The aim of this study is to invistigate the effects of heparinization and the reversal of heparin activity with protamine on platelet function during extracorporeal cardiopulmonary bypass. The venous blood of 10 healthy volunteers was collected in tubes containing 3 2% trisodium citrate or 25??/ml heparin. The expression of P selectin (a secretion marker of platelets) and activated fibrinogen receptor GP Ⅱb Ⅲa (an aggregation marker of platelets) on normal platelets in response to the treatment with heparin and protamine in vitro were examined using whole blood flow cytometry. The results showed that heparin (5～50?g/ml) could increase adenosine diphosphate (ADP) induced expression of P selectin and GPⅡb Ⅲa in a dose dependent manner ( P

Objective To investigate the immunoisolation effect of xenografts of microencapsulated human chromaffin cells (HCCs) .Methods HCCs were microencapsulated with APA microcapsules. Forty-eight SD rats were randomly divided into 3 groups ( n = 16 each) . HCCs (group I ) , empty APA microcapsules (group II ) and microencapsulated HCCs (group III ) were implanted into the anterior chamber of the eyes and the sole of the feet. Seven days after transplantation blood samples were collected for determination of serum IL-2, IgG and IgM concentration. The right eye-balls and left feet were obtained for microscopic examination. Results The serum IL-2, IgG and IgM concentrations were significantly lower in group II and group III than in group I ( P

Objective To compare the survival of isolated chromaffin cells with that of adrenal medullary pieces implanted into the subarachnoid space .Methods Forty male Sprague Dawley rats, 180 220g, were randomly allocated to be implanted into the subarachnoid space with the homologous adrenal medullary pieces washed with PBS(group A,n=20) or the isolated chromaffin cells 5?107 in 10?l suspension (group B,n=20), respectively, after the implants were in vitro cultured in three days . The thermal threshold was determined before ,5 and 10 weeks after the transplantation. Five or ten weeks after the transplantation, 6 rats of either group were randomly selected to obtain the adrenal medullary grafts from the subarachnoid space or the sediments of cerebrospinal fluid ,observed with an electron microscopy.Results Five weeks after transplantation, the thermal threshold in both groups increased markedly,but without significant difference between them ,and there were intact chromaffin cells in the sections of both groups. Ten weeks after the operation, the thermal threshold in group A decreased to basaline, and was significantly lower than in group B; no intact chromaffin cells were found ,with the infiltration of a large number lymphocytes in the sections of group A , and in the sections of group B, the intact chromaffin cells were found with the infiltration of lymphocytes in lower amount and density. Conclusions The isolated chromaffin cells implantation is superior to the adrenal medulla pieces implantation for analgesia.

Objective:To study the significance of QT dispersion(QTd) changes in electrocardiogram(ECG) after coronary artery bypass graft. Methods:Forty eight patients scheduled for elective coronary artery bypass graft were studied. The changes of QTd were monitored by 12 lead electrocardiogram system before surgery (as baseline values), at the end of surgery, and 1 4 d and 7 d after surgery.Results:The baseline values for QTd was (56.32?2.25) ms.QTd were significantly longer as compared to the baseline values ( P

BACKGROUND: Based on previous technique prepared for encapsulating living cells with alginate-polysine- alginate (APA) microcapsules, it has been confirmed that microencapsulated chromaffin cells have good analgesic effects. The immunoisolated effects of such microcapsule materials need to be evaluated. OBJECTIVE: This study aimed to investigate the immunological rejections of APA microencapsulated chromaffin cells transplanted into rat anterior chamber of eyes and tendon of feet, and to evaluate the immunoisolated effect of microencapsulation.DESIGN: A randomized controlled animal experiment. SETTING: Department of Anesthesiology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology.MATERIALS: Forty-eight female SD rats, with the age of 3 months, were provided by the Laboratory Animal Center, Tongji Medical College, Huazhong University of Science and Technology. The protocol was carried out in accordance with ethical guidelines for the use and care of animals. Alginate and polylysine used in the experiment were the products of Sigma Company, USA. Microcapsule generator was gifted by Germany. METHODS: This study was performed at the Department of Anesthesiology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology from September 2002 to September 2003. Suprarenal medulla was taken from 6 healthy adult cadavers of brain death. After isolated, digested and cultured, suprarenal medulla was prepared into chromaffin cell suspension. Written informed consents were obtained from the family members of donors, and the protocol was given approval by the Ethics Committee of the hospital. Empty microcapsules and microencapsulated cells were prepared by APA. The 48 rats were randomly divided into the human chromaffin cell (HCC) group, the empty microcapsule group and the microencapsulated HCC (ME-HCC) group. In each group, there were two transplanted regions of anterior chamber of eyes and tendon of feet, with 8 rats used for each region. Each rat in the HCC group was perfused 2×1010 L-1 cell suspension into the anterior chamber of eyes and tendon of feet. Those in the empty microcapsule group and the ME-HCC group were perfused 100 empty capsules and ME-HCCs (100 microcapsules, 400-500 HCCs per microcapsule) into the same regions, respectively. MAIN OUTCOME MEASURES: On day 7 after transplantation, serum interleukin (IL)-2 level was determined by ELISA. Serum IgG and IgM levels were determined with a laser turbidimeter. On day 28 after transplantation, rat right eyeball and left feet were harvested, routinely sliced and stained by haematoxylin-eosin (HE). Histo-morphological structure was observed under a 40×light microscope. RESULTS: Forty-eight rats were included in the final analysis. Serum IL-2, IgG and IgM levels were significantly lower in the empty microcapsule group and ME-HCC group than in the HCC group (t=8.544-21.64, P < 0.01). A lot of lymphocyte and neutrophile infiltration could be found in the anterior chamber of eyes and tendon of feet of rats in the HCC group, but a little seen in that of the empty microcapsule group and ME-HCC group. CONCLUSION: APA microencapsulation has an effective immunoisolated effect on immunological rejection due to its good biocompatibility and mechanical stability.

Objective To investigate the early diagnosis and treatment of pelvic fracture with vaginal injury.Methods From January 2000 to July 2010,13 patients suffered from pelvic fracture with vaginal injury were treated in our hospital,whose average age was 31.7 years.According to the Tile classification,there were 4 cases of type B1,1 case of type B2,4 cases of type B3,3 cases of type C1,and 1 case of type C2.Emergency repair of vagina together with open reduction and internal fixation of pelvic fracture was performed in 3 patients.After the patients' condition became stable,5 patients with shock were treated with emergency repair of vagina together with primary external fixation of pelvic fracture.Prompt repair of vagina together with open reduction and internal fixation or primary external fixation of pelvic fracture was performed in 2 patients who underwent delayed diagnosis.Two cases of extensive pelvic abscess due to missed diagnosis of vaginal laceration were treated with debridement and external fixation of pelvic fracture,and reconstructions of vagina were performed after infection control.Results Twelve patients survived,and 1 patient died 6 h after admission.Eleven patients were followed up for 8 to 36 months (average,17 months).Among 9 patients who underwent one-stage repair of vagina,5 married patients had normal sexual life,1 suffered from pain during sexual intercourse,and 3 unmarried patients had normal menses.Two patients who underwent second-stage reconstruction of vagina suffered from pain during sexual intercourse.At final follow-up,the mean Majeed score was 82.2 (range,56 to 96),and the results were excellent in 6 cases,good in 3 cases,fair in 2 cases.Conclusion Vaginal injury should be highly suspected in females with anterior pelvic ring fracture.Early diagnosis and repair of vaginal injury is crucial to good clinical outcomes.Delayed diagnosis and treatment may lead to severe complications.

ObjectiveTo evaluate the consistency of color Doppler ultrasonography (CDFI) and digital subtraction angiography (DSA) in diagnosis of carotid artery stenosis or occlusion. MethodsThe agreement and disagreement between CDFI and DSA examination results in 215 cases with unilateral carotid artery stenosis or occlusion were studied. By reviewing the CDFI sonogram and DSA dynamic image, the reason of discrepancy between two imaging modalities was analyzed.ResultsThe agreement rate was 90.7% (195 cases) between first CDFI scan and DSA, while disagreement rate was 9.3%(20 cases). Thus CDFI and DSA showed a good consistency (Kappa=0.7731,P<0.01). After reviewing the CDFI sonogram and DSA dynamic image, the discrepancy was attributed to treatment response in10 cases (4.7%), imaging principle difference in 3 cases (1.4%) , and inconsistent physician diagnoses in 7 cases (3.2%). ConclusionIn diagnosis of extracranial carotid artery stenosis or occlusion, the results of CDFI and DSA were highly consistent . In inconsistent cases, the examination results should be viewed under comprehensive and complementary analysis.

ObjectiveTo investigate fecal diversion in the management of pelvic fractures associated with perineal injuries.MethodsThis retrospective study involved 27 patients of pelvic fractures associated with perineal injuries during April 2005 to April 2011.There were 23 males and 4 females,and the mean age was 32.9 years old (range,16-62 years old).Fractures type according to Tile classification:4 cases were type A,10 cases were type B,and 13 cases were type C.The pelvic external fixator and fecal diversion were selectively used.Results Of the 27 patients of pelvic fractures associated with perineal injuries,24survived.The overall mortality of pelvic fractures associated with perineal injuries in the present study was 11％.The survived 24 patients were totally reviewed clinically.The mean follow-up time of these patients was 10.9 months (range,4-42 months).Of those patients who underwent early fecal diversion (＜ 48 h),none experienced infectious completions.However,of those underwent non-early (＞48 h) fecal diversion (including those who did not undergo fecal diversion),four patients experienced infectious completions.Fisher's exact test was used to compare the infection rate of these two groups.And the result of Fisher's exact test demonstrated that those patients who underwent early (＜ 48 h) fecal diversion and non-early (＞48 h) fecal diversion (including those who did not undergo fecal diversion).ConclusionStabilization of hemodynamic; selective fecal diversion; early stabilization of pelvic fracture are necessary for the emergency management of pelvic fractures associated with perineal injuries.Rectal injury and severe perineal injury without involvement of rectum should undergo fecal diversion.Early fecal diversion (＜ 48 h) could reduce the infection rate of pelvic fractures associated with perineal injuries.

Objective To understand the specimen sources,clinical characteristics,and antimicrobial resistance of Burkholderia cepacia (B .cepacia )isolated from infected patients in intensive care unit(ICU),so as to provide reference for guiding rational use of antimicrobial agents.Methods Clinical data of patients with B .cepacia infec-tion in an ICU between 2011 and 2014 were analyzed retrospectively,antimicrobial resistance of strains was ana-lyzed.Results A total of 267 B .cepacia strains were isolated,the major specimen sources were sputum (80.15%, n=214),blood(14.23%,n =38),and urine(3.37%,n =9).Antimicrobial susceptibility testing results revealed that B .cepacia had multiple resistance,and was naturally resistant to multiple clinically used antimicrobial agents, such as ampicillin,cefazolin,ampicillin/sulbactam,nitrofurantoin,and cefuroxime,resistant rates were all 100%;resistant rates to ceftazidime and levofloxacin were 4.12% and 3.00% respectively;resistant rate to compound sulfa-methoxazole had increased tendency(χ2 =5.885,P =0.015).Conclusion Isolation of B .cepacia in ICU increased year by year,antimicrobial resistance is serious,management and targeted monitoring of prevention and control of healthcare-associated infection should be strengthened,antimicrobial agents should be chosen according to antimi-crobial susceptibility testing results.

Objective To explore susceptibility of praziquantel(PQT) against Schistosoma japonicum in the repeated chemotherapy areas in Dongting Lake region of China. Methods Sixty mice were divided into two groups, and infected respectively by cercariae released from the infected snails which were collected from new and old endemic areas. After 5 weeks, the mice in each group were divided into control groups and treatment groups (PQT group). The mice in each PQT group were treated with a single oral dose of praziquantel (600 mg/kg). Three weeks post treatment, mice were dissected, and the number of adults, the stool eggs per gram (EPG), the liver EPG and the hatching rates were observed. Results The worm reduction rates of the PQT groups of new and old epidemic areas were 98.24% and 98.71% respectively, and the stool egg reduction rates 99.94% and 99.64%, the liver egg reduction rates 75.85% and 73.10%,and there were no significant differences between the new and old endemic areas. The stool hatching test was positive in the control groups, and negative in the PQT groups. Conclusion Susceptibility of praziquantel against Schistosoma japonicum does not decrease in repeated chemotherapy areas in Dongting Lake region.