Objective To investigate the changes in atrial tissue and atrial myocytes as a result of chronic atrial fibrillation (AF) in humans. Methods Twenty patients with rheumatic heart disease were divided into chronic atrial fibrillation group (n=10) and non-fibrillation group (n=10). Tissue specimens harvested from the atrial appendage were studied with light and electron microscopy. Results The content of atrial connective tissue in the fibrillation group (26.7?7.2) was significantly higher than that in non-fibrillation group (12.4?5.9) (P

Objective To study the relationship between intracellular calcium concentration of atrial myocytes and atrial fibrillation (AF) in humans. Methods Atrial myocytes were isolated from right atrial appendages of rheumatic heart disease (RHD) patients with or without AF, and also isolated from that of congenital heart disease (CHD) patients with sinus rhythm. Intracellular Ca 2+ concentration was measured with the fluoresent Ca 2+ indicator Fluo-3 and laser scanning confocal microscopy. Results Intracellular Ca 2+ concentration of RHD patients with AF was significantly higher than that of non-AF RHD patients [(517?98) nmol/L vs (262?65) nmol/L, P

Objective To assess the effects of Guanxinshutong capsule(GXST)on protection of left ventricular(LV)function after acute myocardial infarction(AMI)in rats.Methods Twenty-eight male Sprague Dawley rats were randomized to Model group,Drug group and Sham-operated group,with acute myocardial infarction(AMI)achieved by ligating coronary artery in Model and Drug groups.From one week before surgery to four weeks after surgery,GXST for Drug group(1.5 g/kg,2 times/day)or saline for Model and Sham-operated groups was administered via direct gastric gavage.After four weeks of treatment following surgery,measurement of LV function,pathohistological observation and analysis were performed.Results Compared with rats in the Model group,LV systolic pressure(LVSP)[(97.7 ± 9.0)mm Hg (1 mm Hg =0.133 kPa)vs(85.9 ±9.4)mm Hg],the maximum rising rate of LV pressure(+ dp/dtmax)[(4810.2 ± 595.0)mm Hg/s vs(3786.2 ± 723.0)mm Hg/s]and the maximum dropping rate of LV pressure(-dp/dtmax)[(3781.6 ±573.6)mm Hg/s vs(2774.4 ±633.5)mm Hg/s]in the Drug group were significantly increased,while LV end-diastolic pressure(LVEDP)[(10.3 ± 0.7)mm Hg vs(12.7 ±2.4)mm Hg]in the Drug group was significantly decreased(all P ＜ 0.05).Myocardial pathohistological morphology was improved in the Drug group with fibrosis alleviated[(5.13 ± 1.37)％ vs(7.27 ±1.01)％]and infarct size reduced[(20.14 ± 8.49)％ vs(31.90 ± 4.98)％].Apoptosis index(AI)was decreased[(14.05 ± 4.04)％ vs(20.87 ± 6.03)％]and vessel density was significantly increased by 1.48-fold in the Drug group(all P ＜ 0.05).Conclusions GXST is effective in protecting LV function after AMI in rats,which may be affect through increasing vessel density of infarction area,improving myocardial pathohistological morphology,alleviating fibrosis,reducing infarct size and decreasing AI.

To discuss treatment of wide-necked aneurysms.Methods Guglielmi detachable coil(GDC)after stent Pacement treat wide-necked aneurysm.Results Aneurysm was complete embolized,parent artery was intact.Conclusions Endovascular treatment of wide-necked aneurysms using and GDC is technically feasible.

Objective To study the changes of diamine oxidase (DAO )and intestinal fatty acid binding protein (I-FABP)levels in neonates with hypoxic-ischemic encephalopathy treated with selective brain hypothermia.Methods Collect a sample of 60newborns with moderate and severe hypoxic-ischemic encephalopathy who were hospitalized in the NICU of Matemal and Child Health Care Hospital of Baoding from June 2013to December 2014.The 60newborns were divided into two groups randomly:hypothermia group(n=30)and conventional treatment group(n=30).Selected 30cases hospitalized at the same period, except the related to the ischemia hypoxia and gastrointestinal dysfunction disease as the control group.The levels of serum levels of DAO and I-FABP were measured by ELISA on admission and 7days after treat-ment,respectively.And the score of gastrointestinal dysfunction were compared.Results Neither the levels of DAO and I-FABP in hypothermia group and conventional treatment group had statistical differences on ad-mission[DAO:(15.77±2.04)U/ml,(15.81±1.85)U/ml,P﹥0.05;I-FABP:(310.01±46.43)ng/L, (301.12±38.61)ng/L,P﹥0.05],but were higher than that in the control group [(7.65±0.74)U/ml, (51.65±6.91)ng/L].Seven days after treatment,both the levels of DAO and I-FABP of hypothermia group and conventional treatment group decreased [DAO:(7.88±1.87)U/ml,(12.51±1.53)U/ml;I-FABP:(59.16±6.17)ng/L,(121.31±21.54)ng/L],meanwhile,the variation of hypothermia group was more significant(P﹤0.05).The correlation of the plasma DAO and I-FABP levels and the score of gas-trointestinal dysfunction was significantly (r1=0.831,r2=0.827,P ﹤0.01).Conclusion Hypothermia treatment could effectively reduce the levels of DAO and I-FABP,thus improve the gastrointestinal function in some extent.

Background The protective effects against reperfusion injury of cardioprotective drugs have recently been evaluated and found to be inadequate. Guanxinshutong (GXST), a combination of the traditional herb and Mongolian medicine, is effective and safe in treating angina pectoris in clinical trials. We assess the cardioprotective effects of GXST against myocardial ischemia and reperfusion (MI/R) injury in rats and explore its possible mechanism. Methods Forty-five male Sprague Dawley rats were randomized into three groups: non-MI/R group (Sham, n = 15), MI/R group treated with vehicle (Control, n = 15) and MI/R group treated with GXST (Drug, n = 15). MI/R was induced by ligation of the left anterior descending coronary artery (LAD) for 30 minutes, followed by 2/24 hour reperfusion in the Control and Drug groups. In the Sham group, the LAD was exposed without occlusion. GXST powder (in the Drug group) or saline (in the Control and Sham groups) were administered via direct gastric gavage from 7 day prior to surgery. Blood samples were collected from the carotid artery (10 rats each group) after 2 hours of reperfusion, to determine the levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6) and intercellular adhesion molecule-1 (ICAM-1) using enzyme-linked immunosorbent assays. The animals were then sacrificed and the hearts were harvested for histopathology and western blot analysis. Infarct size was measured in the remaining five rats in each group after 24 hours reperfusion. Results GXST significantly decreased levels of TNF-α, IL-1β, IL-6, ICAM-1, apoptosis index (AI) and infarct size. GXST also obviously inhibited nuclear factor kappa B (NF-κB) activity when compared with the Control group (all P < 0.05). Conclusions GXST is effective in protecting the myocardium against MI/R injury in rats. Its possible cardioprotective mechanism involves inhibition of the inflammatory response and apoptosis following MI/R injury.

To determining the postmortem interval (PMI) through quantitative analysis of the DNA degradation of cell nucleus in human brain and spleen by using image analysis technique (IAT). The brain and spleen tissues from 32 cadavers with known PMI were collected, subjected to cell smear every 1 h within the first 5-36 h after death, stained by Feulgen-Van's staining, Three indices reflecting DNA in brain cells (astrocytes) and splenic lymphocytes, including integral optical density (IOD), average optical density (AOD), average gray (AG) were measured by employing the mage analysis instrument. The results showed that IOD and AOD declined and AG increased with the prolongation of dead time within 5-36 h. A correlation between the PMI and gray parameters (IOD, AOD and AG) was identified and the corresponding regression equation was obtained. The parameters (IOD, AOD and AG) were proved to be effective quantitative indicators for accurate estimation of PMI within 5-36 h after death.
Cell Nucleus/*pathology ; DNA Degradation, Necrotic ; Forensic Pathology ; Liver/*pathology ; Postmortem Changes ; Spleen/*pathology ; Time Factors

Objective This study aimed to explore the clinical characteristics and treatment of congenital central hypoventilation syndrome(CCHS),to raise awareness on the CCHS for early diagnosis and treatment.Methods The clinical data of 4 babies with CCHS were analyzed,all of the babies were repeated bruising,hypercapnia,and difficult-to-wean.After the relevant checks,we precluded the primary diseases of heart,lung and neuromuscular dysfunction that lead to low ventilation,and detected the major pathogenic genes,Phox2b of CCHS,refer to literature and diagnostic criteria of CCHS.Results Four babies all had typical clinical features of CCHS:enough ventilation when awake.But when they were asleep,their respiratory rate slowed down,hypoventilation,cyanosis and hypercapnia appeared,and they can not be awaked by hypercapnia and hypoxemia caused by hypoventilation.Genetic testing confirmed the presence of Phox2b mutations.Two infants were supported by non-invasive biphasic positive airway pressure(BiPAP),an infant was discharged home at 3 months of age with non-invasive BiPAP,and an infant was discharged home at 1 month of age.Both of them were monitored and treated at home,and showed normal development.Conclusion For babies who were repeated bruising,hypercapnia,and difficult-to-wean,but no primary diseases of heart,lung and neuromuscular dysfunction that lead to low ventilation,CCHS must be considered.Genetic testing of Phox2b can be used as an important diagnostic tool,and non-invasive BiPAP is one of the efficacious methods in the treatment of CCHS.

Objective To evaluate the safety and efficacy of bivalirudin in patients with acute myocardial infarction ( AMI) and diabetes undergoing primary percutaneous coronary intervention ( PCI) . Methods BRIGHT was a multicenter , randomized , controlled study which enrolled AMI patients underwent primary PCI in 83 Chinese centers between August 2012 and June 2013.All patients were randomly assigned to receive bivalirudin , heparin or heparin plus tirofiban. This study was a prespecified subgroup analysis of the BRIGHT study.A total of 465 diabetics in the BRIGHT study were included , consisted of 168 in the bivalirudin group , 137 in the heparin group and 160 in the heparin plus tirofiban group .Primary endpoint was net adverse clinical event ( NACE) at 30 days, which was defined as a composite of major adverse cardiac and cerebral events ( MACCE ) and any bleedings .Results The incidences of NACE at 30 days were significantly different among three arms ( Bivalirudin:10.1% vs.heparin:16.1% vs.Heparin plus tirofiban 20.6%, P=0.031 ) .Compared with heparin plus tirofiban , bivalirudin was associated with a significantly lower NACE rate (P<0.01).Bivalirudin treatment significantly reduced bleeding events at 30 days compared with heparin and heparin plus tirofiban ( 3.0% vs.7.3% vs.12.5%, P <0.01 ) .The 30-day incidences of MACCE and stent thrombosis were similar among the three groups ( P>0.05 ) . Conclusions The use of bivalirudin has dramatically reduced the rate of bleeding and did not increase the incidence of ischemic events compared with heparin and heparin plus tirofiban , indicating a better safety and efficacy profile of bivalirudin during primary PCI in patients with AMI and diabetes .

Objective To train medical students' competence of independent thinking and problem solving and to improve the quality of teaching.MethodsThe case-based PBL teaching model was introduced to teaching practice for 25 undergraduates majoring in medical laboratory.The teaching process included pre-class mobilization,question,self-study,discussion and summary.Effectiveness of teaching was evaluated with questionnaire.Results For these medical students,the enthusiasm of learning ( 83.3％ ),ability of self-learning and information seeking ( 79.2％ ),ability of discussing and problem solving ( 79.2％ ),ability of scientific thinking and clinical reasoning ( 79.2％ ) were significantly improved.Teaching satisfaction rate of case-based PBL teaching model was up to 95.8％.ConclusionBetter results of teaching were achieved and the case-based PBL teaching model is worth spreading.