Ischemic preconditioning (IPC), as a powerful endogenous cardioprotective adaptation, has brought a new research field for prevention and inhibition of myocardial ischemic reperfusion injury. This article is to evaluate the current information regarding the process of IPC and the possible mechanisms involved, with special attention paid to the protein kinase C and mitochondrial ATP sensitive potassium channels. The article also pointed out that the future role of IPC in clinical practice would strongly depend on the exact cellular and molecular mechanism underlying the IPC phenomenon. Pharmacological preconditioning seems to represent a perspective role of IPC in clinical practice.

Objective To investigate the long-term morphologic and functional changes of the tricuspid valve after mitral valve replacement. Methods The tricuspid valve function was evaluated by Doppler echocardiography in 903 patients who underwent mitral valve replacement during recent 10 years. Tricuspid regurgitation and annular dilatation in various degrees were found in all patients preoperatively. 686 patients underwent Kay annuloplasty or DeVega annuloplasty, 106 patients underwent tricuspid ring annuloplasty, and 201 untreated. Results Among 201 patients who did not undergo tricuspid annuloplasty, severe tricuspid regurgitation developed in 46 during 2 to 3 years follow-up. One out of 16 patients who underwent tricuspid ring annuloplasty developed moderate tricuspid regurgitation 2 years after operation. Of 686 patients who underwent Kay annuloplasty or DeVega annuloplasty, 150 developed moderate or severe tricuspid regurgitation during 3~5 years after operation. Conclusion Tricuspid annular dilatation, right heart impairment and severe pulmonary hypertension are responsible for the development of late tricuspid regurgitation after mitral valve replacement. For the patient who underwent mitral valve replacement ,tricuspid annuloplasty should be performed when annular dilatation was found, even without tricuspid regurgitation and tricuspid ring annuloplasty should be performed in patient with severe tricuspid regurgitation and obvious tricuspid annular dilatation.

With the development of tissue engineering technology .tissue engineering of heart valve by seeding cells and scaffolds has become a hot issue in valve surgery. In this article we reviewed the selection of scaffold. acquirement and culture of seeding cells, in vitro pre-condition and in vivo experiment. The questions need to be resolved in the future study is also put forward.

[Objective] To discuss effective method for early DN.[Method] On the base of routine treatment,the treatment group 56 cases were added with Astragalus Injection;the control one 52 only routine therapy.[Result] In treatment group,41 had marked effect,14 had effect,1 had no effect,total effective rate was 98.2%;they were 14,23,15 and 71.1% respectively for control one.There’s obvious difference of meaning on effective rates(P

Objective: To elucidate the possible mechanism responsible for the improved protection of terminal warm blood cardioplegia (TWBC) after hypothermic cardiopulmonary bypass (CPB) through analysis of tubulin (TB) components changes in myocardial cells exposed to TWBC. Methods: Stable animal models of CPB were established in cats, which were then randomly divided into 2 groups. Group Ⅰ was subjected to intermittent cold blood cardioplegia (ICBC) whereas group Ⅱ to ICBC followed by TWBC before uncross-clamping. Left ventricular performance was then monitored and evaluated by LVSP, LVEDP, ±dp/dtmax and t-dp/dtmax in both groups and semi-quantitive analysis was conducted with Western blot method as to the content and constitution of TB in myocardial cells at 15 min, 120 min after aortic crossclamping (ACC) and 5 min,15 min, 60 min,120 min after reperfusion. Results: Within 120 min after reperfusion, systolic and diastolic functions decreased significantly in group Ⅰ as compared with group Ⅱ(P<0.05). At 115 min after ACC and 15 min after reperfusion, the content of free and polymerized TB in both groups had no difference (P>0.05). At 120 min after ACC and 5 minutes after reperfusion, there was a significant difference between groupⅠ andⅡ (P<0.01). Conclusion: TWBC accelerates the repolymerization of myocardial TB during hypothermic CPB, which may mediate the improved cardiac performance in the early stage of myocardial reperfusion.

To investigate the electrophysiologic characteristics of f-wave amplitude and to evaluate its role in development and persistence of chronic atrial fibrillation (AF) associated with rheumatic heart disease (RHD). Methods: Epicardial mapping was performed in 44 patients with chronic AF of RHD who underwent heart valve surgery. Ten patients with supraventricular tachycardia served as the control group. Results:The f-wave amplitude of left atrium (LA) and middle and low LA posterior regions were significantly lower than those of the control group. The f-wave amplitudes of the upper, middle and low sections in LA posterior region were significantly lower than those in right atrium (RA) (P<0.05). The f-wave amplitudes were compared before and after electrocardioversion in 14 patients with chronic AF. The mean atrial electrogram amplitude during sinus rhythm was significantly higher than that during AF (P<0.01).The f-wave amplitude in left appendage was higher than that in LA posterior region (the upper,middle and the lower part),P<0.05.The f-wave amplitude in the upper section of LA was significantly higher than that in the middle section. The f-wave amplitude in AF group was not correlated to the diameter or volume of both atria. Conclusion: There are amplitudes differences between the upper, middle and lower LA,suggesting that the middle and lower sections of LA posterior wall may be the region producing anisotropy and reentrant circle.

OBJECTIVETo investigate the potential role of intestinal bifidobacteria in the pathogenesis of gut-origin bacteria/endotoxin translocation in scalded rats.

METHODSWistar rats inflicted with 30% III degree scalding on the back were employed as the model with the rats undergoing sham injury as the control. The intestinal bacteria/endotoxin translocation and the changes in cecal mucosal microflora were determined by routine methods. And the plasma IL-6 concentration was measured with ELISA.

RESULTSThe incident of bacterial translocation into internal organs increased markedly in scalded rats (P = 0.001). The plasma LPS levels on 1, 3 and 5 postburn days (PBDs) in scalded rat group were much higher than those in sham injury group. The number of bifidobacteria decreased sharply 20 - 250 fold, the fungi increased 5 - 60 fold and E. coli increased 0.5 - 30 fold in the caecal mucosal microflora in the scalding group. The ratio of bifidobacteria to E. coli in the scalding group (4 - 800:1) was much lower than that in the sham injury group (25000:1). Furthermore, the plasma IL-6 level increased evidently in the scalding group. It was indicated by further analysis that compared with the rats without bacterial translocation, the bifidobacteria decreased 120 fold, the fungal number increased 50 fold and the E. coli number increased 30 fold in the scalded rats. The bifidobacterial number in the caecal mucosal microflora was negatively correlated with the plasma concentrations of IL-6 and LPS (P < 0.01) in the scalding rat group, and the plasma concentration of IL-6 was significantly and positively correlated with that of LPS.

CONCLUSIONSevere scalding injury could lead to an the imbalance of intestinal microflora and the increased intestinal translocation of bacteria and LPS. The decrease of the ratio and number of bifidobacteria in the caecal mucosal microflora might be a contribute to the occurrence of postburn intestinal bacteria/endotoxin translocation.

Animals ; Bacterial Infections ; blood ; microbiology ; Bacterial Translocation ; physiology ; Bifidobacterium ; isolation & purification ; physiology ; Burns ; microbiology ; Colony Count, Microbial ; Escherichia coli ; isolation & purification ; physiology ; Female ; Interleukin-6 ; blood ; Intestines ; microbiology ; Kidney ; microbiology ; Lipopolysaccharides ; metabolism ; Liver ; microbiology ; Lymph Nodes ; microbiology ; Male ; Rats ; Rats, Wistar ; Spleen ; microbiology ; Time Factors

Objective To study the mRNA expressions of Toll-like receptor (TLR) 2 and 4 in peripheral blood mononuclear cells (PBMCs) of patients with leprosy. Methods SYBR Green fluorescence quantitative RT-PCR was conducted to detect the mRNA expressions of TLR2 and 4 in PBMCs from 30 patients with cured leprosy, 30 patients with active leprosy and 30 normal human controls. Results The expression of TLR2 mRNA in patients with active leprosy was significantly higher than that in those with cured leprosy and in controls (both P ＜ 0.01 ), but there was no significant difference between the latter two groups (P ＞ 0.05). The expression of TLR4 mRNA was of no significant difference between patients with active leprosy and those with cured leprosy orthe controls (both P＞ 0.05). Conclusion The expression of TLR2 mRNA is decreased in PBMCs from leprosy patients, suggesting that TLR2 may be a specific recognition receptor in patients with leprosy.

We reviewed 100 cases with Guillain-Barré syndrome (GBS) from 1980 to 1999, and found that the features of GBS in electrophysiological classification, age, area, seasonal distributions, and in preceding illness in northwestern China are different in some aspects from those in Europe and North America or in northern China. The demyelinating pattern appeares as a major subtype not only in different age groups, but also in different test times after symptom onset.

A 34-year-old female patient presented with itchy nodules on the left posterior ear for 7 years.Skin examination showed clustered light-red or brown-black nodules measuring about 4 cm × 5 cm in size on the left posterior auricle,as well as from the posterior sulcus of the auricle to the anterior border of the hair line on the posterior auricle.Histopathological examination of the skin lesion revealed epidermal hyperkeratosis,proliferation of a lot of small blood vessels in the dermis,swelling vascular endothelial cells with enlarged nuclei and eosinophilic cytoplasm bulging into vascular cavity,and perivascular infiltration of lymphocytes and many eosinophils.The patient was diagnosed with angiolymphoid hyperplasia with eosinophilia.After extended surgical resection,a skin graft from the left lower abdomen was used to repair the defect.After the surgery,the flap survived well,and the appearance of the auricle was improved.No recurrence was observed during 1 year of follow-up.