Objective To evaluate the changes in the right ventricular systolic and diastolic function during the early period after cardiopulmonary bypass (CPB) in patients undergoing coronary artery bypass grafting (CABG).Methods Eighteen ASA physical status Ⅱ or Ⅲ patients of both sexes,with coronary heart disease (NYHA Ⅱ or Ⅲ),aged 50-80 yr,weighing 51-96 kg,with left ventricular ejection fraction≥50％,scheduled for elective CABG under CPB,were enrolled in this study.Before splitting of sternum and at 5 min after termination of CPB,the parameters of hemodynamics,cardiac output (CO)and variables of right ventricular function (using transesophageal echocardiography) including tricuspid annular plane systolic excursion (TAPSE),right ventricular fractional area change (RVFAC),tricuspid annular peak velocity during isovolumic contraction (IVV),peak velocity during ejection phases (St),early diastolic peak velocity (Et),late diastolic peak velocity (At),E/Et ratio and Et/At ratio were recorded.Results Compared with the baseline value before splitting of sternum,TAPSE,IVV,St,RVFAC,CO,E,Et and At were significantly increased,and no significant change was found in the parameters of hemodynamics and E/Et and Et/At ratios at 5 min after termination of CPB.Conclusion For the patients undergoing CABG,the right ventricular systolic function is significantly enhanced,and there is no obvious improvement in the right ventricular diastolic function during the early period after CPB.

OBJECTIVE: To explore the clinical treatment effects of sea buckthorn oil for in different size traumatic perforation of tympanic membrane in different size. METHOD: Prospective, randomized study of 199 outpatients with traumatic perforation of tympanic membrane who were enrolled between December 2012 and December 2014 after informed consent. The patients were divided into treatment group (101 cases) and control group (98 cases). According to the size of the perforations, patients in each group were divided into large perforation group, middle perforation groups and small perforation group. The cases in large perforation group, middle perforation groups and small perforation group were 36, 34, 31 in treatment group and 35, 33, 30 in control group. The patients in treatment group were treated with sea buckthorn oil once a week, while the patient in control group were self-healing and checked once a week. All the patients were followed-up in two months. The healing rate of two groups was applied for the evaluation indicator of clinical effect. We compared the healing rate, average healing time and phological change of tympanic membrane of patients at the first and second month. RESULT: The total healing ratio of patients in treatment group is 62.4% and 79.2% compared with 29.6% and 57.1% in control group at the first and second month (P < 0.05). There is statistical significance between the healing ratios of middle, large perforation groups in treatment group and control group (P < 0.05). There is no statistical significance between the healing ratios of small perforation group in treatment group and control group (P > 0.05). The average healing time of large, middle and small perforation group at the second month are significantly shorter than the control group. CONCLUSION It is better to apply observation method and let it self-healed for small traumatic tympanic membrane perforation according to its higher healing ratio. While, it is better to apply sea buckthorn oil method for middle and large traumatic tympanic membrane perforation according to its lower healing ratios. Sea buckthorn oil treatment is benefitial for increasing the ratio of perforation healing, shorten the healing time, resumpting of the middle ear function earlier, helping most of the patients to avoid operation and the reduce medical expense. Therefore, it is valuable to promote the method in clinical treatment.
Drugs, Chinese Herbal ; therapeutic use ; Hippophae ; Humans ; Plant Oils ; therapeutic use ; Prospective Studies ; Tympanic Membrane ; injuries ; Tympanic Membrane Perforation ; drug therapy ; Wound Healing ; drug effects

Objective To analyze the sensitivity and specificity of several volume parameters regarding volume responsiveness.The studied volume parameters include pulmonary artery obstruc-tion pressure (PAOP),central venous pressure (CVP),right ventricular end-diastolic volume (RV-EDV)measured by Swan-Ganz pulmonary artery catheter and left ventricular end-diastolic area (LVEDA),inferior vena cava diameter (IVC)measured by transesophageal echocardiography (TEE). Methods Twelve patients with ASA Ⅱ or Ⅲ,scheduled for coronary artery bypass grafting were studied.After anesthesia induction,the TEE probe was put into the esophagus and Swan-Ganz cathe-ter was placed in right internal jugular venous.Measurements were made at the time before cutting the skin (T0 ),20 min after divorcing from cardiopulmonary bypass or finishing vascular anastomosis in off-pump surgery(T1 ),10 min after rapid infusion (T2 )and 30 min after rapid infusion (T3 ),re-spectively.Results The values of PAOP,IVC,LVEDA,COLVOT at time T2 increased significantly compared to those at time T1 (P <0.01).No obvious correlation (r=-0.298 5、r=-0.091 8、r=-0.243 6)was observed between △CVP、△PAOP、△RVEDV and △COLVOT (the difference between T2 and T1 );Meanwhile,△IVC and △LVEDA were well correlated to △COLVOT (r= 0.445 0、r=0.612 0).Using more than 1 5% change of COLVOT after volume expansion as definition of positive re-sponse,the areas under the receiver operating characteristic curves of CVP,PAOP,RVEDV,IVC and LVEDA were 0.389 (95% CI 0.035-0.743 ),0.458 (95% CI 0.109-0.807 ),0.333 (95% CI 0-0.671 ), 0.903 (95% CI 0.701-1.000 ) and 0.889 (95% CI 0.661-1.000 ), respectively. Conclusion PAOP,IVC,LVEDA,CO are more sensitive to the change of volume;while CVP and RVEDV have weak responses to volume changes.This indicates that IVC and RVEDA have more ad-vantage to estimate cardiac output increase and guide volume therapy.

Objective To evaluate the effect of sevoflurane preconditioning on the left ventricular function in patients undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB).Methods Thirty ASA physical status Ⅱ or Ⅲ patients,aged 42-70 yr,with body height 152-181 cm,weighing 43-78 kg,scheduled for elective CABG under CPB,were randomly divided into 2 groups (n =15 each) using a random number table:control group (group C) and sevoflurane preconditioning group (group SP).Group SP inhaled sevoflurane with the end-tidal concentration corresponding to 1 MAC for 30 min after endotracheal intubation.Before sevoflurane preconditioning (T0) and at 60 min after termination of CPB (T1),mean arterial pressure (MAP),stroke volume index (SVI),pulmonary artery obstruction pressure and the TEE variables including left ventricular ejection fraction (LVEF),peak E wave velocity (E),systolic wave velocity (S),and diastolic wave velocity (D),and low propagation velocity (Vp) were recorded.S/D ratio and E/Vp ratio were calculated.Extubation time and duration of ICU stay were also recorded.Results Compared with the baseline value at T0,HR was significantly increased at T1 (P ＜ 0.05 or 0.01),and no significant change was found in the other parameters of the left ventricle function in the two groups (P ＞ 0.05).There was no significant difference in the parameters of the left ventricle function,extubation time and duration of ICU stay between SP group and C group (P ＞ 0.05).Conclusion Preconditioning with inhalation of sevoflurane with the end-tidal concentration corresponding to 1 MAC before CPB does not produce myocardial protection in terms of the left ventricular function or exerts little effect on the short-term outcomes.

Objective To evaluate the changes in early left ventricular myocardial diastolic function after cardiopulmonary bypass (CPB) in the patients undergoing mitral valve replacement.Methods Twenty patients of both sexes,aged 40-70 yr,of ASA physical status Ⅱ or Ⅲ (NYHA Ⅱ or Ⅲ),with left ventricular ejection fraction (LVEF) ≥ 45 ％,scheduled for elective mitral valve replacement with CPB,were enrolled in the study.Global and regional left ventricular diastolic function was measured by using TEE.After splitting of sternum and at 30 and 90 min after termination of CPB,HR,mean arterial pressure,central venous pressure,cardiac index,LVEF,early diastolic transmitral velocity (E),early diastolic tissue velocity (Ea),right ventricular early myocardial velocity (Em) and right ventricular late myocardial velocity (Am).E/Ea and Em/Am ratios were calculated.Results There was no significant difference in the parameters of hemodynamics and left ventricular diastolic function at each time point before and after CPB.LVEF was greater than 50％ and E/Ea ratio was greater than 20 at each time point in the patients.Conclusion There is no further damage to the early left ventricular myocardial diastolic function after CPB in the patients undergoing mitral valve replacement.

Objective:To compare the effect of age and gender on mastication efficiency between healthy volunteers and dysphagic stroke survivors and to document any correlation of mastication efficiency with mandible movements.Methods:Thirty-two stroke survivors with dysphagia and 84 healthy volunteers were asked to chew two-color gum. Their chewing efficiency was indicated by the degree of color mixing after chewing (SDHue). The SDHue value was evaluated using ViewGum software. The healthy volunteers were further divided into an age 20-40 years group, a 41-60 years group and an over-60 group. The SDHue values were compared among the 3 groups. The SDHue values were correlated with clinical mandibule movement scores.Results:Among the healthy volunteers, those older than 60 years had significantly higher SDHue values on average than those between 20 and 40 years. However, no significant gender difference was observed. The dysphagic stroke survivors had, on average, significantly higher SDHue results than the healthy volunteers, and those results were positively correlated with their mandible movement scores.Conclusions:Mastication efficiency tends to be age-related but not gender-related. Among those with post-stroke dysphagia mandible movement is positively correlated with mastication efficiency.

OBJECTIVE: To determine the regulation effect of bone morphogenetic protein-4 (BMP-4) on the proliferation and differentiation of rat hepatic precursor cells. METHODS: We used Noggin (200 ng/mL) as the function blocking control of BMP-4, and the hepatic precursor cells of WB-F344 were treated with recombinant BMP-4 at 50 ng/mL at different time points. The proliferation of WB-F344 cells were tested by methyl thiazolyl tetrazolium (MTT) colorimetric assay. The ultrastructural characters of differentiated WB-F344 cells regulated by BMP-4 were observed under a transmission electron microscope. RT-PCR was used to examine mRNA expression of specific molecular markers for different cellular phenotypes potentially differentiated from the WB-F344 cells. RESULTS: At different time points, the absorbance values in the BMP-4 treatment groups were higher than those in the control groups of Noggin and blank treatment (P<0.01). The WB-F344 cells treated with BMP-4 exhibited typical ultrastructural characters of well-differentiated epithelial cells. The hepatocyte mRNA markers were more significantly promoted in the differentiated WB-F344 cells in the BMP-4 treatment group than those in the other 2 control groups. CONCLUSION BMP-4 can promote the proliferation and directional differentiation towards hepatocytes of rat hepatic precursor cells of WB-F344.
Animals ; Bone Morphogenetic Protein 4 ; antagonists & inhibitors ; genetics ; physiology ; Carrier Proteins ; pharmacology ; Cell Differentiation ; Cell Line ; Cell Proliferation ; Hepatocytes ; cytology ; Rats ; Recombinant Proteins ; Stem Cells ; cytology

OBJECTIVE: To determine the treatment effects of transplanted hepatic progenitor cells (WB-F344 cells) combined with heparin on the acute liver injury in SD rats. METHODS: A total of 2*10(7) hepatic stem cells (WB-F344) infected with GFP lentivirus and 8 μL heparin were transplanted through the spleen in SD rats with acute liver injury, which was induced by an intraperitoneal injection of CCl4. The liver and spleen tissues underwent fluorescence examination 1 day after the transplantation. The liver functions were tested, and the liver tissues were histopathologically examined on the 3rd, 7th, 14th, and 28th day of the cell transplantation. RESULTS: The transfected WB-F344 cells expressed GFP 3 days after the lentivirus infection and were found in the rat liver 1 day after the WB-F344 transplantation. The liver function and histopathological recovery of the liver tissues in the group of WB-F344 transplantation were better than those of the control group (P<0.05). CONCLUSION Transplantation of hepatic stem cells combined with heparin can promote the liver recovery in rats with acute liver injury induced by CCl4.
Animals ; Carbon Tetrachloride ; Carbon Tetrachloride Poisoning ; Heparin ; therapeutic use ; Hepatocytes ; transplantation ; Liver Failure, Acute ; chemically induced ; therapy ; Male ; Rats ; Rats, Sprague-Dawley ; Stem Cell Transplantation ; methods

Objective To explore the classification and changes of macrophage subsets in liver transplant rejection.Methods Rat liver transplantation model were established and divided into immune tolerance group(B-B),where the liver of BN rat donors was transplanted to BN rat recipients,and immune rejection group(L-B),in which the liver of Lewis rat donors was transplanted to BN rat recipients.Single-cell RNA sequencing and high-throughput RNA sequencing were used to distinguish the macrophage subsets of rat liver transplantation,and to find differential gene in rejection reactions.Immunohistochemistry was used to determine the changes and distribu-tion of protein expression and cell subsets.Results CD68 positive macrophages were higher in the rejection group than that in the tolerance group(P<0.05),and macrophages could be divided into 9 subsets.During the rejection reaction,the CXC chemokine ligand 9(CXCL9)in the 8th subsets of macrophages was significantly increased,while the gene for white blood cell differentiation antigen 74(CD74)in the 5th subsets was significantly increased(P<0.05).CD74 ranked first in the differential gene synthesis of macrophages during rejection,followed by CXCL9.Compared with the tolerance group,a large number of CD74 positive macrophages were observed in the hepatic portal area of the rejection group,and the infiltration of CD74 positive macrophages in the hepatic sinuses was also significantly increased(P<0.05),while a large number of CXCL9 positive macrophages were observed in the hepatic portal area and hepatic sinuses of the rejection group,especially in the portal area(P<0.05),and CD14 positive cells were significantly increased(P<0.05).Conclusions The CD74 positive macrophage subsets and CXCL9 positive macrophage subsets may be key subgroups in promoting liver transplant rejection,improving the mechanism of macrophage action in liver transplant rejection.

Objective: To investigate the dynamic expression of hepatic carnitine palmitoyltransferase-II (CPT-II) in the mitochondrial inner membrane during hepatocyte malignant transformation induced by lipid accumulation. Methods: Male Sprague-Dawley rats were divided randomly into control, fatty liver, and induced cancer groups, which were fed with normal, high-fat (HF), and HF containing 2-fluorenylacetamide (0.05%, 2-FAA) diets, respectively, for 14 weeks. One rat from each group was sacrificed every two weeks and the blood and liver samples were collected. Liver morphological changes were evaluated with hematoxylin and eosin staining, and the liver tissue samples were divided into control, fatty liver, degeneration, precancerous, and cancerous groups accordingly. Hepatic lipids were dyed by the oil red O method. The CPT-II expression was measured by immunohistochemistry and compared with the specific CPT-II concentration (ng/mg liver protein, ng/mg P) among different groups. Serum levels of circulating total cholesterol (Tch), triglyceride (TG), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were quantitatively analyzed. Results: Massive lipid accumulation hepatocytes was seen in rats on HF and HF containing 2-FAA diets. The lipid levels in the control group were significantly lower than those in the fatty liver (t = -11.556, P < 0.001), degeneration (t = -4.847, P = 0.04), precancerous (t = -13.652, P = 0.005), and cancerous groups (t = -10.896, P = 0.008). The serum TG and Tch levels in the degeneration, precancerous, and cancerous groups were 2-3 times higher than those in the control group (P < 0.05). After 2-FAA treatment, the morphological changes of rat hepatocytes showed the progression from degeneration and precancerosis to cancerosis, with hepatocyte injury. The serum AST and ALT levels in the degeneration, precancerous, and cancerous groups were significantly higher (4-8 times) than those in the control group (P < 0.05). The specific concentration of liver CPT-II expression was significantly reduced during hepatocyte malignant transformation, as confirmed by immunohistochemistry, with the CPT-II levels significantly lower in the cancerous group than in any of other groups (P < 0.05). Conclusion Low hepatic CPT-II expression might lead to abnormal lipid accumulation in hepatocytes, which should promote the malignant transformation of hepatocytes.