Psoriasis is a kind of immune-mediated chronic inflammatory disease, characterized with skin and joints. This paper reviewed the effect of traditional Chinese medicine on thepsoriasis related cytokines, such as interleukin, interferong, tumor necrosis factorα, colony stimulating factor, chemokines and transforming factor, in order to provide theoretical reference for TCM treatment of psoriasis.

Objective To investigate and analyze the efficacy of intravenous levosimendan in the treatment of acute cardiac failure after cardiac surgery. Methods The study of the 80 cases of acute heart failure in patients undergoing cardiac surgery after treatment in March 2014 to March 2017, the patients were monitored in the treatment before and after treatment of 24 h heart rate, left ventricular ejection fraction, mean arterial pressure and central venous pressure and other related indicators. Results Of all patients, 58 survived after treatment, and 22 died during or after treatment. Compared with before treatment, after treatment of 24 h in left ventricular ejection fraction in patients, mean arterial pressure, central venous and changes in heart rate were significantly improved, data between the two groups had significant difference compared with statistical significance(P<0.05). In 8 patients, transient blood pressure reduction occurred during treatment, but symptoms disappeared after taking appropriate measures, and other patients had no more severe adverse reactions. Conclusion According to the method of intravenous levosimendan in treatment of acute heart failure in patients undergoing cardiac surgery after treatment can make the patient's cardiac function improved, has a significant effect on the prognosis of patients, should have a relatively high value.

The evaluation system of PBL teaching was constructed to develop PBL teaching in combination with the characteristics of medical courses. It covered students evaluation system, teacher's evaluation, and teaching pattern system in all aspects of teaching. The present study was carried out through repeated verification in many clinical medicine curriculum and many grades of students, and standardized assessment model, a more mature evaluation system, has been fully applied. All the indices of the evaluation system were comprehensive in contents, scientific, objective, manipulated easily and with good results, which is worth promoting the application of PBL teaching in the future.

Objective To investigate whether mixed venous-arterial carbon dioxide difference (Pv-aCO2) combined with passive leg raising (PLR) could better guide volume management for patients post off-pump coronary artery bypass grafting (OPCABG).Methods Eighty patients experienced OPCABG, and admitted to Tianjin Chest Hospital from June 1st to October 1st in 2016 were enrolled. They were randomly divided into two groups: observation group given Pv-aCO2 combined with PLR directed therapy and control group given central venous pressure (CVP) directed therapy, 40 cases in each group. The difference in body temperature (T), heart rate (HR), mean arterial pressure (MAP), CVP, oxygenation index (PaO2/FiO2), mixed venous oxygen saturation (SvO2), Pv-aCO2, blood lactate (Lac), fluid intake, scores of the vasoactive agents at 6 hours post-operation, sequential organ failure assessment (SOFA) of 24 hours, mechanical ventilation time, the length of intensive care unit (ICU) stay, and hospitalization time were compared. The correlation between Pv-aCO2 and cardiac index (CI), Pv-aCO2 and Lac were analyzed by Spearman analysis in observation group.Results The T, HR, MAP, CVP, PaO2/FiO2, SvO2 and Lac at 6 hours post-operation were higher than those at admission in two groups, and Pv-aCO2 were significantly decreased. The SvO2 and fluid intake in observation group were higher than those in control group [SvO2: 0.671±0.068 vs. 0.634±0.052, fluid intake (mL): 454±151 vs. 304±106, bothP < 0.05], Pv-aCO2, Lac and scores of the vasoactive agents were lower than those in control group [Pv-aCO2 (mmHg, 1 mmHg = 0.133 kPa): 6.1±1.8 vs. 7.0±1.8, Lac (mmol/L): 1.7±0.5 vs. 2.8±0.6, scores of the vasoactive agents: 3.18±1.01 vs. 4.48±1.50, allP < 0.05], mechanical ventilation time and the length of ICU stay were less than those in the control group (hours: 16.52±6.41 vs. 21.96±9.00, 45.51±9.36 vs. 51.76±13.66, bothP< 0.05). There was no significant difference in SOFA, hospitalization time between the two groups. There was negative correlation with Pv-aCO2 and CI (r = -0.752,P < 0.01), and no correlation with Pv-aCO2 and Lac (r = -0.154,P = 0.171).Conclusion Pv-aCO2 combined with PLR can better guide volume management in the patients post OPCABG, reduce the usage of vasoactive agents and decrease the mechanical ventilation time and the length of ICU stay.

OBJECTIVE:To explore the effect of propofol target-controlled infusion on extubation time in patients with ENT surgery under Narcotrend classification guidance. METHODS:52 patients with endotracheal intubation intravenous anesthesia and minimally invasive ENT surgery received target-controlled infusion for anesthesia induction and anesthesia. NI value, plasma concentration of propofol(cm),mean arterial pressure(MAP),pulse oxygen saturation(SpO2)before anesthesia and different time points in recovery period,the correlation of NI with propofol cm of all patients were recorded,and NI with propofol cm and time when extubation was omalysed. RESULTS:There were no significant differences in SpO2 before anesthesia and different time points in recovery period(P>0.05);MAP was significantly higher than before anesthesia at T3,MAP was significantly lower than before anesthesia at T0-T1,propofol cm was T0>T1>T2>T3>T4>T5,NI was significantly lower than before anesthesia at T0-T3, and T00.05). NI when extubation was(86.17±5.29),propofol cm was(0.96±0.31)μg/ml,and average extubation time was (8.26 ± 2.93) min. When extubation,NI showed negative correlation with propofol cm(r=-0.812);and decreased with the prolong of extubation time (r=-0.792);the predictive rates of NI and propofol cm's prediction awareness change in recovery period were 0.93 and 0.86. There were no obvious adverse reactions during treatment. CONCLUSIONS:Propofol target-controlled infusion under Narcotrend classification guidance can accurately predict the awareness change from no response to stimuli to shouting and opening eyes,has a high reference value on extubation time.

OBJECTIVE To investigate the patterns of catheter related infection in critically ill patients after cardiac surgery with prolonged central venous catheters. METHODS The materials of culture of catheter tip and subcutaneous segments in 166 critically ill patients after cardiac surgery with prolonged central venous catheters were reviewed. RESULTS The positive pathogenic bacteria ratio of catheter tip segments was 41.0% and the positive ratio of catheter subcutaneous segments was 47.0%.Catheterization longer than 18 days,body temperature higher than 38.5 ℃ and insertion sites of femoral veins were the variables associated with significantly increased risk of catheter related infection. CONCLUSIONS The positive pathogenic bacteria ratio of central venous catheters in critically ill patients after cardiac surgery with prolonged central venous catheters is high,more attention must be paid to catheter related infection,and efficacious interventions must be laid down.

Objective: To acquire the 3D point-cloud of the dental casts of intercuspal position and rebuild it in computer. Methods:Aspecial scanning method was used to acquire the point-cloud of dental cast by using the D.02-L-3D SCANNER and rebuild the model by computer. Results: The method could acquire a 3D model with high resolving power and clear-cut dental anatomic configuration for the dental casts of intercuspal position. Conclusion: This is a viable method of scanning with many advantages, such as precision, simplicity , high efficiency. It could satisfy the requirements of clinical practice, teaching and scientific research.

In order to provide morphological data and theoretical basis for pig-to-human hepatic xenotransplantation, the difference in morphological parameters and vessel wall structural factors between human and porcine hepatic portal vein was studied. From human subjects and pigs of varying ages, hepatic portal veins were collected, paraffin-embedded and cut into sections. The histological structures were stained with HE, and elastin, collagen and smooth muscles were stained with Weigert, Aniline blue and orange G, respectively. Morphological parameters and relative contents of structural components were determined under microscopy and by computer image analysis system, respectively. The results showed that histological structures of human and porcine hepatic portal vein wall were similar. Caliber, wall thickness, lumen and wall area in pigs increased with age, all in linear correlation to months. Morphological parameters of 6- month-old pigs were similar to those of human. In pigs, collagen content increased gradually with months, elastin content remained relatively stable, smooth muscle content reached the peak at the 3rd month, and collagen/elastin (C/E) rose gradually. The contents of collagen and elastin in porcine hepatic portal vein wall were lower, while the content of smooth muscle was higher than in human, and C/E at the 5th and 6th month was similar to that in human. It is concluded that morphological parameters and contents of structural components of porcine hepatic portal vein vary with age. At the 6 month, its caliber, wall thickness, lumen and wall area are similar to those of human. There are differences in contents of structural components between human and pigs. However, in terms of C/E, mechanic properties of pigs at the 5th and 6th month mimic those of human, hence inosculation is viable in xenotrans-plantation between pigs and human.
Collagen/*analysis ; Elastin/*analysis ; Image Processing, Computer-Assisted ; Liver Transplantation ; Muscle, Smooth, Vascular/cytology ; Portal Vein/*anatomy & histology ; Portal Vein/chemistry ; Swine ; Transplantation, Heterologous

Objective To label rat bone marrow mesenchymal stem cells with superparamagnetic iron oxide (SPIO) and to explore the tropism of BMSCs for hepatocellular carcinoma cells after transplantation in vivo. Methods BMSCs from bone marrow of Sprague-Dawly (SD) rats were cultured isolated and purified, Labeled BMSCs was achieved using Feridex. Twenty-four hepatocellular carcinoma models of SD rats were induced two weeks before tmnsplantation. The models were divided into three groups in random: the labeled BMSCs and unlabeled BMSCs were transplanted respectively into the rat's livers of experimental group (n = 12) and control group A(n =6) via spleens, and no transplant was done for control group B (n =6). MR imaging was performed to monitor the transplanted cells after 1,3,7,14 d using 1.5 T MR system. Signal intensity ratio (SI/SI*) between tumor and hepatic tissue on T_2 * WI were measured and compared by one-factor analysis of variance. After MR imaging, Prussian blue staining was performed. MR imaging findings were compared with histological sections. Results Prussian blue staining confirmed the labeling efficiency of BMSCs was above 90%. SI/SI* of experimental group before and 1, 3, 7, 14 d after transplantation were 3.18±0.21,1.98±0.20,2.38±0.28,2.70±0.25 and 3.16±0.24 respectively. Following transplantation of BMSCs, signal intensity decrease was found in hepatocellular carcinoma of experimental group(F =56.65,P <0.05) and low signal change decreased gradually and disappeared at two weeks after transplantation, while no remarkable low signal change was seen in the control group by T_2 * WI (P > 0.05). A large number of Prussian blue staining positive cells were found in hepatocellular carcinoma in experimental group. Histological section with Prussian blue staining had a good correlation with the signal intensity changes on MR images at different time. Conclusion BMSCs display significant tropism to hepatocellular carcinoma and may be an ideal gene therapy vehicle against hepatocellular carcinoma.

BACKGROUND: Due to the source of conspecific heart transplanted organ is limited and it becomes more and more deficient, and porcine cardiovascular system and haemodynamics are very similar to that of human being, therefore, domestic and foreign scholars have paid more attention on the heterogeneic heart transplantation from swine to human, and there are more and more basic studies about it.OBJECTIVE: To compare the zero-stress state of ascending aorta and pulmonary artery trunk between swine of different months and healthy persons, which provides necessary vascular tissue reconstruction basis for anastomosing vessel of heterogeneic heart transplantation from swine to human being.DESIGN: Open experiment.SETTING: Laboratory of Biomechanics, Yunyang Medical College.MATERIALS: This experiment was carried out at the Laboratory of Biomechanics, Yunyang Medical College from October 2001 to September 2002. Human heart specimens were chosen from 6 male adult corpses who had no visible manifestation of cardiovascular diseases, aged 18 to 30 years. Informed consents were obtained from all the relatives. Totally 42 conspecific swine, aged one month, were also chosen and divided into 7 groups, named as 1,2,3,4,5,6 and ＞ 6 months groups respectively, with 6 in each group. Swine were anesthetized at 1,2,3,4,5,6,＞ 6 months respectively and sacrificed in each group.METHODS: The corresponding ascending aorta and pulmonary artery trunk were dissected and isolated. Each arterial anterior wall was labeled in situ with coloring pen, and then artery was shifted into the oxygen-saturated Kreb's solution. Five isometric vascular rings were divided along the axial direction, then each vascular ring was cut open along the radial direction. Opening angle of each vascular ring at zerostress state was measured and recorded by computer 20 minutes later(The included angel formed through connecting the middle point of inner wall of open vascular plane and two end points of inner wall). The experiment was conducted at room temperature 20-30 ℃. All the procedures of vascular samples were performed within 24 hours after subjects died.MAIN OUTCOME MEASURES: Measuring results of opening angle of ascending aorta and pulmonary trunk at zero-stress state of swine at different months and human being.RESULTS: ①Comparison of measuring results of opening angle of ascending aorta and pulmonary trunk between swine at different months and human being: Opening angle of ascending aorta of human being increased from (100.4±12.8)°at proximal end to (152.8±18.6)°at distal end. Opening angle of swine at different months increased from about 68°at proximal end to about 130°at distal end; Opening angel of pulmonary artery trunk of human being did not changed significantly along axial direction, and opening angel of pulmonary artery trunk of swine at different months increased from about 65° at proximal end to about 125°at distal end. There was significant difference of opening angle of ascending aorta and pulmonary trunk at zero-stress state between human being and swine (P=0.028 ＜ 0.05).But the opening angle of ascending aorta of human being was similar at the second segment to at the fourth and fifth segments of swine of different ages; Opening angle of each segment of pulmonary artery trunk of human being was close to that of proximal end (first and second segments) ofpulmonary artery trunk of swine.② Comparison of measuring results of ascending aorta and pulmonary artery trunk at zero-stress state of swine at different months: Opening angle of ascending aorta and pulmonary artery trunk of swine did not changed with the increase of age (P=-0.063 ＞ 0.05).CONCLUSION: Opening angels of ascending aorta and pulmonary artery trunk at zero-stress state are close in some segments between human being and swine, suggesting that corresponding ascending aorta or pulmonary artery trunk can mutually anastomose in some segments in the heterogeneic heart transplantation from swine to human, and the effect of age is not significant in vascular reconstruction.