Objective:To investigate the effect of neonatal dog peripheral mononuclear cells on left ventricular function, haemodynamic, and infarcted size when transplanted into infarcted myocardium. Methods: Mononuclear cells from neonatal dogs were isolated and purified. The descending coronary arteries of adult dogs were ligated and the cells were injected into the border zone of the infarcted region. The control group was injected with non serum culture medium. Left ventricular pressure, d p /d t max , and power of LV were measured during and 30 d after operation. Echocardiogram(HP Sonos 5500, 2.5 MHz) were performed promptly and 30 d after operation to determine the changes of left ventricular function. Infarcted size, capillary density and cardiac muscle width were measured 30 d after operation. Results: LV pressure decreased in both groups, there were no marked differences between the 2 groups. LV pressure and d p /d t max of transplant group were greater than those of control group 30 d after operation. The systolic and diastolic functions were preserved after mononuclear cell transplantation. Infarcted sizes were lower and capillary density was greater in transplant group than those of control group. Conclusion: Transplantation of neonatal dog peripheral mononuclear cells into the infarcted regions can increase the capillary density and decrease infarcted size, preserving left ventricular function.

Objective To evaluate the effects of different doses of dexmedetomidine on atrioventricular node (AVN) conduction function in the healthy volunteers.Methods Sixteen healthy volunteers of both sexes,aged 18-30 yr,with body mass index of 19-26 kg/m2,were included in the study.Dexmedetomidine was infused in a loading dose of 1.0 μg/kg over 10 min,followed by an infusion of 0.5 μg · kg-1 · h 1 for 50 min (Dose Ⅰ);1-2 weeks later,dexmedetomidine was infused in a loading dose of 1.5 μg/kg over 10 min,followed by an infusion of 0.75 μg · kg-1 · h-1 for 50 min (Dose Ⅱ).Before infusion of dexmedetomidine (T0) and at 15 and 35 min of infusion (T1.2),AVN Wenckebach point,AVN 2 ∶ 1 block point,AVN relative refractory period (AVNRRP),and AVN effective refractory period (AVNERP) were measured.Results AVN Wenckebach point and AVN 2 ∶ 1 block point were significantly decreased,and AVNRRP and AVNERP were significantly prolonged at T1,2 compared with those at T0 (P＜0.05).Compared with Dose Ⅰ,AVN Wenckebach point at T2 and AVN 2 ∶ 1 block point at T1,2 were significantly decreased,and AVNRRP and AVNERP were significantly prolonged at T1,2 in the subjects receiving Dose Ⅱ] (P＜0.05).Conclusion Dexmedetomidine can inhibit AVN conduction function in the healthy volunteers,and the inhibitory effect is enhanced with the increasing doses.

Objective To investigate the impact of relevant factors in mechanical ventilation on intraabdominal pressure in patients with ALI/ARDS by continuous monitoring of intra-abdominal pressure.Methods A total of 116 ALI/ARDS patients treated with mechanical ventilation in ICU were enrolled in this study.Intra-abdominal pressure (IAP) was recorded continuously.Meanwhile ventilator parameters, arterial blood gas analysis, hemodynamic variables, and as well as the levels of IL-4, IL-8 and TNF-α in blood and bronchial alveolar lavage fluid (BALF) were determined and recorded.The detection of risk factors for intra-abdomen hypertension (IAH) were carried out using multivariate stepwise logistic regression.ROC curve analysis used to estimate the diagnostic performance of these parameters for IAH.Results The oxygenation index (PaO2/FiO2) in patients with IAH after 2 hours' mechanical ventilation was significantly lower than that in patients with normal intra-abdomen pressure (IAP) (P ＜ 0.01);PEEP and RR in mechanical ventilation were higher in IAH group (P ＜ 0.01 or P =0.001);Mean artery pressure (MAP), ejection time percent (ET), stroke volume (SV), cardiac index (CI) were lower in IAH group than those in normal IAP group (P ＜ 0.01);the levels of IL-4, IL-8 and TNF-α in blood and bronchial alveolar lavage fluid were higher in IAH group than those in normal IAP group (P ＜ 0.01);IAH patients have a higher mortality on 28 d (Log rank test, P =0.023).Poor oxygenation index (PaO2/ FiO2) after 2 hours' ventilation, high PEEP setting, low MAP, ET, SV, CI and elevated IL-4 in the BALF were resulted in increasing risk of IAH for ARDS patients under mechanical ventilation support.Conclusions The monitoring of intra-abdominal pressure should be emphasized for ALI/ARDS patients when mechanical ventilation was employed.PaO2/FiO2, SV and IL-4 in BALF might be the independent risk factors of IAH.

Objective To search specific biomarkers of pathogenic bacteria in patients with sepsis so as to guide early using rationally antibiotic treatment.Methods Prospective survey of 147 patients with sepsis in ICU was carried out from Jan 2012 to Mar 2015.When patients blood culture was positive, clinical data including age, gender, vital signs, blood and, urine routine examination, DIC, blood biochemistry, c-reactive protein (CRP), procalcitonin (PCT), microbial detection, etc were recorded.Cultured blood samples were from central venous catheter and peripheral vessel.ELISA method was employed to detect soluble toll-like receptor 2 ( sTLR2 ) and interleukin-8 ( IL-8 ) , and the Acute Physiology and Chronic Health Evaluation Ⅱ( APACHEⅡ score ) was calculated.The chi-square test and analysis of variance were performed where necessary.Receiver operating characteristic ( ROC ) curves were used to calculate cut-points ( CP ) and area under the curve ( AUC) .Results According to the results of blood culture, patients were divided into three groups:GP group [ gram-positive bacteria ( G+) group];GN group [ gram-negative bacteria ( G-) group];FG group ( fungi group) .There were no significantly statistical differences in age, APACHEⅡ score, vital signs and markers of inflammation among three groups (P>0.05).Gram negative pathogenic bacterium was the most common microbe.Compared with GN group, the level of sTLR2 in the GP group was obviously higher ( P=0.000); but there was no significant difference in sTLR2 level between GP group and FG group (P=0.187). The amount of (1, 3) -beta glucan in the FG group was significantly higher than that in the GP group ( P=0.000).The sTLR2 level in FG group was obviously higher than that in the GN group (P=0.000).There were no significantly statistical differences in PCT, CRP and IL-8 among the three groups (P>0.05).For the diagnosis of gram negative bacteria infection, sTLR2 area under the curve was 0.768, and the sensitivity and specificity were 88.90%and 59.60%, respectively and the best cut-off point was 8.083 pg/mL.Namely, the diagnosis of gram negative bacteria infection was less likely, when level of sTLR2 was higher than 8.083 pg/mL.The markers of PCT, CRP, (1, 3) -beta glucan and IL-8 were less valuable for the diagnosis of Gram negative bacteria infection because the area under the curve was less than 0.5.Conclusions The combination of inflammatory indicators such as sTLR2 and (1, 3) -beta glucan etc, can imply the kind of pathogenic microorganisms partly.

Objective To evaluate the effect of dexmedetomidine on heart rate (HR) of rabbits through in vitro and in vivo experiments, and investigate the mechanism by which dexmedetomidine lowered HR.Methods In vitro experiment Healthy adult rabbits of both sexes, weighing 2.0-2.5 kg, aged 8-10 weeks, were studied.The 24 isolated hearts passively perfused in a Langendorff apparatus were randomly divided into 3 groups (n =8 each) using a random number table: control group (group C) , and dexmedetomidine 3 and 30 ng/ml groups (D1 and D2 groups).The isolated hearts were continuously perfused with K-H solution for 45 min in group C.After 15 min of equilibration, the isolated hearts were perfused for 30 min with K-H solution containing dexmedetomidine 3 and 30 ng/ml in D1 and D2 groups, respectively.At 15 min of equilibration, and at 15 and 30 min of perfusion with K-H solution containing dexmedetomidine, HR and left ventricular systolic pressure (LVSP) were recorded.In vivo experiment Twenty-five healthy adult rabbits of both sexes, weighing 2.0-2.5 kg, aged 8-10 weeks, were randomly divided into 5 groups (n=5 each) using a random number table: dexmedetomidine 3, 6, 9, 12, and 15 μg/kg groups (D3, D6, D9, D12, D15groups), to receive the corresponding doses of dexmedetomidine which was intravenously infused over 10 min.HR and mean arterial pressure were monitored and recorded before administration (T0) , and at 15 and 40 min after administration (T1,2).The correlation between doses of dexmedetomidine and change rate of HR was tested by Spearman correlation analysis.Results In vitro experiment Compared with group C, no significant changes were found in HR and LVSP at each time point in D1 and D2 groups (P＞0.05).In vivo experiment Compared with those at T0 , HR at T1 in D6 and D9 groups, HR at T1,2 in D12 and D15 groups, and mean arterial pressure at T1,2in D6, D9, and D12 groups were significantly decreased (P＜0.05) , and no significant change was found in HR at each time point in group D3 (P＞0.05).The correlation coefficient between doses of dexmedetomidine and change rate of HR was 0.944 (P＜0.05).Conclusion The mechanism by which dexmedetomidine lowers HR of rabbits is not related to direct inhibition of sinoatrial nodes, but associated with the balance of autonomic nervous system.

Pulse waves contain abundant physiological and pathological information of human body. Research of the relationship between pulse wave and human cardiovascular physiological parameters can not only help clinical diagnosis and treatment of cardiovascular diseases, but also contribute to develop many new medical instruments. Based on the traditional double elastic cavity model, the human cardiovascular system was established by using the electric network model in this paper. The change of wall pressure and blood flow in artery was simulated. And the influence of the peripheral resistance and vessel compliance to the distribution of blood flow in artery was analyzed. The simulation results were compared with the clinical monitoring results to predict the physiological and pathological state of human body. The result showed that the simulation waveform of arterial wall pressure and blood flow was stabile after the second cardiac cycle. With the increasing of peripheral resistance, the systolic blood pressure of artery increased, the diastolic blood pressure had no significant change, and the pulse pressure of artery increased gradually. With the decreasing of vessel compliance, the vasoactivity became worse and the pulse pressure increased correspondingly. The simulation results were consistent with the clinical monitoring results. The increasing of peripheral resistance and decreasing of vascular compliance indicated that the incidence of hypertension and atherosclerosis was increased.
Aorta ; Arteries ; physiology ; Atherosclerosis ; Blood Pressure ; Cardiovascular Diseases ; Electricity ; Heart ; physiology ; Hemodynamics ; Humans ; Hypertension ; Models, Cardiovascular ; Vascular Resistance

Objective To evaluate the efficacy and safety of rhTPO (recombinant human thromobopoietin) employed for the treatment of sepsis-associated thrombocytopenia. Method There were 47 patients with sepsis-associaiod thrombocytopcnia eligible for the prospective, randomized (random number) and controlled clinical study from January 2009 to November 2009 in ICU of the Tianjin First center Hospital. According to the principle of minimum distribution imbalance index, these patients were randomly divided into the rhTPO group (n = 21) and the IVIG (intravenous immunoglobulin) control group (n = 22). In the rhTPO group, rhTPO was given subcutaneously to patients in a dose of 300 U/kg/d for 2 ～ 8 d, and in the IVIG control group, IVIG was used instead of rhTPO in a dose of 400 mg/kg/d for 5 days. Laboratory tests included blood routine examination, hepatic function, kidney function, coagulation function. The amount of blood products used, bleeding events, the days of ICU and hospital stay, total therapy cost and 28-day mortality were compared between two groups. Results The maximal platelet count in the rhTPO group was significantly higer than that in the contral group (t = 2.21, P =0.032). The mean value of difference between minimal and maximal platelet counts in the rhTPO group was much higher than that in the control group (t =7.40, P ＜0. 001). The average platelet count was no statistical difference between two groups before treatment (t =0. 458, P ＞ 0.05), but the average platelet counts in the rhTPO group were significantly higer than those in the contral group on the second and third day after treatment(t = 2. 166 and t = 2. 132, P =0. 036 and P =0.041. There were no statistical differences in incidence of bleeding, length of ICU stay and mortality between two groups (χ2 =0.720, t =0.91 and χ2 =0.264, P ＞0.05) , but the amounts of plasma and platelet transfusion were significantly less in the rhTPO group than those in the control group (t = 2.038 and t =2.252, P=0.048 and P=0.030) and the medical cost was cut down significantly in rhTPO group (t = 16.93, P ＜ 0.001). There was no adverse reaction occurred during period of observation. Conclusions The rhTPO can significantly increase platelet count, and decrease the amount of blood transfused and the medical cost. The administration of rhTPO is safe and efficient for the treatment of sepsis-associated thrombocytopenia.

Object To observe the effects of coumarin (CM) and Verapamil (Ver) on contractivity and its relationship with Ca 2+ in isolated ileal smooth muscle of the rabbits. Methods The effects of CM and Ver were observed in three doses by routine experimental methods in isolated rabbit ileal. Results CM and Ver inhibited the contraction of isolated ileal smooth muscle induced by acetylcholine and CaCl 2. The responses were a concentration-dependent and non-competitive manner. CM and Ver were effective against the initial and sustained peak induced by acetylcholine. Conclusion CM has a calcium-antagonistic effect which is similar to that of Ver.

Aim To investigate the effects of TMCC on abnormal L-type calcium current (ICa,L) in rat ventric-ular cardiomyocytes during hypoxia-reoxygenation to find out the mechanism of antiarrhythmic effect. Methods Whole-cell patch clamp was used to record ICa,L in the ventricular cardiomyocytes during hypoxia-reoxygenation in rat under amiodarone and different concentrations of TMCC. Results In hypoxia-reoxy-genation model, peak ICa,L increased from ( 3. 35 ± 0. 50 ) pA/pF to ( 5. 69 ± 0. 25 ) pA/pF ( n =6 , P <0. 01 ) , which was restored to ( 5. 28 ± 0. 18 ) pA/pF (n=6, P>0. 05),(4. 41 ± 0. 22) pA/pF, (3. 82 ± 0. 21)pA/pF(n=6, P<0. 01) by TMCC(100, 200, 400 μmol·L-1 ) and amidodarone 24. 24 μmol·L-1 restored peak ICa,L to(3. 66 ± 0. 27)pA/pF (n=6,P<0. 01 ) . Compared to control group, hypoxia-reoxy-genation turned ICa,L steady-state activation curves to left and inactivation curves to right, which quickened activation and slowed inactivation, TMCC ( 200, 400μmol · L-1 ) and amiodarone could restore the left shift activation curves and right shift inactivation curves. Conclusion TMCC can concentration-de-pendently restore the increase of calcium current due to hypoxia-reoxygenation by promoting inactivation process and inhibiting activation process, and the effect is equal to that of amiodarone. TMCC blocks ICa,L of the ventricular cardiomyocytes, which may be one of its antiarrhythmic mechanisms.

Yinchuan city began since January 1,201 5 to implement the“Disease scoring settlement under total budget”for hospitalization cost settlement.The new settlement method impels the hospitals to strengthen internal management,strengthen cost control,implement clinical pathway,strengthen the construction of hospital informationization,and standardize the hospital medical information upload.This paper covered the policy background and hospital internal management requirements,as well as hospital response measures,for reference of government healthcare authorities in the formulation of policy specific measures,and for the hospital’s medical insurance management department to adjust management mode and work flow,in order to better respond to and implement the policy.