Objective To evaluate the effects of continuous pulmonary artery Perfusion with hypothermic oxygenated blood on lung function in children with congenital heart defects (CHD) and pulmonary hypertension(PH). Methods 20 patients diagnosed with CHD and PH were divided into group 1( perfused with oxygenated blood) and group 2 (conventional CPB). A canula was inserted into the main pulmonary artery for the perfusion with a rate of 15～30 ml?kg -1 ?min -1 . CPB was established as usual. The data of two groups including the oxygen concentration, airway pressure, blood gas analysis were recorded. At fixed times, blood sample was taken out for the measurement of the sICAM-1 and MDA. Results The concentration of sICAM-1 and MDA in group 1 was much lower than that in group 2 on 12 and 24 hours after surgery. Issues of the lung function including OI?A-aDOa_2 and airway pressure was significantly different between the two groups. Conclusion The study showed that the continuous pulmonary perfusion with oxygenated blood could preserve lung function in patients with CHD and PH.

Objective To explore the safety and clinical effect of combined laparoscopic-colonoscopy resection of colorectal tumor.Methods A total of 26 patients with early colorectal tumor was treated by combined laparoscopic-colonoscopy resection.To observe the postoperative complications,the mean operative time,mean intraoperative blood loss,mean time of gastrointestinal function recovery,and mean postoperative hospital stay were analyzed.Results All the 26 cases were operated successfully.The mean operative time was 60 ～ 162 (93.7 ± 22.5)min.The mean intraoperative blood loss was 15 ～ 120 (35.9 ± 24.2) ml.The mean time of gastrointestinal function recovery was 48 ～ 120(73.2 ± 14.5)h.The mean postoperative hospital stay was 5 ～ 13 (7.4 ± 1.8) d.No postoperative complications occurred,such as stomach leak,enterobrosis and intestinal obstruction.Follow up 6 ～ 12 months,there were no tumor residue and recurrence.Conclusions The combined laparoscopic-colonoscopy resection was located exactly,reasonable excision scope,minimally invasive,quick recovery and other advantages.It was worth of clinical application.

Objective To inhibit the gene expression of signal transducer and activator of transcription factor 1 (STAT1) in human esophageal squamous cell carcinoma cell line Eca109 by RNA interference and investigate its effect on the radiosensitivity and cell cycle of Eca109 cells.Methods Interference vector pSTAT1-shRNA for STAT1 gene was designed and constructed.After being mixed with lentiviral packaging plasmids,the interference vectors were used to transfected 293T cells.Virus solution was collected to infect ECA109 cells.Real-time PCR and Western blot were used to measure the mRNA and protein expression levels of STAT1 in Eca109 cells.Colony formation assay and flow cytometry were used to evaluate the radiosensitivity and cell cycle distribution of Eca109 cells.Results All Eca109 cells were divided into blank control group,transfection-positive group,and transfection-negative group.The transfection-positive group showed significantly lower mRNA and protein expression levels of STAT1 than the other two groups.The values of D0,SF2,and Dq of transfection-positive group were 2.03 Gy,0.83,and 1.20 Gy,respectively,lower than those of blank control group (2.98 Gy,0.88,and 1.39 Gy) and those of transfection-negative cells (3.02 Gy,0.88,and 1.57 Gy).At 12 h,24 h,and 48 h after 4 Gy-irradiation,the transfection-positive group showed significantly higher percentage of G0 + G1 than the blank control group and transfection-negative group (34.13％ vs 22.03％ vs 22.27％,F =7.56,P =0.023 ; 43.80％ vs 28.40％ vs28.63％,F=10.01,P=0.012;53.20％ vs42.2％ vs41.83％,F＝10.73,P=0.010) and significantly lower percentage of G2 + M than the blank control group and transfection-negative group (14.33％ vs 32.23％ vs 32.23％,F=16.86,P=0.003;27.73％ vs 43.53％ vs 44.00％,F=26.62,P=0.001;14.23％ vs27.97％ vs27.93％,F=40.34,P=0.000).Conclusions RNAinterference of STAT1 in Eca109 cells does not affect the proliferation ability of Eca109 cells,and it can increase the radiosensitivity of Eca109 cells probably by regulating cell cycle after irradiation.

Objective To summarize the experiences and results of completed surgical treatment for double outlet of right ventricle in 135 cases.Methods From May 2007 to May 2012,135 cases with double outlet of the right ventricle,males are 79 cases,female are 56 cases,age from 25 days to 12 years,weigh is 3.5-30.0 kg,underwent surgical procedure.There were 89 cases subaortic ventricular septal defect,33 cases doubly committed ventricular septal defect,repaired VSD with introventricular tunnel and relive right ventricle outflow tract directly with pericardial patch.There are 8 cases subpulmonary (Taussing-Bing)VSD,5 received Rastelli procedure,3 received arterial switch procedure and repaird VSD.There are 5 cases noncommited VSD,3 received Rastelli procedure,2 received arterial switch procedure and repaired VSD.Results Four cases died in the early postoperative period,with a mortality of 3.70％.1 case with subpulmonary VSD was performed arterial switch procedure and repaired VSD.1 case with noncommited VSD,2 cases with subaortic VSD(with pulmonary stenosis) were performed repaired VSD with introventricular tunnel and relive right ventricle outflow tract directly with pericardial patch.1 case with noncommited VSD was performed Rastelli procedure.Conclusion The anatomic type,especially the position of ventricular septal defect,correlates with surgical strategy significantly.

Objective To enhance the understanding of systemic lupus erythematosus (SLE) associated with intestinal pseudo-obstruction (IPO) and ureterohydronephrosis. Methods Ten cases of SLE with IPO and ureterohydronephrosis were analyzed retrospectively. Results IPO was the initial manifestation of SLE in three patients. Seven cases (7/9) had concurrent bilateral ureterohydronephrosis, 5 (5/9) had thickened bladder wall, and 6 cases (6/8) were associated with thickened gallbladder wall simultaneously. All cases were ANA positive and hypocomplementemia, 6 had positive anti-dsDNA, 5 had positive anti-SSA, 6 had positive anti-RNP, and 4 were ACA-IgG positive (4/7). IPO responded readily to high dose steroid therapy within one week in all patients. Conclusions The pathogenic mechanism of IPO is not fully understood. The coexistence of IPO, ureterohydronephrosis and thickened gallbladder wall probably suggests a visceral smooth muscle dysmotility. Early recognition of the syndrome is necessary for the initiation of the appropriate medical treatment and prevention of inappropriate surgical intervention.

OBJECTIVETo further demonstrate the cognition upon the prominent effect of Yiguanjian and Xiayuxue Decoction on the CCI4 induced rat model of chronic liver fibrosis which have been verified in the previous studies. From the viewpoint of detecting TCM syndrome by recipe used, through this cognition the pathological features of the liver injury model manifesting a syndrome of "Gan-yin deficiency with blood stasis obstructing collaterals" were further explored.

METHODSWistar rats were randomly divided into the normal group, the model group, and the three medicated groups. All rats, except those in the normal group, were made into chronic liver injury model by subcutaneously injecting CCI4 for 12 weeks. Medication for the three medicated groups began from the 9th week after modeling, with oral administering of Yiguanjian (YGJ, a recipe has been verified to be effective for liver injury and fibrosis), Liuwei Dihuang Decoction (LWDH, a recipe with effects similar to YGJ) and Yinchenhao Decoction (YCHD, a recipe functioned differently) respectively for four weeks. Rats were sacrificed at the end of the experiment, changes of hepatic function, liver pathology and hydroxyproline (Hyp) content in the liver tissue were detected, and contents of Afamin and mRNA expression of alpha-smooth muscle actin (alpha-SMA) in the liver tissue were assayed as well with Real-time PCR.

RESULTSAs compared with the normal group, the pathological figures of the chronic liver injury and fibrosis and hepatic function deterioration obviously appeared in the model rats, with the liver content of Hyp and alpha-SMA mRNA expression increased, and Afamin mRNA expression decreased significantly. In the YGJ treated group, the hepatic collagen hyperplasia and deteriorated hepatic function alleviated significantly after treatment, with content of Hyp significantly lowered, and mRNA expressions of alpha-SMA and Afamin restored to some extent (P < 0.05); the same effects on mRNA expressions of alpha-SMA and Afamin were shown in the LWDH treated group, also a decreasing trend of Hyp content (0.05 < P < 0.1), and a significant decreasing of alanine transaminase (ALT) activity was found; while in the YCHD treated group these pharmacological effects mentioned above were not observed at all.

CONCLUSIONThe pharmacological effects of LWDH and YGJ were similar to some degree, which gives support to the cognition that the feature of chronic liver injury model rat induced by CCI4 is attributable to yin-deficiency sydrome.

Animals ; Carbon Tetrachloride ; Diagnosis, Differential ; Drugs, Chinese Herbal ; therapeutic use ; Liver Cirrhosis, Experimental ; chemically induced ; drug therapy ; Male ; Medicine, Chinese Traditional ; methods ; Phytotherapy ; Random Allocation ; Rats ; Rats, Wistar ; Yin Deficiency ; diagnosis ; drug therapy

Objective To investigate the significance of ultrasonography in the examination of rheumatoid arthritis(RA). Methods The wrist joints of activated RA and wrist, metacarpophalangeal, proximal interphalangeal joints of remission of RA were determined, and the imaging features were analyzed. Results Patients with activated RA were divided into two groups. The bone erosion and sheath lesions were lower in the group of duration less than 1 year than those in the group of duration over 1 year (P < 0.01). The positive rate of ultrasound was higher than that of X-ray in bone erosion (P < 0.05). To patients with the remission of RA, the positive rate of ultrasound was higher than that of the physical examination in synovitis ( P < 0 . 05 ) . Conclusions For bone erosion, ultrasound is better than X-ray for patients with early RA. For synovitis, the sensitivity of ultrasonography is higher than the physical examination in remission for RA patients.

OBJECTIVETo observe the effects of Danggui Buxue Decoction (DBD) on liver fibrosis and to explore its mechanism related to hepatic lipid peroxidation in rats.

METHODSLiver fibrosis model was established in 28 rats by the combination of injecting carbon tetrachloride (CCl4) subcutaneously and feeding high lipid and low protein diet. The model rats were randomly divided into 2 groups, the model group (n = 14) and the treated group (n = 14). Besides, a normal group was set up with 10 normal rats. For the treated group, rats were administered with DBD at a dosage of 6 g/kg body weight once a day by gastrogavage starting from the day of modeling for 6 successive weeks and to the control group, equal volume of normal saline was administered instead. The inflammation and fatty degeneration in rat liver tissues were examined with HE staining; the collagen deposition observed with sirius red; the liver function including serum level of alanine transaminase (ALT), aspartate aminotransferase (AST), albumin (Alb) and total bilirubin (TBil) were determined using corresponding test kits; the hepatic lipid peroxidation indexes, including triglyceride (TG), superoxide dismutase (SOD) and malondialdehyde (MDA) were measured by biochemical methods; the hepatic hydroxyproline (Hyp) content was detected with Jamall's method and the expression of collagen type I was analyzed by Western blotting.

RESULTSCompared with those in the normal rats, serum ALT, AST, TBil level, TG and MDA content remarkablely increased, level of Alb and SOD activity decreased, and hepatic fatty degeneration and collagen pathological deposition in liver was more obvious in the model rats (all P < 0.05). While in the DBD group, the hepatic fatty degeneration and collagen deposition were significantly improved, changes of all the above-mentioned indexes were significantly reversed (P <0.05).

CONCLUSIONDBD has a good antagonist effect against experimental liver fibrosis, and its mechanism may be related to the anti-lipid peroxidation injury effect.

Animals ; Carbon Tetrachloride ; Collagen ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Lipid Peroxidation ; drug effects ; Liver ; drug effects ; metabolism ; pathology ; Liver Cirrhosis ; chemically induced ; drug therapy ; metabolism ; Male ; Phytotherapy ; Random Allocation ; Rats ; Rats, Wistar

Herb-induced liver injury （HILI） tends to have complex toxic material basis and toxic mechanism， which greatly affects the safety of traditional Chinese medicine. This article summarizes the main toxic components of Chinese herbal medicine causing liver injury and their mechanism of action. The toxic components of Chinese herbal medicine causing liver injury can be classified into two categories of drug-derived and non-drug-derived toxic components. Drug-derived toxic components mainly include alkaloids， terpenoids， anthraquinones， and phenylpropanoids， and their mechanism of action involves oxidative stress， apoptosis and necrosis， CYP450 enzymes， and genotoxicity. Non-drug-derived toxic components mainly include pesticide residues， sulfur dioxide residues， heavy metals， fungi， and plant growth regulators， and their mechanisms involve oxidative stress， apoptosis， metabolic disorders， and CYP450 enzymes. On this basis， this article further proposes the unsolved problems and research difficulties， in order to promote the basic research on the hepatotoxicity of traditional Chinese medicine.

Due to the diverse application forms of Chinese herbal medicine products， the wide range of users， and the complex conditions of medication in China， adverse events including herb-induced liver injury （HILI） occur frequently in recent years. In order to further understand HILI and standardize its risk management and prevention and treatment measures， this article discusses the risk management， clinical evaluation， prevention， and treatment of HILI based on related clinical research advances and experience in recent years. In the multiple links of traditional Chinese medicine including production and clinical application after marketing， the establishment of a comprehensive control system is of great importance for the prevention and treatment of HILI and other adverse events， involving product quality control， patient safety education， rational drug use by clinicians， regular monitoring， and graded and classified treatment， which provides a reference for the rational and safe clinical use of Chinese herbal medicine in the future.