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BACKGROUND: Curcumin pre-conditioning can alleviate liver injury induced by limb ischemia/reperfusion (l/R), but whether curcumin post-conditioning has protective effect against liver cold l/R injury and its mechanism are still poorly studied. OBJECTIVE: To investigate the effects of curcumin post-conditioning on hepatocyte apoptosis in rats with liver cold l/R injury in rats. METHODS: Eighty adult male Sprague-Dawley rats were randomly divided into four groups (n=20 per group) by using a random number table: sham group, l/R group, curcumin post-conditioning group (l/R+Cur group), and dexamethasone group {l/R+Dex group). The liver blood flow was completely blocked. Then the splenic vein and the adrenal vein were used as the inflow and outflow tracts to inject 0 °C compound Ringer lactate solution followed by cold perfusion for 30 minutes. After stopping cold perfusion, the proximal splenic vein and the right adrenal vein were ligated to remove the spleen, and then the blood flow in the liver restored. The cold l/R model was successfully established. After 30 minutes of cold ischemia, 60 mg/kg curcumin was injected into the rat tail vein in the l/R+Cur group, 0.5 mg/kg dexamethasone was injected into the rat tail vein in the l/R+Dex group, and the same amount of saline was injected in the other groups. Blood sample was taken from the carotid artery at 6 hours after reperfusion. Serum levels of aspartate aminotransferase and alanine transferase were detected. Then the rats were sacrificed to detect malondialdehyde level in liver tissue, observe liver pathological changes by hematoxylin-eosin staining, measure hepatocyte apoptosis index by Hoechst 33258 staining, detect expression of Bcl-2 and Bax protein by western blot, expression of caspase-9 mRNA by RT-PCR, and levels of tumor necrosis factor-α and interleukin-1β by ELISA. RESULTS AND CONCLUSION: Compared with the sham group, aspartate aminotransferase, alanine transferase, malondialdehyde levels and apoptosis index in the l/R group increased significantly (P < 0.05). Hematoxylin-eosin staining showed a large number of inflammatory cells infiltrated in the hepatic sinusoids, eosinophilic changes of hepatocytes, cytoplasmic loosening, balloon-like changes of hepatocytes, occasional patchy necrosis, and scattered punctate necrosis foci in the l/R group. The l/R group had significantly decreased expression of Bcl-2, and increased expression of Bax (P < 0.05), Caspase-9 mRNA, tumor necrosis factor-α and interleukin-1β (P < 0.05). Compared with the l/R group, aspartate aminotransferase, alanine transferase, malondialdehyde levels and apoptosis index in the l/R+Cur group decreased significantly (P < 0.05). Hematoxylin-eosin staining showed that inflammatory infiltration in the hepatic sinusoids decreased significantly, eosinophilic and balloon-like hepatocytes decreased significantly, but occasionally a small amount of scattered punctate necrosis was observed in the l/R+Cur group. There was significantly increased Bcl-2 expression, and significantly decreased Bax (P < 0.05), Caspase-9 mRNA, tumor necrosis factor-α and interleukin-1β (P < 0.05). No significant differences were observed between l/R+Cur group and l/R+Dex group (P > 0.05). In a word, curcumin-post conditioning can alleviate liver injury induced by cold l/R in rats. Its mechanism may be related to down-regulation of Bci-2/Bax ratio, inhibition of caspase-9 m RNA expression, and reduction of the release of tumor necrosis factor-α and interleukin-1β. therefore playing an anti-apoptotic role in liver protection. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether transplantation of autologous peripheral blood CD34+ stem cells is a viable approach for treating patients with advanced cirrhosis,which is currently hindered by a shortage in liver donors., Methods: A total of 100 patients with advanced cirrhosis and who had failed to respond to conservative therapy were recruited for transplantation of autologous peripheral blood CD34+ stem cells.The success of transplantation was investigated 6-and 12-months later by measuring markers of liver biosynthesis function (coagulation,albumin level,indocyanine green clearance,Child-Pugh score) and assessing pathological changes (Knodell score) and morphologic changes in the liver tissue.Complications were also recorded during follow-up., Results: The 1-year cumulative survival rate was 100%. Fifty-two patients with massive ascites showed gradual reduction and disappearance of the ascites.Four patients experienced upper gastrointestinal bleeding and three patients developed with hepatic encephalopathy (I-II degree) at 3 months post-transplantation.All patients showed significantly improved liver biosynthesis function,liver elasticity and Knodell score after transplantation (P less than 0.05)., Conclusion: Autologous peripheral blood CD34+ stem cell transplantation is a safe and effective treatment for advanced cirrhosis,and has high cost-benefit since it improves liver function,liver histology,and quality of life.

Objective: To evaluate the values of radiology, computed tomography (CT) and magnetic resonance imaging (MRI) in assessing symptomatic osteoporosis vertebral compression fractures in vertebroplasty and kyphoplasty., Methods: Retrospective reviews were conducted for 41 osteoporotic vertebral compression fractures patients with preoperative CT (with 3D reconstruction)/MRI (with fat saturation sequence) and preoperative and postoperative radiological imaging data. All patients underwent percutaneous vertebroplasty (PVP) or balloon kyphoplasty (BKP) when conservative treatment failed to offer pain relief., Results: CT scan showed 52 vertebral fractures while MRI detected a total of 70 lesions of vertebral body, including 44 new fractures, 8 old fractures and 18 bone bruises. Eight old fractures and 2 mild bone bruises were treated conservatively. In conjunctions with MRI, especially fat saturation sequence, 60 therapeutic vertebral bodies were visualized. It was superior to CT. As demonstrated by preoperative and postoperative radiology, vertebral body height improved and Cobb Angle slightly decreased for 60 lesions., Conclusion: For vertebral compression fractures in osteoporosis patients, preoperative CT and MRI examinations have important clinical significance in providing treatment guidance and assessing postoperative outcomes.

Objective: To explore the effects of autotransfusion on intraoperative blood loss and postoperative drainage volume in posterior lumbar spinal surgery., Methods: From June 2010 to January 2012, a total of 183 patients with lumbar disease were enrolled. There were 74 males and 109 females with an average age of 56.6 (31-81) years. There were lumbar disc herniation (n = 80), lumbar stenosis (n = 69), lumbar spondylolisthesis (n = 32) and discogenic pain (n = 2). And one-level (n = 83) and two-level (n = 100) operations were performed. The treatments were non-transfusion (n = 34), auto-blood (n = 109) and allogeneic blood (n = 20) and both (n = 20).Operative duration, operative level, intraoperative autologous blood transfusion, intraoperative allogeneic blood transfusion, intraoperative blood loss, immediate drainage volume, duration of drainage tube and final drainage volume were recorded., Results: The mean intraoperative blood loss was (369.4 ± 284.0) ml and (568.8 ± 398.7) ml for two-level operation, there were significant differences between them(t = 3.94, P < 0.001). The final drainage volume was (186.3 ± 135.6) ml for one-level patients and (301.4 ± 286.8) ml for two-level patients, there were significant differences between them (t = 3.56, P < 0.05). The total intraoperative blood loss was (478.3 ± 364.3) ml and total final drainage volume was (249.2 ± 237.4) ml, there were significant differences between them(P < 0.001). There were significant differences in blood loss between autologous blood transfusion for non-transfusion groups (P < 0.001) .However, there was no difference for immediate drainage and final drainage comparing with other blood transfusion methods (P > 0.05) ., Conclusion: Using autologous blood transfusion alone during operation has significant difference for inoperative blood loss compared with non-transfusion. Yet there is no effect on immediate or final drainage volume.