Objective To investigate the method of cardiopulmonary bypass(CPB) for the repair of atrial septal defect with thoracoscopy. Methods Thirty-six patients with atrial septal defect were operated on.The artery channel and one venous channel were placed in the right femoral artery and femoral venous,the other venous channel was placed in the superior venous cave to set up CPB.The thoracoscope was put into thoracic cavity by the seventh interspace;the other two holes in the fourth interspace were used for operative procedure.The atrial septal defect was closed by thoracoscopy with the help of CPB. Results Except one patient whose incision was extended to stanch bleeding so as to avoid accidents when CPB stopped resulting in low oxygen saturation operation for other patients was successful.After operation,thirty-five patients recovered well and no complication occurred. Conclusions It is safe and reliable to repair atria septal defect with thoracoscopy with the help of CPB.

To explore the mechanism of the absorption of flavonoids from Abelmoschus manihot flowers, in situ intestinal recirculation was performed to study the effect of the absorption at different concentrations and different intestinal regions. To evaluate the conditions of the absorption of six flavonoids from Abelmoschus manihot flowers, the concentrations of Abelmoschus manihot in the perfusion solution were determined by HPLC at predesigned time. And we have investigated the inhibitory effect of six flavonoids from Abelmoschus manihot flowers on P-glycoprotein (P-gp) drug efflux pump. The results demonstrated that the absorption rates of flavonoids from Abelmoschus manihot flowers are not significantly different (P > 0.05) at various drug concentrations, the absorption of flavonoids from Abelmoschus manihot flowers is a first-order process with the passive diffusion mechanism. The absorption rates of each of flavonoids are significantly different. The absorption rate of flavonoid glycoside was lower than that of aglycone; the flavonoids from Abelmoschus manihot flowers could be absorbed in all of the intestinal segments. The best parts of intestine to absorb hyperoside and myricetin are jejunum and duodenum, separately. Verapamil could enhance the absorption of isoquercitrin, hyperoside, myricetin and quercetin-3'-O-glucoside by inhibiting P-glycoprotein (P-gp) drug efflux pump.

To analyze naringin, naringenin and its metabolites in rat urine and feces after intragastric administration of alcohol extract of Exocarpium Citri Grandis, healthy SD rats were fed with alcohol extract of Exocarpium Citri Grandis for 3 days. On the last day, 0-24 h feces and 0-4 h, 4-8 h, 8-24 h urine were collected and analyzed by UPLC-Q-TOF/MS. The post-acquisition data were processed using Metabolynx The result is that naringin and its 6 metabolites, naringenin and its 4 metabolites were detected in the urine of rat. Meanwhile, naringin and its 3 metabolites, naringenin and its 2 metabolites were detected in the feces of rat.

AIM: To establish HPLC fingerprint of Venenum Bufonis in an attempt to become a standard of quality control. METHODS: The HPLC method was set up using Alltima C_(18)(250 mm?4.6 mm,5 ?m) column with mobile phase of acetonitrile-0.5% potassium dihydrogen phosphate solution of water;UV detection wavelength at 296 nm and column temperature at 30 ℃ with the flow rate of 1.0 mL/min;20 ?L of the injection volume. RESULTS: In this chromatogram condition,10 peaks were identified as the characteristic fingerprints of Venenum Bufonis.All samples showed the content differences among the samples.The retention times for resibufogenin、cinobufagin、bufalin、bufotalin and cinobufotalin in Venenum Bufonis were consistent with each other.The fingerprint showed good similarity up to 93% in samples from different habitats. CONCLUSION: The method is exact、simple and accurate,and can be used for the identification and quality control of Venenum Bufonis.

Objective To summarize extracorporeal membrane oxygenation (ECMO) in percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) with cardiac arrest,and to evaluate the clinical efficacy comparing with literature review.Methods 5 patients of AMI with cardiac arrest who proved invalid to conventional cardio-pulmonaryresuscitation (CPR),were successfully resuscitated with ECMO support,and underwent emergency PCI with stable hemodynamic status.Results In support of ECMO,4 patients were successfully resuscitated with stable hemodynamic status,and underwent primary PCI.The duration of ECMO support ranged from 42 to 220 h (average 126.6 h).3 patients discharged with full recovery,one patient didn't wean from ECMO successfully,and one died of respiratory failure.Conclusion Although mortality of AMI with cardiac arrest is high,early ECMO-assisted cardiopulmonary resuscitation and secondary PCI treatment increase the possibility of cardiac recovery,and provide conditions for emergency revascularization treatment.This reduces mortality in critical patients with AMI,and is an effective short term life support method.

Storage of Chinese medicinal materials was an important part in the circulation process. During storage, medicinal herbs, the factors in the outside world and their own physical and chemical properties of the interaction, gradually occurring physical, chemical and biological changes. Phenomenon such as mold, moth-eaten, color change, taste change and "Fan You" would be seen. The intrinsic quality changes related to the mechanism: oxidation, polymerization or decomposition reaction, Maillard reaction, enzymatic reaction and transformation reactions. It resulted to increasing or decreasing of the active ingredient content in medicinal materials, losing of volatile components, forming of biological metabolites and transformation products of damage insects.
Drug Contamination ; Drug Stability ; Drug Storage ; Drugs, Chinese Herbal ; chemistry ; Plants, Medicinal ; chemistry

Objective To explore the application of low-dose prospective ECG-triggering dualsource CT (DSCT) angiography in infants and children with Kawasaki disease (KD).MethodsNineteen children diagnosed of Kawasaki disease underwent low-dose prospective ECG- triggering DSCT angiography (DSCTA) with free breathing and transthoracic echocardiogram (TTE).The overall imaging quality was graded on a five-point scale. Interobserver agreement in subjective image quality grading was assessed by Kappa statistics.The location,number and size of the aneurysms and dilations were recorded and compared with those of TTE.Pearson correlation analysis was used to evaluate the agreement on measurements between DSCTA and TTE.The average effective dose of DSCTA in all 19 children was calculated.ResultsDSCTA was performed successfully in all 19 children.A total of 91.5 ％ (226/247) segments permitted visualization with diagnostic image quality. Fifteen patients were diagnosed with coronary artery lesions. A total of 28 aneurysms and 15 arterial aneurysmal dilations were detected by DSCTA,while 19 aneurysms and 13 arterial aneurysmal dilations were found by TTE.TTE failed to detect 9 aneurysms (2 in the distal right coronary artery,2 in the posterior descending artery,1 in the middle of left anterior descending artery,1 in the middle of left circumflex artery,2 in the distal of LCX and 1 in the obtuse marginal branch)and 2 arterial aneurysmal dilations (1 at the diagonal branch and 1 at obtuse marginal branch). The concordance of DSCTA and TTE in measurement of diameter and length of these aneurysms and aneurysmal dilatations are good (0.63 ± 0.20) and (0.58 ± 0.20) cm vs ( 1.49 ± 0.83 ) and ( 1.22 ± 0.66) cm ( r =0.989 and 0.965,P ＜ 0.05 ).There was a good agreement on overall image quality ( Kappa =0.87 ). The mean effective dose was(0.24 ± 0.08) mSv.ConclusionProspective ECG-triggering DSCTA with very low effective radiation dose is safe,reliable and more sensitive than TTE on diagnosing of coronary artery lesions,especially in the distal lesions,in infants and children with KD.

ObjectiveTo explore the clinical characteristics and radiological manifestations of immune reconstitution inflammatory syndrome(IRIS)in acquired immunodeficiency syndrome(AIDS)patients with tuberculosis(TB)during highly active antiretroviral therapy(HAART).MethodsThe clinical and radiological data in 4 AIDS patients with TB who presented IRIS were analyzed retrospectively.ResultsThe clinical presentations of IRIS in 4 patients included fever(4 cases),weakness and weight loss(3 cases),abdominal pain(2 cases),cough with sputum(1 case),dyspnea(1 case).Cervical and(or)supra-clavicular lymph node enlargement were seen in 3 patients,inguinal lymph node enlargement in 1 patient,abdominal lymph node enlargement in 1 patient,hilar or mediastinal lymph node enlargement in 2 patients,pulmonary parenchyma and liver were involved in 2 patients,the involvement of kidney,adrenal gland,mesentery,peritoneum,psoas,brain and cutis was respectively found in 1 patient.The clinical and radiological presentations of IRIS were temporary and self-limited,improvement can be seen with antituberculosis therapy and HAART. ConclusionsIt is possible to have IRIS during HAART in AIDS patients with TB.Imaging examinations play an important role in the early diagnosis,monitoting and evaluating the response to therapy of IRIS.