Objective To discuss the treatment after orthotopic heart transplantation and the experiences in deal- ing with ins complications.Methods To summarize the postoperative monitoring and management of 9 cases of patients af- ter heart transplantation.Results All 9 cases got out of hospital after recovery with better postoperative cardiac function and life quality.Among of them acute rejection appeared in 1 case earlier and 2 cases later after operation.1 case died later and 1 case had acute renal failure earlier after operation.Conclusion The effective monitoring for immunity and the scientific use of immunosuppressive agents after orthotopie heart transplantation,the active prevention and treannent of complications and its consanguineous follow-up are key factors for improving the survival rate.

To find novel antihepatitis drugs, a series of nitrate-oleanolic acid (OA) hybrids (10a, 10b, 11a-11e and 12a-12c) were designed and synthesized on the basis of previous studies using OA as lead compound, which is widely found in natural plants and liver-specific metabolism. In the present study, ten novel NO-releasing derivatives of OA were synthesized by connecting nitrate to the OA-3-OH through varying lengths of linkers containing antioxidants which were designed to increase the ability of these target compounds to scavenge free radicals. The structures of these objective compounds were determined by IR, MS, 1H NMR and elemental analysis. Their protective effects on anti-Fas mediated HepG2 cell apoptosis were in vitro evaluated by LDH assay. Compound 12a is the most potent inhibitor. Its effect on anti-Fas mediated HepG2 cell apoptosis and amount of NO-releasing in vitro are similar to those of positive control NCX-1000.
Antioxidants ; chemistry ; Apoptosis ; drug effects ; Hep G2 Cells ; Humans ; Nitrates ; chemical synthesis ; chemistry ; pharmacology ; Nitric Oxide ; metabolism ; Nitric Oxide Donors ; chemistry ; Oleanolic Acid ; chemical synthesis ; chemistry ; pharmacology ; Structure-Activity Relationship ; Ursodeoxycholic Acid ; analogs & derivatives ; pharmacology

OBJECTIVETo observe and compare perioperative myocardial enzyme changes in 107 patients with congenital (CHD, n = 53), rheumatic (RHD, n = 40) and coronary artery (CAD, n = 14) diseases, and to find whether different diseases can affect the release and recovery of myocardial enzymes after heart operations.

METHODSOn the day before operation and the 1st, 3rd, 5th and the 8th day after operation, the venous blood was taken to measure the release of myocardial enzymes: aspartate aminotransferase (AST), creatine kinase (CK), MB isoenzyme of creatine kinase (CK-MB), lactate dehydrogenase (LDH) and LDH-1.

RESULTSAll the enzymes measured before operation in three groups were in the normal range; their release increased abruptly on the 1st day postoperatively to 2 - 15 times of those before operation; on the 3rd day, they recovered to some degrees, and on the 8th day they recovered to normal in all groups except LDH and LDH-1 in rh and CAD groups. Because the aortic cross-clamp time (CCT) had a good positive correlation to the release of myocardial enzymes, those patients whose CCT was over 60 minutes in three groups were compared revealing that the CCT was not different between three groups (P < 0.05). The release of CK, CK-MB and AST was significantly higher in CHD60 group than those in CHD60 and CAD60 groups, they recovered afterwards; while the release of DH and LDH-1 was higher in CAD60 group than those in CAD60 and in CHD60 groups from the 1st day to the 8th day postoperatively.

CONCLUSIONSThe release of all the 5 enzymes measured before operation was in normal range in selected CHD, RHD and CAD patients. The release peak and the recovery order of all enzymes were the same in three groups. The release of CK, CK-MB and AST was higher in CHD60 group than those in RHD60 and CAD60 groups on the 1st day. The release of LDH and LDH-1 was higher in RHD60 group than those in CHD60 and CAD60 groups from the 1st day to the 8th day postoperatively. The shorter the CCT is, the less the release of myocardial enzymes. Using the release of LDH and LDH-1 to evaluate the recovery of myocardial injury after open-heart operations was recommended.

Adolescent ; Adult ; Aspartate Aminotransferases ; blood ; Child ; Coronary Artery Bypass ; Coronary Artery Disease ; blood ; enzymology ; surgery ; Creatine Kinase ; blood ; Creatine Kinase, MB Form ; blood ; Female ; Heart Defects, Congenital ; blood ; enzymology ; surgery ; Humans ; Intraoperative Period ; Isoenzymes ; blood ; L-Lactate Dehydrogenase ; blood ; Male ; Middle Aged ; Myocardium ; enzymology ; pathology ; Rheumatic Heart Disease ; blood ; enzymology ; surgery ; Time Factors

Objective To investigate the effect of resveratrol on the expression of peroxisome proliferator activated re-ceptor γ coactivator-1α(PGC-1α)in skeletal muscle of rats with chronic obstructive pulmonary disease(COPD). Methods A total of 45 male Sprague Dawley rats were randomly divided into control group,model group and resveratrol group,15 rats in each group. The rats in the model group and resveratrol group were made COPD model through the intratracheal instillation of lipopolysaccharide and repeated smoke exposure,except the rats in the control group. From the 29th day of smoke exposure,the rats in the control group and model group were given 2 mL saline by gavage,once a day for 30 days;and the rats in the resvera-trol group were given 2 mL resveratrol solution by gavage(100 mg·kg - 1 ·d - 1 ),once a day for 30 days. After 30 days of con-tinuous gavage,the rats were sacrificed,then arterial blood and skeletal muscles were harvested. The level of tumor necrosis factor-α(TNF-α)in serum and skeletal muscle of rats was detected by enzyme linked immunosorbent assay. The expression of PGC-1α,nuclear respiratory factor 1(NRF1),mitochondrial transcription factor A(Tfam)and cytochrome C oxidase Ⅳ(COXⅣ)mRNA in skeletal muscle tissues of rats was determined by quantitative real-time polymerase chain reaction. The expres-sion of PGC-1α,NRF1,Tfam and COX Ⅳ protein was detected by Western blot. Results The level of TNF-α in serum and skeletal muscle tissues of rats in the model group and resveratrol group was significantly higher than that in the control group (P < 0. 01). The level of TNF-α in serum and skeletal muscle tissues of rats in the resveratrol group was significantly lower than that in the model group(P < 0. 01). The expression of PGC-1α,NRF1,Tfam,COX Ⅳ protein and mRNA in skeletal mus-cle tissues of rats in the resveratrol group and model group was significantly lower than that in the control group(P < 0. 01). The expression of PGC-1α,NRF1,Tfam,COX Ⅳ protein and mRNA in skeletal muscle tissues of rats in the resveratrol group was significantly higher than that in the model group(P < 0. 01,P < 0. 05). Conclusion Resveratrol can reduce the level of TNF-α in serum and skeletal muscle tissues of COPD rats,increase the expression of PGC-1α,thereby improving the mitochon-drial biosynthesis function.

OBJECTIVETo evaluate the value of human fatty acid binding protein (h-FABP) in predicting myocardial ischemia and injury in the perioperative period of cardiac surgery, we observed the dynamic changes of h-FABP in perioperative period of patients underwent coronary artery bypass grafting and ventricular septal defects repairing surgery, and evaluated the relationship of h-FABP and ischemia modified albumin (IMA), CK-MB, cTnI.

METHODSPatients underwent coronary artery bypass grafting (n=30) and ventricular septal defect repairing (n=30) surgery between February 2008 and December 2008 were included in this study. Venous blood sample was obtained at preoperative, aortic clamping, aortic unclamping of 10 min, 2 h, 6 h, 12 h, 24 h for the measurements of h-FABP, IMA, cTnI and CK-MB.

RESULTSh-FABP and IMA changed in the same way at various examined time points, h-FABP changes also paralleled cTnI and CK-MB changes, h-FABP peaked early during myocardial ischemia and injury and returned to baseline level at 2 h post myocardial ischemia and injury. Linear correlation analysis showed that the peak value of h-FABP was positively correlated with IMA, CK-MB and cTnI in both CABG group (r = 0.948, 0.964 and 0.961, P < 0.05) and in the VSD group (r = 0.986, 0.978 and 0.957).

CONCLUSIONSh-FABP is an early diagnostic parameter reflecting perioperative myocardial ischemia and injury in cardiac surgery. Quantitative h-FABP monitoring could predict the severity of myocardial ischemia and injury early during cardiac surgery.

Aged ; Albumins ; analysis ; Biomarkers ; blood ; Creatine Kinase, MB Form ; blood ; Fatty Acid-Binding Proteins ; blood ; Humans ; Middle Aged ; Myocardial Ischemia ; diagnosis ; surgery ; Myocardium ; metabolism ; Perioperative Period ; Predictive Value of Tests ; Thoracic Surgery ; Troponin I ; blood

Animals ; Cytoskeletal Proteins ; biosynthesis ; genetics ; Drugs, Chinese Herbal ; pharmacology ; Hepatocytes ; metabolism ; ultrastructure ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo observe the influence of combined injection with human interferon (hlFNgamma) and human insulin-link growth factor-1 (hIGF-1) on regeneration and fibrosis of skeletal muscle after acute contusion.

METHODSA standard contusion model was reproduced at the right gastrocnemius in 64 male mice of 7 to 12 weeks. All the mice were randomly divided into 4 groups, such as group A (injection with hIFNgamma), group B (injection with hIGF-1), group C (injection with hIGF-1 and hIFNgamma), and group D (injection with physiological saline as control). All injections were introduced on day 10 after injury at local injured gastrocnemius. Before intervention (7 d following injury), and 4 d, 18 d, 32 d after intervention, the local injured gastrocnemius were harvested from 4 mice of each group. Then the expression of MHC- II b and vimentin was detected by real time PCR and immunohistochemistry techniques.

RESULTS(1) At the each time following intervention, the expression of MHC-II b mRNA and protein in local injured muscle of group B and C were significantly higher than those of group A and D. (2) After intervention,the expression of vimentin mRNA and protein in local injured muscle of group A, group B, and group C were more inhibited than those of group D. The inhibition of vimentin expression in group A and C was significant.

CONCLUSIONIt is indicated that injection of hIGF-1 into the injured skeletal muscle following acute contusion could enhance muscle regeneration,and inhibit fibrosis to some extent. (2) It is identified that hIFNgamma injected into injured muscle has the effect of anti-fibrosis, which is more significant than that of hIGF-1. (3) Combined injection with hIGF-1 and hIFNgamma could improve muscle regeneration and inhibit fibrosis simultaneously, and promote the healing of injured muscle.

Animals ; Immunohistochemistry ; Injections ; Insulin-Like Growth Factor I ; administration & dosage ; Interferon-gamma ; administration & dosage ; Male ; Mice ; Mice, Inbred C3H ; Muscle, Skeletal ; injuries ; Myosin Heavy Chains ; analysis ; genetics ; Polymerase Chain Reaction ; RNA, Messenger ; analysis ; Transforming Growth Factor beta1 ; analysis ; Vimentin ; analysis ; genetics ; Wound Healing ; drug effects

OBJECTIVETo evaluate the efficacy and safety of Capsule metadoxine in the treatment of alcoholic liver disease.

METHODSA randomized double blind multicenter placebo-controlled clinical study was performed to evaluate the therapeutic effectiveness and safety of capsule metadoxine. Patients in metadoxine group received capsule metadoxine 500mg tid po. Patients in placebo group received placebo 2 pillows tid po. The treatment duration was 6 weeks. Patients were followed up 2 weeks after the treatment. Patients were visited once every 3 weeks during the treatment period. Clinical symptoms and liver function were evaluated in all the patients before treatment, at week 3, week 6 and 2 weeks after therapy. CT scan was done in some patients before treatment and at the end point of therapy.

RESULTS254 patients were recruited in the study, 126 in metadoxine group and 128 in placebo group. Median ALT, AST, GGT level in metadoxine group were decreased from 80.0 U/L, 59.2 U/L, 123.0 U/L (before treatment) to 41.1 U/L, 36.0 U/L, 57.0 U/L (after 6 weeks therapy). The improvement in liver function was more significant in metadoxine group than in placebo group (P less than 0.05). For the patients who stopped drinking during the study, the total effective rate of improvement in liver function was 82.8% in metadoxine group, much higher than that in placebo group (55.7% , P=0.0000). For the patients who did not stop drinking during the study, the total effective rate of improvement in liver function was 65.4% in metadoxine group, which is not significantly higher than that in placebo group (44.8%, P=0.1767). The CT value ratio of liver to spleen was significantly improved in metadoxine group (P=0.0023), and there was no significant difference between the two groups (P=0.6293). The rate of adverse was 1.6% in both of groups.

CONCLUSIONCapsule metadoxine is an effective and safe treatment for alcoholic liver disease.

Administration, Oral ; Adult ; Aged ; Alanine Transaminase ; blood ; Alcohol Deterrents ; administration & dosage ; therapeutic use ; Analysis of Variance ; Aspartate Aminotransferases ; blood ; Capsules ; Double-Blind Method ; Drug Combinations ; Fatty Liver, Alcoholic ; blood ; drug therapy ; pathology ; Female ; Follow-Up Studies ; Humans ; Liver ; diagnostic imaging ; pathology ; Liver Diseases, Alcoholic ; blood ; drug therapy ; pathology ; Liver Function Tests ; Male ; Middle Aged ; Pyridoxine ; administration & dosage ; therapeutic use ; Pyrrolidonecarboxylic Acid ; administration & dosage ; therapeutic use ; Treatment Outcome ; Ultrasonography ; Young Adult ; gamma-Glutamyltransferase ; blood

BACKGROUNDAspirin can inhibit inflammatory reactions and platelet aggregation, but little is known about the effects of the combination of aspirin plus clopidogrel, a new antiplatelet agent, on inflammation. The purpose of this study was to determine whether aspirin plus clopidogrel can further suppress inflammation in patients with non-ST-segment elevation acute coronary syndrome (NSTEACS).

METHODSOne hundred and fifteen patients with NSTEACS were randomized into two groups: group A (aspirin alone, n =58) and group B (aspirin plus clopidogrel, n =57). Patients in group A received a loading dose of 300 mg aspirin, then 100 mg per day. The patients in group B received a loading dose of 300 mg aspirin and 300 mg clopidogrel, then 100 mg aspirin and 75 mg clopidogrel per day. Serum high sensitivity C-reactive protein (hs-CRP) and tumor necrosis factor-alpha (TNF-alpha) were measured in all patients at baseline prior to any drug treatment after admission, and at 7 and 30 days after beginning drug treatment. Thirty healthy volunteers on no medications were enrolled as controls (group C).

RESULTSBaseline levels of hs-CRP and TNF-alpha in group A and group B were significantly higher than those in group C. Seven days after administration, the levels of hs-CRP in both group A and group B decreased significantly [Group A: (6.15 +/- 1.39) mg/L vs (9.18 +/- 1.62) mg/L, P <0.01; Group B:(4.99 +/- 1.62) mg/L vs (10.29 +/- 1.47) mg/L, P <0.01]. Similarly, levels of TNF- alpha in both groups decreased at 7 days compared to baseline [Group A: (90.99 +/- 28.91) pg/ml vs (117.20 +/- 37.13) pg/ml, P <0.01; Group B: (74.32 +/- 21.83) pg/ml vs (115.27 +/- 32.11) pg/ml, P <0.01]. Thirty days after administration, the levels of hs-CRP in both group A and group B decreased further to (3.49 +/- 1.53) mg/L, and (2.40 +/- 1.17) mg/L respectively (P <0.01 for both comparisons). Levels of TNF-alpha in groups A and B also decreased significantly between 7 and 30 days, to 63.28 +/- 29.01 pg/ml (group A) and (43.95 +/- 17.10) pg/ml (group B; P <0.01 for both comparisons). Significantly lower levels of hs-CRP and TNF-alpha were observed in group B compared to Group A at thirty days after initiating drug treatment (P <0.05).

CONCLUSIONSAspirin plus clopidogrel treatment reduced levels of serum hs-CRP and TNF-alpha in patients with NSTEACS significantly more than aspirin alone. Because both aspirin and clopidogrel produce important anti-inflammatory effects, these results suggest the possibility that long-term treatment with aspirin plus clopidogrel may produce greater clinical benefits compared to treatment with aspirin alone.

Adult ; Aged ; Angina, Unstable ; blood ; physiopathology ; Aspirin ; administration & dosage ; C-Reactive Protein ; analysis ; Drug Therapy, Combination ; Electrocardiography ; Female ; Humans ; Inflammation ; drug therapy ; Male ; Middle Aged ; Myocardial Infarction ; blood ; physiopathology ; Ticlopidine ; administration & dosage ; analogs & derivatives ; Tumor Necrosis Factor-alpha ; analysis

BACKGROUND: The main factors associated with weight loss in patients with COPD are not well known. Since chronic inflammation and oxidative stress play a major pathogenic role in COPD, these factors may be responsible for the patients' weight loss. Therefore, this study measured the body mass index (BMI) in COPD patients and evaluated the variables, such as systemic inflammatory marker, oxidative stress and lung function, that correlate with the BMI. METHOD: The stable COPD patients (M:F=49:4, mean age=68.25+/-6.32) were divided into the lower (<18.5), normal (18.5-25) and higher (>25) BMI group. The severity of the airway obstruction was evaluated by measuring the FEV1. The serum IL-6 and TNF-alpha levels were measured to determine the degree of systemic inflammation, and the carbonyl protein and 8-iso-prostaglandin F2alpha level was measured to determine the level of oxidative stress. Each value in the COPD patients and normal control was compared with the BMI. RESULTS: 1) Serum 8-iso-prostaglandin F2alpha in COPD patients was significantly higher (456.08+/-574.12 pg/ml) than that in normal control (264.74+/-143.15 pg/ml) (p<0.05). However, there were no significant differences in the serum IL-6, TNF-alpha, carbonyl protein between the COPD patients and normal controls. 2). In the COPD patients, the FEV1 of the lower BMI group was significantly lower (0.93+/-0.25L) than that of the normal BMI (1.34+/-0.52L) and higher BMI groups (1.72+/-0.41L) (p<0.05). The lower FEV1 was significantly associated with a lower BMI in COPD patients (p=0.002, r=0.42). The BMI of very severe COPD patients was significantly lower (19.8+/-2.57) than that of the patients with moderate COPD (22.6+/-3.14) (p<0.05). 3). There were no significant differences in the serum IL-6, TNF-alpha, carbonyl protein and 8-iso-prostaglandin F2alpha according to the BMI in the COPD patients. CONCLUSION: The severity of the airway obstruction, not the systemic inflammatory markers and oxidative stress, might be associated with the BMI in stable COPD patients. Further study will be needed to determine the factors associated with the decrease in the BMI of COPD patients.
Airway Obstruction ; Body Mass Index* ; Humans ; Inflammation ; Interleukin-6 ; Lung ; Oxidative Stress* ; Pulmonary Disease, Chronic Obstructive* ; Tumor Necrosis Factor-alpha ; Weight Loss