There aren't official standards on syllabus,content,teaching materials and teaching methods of curriculum on three-year rehabilitation therapy specialty in the higher vocational education yet.This paper discussed the course of traditional rehabilitation therapy based on the characteristics,objectives and the actualities of traditional rehabilitation teaching in the vocational college.

ObjectiveLevosimendan,a new calcium ion sensitizer,is currently used in the treatment of heart failure and as an option for patients with injury to the left heart or at high risk for surgery.The study tried to evaluate the effects of levosimendan and ulinastain for protecting myocardium from ischemia-reperfusion (I/R) injury to the isolated immature rabbit hearts and investigate the possible mechanism.MethodsFifty New Zealand long-ear white immature rabbits were anesthetized and heparinized.Their hearts were rapidly removed and mounted on modified Langendorff apparatus.A left ventricle pressure monitoring line was inserted through the left atrial and mitral valve.The hearts were equilibrated with oxygenated K-H solution at 37℃ for 10 minutes.The rabbit hearts were randomly divided into 5 groups with 10 hearts in each group.Hearts in group C were perfused with K-H solution,in group U were perfused with ulinastain (50000 U/kg),in group LI were perfused with Levosimendan 0.1 μmol/L,in group L2 were perfused with Levosimendan 0.3 μmol/L,and in group L + U were perfused with Ulinastain (50 000 U/kg) and Levosimendan 0.1μmol/L.The hearts were arrested with St-Thomas solution for 30 min.Hearts in each group underwent 30 min-reperfusion with the same solutions after 30 min-global myocardial ischemia.Heart rate ( HR) Jeft ventricular pressure ( LVP) and LVdp/dtMax were monitored.Effluent from coronary sinus was collected at time of ischemia /reperfusion for measuring the concentration of TNF-α,IL-6,CK and cTnI.ResultsLVP and LVdp/dt in group L1,L2 and L + U were better than those in group C and U.But the heart rates in group L2 were higher than in other groups.Concentrations of CK,cTnI,TNF-α and IL-6 in the effluent from coronary sinus at 0、10 and 30 min of reperfusion were significantly lower in group L + U than in the other groups.ConclusionLevosimendan may have the similar effects with ulinastain in reducing the reperfusion injury to the immature myocardium.The protective effect of levosimendan (0.1 μmol/L) in combination with ulinastain (50 000 U/kg) was better than that of levosimendan or ulinastain alone.

Objective To evaluate the clinical value of percutaneous renal artery angiography and embolization of the renal artery pseudoaneurysms. Methods A retrospective analysis was made on 15 cases of postoperative urethral bleeding following urinary calculi surgery from January 2012 to February 2014, which were diagnosed of renal artery pseudoaneurysms via the renal artery angiography.Superselective catheter placement was carried out into the proximal of parent artery and the pseudoaneurysm was embolized by using a coil and gelatin sponge. Results Renal artery angiography clearly displayed pseudoaneurysms in the 15 cases, which were located in interlobular artery in 11 cases, arcuate artery in 3 cases, and minor interlobular artery in 1 case.Urethral bleeding was stopped after using gelatin sponge and spring coil embolization.Among them urethral bleeding recurred in 1 case after two days, and a second embolization was conducted.After the embolization, transient renal colic happened in 2 cases and a fever of 37.8-39.3 ℃lasting for 3-8 d was seen in 7 cases.Follow-ups for 3-24 months ( mean, 15 months) showed no renal dysfunction and urinary tract bleeding. Conclusion The transcatheter embolization and angiography can diagnose and treat renal artery pseudoaneurysms, with safe and effective outcomes.

Objective To evaluate clinical efficacy of single center intracavitary isolation procedure for treating elderly Standford type B aortic dissection.Methods 46 consecutive patients aged ≥ 65 years with Standford B aortic dissection,who underwent membrane stent intracavitary isolation treatment,in Tianjin Chest Hospital between 2010-2015 were enrolled in this study.All enrolled patients received examinations of echocardiography,contrast-enhanced CT,hepatic and renal functions,and the blood and urine routine tests before the procedure.After the procedure,the contrastenhanced CT of whole aorta was annually rechecked for all patients in the four time points of predischarge,3,6,12 months after operation.Deadline date of the follow up was December 2015.The outcomes of whole aorta CT and survival rate were analyzed.Results Successful stent implantation was performed in all patients (100 ％).Two (4.3 ％) patients died in the perioperative period,and one died due to the new aortic dissection at the last 8 months after operation.Overall survival rate was 89.1％(41 cases)during the follow-up period(95％CI:52.5-63.6 and 32.6-38.9,all P＜0.05).Conclusions The short and long term outcomes of intracavitary isolation procedure for treating Standford B aortic dissection are satisfactory in elderly patients.Perioperative blood pressure control,strict image measure,and carefully selecting the appropriate scaffold model are the keys for successful operation.

Rehabilitation evaluation was an important special basic course of healing cure specialty in the higher vocational college. It was a key to improve teaching quality of training students' occupation capacity. The establishment of aim, class teaching contents and outline, the preparation of teaching data, the innovation of teaching methods and measures, the reinforcement of practical teaching, and etc. were discussed in this paper. Considerations and experiences on the practical teaching reform and construction of rehabilitation evaluation courses were put forward in the higher vocational colleges.

Objective We want to study the therapeutic efficiency of autologous ADMSC transplantation in myocardial infarction.And we try to find out a good way to improve the therapeutic efficiency by using the combination of gene therapy and cell therapy.Anti-apoptotic protein XIAP was selected to fight against the ischemic environment of myocardic infaction.Methods ADMSC was isolated from rat inguinal fat tissue.ADMSC was cultivated with DMEM.XIAP experession plasmid was elertco-transduced to ADMSC.The anti-apototic function of XIAP was tested by serum stavation induced apotosis.The method of ligation of the left anterior descending artery was used to prepare the Myocardial infarction model.Then rats were randomly separated into three groups to receive direct epicardial injections of normal saline,or ADMSCs cell suspension or XIAP modified ADMSCs cell suspension at five sites in central zones of myocardial infarction and border zone.Cardiac function and the infarct size were evaluated 4 weeks after ADMSCs transplantation.Results West blotting suggest that,XIAP over-expression block serum starvation induced apotosis.It showed that there are significant statistic difference among XIAP modified ADMSC transplantation group,ADMSC transplantation group and control group 4 weeks after myocardial infarction (P ＜ 0.05).Left ventricular ejection fraction(LVEF) showed a significant improvement in ADMSCs transplantation group compared to control group (P ＜0.05).Left ventricular end systolic diameter(LVDs) and left ventricular end diastolic diameter(LVDd) of ADMSCs group were smaller than control group(P ＜ 0.05).The area of myocardial infarction was significantly reduced in the ADMSCs transplantation group compared to the saline group(P ＜0.05).Compared to ADMSCs transplantation group,effect of the XIAP modified ADMSC in rats with myocardial infarction is more obvious.The reduction of LVEF of XIAP modified ADMSCs group was signific antly lower(9％) than the ADMSCs group(16％) (P ＜ 0.01).Infarction area in XIAP modified ADMSCs group(3.26 ±0.95)％ was smaller than ADMSCs group(5.17 ±2.03)％ (P ＜0.05).Conclusion Autologus ADMSC transplantation is an efficient therapeutic tool in myocardial infarction therapy.Over expression of XIAP can partly inhibit lowserum induced apotosis of ADMSC in vitro,and it can improve left ventricular function better in vivo.Over expression XIAP of ADMSC can improve the therapeutic efficiency compare to ADMSC transplantation.

Objective To investigate the feasibility of genetically modified X-linked inhibitor of apoptosis protein (XIAP) of rat adipose-derived mesenchymal stem cells (ADSCs) by isolating and cultivating rat ADSCs in vitro. Methods ADSCs were isolated from rat groin fat pads by collagenaseⅠdigestion under sterile condition. ADSCs were passaged and amplified with 10%FBS DMEM. The multi-differentiation potential of ADSCs was verified by cultivated with differentiation medium. XIAP expression plasmid was transfected into ADSCs. The anti-apoptotic ability of XIAP transduction was detect-ed by Western blotting assay. Results ADSCs were mainly spindle-shaped and whirlpool-shaped arranged. Results of flow cytometry showed that there were higher expressions of CD29, CD44, CD90 and CD105 in ADSCs, which differentiated into lipocytes, chondrocytes and osteoblasts under specific conditions. There is XIAP gene modified adipose-derived mesenchy-mal stem cells Band in the corresponding molecular mass of PVDF membrane area. Conclusion ADSCs were isolated from rat subcutaneous fat pads and were easily cultivated, passaged and amplified. ADSCs can differentiate into osteoblasts, chon-drocytes and adipocytes under specific conditions, which are better resource for being used in cell therapy and tissue engi-neering.

Objective To evaluate results of surgical treatment for patients with acute type A aortic dissection using Sun’s operation and triple-branched stent graft. Methods According to the operation mode, thirty-three patients with type A aortic dissection were divided into Sun’s operation group (n=22) and triple branches aortic arch stent-graft placement op?eration (triple-branched) group (n=11). Preoperative examinations included cardiac ultrasound, aortic CT angiography (CTA), hepatic and renal functions and blood routine test in all patients. Intraoperative monitoring included the index about cardiopulmonary bypass and blood loss. The perioperative hepatic and renal functions and complications were also recorded. Survival and recovery rates were evaluated by follow-up between two groups of patients. Results There were six periopera?tive death in Sun’s group, and three patients died in triple-branched group. In triple-branched group, the intraoperative blood loss was significantly increased than that in Sun’s group [(3 586.4±2 926.8) mL vs. (2 630.5±1 821.2) mL, P<0.05]. Postoperative echocardiographic examinations revealed that the left ventricular size (LVEDd) and the aortic diameter were decreased while the left ventricular ejection fraction (LVEF) was elevated after surgery in Sun’s group [(50.9±6.9) mm vs. (55.0±7.5) mm,(28.2±1.6) mm vs. (48.8±11.0) mm, 0.620±0.031 vs. 0.469±0.104, P<0.05]. Whereas, only the aortic diame?ter was decreased after surgery in triple-branched group [(28.6±3.9) mm vs. (50.9±9.2) mm, P<0.05]. Kaplan-Meier surviv?al curve showed that five-year survival rate of Sun’s group was similar with that of triple-branched group (Log-rank χ2=0.095,P>0.05). At 5 year after operation, there were no significant differences in the recurrence of new aortic dissection, the incidence of cerebral infarction and mortality between Sun’s group and triple-branched group (P>0.05). Conclusion Sun’s operation can significantly decrease patient’s intraoperative blood loss and improve cardiac function. But its survival rate and long term results need advanced observation.

Objective To evaluate the short term outcome after mitral valve replacement with the Perimount bovine pericardial valve. Methods Eighty-eight patients underwent mitral valve replacement with the bovine pericardial valve in hospital were included in this study. Postoperative general condition including mortality and cerebral hemorrhage was observed. The hemodynamic and New York heart disease association (NYHA) heart function classification were recorded by Doppler echocardiograms before operation, postoperative 1 week, 3 months and 1 year after mitral valve replacement. Values of the different time points of NYHA, left atrial diameter (LA), left ventricular end diastolic diameter (LVDD), left ventricular end systolic diameter (LVSD), left ventricular ejection fraction (LVEF) and pulmonary artery pressure (PAP) were compared. The hemodynamic parameters were also compared including the peak cross valve pressure (PG), mean cross valve pressure (MG), peak cross valve velocity (PV) and effective orifice area (EOA) 1 week, 3 months and 1 year after surgery. Results There were two cases (2.3%) dead in one year (one died of cerebral hemorrhage and another one died of thromboembolism). There was 1 perivalvular leakage (1.2%). There was no endocarditis or structural valve deterioration. NYHA cardiac function was improved at postoperative 3 months and 1 year (P < 0.05). The values of LA, LVDD and PAP were significantly decreased at postoperative 1 week, 3 months and 1 year compared with those before operation (P<0.05). Values of LVSD and LVEF were significantly decreased at postoperative 1 week compared with those before operation (P<0.05). The value of LVEF was significantly increased at postoperative 3 months and 1 year (P<0.05). Compared with postoperative 1 week, the values of LA and LVEF were significantly increased at postoperative 3 months and 1 year (P < 0.05). There were no significant differences in PG, MG, PV and EOA between postoperative 1 week, 3 months and 1 year. Conclusion With the excellent performance of cardiac function recovery, left ventricular restoration and hemodynamic, the Perimount bovine pericardial valve remains a reliable choice as a mitral tissue valve.

Objective To study in vitro hydrodynamics of a pneumatic pulsatile ventricular assist device developed ex?clusively by China, and establish an animal model for the detection by the device. Methods The hydromechanics experi?ment was performed on an in vitro test loop using MEDOS-System to drive the ventricular assist device, and lycerl-water so?lution was used as circulating medium. The changes of afterload pressure and the output of the pump were monitored, and the impermeability and stability were also assessed after the experiment. Six adult dogs were used as the experimental animals. The device worked in the left heart assistance mode for 1 hour then the ventricular fibrillation was induced by potassium chloride, and then defibrillated after 5 min while the device remained working. The hemodynamics data were monitored con?secutively during the trial. Results The ventricular assist device worked stably and reliably during the hemodynamic exper?iment. The pump can generate more than 4 L/min flow against the afterload pressure of 100 mmHg. There were no significant changes in heart rate at different time points in experimental dogs after left ventricular assist. Comparison between after auxil?iary immediately and former auxiliary, the diastolic blood pressure of dogs increased 30 mmHg with the ventricular assist, and the diastolic pressure increased 19 mmHg. No obvious fluctuation in blood pressure was found during the auxiliary pro?cess. The diastolic blood pressure stayed at 60 mmHg when the heart was in ventricular fibrillation, and returned to normal after electrical defibrillation. Conclusion The ventricular assist device works stably in vitro test, and the pump can meet the need of adult’s ventricular assist. It is effective and security to dogs in short term. The effects of long-term use need to be future proved.