Human umbilical cord blood serum in culture medium on oocyte maturation In vitro

In vitro maturation (IVM) of immature oocytes for infertile patients is an attractive treatment. It can avoid side effects of ovarian stimulation with gonadotropins. However, at the present the successful results of IVM treatment are lower than conventional in vitro fertilization (IVF) treatment. The key issue may be the IVM medium for immature oocyte maturation. In the present study, we compared 20% (v/v) human follicular fluid (hFF) and 20% (v/v) human umbilical cord serum (hUS) as a supplement to IVM medium. A total of 47 patients with polycystic ovary syndrome (PCOS) underwent 47 IVM treatment cycles. Immature oocytes (349) collected from 32 patients were cultured in IVM medium supplemented with hFF, and immature oocytes (160) collected from 15 patients were culture in IVM medium supplemented with hUS. The results indicate that the final maturation rate of oocytes cultured in IVM medium supplemented with hUS (93.8%) is significantly higher than those cultured in IVM medium supplemented with hFF (77.1%). The percentage of high-quality embryos produced from IVM medium supplemented with hUS (50.0%) is significantly higher than IVM medium supplemented with hFF (23.8%). In addition, the results also indicate that the final maturation rate of oocytes is higher in IVM medium supplemented with hUS and the time course of oocyte maturation is hastened. Following transfer 6 out of 15 patients (40.0%) become pregnant when IVM medium was supplemented with hUS, and 7 out of 31 patients (22.6%) were pregnant when IVM medium was supplemented with hFF. These results suggest that IVM medium containing hUS appears to be a more effective means to stimulate in vitro oocyte maturation and is capable of achieving a promising clinical outcome.     

Intrathecal landiolol inhibits nociception and spinal c-Fos expression in the mouse formalin test

PURPOSE: The purpose of this study was to determine if intrathecal landiolol, a beta1-blocker, can modulate formalin-induced nociception and spinal c-Fos expression in mice, in the absence of anesthesia. METHODS: Thirty-two mice were randomly assigned to one of four groups: the control group (n = 8) received intrathecal normal saline 10 microL, while the other three groups (n = 8 for each) received intrathecal landiolol at escalating doses of 250 microg.kg(-1), 500 microg.kg(-1) and 750 microg.kg(-1) respectively, immediately after induction of anesthesia with isoflurane. After awakening, inflammatory pain was induced by 10 microL of 5% formalin solution injected into the dorsal surface of the right hind paw. The nociceptive behaviours including licking, biting and lifting of the injected paw were cumulatively recorded as seconds of behaviours/min during phase I (0-10 min) and phase II (10-45 min). The c-Fos protein expressions in the spinal dorsal horn were detected with immunohistochemical techniques in the control and landiolol 750 microg.kg(-1) groups. RESULTS: Compared to the control group, intrathecal injection of landiolol 750 microg.kg(-1) significantly decreased pain-related behaviours in phase I, while intrathecal landiolol 250 microg.kg(-1), 500 microg.kg(-1) and 750 microg.kg(-1) significantly decreased pain-related behaviours in phase II during the formalin test. The numbers of c-Fos immunoreactive nuclei in the L5 spinal dorsal horn were significantly lower in the landiolol 750 microg.kg(-1) group compared to the control group (landiolol 750 microg.kg(-1) 2.4 +/- 1.1 vs control 9.2 +/- 3.9; P < 0.01). CONCLUSION: The present study indicates that intrathecally administered landiolol produces significant antinociceptive effects in the formalin test. Although further studies exploring the detailed mechanism are needed, these data suggest a potential role of beta1-adrenoreceptors in spinal nociceptive processing.     

SLC34 A1和 RGS14单核苷酸多态性与阿德福韦酯治疗的慢性乙型肝炎患者血磷浓度的相关性

目的：探讨SLC34A1（rs6420094）和RGS14（rs4074995）单核苷酸多态性与长期服用阿德福韦酯治疗的慢性HBV感染者血磷浓度的相关性。方法选取2012年10月至2013年8月河北医科大学第三医院连续服用阿德福韦酯（10 mg／d）单药或联合治疗至少2年的慢性HBV感染者91例,其中低磷血症患者31例,血磷正常患者60例。应用聚合酶链反应-限制性片段长度多态性分析法测定两位点的基因型,应用χ^2检验分析两位点等位基因分布频率与血磷浓度的关系。结果低磷血症组中,rs6420094基因A／A、A／G和G／G型的例数分别为13,13和5例,而血磷正常组上述基因型的例数分别为35,24和1例。此位点的等位基因A在血磷正常组出现的频率高于低磷血症组（78．3％∶62．9％）,两组比较差异有统计学意义（χ^2＝4．947,P＜0．05）。低磷血症组中,rs4074995基因A／A、A／G和G／G型的例数分别为2,11和18例,而血磷正常组上述基因型的例数分别为1,21和38例,等位基因分布频率在两组间差异无统计学意义（χ^2＝0．625,P＞0．05）。结论 rs6420094多态性可能会影响长期服用阿德福韦酯治疗的慢性HBV感染者的血磷浓度。     

两种生物免疫诱导方案对肾移植受者的影响

目的 评估肾移植受者中应用两种不同生物制剂进行免疫诱导治疗的疗效和安全性。方法 回顾性分析2008年6月至2013年4月,在解放军第452医院泌尿外科暨成都军区泌尿外科中心应用生物制剂进行免疫诱导治疗的78例尸体肾移植受者的临床资料。根据应用免疫诱导方案不同分为两组,单克隆抗体组(A组,35例,接受巴利昔单抗治疗)和多克隆抗体组[B组,43例,接受抗胸腺细胞球蛋白(ATG)治疗]。另以同期在该院未接受免疫诱导治疗的肾移植受者作为对照组(C组,32例)。分析3组受者术后12周内的人、肾存活情况。监测3组受者术后7、14、30、60 d血清肌酐(Scr)水平变化。比较3组受者急性排斥反应、移植肾功能延迟恢复、感染等并发症的发生率。结果 术后12周,3组受体人、肾存活率分别为 A组100%和100%,B组97.7%和97.7%,C组100%和96.9%,各组间比较差异无统计学意义(均为P>0.05)。术后7、14 d,与C组比较,A组和B组的Scr水平明显下降,差异均有统计学意义(均为P<0.05)。与C组比较,A、B两组受者急性排斥反应发生率均降低,差异有统计学意义(均为P<0.05);3组受者移植肾功能延迟恢复发生率比较,差异无统计学意义(均为P>0.05)。B组受者术后感染发生率高于A组和C组,差异均有统计学意义(均为P<0.05)。结论 免疫诱导治疗在肾移植受者中应用安全有效。     

一种交叉异位融合肾新亚型及其诊治

目的:观察一种交叉异位融合肾新亚型的发病情况,探讨其临床分型、诊断与治疗以及发病机制。方法:回顾性分析1例交叉异位融合肾合并髂血管后巨输尿管异位开口和胸椎侧弯患者的临床资料,包括患者的病史资料、影像资料和手术探查交叉异位融合肾的术中所见,然后进行文献复习。结果:文献复习证实这可能是交叉异位融合肾的一种新亚型,交叉异位融合肾合并髂血管后异位输尿管在以前的文献中也从未见报道,患者的异位输尿结石并感染通过手术治愈。结论:男性的异位输尿管开口更为隐蔽,需要联合多种方法进行诊断。     

乙型肝炎病毒表面抗原清除的相关因素研究进展

血清乙型肝炎病毒表面抗原（HBsAg）阳性是乙型肝炎病毒（HBV）感染的标志,而HBsAg清除是慢性乙型肝炎（CHB）最接近临床治愈的一个指标。HBsAg清除受宿主、病毒及抗病毒药物等因素的影响。该文就近年来关于CHB患者HBsAg清除的相关因素的研究进展作了综述。     

Physiological Effects of Microgravity on Bone Cells

Life on Earth developed under the influence of normal gravity (1g). With evidence from previous studies, scientists have suggested that normal physiological processes, such as the functional integrity of muscles and bone mass, can be affected by microgravity during spaceflight. During the life span, bone not only develops as a structure designed specifically for mechanical tasks but also adapts for efficiency. The lack of weight-bearing forces makes microgravity an ideal physical stimulus to evaluate bone cell responses. One of the most serious problems induced by long-term weightlessness is bone mineral loss. Results from in vitro studies that entailed the use of bone cells in spaceflights showed modification in cell attachment structures and cytoskeletal reorganization, which may be involved in bone loss. Humans exposed to microgravity conditions experience various physiological changes, including loss of bone mass, muscle deterioration, and immunodeficiency. In vitro models can be used to extract valuable information about changes in mechanical stress to ultimately identify the different pathways of mechanotransduction in bone cells. Despite many in vivo and in vitro studies under both real microgravity and simulated conditions, the mechanism of bone loss is still not well defined. The objective of this review is to summarize the recent research on bone cells under microgravity conditions based on advances in the field.     

Acute kidney injury after radical gastrectomy: a single center study

Objectives

To investigate the incidence of acute kidney injury (AKI) and identify risk factors for AKI in patients who undergo radical gastrectomy.

Methods

This study included 536 patients underwent radical gastrectomy. Primary outcome was AKI, defined as a ≥50 % increase in serum creatinine relative to baseline during the first three postoperative days. Secondary outcomes were duration of hospitalization and all-cause hospital mortality within 30 days after radical gastrectomy.

Results

A total of 37 (6.9 %) patients developed postoperative AKI. Age, body mass index (BMI), presence of hypertension, hyperlipidemia, poor blood glucose control, and preoperative higher cystatin C were associated with increased frequency of AKI. By multivariable analyses, the independent risk factors for AKI were age, BMI, hypertension, hyperlipidemia, and preoperative cystatin C.

Conclusions

Postoperative AKI is not infrequent after radical gastrectomy. Age, BMI, hypertension, hyperlipidemia, and preoperative cystatin C are independently associated with increased risk of postoperative AKI.     

Perirenal fat associated with microalbuminuria in obese rats

Purpose

To determine whether perirenal fat is associated with increased urinary albumin excretion and whether perirenal fat affects renal vascular endothelial function in obese rats.

Methods

Wistar rats were randomly divided into normal and obesity group, which were fed with normal and high-fat diet, respectively. Blood and urine samples were collected. Endothelial function of the aorta was determined by measuring endothelium-dependent vasodilatation. Renal tissues were collected for CD34 immunohistochemistry and free fatty acids (FFA) measurement. Levels of glomerular nitric oxide (NO) and reactive oxygen species (ROS) were measured.

Results

After 24 weeks, plasma FFA, high-sensitivity C-reactive protein, and malondialdehyde levels were elevated and were significantly higher in renal venous blood than in jugular venous blood in obese rats. Urinary albumin/creatinine ratio, glomerular CD34 expression, glomerular ROS level, and renal cortex FFA levels were higher in obese rats. Endothelial dysfunction was more severe in the infra-renal aorta than in the thoracic aorta in obese rats. Plasma adiponectin and glomerular NO levels were lower in obese rats.

Conclusion

Perirenal fat is associated with increased urinary albumin excretion in obese rats. The mechanism may be renal vascular endothelial dysfunction caused by increased oxidative stress and activation of inflammatory molecular pathways due to elevated FFA and low adiponectin levels.     

Peroral Endoscopic Myotomy (POEM): Feasible as Reoperation Following Heller Myotomy

Purpose

The purpose of this study was to demonstrate the feasibility of performing peroral endoscopic myotomy (POEM) in the management of recurrent achalasia after failed myotomy.

Methods

Eight patients presented to our institution between October 2010 and June 2013 with recurrent/persistent symptoms after prior laparoscopic Heller myotomy. Three patients underwent redo laparoscopic Heller myotomy, and five patients consented to redo myotomy with POEM.

Results

Demographics were similar between the groups with exception of age (POEM 69.5 vs. laparoscopic Heller myotomy (LHM) 34.5, p?=?0.003). Preoperative Eckardt scores, motility, and prior interventions were not significantly different. Three patients who underwent POEM and two who underwent laparoscopic Heller myotomy had prior fundoplication. There was one perforation identified after laparoscopic Heller myotomy and one patient with persistent subcutaneous emphysema after POEM. Both POEM and laparoscopic Heller myotomy demonstrated significant improvement in symptoms and Eckardt scores at average follow-up of approximately 5 months (p?<?0.05).

Conclusion

POEM is a feasible option for patients after failed myotomy even in the presence of prior fundoplication. The procedure can be performed safely using a similar technique as for primary myotomy with the exception of creating the myotomy laterally along the right side of the esophagus and lesser curvature avoiding the previous anterior myotomy.