HBsAg reduction rate during the first year was similar to that in other years （P〉0.05）.The HBsAg reduction rate during the first year in patients with eventual HBsAg loss was significantly faster than that in patients without HBsAg loss （P=0.005）.Conclusions Serum HBsAg levels in Chinese CHB patients receiving long-term ADV demonstrated a gradual reduction.Patients with eventual HBsAg loss had a significantly faster HBsAg reduction rate during the first year than those without HBsAg loss.     

Radial shock wave therapy in the treatment of chronic constriction injury model in rats: a preliminary study

Background Pain physicians pay close attention to neuropathic pain （NP）,since there is currently no ideal treatment.Radial shock wave therapy （RSWT） is a noninvasive treatment to chronic pain of soft tissue disorders.So far,there is no information on the use of RSWT for the treatment of NP.Therefore we observe the effects of RSWT on a NP model induced by chronic constriction injury （CCI） in rats.Methods Four different energy densities （1.0,1.5,2.0 and 2.5 bar） RSWT administered as a single session or repeated sessions in rats with NP induced by CCI of the sciatic nerve.The analgesic effect was assessed by measuring mechanical withdrawal threshold （MWT） and thermal withdrawal latency （TWL）.The safety was assessed through calculating sciatic functional index （SFI）.Results MWT and TWL increased after a single session of RSWT from day 1 to day 5 but retumed to baseline levels by day 10.Following repeated sessions of RSWT,both the MWT and TWL were significantly higher than NP group （P ＜ 0.01）for at least 4 weeks.In addition,no significant changes of SFI were observed in any groups after repeated sessions of RSWT and no increased pain or other side effects in any animals.Conclusions A single session of RSWT is rapidly effective in the treatment of CCI,but the efficacy maintained in a short period.However,repeated sessions of RSWT have prolonged efficacy.     

Heliox as a driving gas to atomize inhaled drugs on acute exacerbation of chronic obstructive pulmonary disease: a prospective clinical study

Background Acute exacerbation of chronic obstructive pulmonary disease （AECOPD） is a common condition,which affects not only the quality of life of patients but also their prognosis.The purpose of this study was to explore the effects of an inhaled salbutamol sulfate solution and an inhalation suspension of the glucocorticoid budesonide that were atomized with heliox to treat patients with AECOPD.Methods Twenty-three patients with AECOPD were divided into a treatment group （He/O2=70％/30％） and a control group （N2/O2=70％/30％）.The salbutamol sulfate and budesonide were administered by inhalation twice a day for 7 days.Vital signs,arterial blood gas levels,pulmonary function and the levels of serum myostatin （sMSTN） were measured and lung vibration imaging was performed.Results We found that the PaO2 and PaCO2 values were not significantly different between the two groups at the various time points （P ＞0.05）.There were also no significant differences in any of the parameters of pulmonary function between the two groups.However,after baseline correction,the increase rate of the forced expiratory volume in one second （FEV1）,the forced vital capacity （FVC）,and the maximum minute ventilation （MW） appeared to be significantly increased at some time points compared with the baseline （before treatment） in both groups （P ＜0.05）.Although the values of quantitative lung distribution （QLD） for different regions and the levels of sMSTN were slightly different between the two groups,the repeated measures analysis of variance （ANOVA） revealed that there were no significant differences between the two groups or within any group （P ＞0.05）.Conclusion Although the use of heliox as a driving gas can improve symptoms and benefit patients with AECOPD,the heliox treatment group did not have significant differences in arterial blood gases,lung function,lung vibration response imaging or the levels of sMSTN compared with the control group.（Chinese Clinical Trial Register Center ChiCTR-TRC-00000273）     

Combined incisional ropivacaine infiltration and pulmonary recruitment manoeuvre for postoperative pain relief after diagnostic hysteroscopy and laparoscopy

Background Preoperative incisional local anaesthesia with ropivacaine is a common method of providing postlaparoscopy pain relief.The pulmonary recruitment manoeuvre also provides pain relief,but the combined effect of these two methods on pain following laparoscopic procedures has not been reported.We investigated the efficacy of combining local anaesthetic infiltration of ropivacaine with pulmonary recruitment manoeuvre on postoperative pain following diagnostic hysteroscopy and laparoscopy.Methods This prospective,randomized,controlled study involved 60 patients divided into two groups （n=30,each）.Group 1 received 20 ml of 0.5％ ropivacaine injected peri-incisionally preoperatively,with intra-abdominal carbon dioxide removed by passive deflation.Group 2 received 20 ml of 0.5％ ropivacaine injected peri-incisionally with five manual inflations of the lungs with a positive-pressure ventilation of 40 cmH2O at the end of surgery.The last inflation was held for 5 seconds.The intensity of postoperative incisional and shoulder pain was evaluated using a numerical rating scale at 0,2,4,8,12,24 and 48 hours postoperatively by an independent blinded anaesthesiologist.Tramadol was given postoperatively for analgesia.Results Compared with group 1,incisional ropivacaine infiltration combined with pulmonary recruitment manoeuvre significantly reduced dynamic pain at 0 hour,4 hours,and 24 hours postoperatively （4.1 ± 2.2 vs.2.1 ± 1.9,P=0.002;2.7 ± 2.7 vs.1.2 ± 1.3,P=0.035; and 3.5 ± 2.1 vs.2.1 ± 1.8,P=0.03,respectively）.Static incisional pain was significantly relieved at 0 hour,2 hours,and 24 hours postoperatively （3.1 ± 1.7 vs.1.6 ± 1.3,P=0.001; 1.4 ± 1.3 vs.0.5 ± 0.8,P=0.012;and 2.3 ± 1.9 vs.1.0 ± 1.5,P=0.038,respectively）.Group 2 had more patients without shoulder pain （P＜0.05） and fewer requiring tramadol （P＜0.05）.Conclusion Ropivacaine with pulmonary recruitment manoeuvre provided simple and effective pain relief after diagnostic hysteroscopy and laparoscopy.     

Anti-catabolic effect of caffeic acid phenethyl ester, an active component of honeybee propolis on bone loss in ovariectomized mice: a micro-computed tomography study and histological analysis

Background Osteoporosis （OP） is a common bone disease,which adversely affects life quality.Effective treatments are necessary to combat both the loss and fracture of bone.Recent studies indicated that caffeic acid phenethyl ester （CAPE） is a natural chemical compound from honeybee propolis which is capable of attenuating osteoclastogenesis and bone resorption.Therefore,this study aimed to investigate the effect of CAPE on bone loss in OP mice using micro-computed tomography （CT） and histology.Methods Eighteen mice were prepared and evenly divided into three groups.The six mice in the sham＋PBS group did not undergo ovariectomy and were intraperitoneally injected with PBS during the curing period.Twelve mice were ovariectomized （OVX） to induce OP.Six of them in the OVX＋CAPE group were intraperitoneally injected with 0.5 mg/kg CAPE twice per week for 4 weeks after ovariectomy.The other six OVX mice in OVX＋PBS group were treated with PBS.All the mice were sacrificed 4 weeks after ovariectomy.The tibias were bilaterally excised for micro-CT scan and histological analysis.The Mann-Whitney U test was used to test the statistical differences among groups.Results Bone loss occurred in OVX mice.Compared with the sham＋PBS group,mice in the OVX＋PBS group exhibited a significant decrease in bone mineral density （BMD,P ＜0.05）,bone volume fraction （BV/TV,P ＜0.01）,trabecular thickness （Tb.Th,P ＜0.05）,and trabecular number （Tb.N,P ＜0.01）,as well as a non-insignificant increase in the number of osteoclasts （N.Oc/B.Pm）.With CAPE treatment,the microarchitecture of the tibial metaphyses was significantly improved with a reduction of osteoclast formation.Compared with the OVX＋PBS group,BV/TV in the OVX＋CAPE group was significantly increased by 33.9％ （P ＜0.05）.Conclusion CAPE therapy results in the protection of bone loss induced by OVX.     

Kyphoplasty versus vertebroplasty for the treatment of malignant vertebral compression fractures caused by metastases: a retrospective study

Background There are few comparative studies regarding kyphoplasty (KP) and vertebroplasty (VP) for the treatment of painful vertebral compression fractures (VCF) in patients with cancer. The purpose of this study is to retrospectively compare KP with VP in pain improvement, cement leakage incidence, and the cost of treatment of malignant VCF.

Methods We performed a retrospective study of clinical data for 80 patients with multiple spinal metastases, treated with KP in 42 cases and VP in 38. Visual analog scale (VAS) scores were collected pre-operatively, post-operatively, at 1 month, 6 months, and 1 year after treatment. Cement leakage was identified using fluoroscopy and CT scan. Total cost per patient was also collected.

Results There was a significant difference between the pre- and post-operative VAS scores (7.4±2.0 to 3.8±1.6, P <0.001 in the KP group; 6.7±2.4 to 3.7±1.4, P <0.001 in the VP group), and was maintained at 1-year follow-up (3.2±1.4 in the KP group, 3.1±1.3 in the VP group). However, the difference in VAS score between these two groups was insignificant at baseline and every follow-up assessment post-operatively (P >0.05). The incidence of cement leakage in the KP group was lower than that of the VP group (16.9% (14/83) vs 30.3% (23/76), P <0.05). However, none of the patients developed any symptoms. The length of postoperative hospital stay in the VP group was shorter than that of the KP group ((2.4±1.3) vs (5.3±1.9) days, P <0.05). Total hospital cost in the KP group was much higher than that of the VP group (RMB Yuan 8 492±3 332 vs RMB Yuan 3 173±1 341, P <0.01).

Conclusions VP and KP are both effective in providing pain relief for patients with cancer-related VCF. KP provides no greater degree of pain improvement. KP is associated with a lower rate of cement leakage compared with VP. VP is associated with lower cost and shorter postoperative hospital stay in China.

     

Comparison of low-dose sequences of dual-source CT and echocardiography for preoperative evaluation of aortic valve disease

Background Accurate evaluation of coronary artery,aortic valve annulus diameter （AVAD）,and cardiac function in patients with aortic valve disease is of great significance for surgical strategy.In this study,we explored the preoperative evaluation of low-dose sequence （MinDose sequence） scan of dual-source CT （DSCT） for those patients.Methods Forty patients suspected for aortic valve disease （the experimental group） underwent MinDose sequence of DSCT to observe coronary artery,AVAD,and left ventricular ejection fraction （LVEF）.Another 33 subjects suspected for coronary artery disease （the control group） underwent conventional retrospective electrocardiographically-gated sequence of DSCT.Two-dimensional transthoracic echocardiography （2D-TTE） and four-dimensional transthoracic echocardiography （4D-TTE） were applied in the experimental group to measure AVAD and LVEF and compared with MinDose-DSCT.Results There was a strong correlation between LVEFs measured by 2D-TTE and MinDose-DSCT （r=0.87,P ＜0.01）,as well as between 4D-TTE and MinDose-DSCT （r=0.90,P ＜0.01）.AVAD measured by MinDose-DSCT was in good agreement with corresponding measurements by 2D-TTE （r=0.90,P ＜0.01）.The effective dose in the experimental group was 63.54％ lower than that in the control group.Conclusions MinDose sequence of DSCT with a low radiation dose serving as a one-stop preoperative evaluation makes effective assessment of the coronary artery,AVAD,and LVEF for patients with aortic valve disease.     

Reversion effects of curcumin on multidrug resistance of MNNG/HOS human osteosarcoma cells in vitro and in vivo through regulation of P-glycoprotein

Background P-glycoprotein （P-gp） encoded by ATP-binding cassette sub-family B member 1 （ABCB1） gene is a kind of ATP-dependent drug transporter, which plays important roles in multidrug resistance （MDR） of human cancers, such as osteosarcoma. Curcumin is a natural phenolic coloring compound originating from the rhizomes of Curcuma Ionga, which is proved to possess antitumor biological activities including reversion of MDR. However, the effect and molecular mechanisms of curcumin to osteosarcoma MDR remain unclear.     

Efficacy of multimodal cocktail periarticular injection with or without steroid in total knee arthroplasty

Background Multimodal cocktail periarticular injection （MCPI） with a large volume of low concentration local anesthetics, adrenaline, and anti-inflammatory agents such as non-steroidal anti-inflammatory drug or steroids have shown good pain control and improvement in range of motion after surgery. This study compares the efficacy of pain control after total knee arthroplasty, using multimodal cocktail periarticular injection with steroid or without steroid.     

Distinct properties and metabolic mechanisms of postresuscitation myocardial injuries in ventricular fibrillation cardiac arrest versus asphyxiation cardiac arrest in a porcine model

Background The two most prevalent causes of sudden cardiac death are ventricular fibrillation cardiac arrest （VFCA） and asphyxiation cardiac arrest （ACA）. Profound postresuscitation myocardial dysfunction has been demonstrated in both VFCA and ACA animal models. Our study aimed to characterize the two porcine models of cardiac arrest and postresuscitation myocardial metabolism dysfunction. Methods Thirty-two pigs were randomized into two groups. The VFCA group （n=16） were subject to programmed electrical stimulation and the ACA group （n=16） underwent endotracheal tube clamping to induce cardiac arrest （CA）. Once induced, CA remained untreated for a period of 8 minutes. Two minutes following initiation of cardiopulmonary resuscitation （CPR）, defibrillation was attempted until return of spontaneous circulation （ROSC） was achieved or animals died. To assess myocardial metabolism, 18F-FluoroDeoxyGlucose Positron Emission Tomography was performed at baseline and 4 hours after ROSC. Results ROSC was 100% successful in VFCA and 50% successful in ACA. VFCA had better mean arterial pressure and cardiac output after ROSC than ACA. Arterial blood gas analysis indicated more detrimental metabolic disturbances in ACA compared with VFCA after ROSC （ROSC 0.5 hours, pH： 7.01±0.06 vs. 7.21±0.03, P〈0.01; HCO3： （15.83±2.31 vs. 20.11±1.83） mmol/L, P〈0.01; lactate： （16.22±1.76 vs. 5.84±1.44） mmol/L, P〈0.01）. Myocardial metabolism imaging using Positron Emission Tomography demonstrated that myocardial injuries after ACA were more severe and widespread than after VFCA at 4 hours after ROSC （the maximum standardized uptake value of the whole left ventricular： 1.00±0.17 vs. 1.93±0.27, P〈0.01）. Lower contents of myocardial energy metabolism enzymes （Na＊-K＊-ATPase enzyme activity, Ca2＊- ATPase enzyme activity, superoxide dismutase and phosphodiesterase） were found in ACA relative to VFCA. Conclusions Compared with VFCA, ACA causes more severe myocardium injury an     

Decreased hepatic glucose production in obese rats by dipeptidyl peptidase-IV inhibitor sitagliptin

Background  Dipeptidyl peptidase-IV (DPP-4) inhibitors are now used to improve postprandial glycemic control in type 2 diabetes. However, their effects on hepatic glucose production (HGP) in obesity are not clear. This study was designed to test the hypothesis that gluconeogenesis and HGP can be modulated by DPP-4 inhibitors in obesity.

Methods  Sprague Dawley male rats were divided into four groups, each on a different diet: general rat chow, n=10 (G); G+sitagliptin, n=10; high fat chow (obesity), n=10 (55% fat calories, HFO); HFO+sitagliptin, n=10. After 10 weeks, the rats were fasted overnight and glucose metabolism was determined using 3-³H-glucose and ¹⁴C-glycerol as tracers.

Results  Glycerol rate of appearance (P <0.00001), plasma glycerol (P <0.05) and free fatty acid (FFA) (P <0.05) concentrations, and HGP (P <0.05) were decreased in HFO+sitagliptin group compared with HFO group, but there was no significant difference between G and G+sitagliptin groups (P >0.05). Gluconeogenesis in HFO group was five times of that in G rats (P <0.01), but was significantly declined in HFO+sitagliptin group (P <0.0001).

Conclusions  Gluconeogenesis and HGP were inhibited by sitagliptin in high fat-induced obese rats due to decreased glycerol availability, which was a result of reduced glycerol release from adipose tissues. The finding suggests that sitagliptin is potentially useful for controlling fasting glucose in obesity, thereby delaying or preventing the development of diabetes.

     

Intravitreal ranibizumab therapy versus photodynamic therapy for idiopathic choroidal neovascularization: a comparative study on visual acuity, retinal and choroidal thickness

Background Photodynamic therapy （PDT） has been recommended as a main treatment for idiopathic choroidal neovascularization （I-CNV）.But the visual results of PDT were inconsistent and variable,and PDT may bring severe damage to the retinal pigment epithelium and choriocapillaries.In recent years,intravitreal ranibizumab therapy,showing favorable visual outcomes,has developed as an advanced treatment for choroidal neovascularization （CNV）.Although both methods have been reported to be effective in treating I-CNV,there is no detailed comparative report between the two methods.This study aimed to compare visual outcomes,retinal and choroidal thickness between intravitreal ranibizumab therapy and PDT in the treatment of I-CNV,and investigate the correlation of visual outcomes with retinal and choroidal thickness in each of the two groups.Methods Thirty-seven eyes of 37 patients with I-CNV were involved in this study; 19 eyes were treated with intravitreal ranibizumab therapy and 18 eyes were treated with PDT.The best corrected visual acuity （BCVA） was recorded before and at each follow-up visit after treatments （IogMAR）.Enhanced-depth imaging optical coherence tomography （EDI-OCT） was used to evaluate the retinal structural changes,and to measure central retinal thickness （CRT） and central choroidal thickness （CCT）.Results Mean BCVA was 0.64±0.27 in PDT group and 0.69±0.22 in ranibizumab group at baseline （P=0.55）.When compared with the baseline,mean BCVA in PDT group was improved significantly at 3-month after PDT （0.41±0.16,P=0.002）,then changed little （0.42±0.25 at 12-month,P=0.88）.Whereas mean BCVA in Ranibizumab group was improved significantly at each follow-up visit.It improved much more obviously in the first month and then remained stable.The mean BCVA in the ranibizumab group was significantly better at each follow-up visit than that in PDT （P ＜0.05）.When compared with the baseline,mean CRT in PDT group decreased significantly since 3-month visit,whereas     

Impairment of recovery of muscle function by residual rocuronium after re-transfusion of intraoperative salvaged blood

Background Recurarization has previously been described in the context of acute normovolemic hemodilution.The aim of this study was to investigate the impairment of recovery of neuromuscular function after re-transfusion of intraoperative salvaged blood in patients treated with rocuronium.Methods We enrolled 50 patients undergoing general anesthesia for lumbar surgery.Intraoperative blood salvage （IBS） was used in 30 patients （group Ⅰ）; the remaining 20 comprised a control group （group C）.Anesthesia was induced with fentanyl,midazolam,propofol and rocuronium.Rocuronium was infused to maintain neuromuscular blockade during surgery.Blood was collected from the operative field and re-transfused in the post-anesthesia care unit （PACU）.Neuromuscular function was monitored using the train-of-four ratio （TOFr）.Once the train-of-four ratio exceeded 90 in the PACU,neuromuscular function was evaluated every 5 minutes for 30 minutes.The TOFr and incremental recovery of TOFr from baseline were recorded.Salvaged blood was re-transfused at the beginning of the evaluation for patients in group Ⅰ,and afterwards for patients in group C.Blood gas analysis was assessed before anesthesia and in the PACU.Results Incremental recovery of TOFr from baseline was significantly less in group Ⅰ than controls at 25 minutes （6.1±3.2vs.9.1±3.2,respectively; P=0.001） and 30 minutes （7.1±3.2 vs.10.0±2.2,respectively; P=-0.001）.There were no significant differences in gas exchange between the groups.Conclusions In patients who had received a rocuronium infusion during anesthesia,re-transfusion of salvaged blood significantly impaired recovery of neuromuscular function recovery in the PACU,but without significant impairment of respiratory function.     

Reconstruction of segmental bone defects in the rabbit ulna using periosteum encapsulated mesenchymal stem cells-loaded poly(lactic-co-glycolic acid) scaffolds

Background  Repair of large bone defects remains a challenge for clinicians. The present study investigated the ability of mesenchymal stem cells (MSCs) and/or periosteum-loaded poly(lactic-co-glycolic acid) (PLGA) to promote new bone formation within rabbit ulnar segmental bone defects.

Methods  Rabbit bone marrow-derived MSCs (passage 3) were seeded onto porous PLGA scaffolds. Forty segmental bone defects, each 15 mm in length, were created in the rabbit ulna, from which periosteum was obtained. Bone defects were treated with either PLGA alone (group A), PLGA + MSCs (group B), periosteum-wrapped PLGA (group C) or periosteum-wrapped PLGA/MSCs (group D). At 6 and 12 weeks post-surgery, samples were detected by gross observation, radiological examination (X-ray and micro-CT) and histological analyses.

Results  Group D, comprising both periosteum and MSCs, showed better bone quality, higher X-ray scores and a greater amount of bone volume compared with the other three groups at each time point (P <0.05). No significant differences in radiological scores and amount of bone volume were found between groups B and C (P >0.05), both of which were significantly higher than group A (P <0.05). 

Conclusions  Implanted MSCs combined with periosteum have a synergistic effect on segmental bone regeneration and that periosteum plays a critical role in the process. Fabrication of angiogenic and osteogenic cellular constructs or tissue-engineered periosteum will have broad applications in bone tissue engineering.

     

Myelin protein zero and its antibody in serum as biomarkers of n-hexane-induced peripheral neuropathy and neurotoxicity effects

Background Chronic exposure to n-hexane can lead to peripheral neuropathy that no effective treatment regimen could be applied presently. This study investigated whether myelin protein zero （P0） protein and its antibody could be used to distinguish n-hexane intoxication and protect workers from peripheral neuropathy. Methods We compared P0 protein and its antibody among three levels of n-hexane-exposed groups, which included 18 patients with n-hexane-induced peripheral neuropathy as case group, 120 n-hexane-exposed workers as n-hexane- exposed control group, and 147 non-hexane-exposed participants used as control group. ELISA method was applied to detect P0 protein and its antibody. Results P0 protein in serum was significantly higher in the case group and n-hexane-exposed control group in comparison with the control group （P〈0.01）. Compared with the n-hexane-exposed control group, the case group also had significant increase of P0 protein （P〈0.01）. After 6 months therapy, P0 protein was observed to decrease significantly in the case group （P〈0.01）. The P0 antibody in serum was significantly higher in the n-hexane-exposed control group than in the control group （P〈0.01）, but not significantly different between cases and controls. Conclusions P0 antibodies in serum may be a short-term effect biomarker for n-hexane exposure. P0 protein in serum may be an early effective biomarker for peripheral nerve neuropathy and its biological limit value needs investigation in the future study.     

Pioglitazone inhibits the expression of nicotinamide adenine dinucleotide phosphate oxidase and p38 mitogen-activated protein kinase in rat mesangial cells

Background Oxidative Stress and p38 mitogen-activated protein kinase （p38MAPK） play a vital role in renal fibrosis. Pioglitazone can protect kidney but the underlying mechanisms are less clear. The purpose of this study was to investigate the effect of pioglitazone on oxidative stress and whether the severity of oxidative stress was associated with the phosphorylation level of p38MAPK.