Objective To assess the effects of hypothermia induced by 4 ℃ normal saline (NS) on biochemical function, enzymology and morphology of liver in swine after the success of cardiopulmonary resuscitation (CPR) for cardiac arrest(CA). Method The swine were resuscitated with standard CPR 4 minutes after ventricular fibrillation(VF) ,and the survived swine were randomly(random number) divided into two groups. In hypothermia(LT) group (n = 5), swine were treated with continuous infusion of 4 ℃ NS at the speed of 1.33 mL/(kg·min) for 22 min, and then slow the speed to 10 mL/(kg·h) for 4 h. In normothermia (NT) group ( n= 5) swine were treated with the infusion of NS with room temperature instead of cryogenic NS at the same speed as the LT group. The hemodynamics and the changes of blood gas were monitored until 4 h after restoration of spontaneous circulation (ROSC), and blood samples were taken to detect serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) before VFand 10 min, 2 h and 4 h after ROSC. All swine were sacrificed 24 hours after ROSC, and their liver tissues were taken away for detecting Na+ -K + -ATP enzyme and Ca2+ -ATP enzyme as well as the histological changes under both light and electron microscopy. ResultsThe heart rate, MAP, cardiac output(CO) and coronary perfusion pressure(CPP) of swine were stable in LT group ( P ＞ 0.05). The AST, ALT and LDH increased in both groups but less in LT group. The hepatic ATP enzyme activity was much higher in LT group ( P ＜ 0.05). Compared with the NT group, there were less cellularedema,necrosis or inflammatory cells infiltration, and better morphosis of mitochondria of livers found in swine of LT group. Conclusions The continuous administration of 4 ℃ NS after ROSC could quickly lower the core body temperature, and it could keep hemodynamics and oxygen metabolisms stable, protecting the biochemical function,enzymology and morphology of liver in swine after CPR.

This article summarizes 32 cases of the SCI patients suffered from bladder stones.Respects relating to causes,characteristic,diagnosis,treatment and prevention of bladder stones after SCI are discussed in the article.In order to decrease or avoid complication of indwelling urethral catheter,the patients with neuropathic bladder dysfunction are treated by intermittent catheterization.If it is necessary for SCI patients to indwell urethral catheter,we must strengthen management of the catheter and renew a catheter in time(once a week).

Objective To evaluate the therapeutic effect of implantation of artificial urinary sphincter (AUS) for treatment of patients with trauma-induced genuine stress incontinence. Methods Two patients (1 male and 1 female) with genuine stress incontinence due to urethral rupture underwent implantation of AUS device (AMS 800).In the male case,the cuff of the AUS device was used to wrap the bulbar urethra.The reservoir was placed into the retropubic space.The controllable pump was implanted into the right scrotum. In the female case,the cuff was used to wrap the neck of bladder.The reservoir was placed into the retropubic space. The pump was implanted into the right subcutaneous labium majus.The literature was reviewed to show the indication,efficacy,complication and durability of implantation of AUS device. Results After operation the male patient was followed up for 17 months,and he achieved complete continence.The female was followed up for 14 months,and she had significant improvement in continence with changing 1 or 2 small pads every day.There were no infection, erosion, urethral atrophy and mechanical failure during follow-up.The review of the literature showed that in patients with implantation of AUS the mean of continence rate was 85.5%;the incidence rates of infection,erosion,urethral atrophy and mechanical failure were 6.1%,7.5%,6.1% and 16.7%,respectively. Conclusions The implantation of AUS is an effective,reliable method for patients with trauma-induced genuine stress incontinence.

Objective To investigate the clinical efficacy of off-pump coronary artery bypass grafting (OPCABG) comparing with the conventional coronary artery bypass grafting (CCABG) for treating the patients with coronary heart disease (CHD) and its impact on brain natriuretic peptide (BNP).Methods One hundred and twenty-two patients undergoing elective coronary artery bypass grafting were divided into CCABG group and OPCABG group according to the surgical method.The operative condition and postoperative clinical data,postoperative complications and death of the two groups were observed.The level of BNP was detected before surgery,immediately after surgery,postoperative 6,24,72 h and 1 week.Results The operative time,postoperative mechanical ventilation time,ICU monitoring time,24 h after drainage and blood transfusion,hospital stay in OPCABG group was(210.08 ± 60.02) min,(9.01 ± 2.57) h,(32.08 ±9.17) h,(343.43 ± 98.12) ml,(341.75 ±97.64) ml,(9.70 ±2.77) d,significantly lower than those in CCABG group [(309.38 ± 88.39) min,( 15.25 ±4.36) h,(45.14 ± 12.90) h,(530.24 ± 151.50) ml,(752.90 ± 215.11 ) ml,( 15.44 ± 4.41 ) d] ( P ＜ 0.05 ).The incidence of postoperative complication of OPCABG group and CCABG group was 15.9％(10/63) and 47.5％(28/59),there was significant difference ( χ2 =14.172,P ＜ 0.01).The mortality rate of OPCABG group and CCABG group was 1.6％(1/63) and 8.5％(5/59),there was no significant difference ( x2 =3.091,P ＞ 0.05 ).The level of BNP in CCABG group before surgery,immediately after surgery,postoperative 6 h was (104.54 ±29.87),(114.74 ±32.36),( 129.10 ± 36.15 ) ng/L,and in OPCABG group was ( 103.46 ± 29.56 ),( 109.49 ± 31.28 ),( 126.42 ± 36.12 )ng/L respectively,there was no significant difference (P ＞ 0.05).The level of BNP in CCABG group postoperative 24,72 h and 1 week [(335.57 ± 95.83 ),(429.98 ± 122.85 ),(350.92 ± 100.26) ng/L] were significantly higher than those in OPCABG group [(241.22 ± 68.92 ),( 317.49 ± 90.71 ),(256.86 ± 73.39)ng/L] (P ＜ 0.05).The levels of BNP in both groups postoperative 24,72 h and 1 week were significantly higher than those before surgery (P＜ 0.05).Conclusion The OPCABG surgery is safe and effective,and has certain advantages for maintenance of cardiac function.

Objective: To Study the effects and feasibility of life quality list for idiopathic pulmonary fibrosis(IPF) patients.Methods: Applying the self-made life quality evaluating list,life qualities of 36 cases of IPF patients were analyzed and compared before and after the intervention of traditional Chinese medicine.Results: The evaluating list of life quality is available for IPF patients.Conclusion: The evaluation of life quality is an available method for the observations of clinical therapeutic effect and health status on IPF patients and it is worth further investigation.

Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune disease of the central nervous system that is characterized by inflammatory demyelinating lesions and axonal degeneration in optic nerve and spinal cord. It has high relapse rate and high disability rate. In recent years, as the studies on mechanisms of NMOSD, related immune therapy strategies have been developed rapidly. These immunologic interventions are collectively called the disease modifying therapy, which are helpful in improving the course and outcome of the disease. In this review, the latest treatment progress in NMOSD is summarized to guide clinical choice and application of the medication.

【Objective】To investigate the therapeutic effect of Turbidity-resolving and Stasis-removing Prescription(TSP) for the treatment of nonalcoholic fatty liver disease(NFLD).【Methods】One hundred and thirteen NFLD patients were randomized into groups A and B according to their consulting order.Group A(N=61) received oral use of TSP 100 mL,bid,and group B(N=52) received oral use of ursodesoxycholic acid(UDCA) 150 mg,tid.The treatment lasted 2 months.【Results】The total effective rate was 85.2% in group A,superior to 51.9% in group B (P

ObjectiveTo observe the effect of urethral stent implantation on detrusor-sphincter dyssynergia caused by neurogenic lower urinary tract dysfunction.Methods13 patients with detrusor-sphincter dyssynergia caused by neurogenic lower urinary tract dysfunction were treated with the operation of the urethral stent implantation. Voiding function, renal function, residual urine volume and hytronephrosis were examined before and after the operation to evaluate the effect of this procedure.ResultsAfter operation, 7 patients normally emptied their bladders and 6 patients had urinary incontinence. Urethral stents were removed from 2 patients in this group due to the irritation symptoms, the second implantation was performed in a patient due to the voiding difficulty. The renal function of patients after the operation had a non-significant improvement, but the residual urine volume and hytronephrosis improved significantly.Conclusion Urethral stent implantation can decrease residual urine volume and hytronephrosis in patients with detrusor-sphincter dyssynergia caused by neurogenic lower urinary tract dysfunction.

Objective To explore the effects of zinc finger E-box binding protein (ZEB)2 3′UTR gene transfection on proliferation, invasion and migration in human gastric epithelial cell line GES-1. Methods The synthetic ZEB2 3′UTR and miR-200b micmics were transfected into GES-1 cell line by lipofectamine 2000. We set up control grop, the mutation group and ZEB2 3′UTR group. Real-time quantitative PCR was performed to evaluate the expression levels of miR-200a/b/c and ZEB1/ZEB2 mRNAs after transfection.And then we set up control group, ZEB2 3′UTR group, ZEB2 3′UTR+negative control group and ZEB2 3′UTR+miR-200b micmics group. The protein expression levels of ZEB1, ZEB2, matrix metallopro-teinases (MMP) 2/9 and proliferating cell nuclear antigen (PCNA) were detected by Western blot assay. The invasion and mi-gration capability were analyzed by transwell assay and wound healing test. MTT assay was used to detect the proliferation ability. Results Compared with control group and mutation group, the expressions of miR-200a/b/c were significantly de-creased, especially for miR-200b. And the expressions of ZEB1/ZEB2 were significantly increased at both mRNA and pro-tein levels after transfected with the ZEB2 3′UTR, enhancing the capability of migration,invasion,and proliferation (P <0.05). Compared with ZEB2 3′UTR group, the capabilities of proliferation,invasion and migration were significantly lower in combined group. Conclusion ZEB2 3′UTR can increase the ability of cell proliferation, invasion and metastasis through regulating the levels of miR-200a/b/c, and then influence the regulation of transcription of the target gene, which could lead to malignant transformation of GES-1 cells.

Objective To evaluate clinical effectiveness of transcatheter closure of atrial septal defects ( ASD) with severe pulmonary arterial hyperyension ( sPAH) by fenestrated Amplatzer septal occluders ( ASO) . Methods From September 2002 to April 2013, 17 patients of ASD with sPAH received transcatheter ASD closure using fenestrated occluders. Aged from 18 - 72 years, the diameters of ASDs were 18 - 33 mm. The systolic pulmonary arterial hypertension measured by transthoracic echocardiogram were 80 - 112 (96. 9 ± 8. 9) mmHg. The follow-up study included electrocardiography, chest radiography and echocardiography. All the patients were followed up for 1. 5 - 12 ( mean 6. 4 ± 0. 7) years. Results Systolic pulmonary arterial pressure (sPAP) of 60 - 108 (88. 7 ± 11. 7) mmHg and mean pulmonary artery pressure ( mPAP) of 29. 3 - 60 (51. 0 ± 8. 1) mmHg were measured by cardiac catheterization before ASD closure. Qp/ Qs was 1. 50 - 2. 44 (1. 8 ± 0. 31) and the pulmonary vascular resistance was 3. 1 - 9. 7 (5. 6 ± 1. 5) wood units (wu) . Immediately after the implantation of fenestrated occluders, sPAP decreased to 56 - 99 (70 ± 11. 5) mmHg and mPAP to 27 - 51. 7 (41. 1 ± 7. 1) mmHg. On the 3 d, 3 m and 6 m follow-up exam, RVEDd decreased ( P ﹤ 0. 05), while LVEDd, LVEDV and LVEF increased significantly (P ﹤ 0. 05) . sPAP decreased significantly after transcatheter closure at 3 m and 6 m as compared to pre-closure levels (both P ﹤ 0. 05) . The mean sPAP in long term follow up was (60. 2 ± 13. 3) mmHg which had significant decrease compared to pre-closure level ( P ﹤ 0. 01), but no significant difference found when compared to 6 m follow up (P ﹥ 0. 05). Conclusions ASD closure with fenestrated ASO is a satisfactory approach for ASD with severe PAH.