Objective To observe the concentration of plasma endothelin (ET-1) in patients with nonarteritic anterior ischemic optic neuropathy(NAION) and investigate the relationship between ET-1 and NAION. Methods The plasma levels of ET-1 in 41 patients with NAION and 15 age-matched normal control subjects were measured by radioimmuoassay (RIA). The patients with NAION were divided into high papilloedema group, light papilloedema group, and recovery group according to the degree of papilloedema; and were divided into group1 (within 14 days), 2 (within 15-30 days), 3 (within 31-60 days), and 4 (within 61-180 days) according to the disease course. The plasma levels of ET-1 in different groups were detected and compared. Results The plasma level of ET-1 in patients with NAION was significantly higher than that in the normal subjects ( t=5.02,P

Objective To investigate the difference of IOL Master and A-ultrasound combined with corneal topography meas-urement in intraocular lens ( IOL) power calculation .Methods A total of 84 eyes of 60 cataract patients received phacoemulsification and intraocular lens implantation surgery were selected in Xiangya Hospital from March 2010 to September 2011.There were 57 eyes of 42 age-related cataract patients and 27 eyes of 18 complicated cataract patients .The patients were divided into IOL Master group and A ultrasound combined with corneal topography measurement group .Before surgery , in IOL Master group , axial length ( AL) and corneal curvature were measured with IOL Master , IOL power was calculated according to the Haigis , SRK/T formula and so on.At the same time the axial length ( AL) and corneal curvature were measured with A ultrasound combined with corneal topography respectively and IOL power was calculated by SRK/Ⅱ formula.In A ultrasound combined with corneal topography measurement group , axial length ( AL) and corneal curvature were measured with A ultrasound combined with corneal topography respectively , IOL power was calculat-ed according to the SRK/Ⅱformula.3 months postoperatively , all the patients were conducted refractive outcome and calculating mean absolute refractive error(MAE).Finally the data were analysed.Results ⑴In IOL Master group, before operation there was no sig-nificant difference in mean axial length between IOL Master and A-ultrasound measurement ( P >0.05 ) , while in the patients with AL>26 mm the axial length was (28.53 ±0.57)mm and (29.42 ±0.64)mm using IOL Master and A-ultrasound measurement respec-tively ( P <0.05).The mean corneal curvature was (42.12 ±0.31)D and (43.09 ±0.27)D using IOL Master and corneal topogra-phy measurement respectively ( P <0.01).The mean IOL power were (17.06 ±0.48)D and (16.37 ±0.56)D in IOL Master group and A ultrasound combined with corneal topography measurement group respectively ( P <0.05 ) .⑵3 months postoperatively , the MAE was (0.07 ±1.05)D and (0.16 ±0.81)D in IOL Master group and A-ultrasound combined with corneal topography measure-ment group( P <0.05) respectively.Conclusions In cataract patients with normal axial length , IOL Master and A-ultrasound com-bined with corneal topography have high consistency for axial length measurement and IOL power calculation .But in cataract patients with high myopia , IOL Master is more accurate for axial length measurement and IOL power calculation compared to A -ultrasound com-bined with corneal topography .

Objective To study the impact and mechanism of continuous venovenous hemofiltration (CVVH) in different uhrafihration rates on plasma cytokines in porcine endotoxemic shock. Methods Eighteen anesthetized mechanically ventilated pigs weighing 21-34 kg were randomly divided into three groups. In control group (n=6), the pigs received a 15.7 μg/kg endotoxin (E.coli 0111:84) infusion. In CVVH group (n=6) and high volume hemofihration (HVHF) group (n=6), the pigs received CVVH after the endotoxin infusion for 24 hours with an was taken before endotoxin infusion and at 0, 1, 6, 12, 24 h during CVVH. The plasma levels of TNF-α, IL-6, IL-10 and IL-18 were tested by ELISA. Results The survival time in control group was (15.4±5.2) h,CVVH group was (21.4±7.1) h,HVHF group was (22.4±6.7) h. The survival time in CVVH and HVHF group was significantly longer than that of control group (P< 0.05 ). Heart rate (HR), mean arterial blood pressure (MAP), central venous pressure (CVP) and cardiac output (CO) showed no significant differences among three groups. Plasma BUN and Ser increased gradually after the establishment of porcine endotoxemic shock model. BUN and Scr of CVVH and HVHF group were lower compared to control group (P<0.05), but there was no significant difference between CVVH and HVHF group (P>0.05). Plasma TNF-α and IL-6 peaked at T1, IL-10 peaked at TO, then they declined gradually. While IL-18 increased at TO and did not change after TO. A significant decrease of plasma IL-10 level was observed at T6, T12 and T24 in CVVH group compared with control group (P<0.05). HVHF group accomplished a greater decrease in plasma TNF-α (T6) and IL-10 (T6, T12, T24) levels compared with control group and CVVH group (P< 0.05). The levels of IL-6 and IL-18 showed no significant differences among three groups. There was a negative correlation between IL-6 and survival time (P<0.05). Conclusions HVHF and CVVH can prolong the survival time of porcine endotoxemic shock. IL-10 can be removed effectively with CVVH and HVHF. HVHF can also remove TNF-α effectively. CVVH and HVHF treatment can both remove BUN and Scr effectively. IL-6 is a powerful independent predictive factor for survival time of porcine endotoxemic shock.

BACKGROUND:Gene-modified stem cel s can increase the secretion of peptides and ful-length proteins to protect spinal cord injury and promote recovery of neuronal function, which thus become a research hotspot in recent years. OBJECTIVE:To investigate the effect of nerve growth factor-modified adipose derived stem cel s in repairing spinal cord injury in rats. METHODS:Adipose derived stem cel s were primarily cultured by adherent culture method and cel surface markers were detected by immunofluorescence method, while spinal cord injury models were set by modified Al en method. Nerve growth factor plasmid was transfected into adipose derived stem cel s with Lipofectamine2000 and the expression of nerve growth factor was detected by real-time PCR and western blot. The modified adipose derived stem cel s intervened by nerve growth factor were injected into the injured part of spinal cord injury rat models. Basso-Beattie-Bresnahan score was used to evaluate the repairing effect. Models rats were sacrificed at 3 weeks after cel transplantation. Real-time PCR and western blot were used to testify nerve growth factor expression in the injured spinal segment after cel transplantation. RESULTS AND CONCLUSION:Adipose derived stem cel s were successful y cultured primarily, and positive for CD29 and CD44;the mRNA and protein expression of nerve growth factor was elevated after plasmid transfection. The Basso-Beattie-Bresnahan score was elevated after transplantation of adipose derived stem cel s intervened by nerve growth factor modification compared to control group;and the expression of nerve growth factor in the injured segment of the spinal cord was up-regulated detected by real-time PCR and western blot. These findings indicate that the nerve growth factor-modified adipose derived stem cel s have repairing effects on spinal cord injury in rats.

Objective To investigate the changes of hypothalamic-pituitary-adrenal axis (HPA)function, volume of the hypothalamic, pituitary and adrenal glands in elderly patients with depression. Methods Twenty-five cases of elderly patients with depression and 19 healthy elderly patients were enrolled into the patient group and the healthy control group, respectively. Enzyme linked immunosorbent assay was used to measure the level of the main hormone related with HPA axis in blood. The low dose dexamethasone suppression test was used to assessassessment the negative feedback regulation of HPA axis. The volume of the hypothalamus, pituitary and adrenal glands were determined by the magnetic resonance imaging. Results The Beck Depression Scale (BDI-II) and Montgomerie Rating Scale (MADRs) score of the elderly depression patients were significantly higher than those in the healthy control group (P < 0.01). The values of main hormone related with HPA axis in the patient group, such as CRH, ACTH and CORT, were higher than those in the healthy control group (P<0.01). The non- suppression rate of low dose dexamethasone suppression test in the patient group was significantly higher than that in the healthy control group (P < 0.05). The hypothalamus, pituitary and adrenal gland volume of patients group were 4.7%, 18.3% and 17.5% ,respectively. Significant the differences of pituitary and adrenal volume were observed between two groups (P < 0.05). Conclusion The levels of main hormone related with HPA axis in the elderly patients with depression were significantly increased, the non-suppression rate of low dose dexamethasone suppression test was also increased. Meanwhile, the volume of pituitary and adrenal gland in the elderly patients with depression increased.

Objective To evaluate the effect of ischemic postconditioning on myocardial injury in the patients undergoing cardiac valve replacement under cardiopulmonary bypass (CPB).Methods Thirty patients of both sexes,aged 21-59 yr,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ (New York Heart Association Ⅱ or Ⅲ),with left ventricular ejection fraction ≥ 40％,scheduled for elective cardiac valve replacement under CPB,were divided into 2 groups (n=15 each) using a random number table:control group (C group) and ischemic postconditioning group (P group).In group P,ischemic postconditioning was induced by 3 cycles of 30 s aortic unclamping followed by 30 s cross-clamping starting from 5 min before complete opening of the ascending aorta.After induction of anesthesia and before operation (T1),at 1 h after opening of the ascending aorta (T2),at the end of operation (T3),and at 12,24 and 48 h after opening of the ascending aorta (T4-6),blood samples were taken from the radial artery for determination of plasma concentrations of heart-type fatty acid-binding protein (H-FABP),ischemia-modified albumin (IMA),and cardiac troponin Ⅰ (cTnI).Myocardial specimens in the right auricle were obtained at T2,and the pathological changes were examined using an optical microscope.Results The concentrations of plasma cTnI at T2-6 and H-FABP and IMA at T2-5 were significantly higher than those at T1 in the two groups (P＜0.05).Compared with group C,the concentrations of plasma cTnI at T2-6,H-FABP at T2-4,and IMA at T2,3 were significantly decreased (P＜0.05),and the pathological changes of myocardial tissues were significantly reduced in group P.Conclusion Ischemic postconditioning can reduce myocardial injury in the patients undergoing cardiac valve replacement under CPB.

Acute lung injury/acute respiratory distress syndrome (ALI/ARDS) is an inflammatory lung injury induced by a variety of factors, and these diseases are associated with high rates of mortality due to the lack of effective treatments. Based on the latest research in ALI/ARDS, it is widely accepted that generalized inflammatory responses play a critical role in initiating and developing process of ALI/ARDS. We make a brief review on the immune-pathogenesis and the signaling pathways of ALI/ARDS from the perspective of inflammation, thereby helping develop novel therapeutic strategy for treatment of patients with ALI/ARDS.

Objective To investigate the relationship between inflammatory bowel disease (IBD) activity and choroidal thickness,and evaluate the utility of a choroidal thickness measurement in assessing IBD activity.Methods A total of 100 eyes of 50 patients of IBD with different disease activity,including 23 patients of ulcerative colitis,27 patients of Crohn's disease (CD).Ninety-six eyes of 48 healthy volunteers were recruited as control group.Choroidal thickness was measured using enhanced depth imaging(EDI)optical coherence tomography.Results Compared with the subfoveal choroidal thickness (294.37 ± 35.04) μm in healthy volunteers,the subfoveal choroidal thickness (349.28 ± 76.57) μm in UC patients with severe disease activity,the subfoveal choroidal thickness (326.71 ± 59.71) μm and (354.24 ± 66.34) μm,respectively,in CD patients with moderate and severe disease activity were found to be increased significantly (all P ＜ 0.05).Conclusion Choroidal thickness should be considered as a potential marker to assess the disease activity in patients with IBD,especially in patients with CD.

Objective To explore the effect of inhaled iloprost (Ventavis) for patients with congenital heart disease associated with pulmonary hypertension.Methods Twenty-two patients with congenital heart disease associated with pulmonary hypertension were selected to inhale Ventsvis by atomizer before surgery ,the required dosage is 25-30ng/(kg.min),aerosolization of iloprest was inhaled by PARI Junior BOY N after diluted with 2ml physiological saline at 3-hour intervals .The change of hemodynamic effects was measured by Doppler ultrasonography after 60min,120min,and 180min.Results The left and fight vemfieular cardiac output at 60min,120min and 180rain after therapy were markedly higher than that before inhaled iloprost ,respirator therapy time was shorter in patients inhaled iloprost.Conclusion inhaled iloprost can increase cardiac output and improve patients cardiac function.Thus,the therapy with inhaled iloprost is effective and feasible.

Objective It is still controversial how to deal with the congenital heart disease with advanced pulmonary hypertension.The choices of treatment for these patients must depend on the character and degree of pulmonary vascular change.The pulmonary vascular change correlates well with hemodynamics and acute pulmonary vasoreactivity test.Therefore,it will play an important role to obtain accurately these evaluations.Methods This paper studies 85 cases (38 males and 46 females) with congenital heart disease complic ated with advanced pulmonary hypertension and bidirectional shunt,which are diagnosed by echocardiography.Whose age range is (22.8 ± 16.5 ) and weight range (46.4 ± 12.1 ) kg.Among those cases,42 are VSD,11 are ASD,9 are VSD with patent ductus arteriosu,7 are patent ductus arteriosu,5 are ASD with VSD,and 11 are the others.With congenital heart disease complicated with advanced pulmonary hypertension and bidirectional shunt,which are diagnosed by echocardiography.There were floating catheter retention of 4 to 13 days ( average 7.5 days).Through the right subclavian vein or jugular vein,floating catheter is inserted into pulmonary artery.Pulmonary artery pressure is recorded continuously and analyzed.Hemodynamics,acute pulmonary vasoreactivity test and drug sensitivity test are evaluated.Differences of the hemodynamics are analyzed between echocardiography and floating catheter examination.Results Compared with floating catheter examination,there are not significantly difference for the diagnosis of advanced pulmonary hypertension(98.8％ vs.100％,P ＞ 0.05),less accurately diagnosis (64.3％ vs.100％,P ＜ 0.05 ) and higher (H)false positive rate (8.4％ vs.0,P ＜ 0.05) for Eisenmenger syndrome in echocardiography examination.Floating catheter examination shows that mean systolic pulmonary artery pressure(PAP)/mean systolie body artery blood pressure (BP) and mean PAP / mean BP were equal to 1.22 ± 0.35 and 1.07 ± 0.11 respectively.The patients presented total pulmonary vascular resistance of ( 17.6 ± 8.3) Wood units.Bidirectional shunt volume is more than 30％ cardiac outputs in 7 cases.Apart from 14 cases with Eisenmenger syndrome,total pulmonary vascular resistance is ( 11.3 ± 3.7) Wood units.Acute pulmonary vasoreactivity test presents positive in 67 cases.After drug sensitivity test,14 cases with Eisenmenger syndrome underwent medical treatment and waited lung transplantation or heart-lung transplantation.Floating catheter examination happened hematoma(2/85 ) in 2 patients.71 cases underwent surgical treatment.Operative complications included right heart failure (6/71) and pulmonary infection (5/71).Operative mortality was 5.6％ (4/71).The main causes of death were right heart failure.Compared with preoperative arterial oxygen saturation,postoperative arterial oxygen saturation increased by (9.7 ± 4.1 ) ％ ( P ＜ 0.05 ).Conclusion Floating catheter examination can evaluate accurately pulmonary hypertension,hemodynamics,acute pulmonary vasoreactivity test,drug sensitivity test and bidirectional shunt volume.All the patients,who were diagnosed as advanced pulmonary hypertension with bidirectional shunt by echocardiography,should undergo floating catheterization.Floating catheter examination can provide reliable,objective theoretical basis for the choice of treatment in the congenital heart diseases with advanced pulmonary hypertension.