Objective To assess the therapeutic ef fects of Compound Zaofan Pill (CZP) on aplastic anemia (AA). Methods A prospective randomized control trial was carried out. Thirty_six cases of AA treated with C ZP combined with stanozolol were allocated to Group A and other 30 cases treated with levamisole, prednisone, stanozolol and folacin served as Group B. Hemoglob in content, leukocyte and platelet counts were detected. Results The total e ffective rate was higher in G roup A (86%) than that in Group B ( 53.5% ), the differences bein g significant (P

Objective To observe the therapeutic effect of Xuemeian Capsule for intermission of acute leukemia with bone marrow arrest after chemotherapy.Methods A prospective trial was carried out in 136 cases of acute leukemia after chemotherapy. The cases were randomly allocated to two groups.Group A(n=86)was treated with Xuemeian Capsule and routine western medicine and Group B(n=50)with routine western medicine.The changes of hemoglobin,platelet and leukocyte and the hyperplasia of bone marrow were observed.Results The totally effective rate was 93% and 54% in Group A and Group B respectively,the difference being significant(P

Objective To investigate the therapeutic effects of retinal angiomatosis in differentclinical stages.To discuss the indication of vitrectomy for retinal hemangioblastoma. Methods TheclinicaI data of 22 cases(33 eyes)were retrospectively analyzed.The retinal hemangiomas were dividedinto 5 stages according to their degrees of development from simple angioma without vessel dilation tofeeder vessel dilation and intra-retinal exudates.local retinal detachment,massive retinal detachment andcomplication occurrence in proper order.The methods of treatment were laser photocoagulation,trans-scleral cryotherapy and vitrectomy. 13 eyes were treated with laser photocoagulation, 5 eyes withcryotherapy combined with laser and 11 eyes with vitrectomy.Tumor resection and silicone oil tamponadewas performed in 3 eyes during vitrectomy.The patients were followed up for 46 months on average.Visual acuity(VA),the condition of the hemangioma and retina was compared pre～and post-operationrespectively. Results In a11 13 eyes treated with laser phot.coagulation the hemangiomas regressed andthe retina remained attached.VA improved in 2 eyes,and remained unchanged in 11 eyes.Cryotherapycombined with laser photocoagulation was performed on 5 eyes. In this group,4 eyes'hemangiomasregressed and no new hemangiomas occurred,proliferative vitreous retinopathy and vitreous hemorrhagewas observed in 1 eye which vitrectomy was performed later.VA improved in 2 eyes,unchanged in 2 eyesand decreased in 1 eye.In the 11 eyes treated with vitreoretinal surgery,new hemangiomas was found in 1eye,exudative retinal detachment was caused by hemangiomas in 2 eyes,proliferative vitreous retinopathywas observed in 2 eyes.and the retina remained attached in 8 eyes.VA improved in 3 eyes,unimproved in3 eyes,and decreased in 5 eyes.In the 3 eyes with surgical resection of retinal hemangioma during vitrectomy,2 eyes'retina remained attached,1 eye had exudative retinal detachment and no new hemangiomas occurred.VA improved in 2 eyes and decreased in 1 eye. Conclusions Laser photocoagulation or combined with cryotherapy is effective in treating the hemangiomas in early stage.Vitreetomy is advisable for late stage of retinal angiomatosis,especially with vitreous hemorrhage,epiretinal membrane,proliferation and large scale of retinal detachment.Surgical resection of isolated large retinal hemangioblastoma may be useful for selected patients.

Objective To investigate the effects of Hep-A and He p-B on vascular endothelial growth factor (VEGF)-induced breakdown of blood-r etinal barrier. Methods The mice were subcutaneously injected vehicle, Hep-A or Hep-B 10 mg/kg twice a day for 5 days. Then, 1 ?l of 10 -6 mol/L VEGF were intravitreous injected. After 6 hours, 13.7?10 4 Bq /g 3H-mannital were injected intraperitoneally. The mice were sacrificed and the retinas, lungs, kidneys were removed and examined for radioactivity. The result were analyzed using SPSS software to calculate and compare retina/lung and et ina/kidney leakage ratio among groups of different treatment. Result The retina/lung and retina/kidney leakage ratio were 0.38?0.04 an d 0.21?0.03 respectively in normal mice; increased significantly to 1.05?0.11 and 0.46?0.04 respectively in model mice, both P

目的探讨高水平篮球运动员创伤性前交叉韧带损伤关节镜术后的疗效。方法1991～1998年,国家级篮球运动员前交叉韧带损伤患者9例9膝,其中男4例,女5例;年龄20～27岁,平均25岁;从受伤到手术时间为1～21d,平均11d。均为训练和比赛过程中发生膝关节扭伤,其中合并半月板损伤5例,骨软骨损伤1例。所有患者均行X线、MRI检查,行关节镜下检查并同时实施手术。结果所有患者均在关节镜下行前交叉韧带重建术。术后Lysholm评分优6例、良2例、可1例。全部患者获得随访,随访时间10～18年,平均13年。无感染和再断裂病例。现有5名仍参加全国职业篮球联赛,其他4名从事教练工作。结论篮球运动员膝关节前交叉韧带损伤多为急性撕裂,关节镜下修复具有创伤小、恢复快等优点。远期随访疗效满意。

Objective To analyze the risk factors leading to prolonged mechanical ventilation following valve replacement surgery with the purpose of improving the management of these patients.Methods The risk factors of prolonged mechanical ventilation at preoperative,operative and postoperative clinical data of 307 patients who underwent valve replacement surgery were retrospectively analyzed.Binary Logistic regression model was used to assess the factors.Results The time of mechanical ventilation after valve replacement surgery was (15 ± 35) h,and 31.6％ (97/307) of these patients underwent prolonged mechanical ventilation (＞ 8 h).Age ≥ 65 years (P =0.003),smoker (P =0.024),left ventricular ejection fraction (LVEF) preoperative (P =0.002),duration of operation (P =0.000),aortic block time (P =0.046),cardiopulmonary bypass time (P =0.030),number of replaced valve (P =0.001),volume of postoperative chest drainage (P =0.000) and postoperative complications (P =0.010) were risk factors of prolonged mechanical ventilation.Logistic regression analysis showed that LVEF (P =0.026),duration of operation(P =0.037),aortic block time (P =0.001),cardiopulmonary bypass time (P =0.013),number of replaced valve (P =0.017),volume of postoperative chest drainage (P =0.020) and postoperative complications (P =0.014) had extremely affection.Conclusions Greater importance should be attached to healthcare education,early treatment to avoid multivalvular involvement,preoperative heart function regulation,lower duration of operation especially aortic block time and cardiopulmonary bypass time,lower postoperative chest drainage and better preservation of organs during operation to decrease the rate of prolonged mechanical ventilation and optimize the clinical quality.

BACKGROUND:Among the factors causing vascular endothelial cell injury,angiotensin Ⅱ(Ang Ⅱ) caused by renin-angiotensin system (RAS), especially by local RAS, plays an important patho-physiological role.OBJECTIVE: To observe the effect of tanshinone ⅡA on the vascular endothelial cells secreting nitric oxide (NO) and endothelial nitric oxide synthase (eNOS) gene expression as well as intracellular Ca2+ level induced by Ang Ⅱ, and investigate the protective effect of tanshinone ⅡA on vascular endothelial cells.DESIGN: Controlled observation experiment.SETTING: Department of Emergency, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology.MATERIALS: This experiment was carried out in the Experimental Center for Basic Medicine, Tongji Medical College,Huazhong University of Science and Technology from March 2006 to October 2006. Porcine aorta used in this experiment was provided by the Department of Pathophysiology of Tongji Medical College.METHODS: Nitric acid deoxidization method and reverse transcription-polymerase chain reaction (RT-PCR) were used to detect the effects of Ang Ⅱ of different concentrations (10-8 to 10-6 mol/L) on endothelial cells secreting NO and eNOS mRNA expression in cultured porcine aortic endothelial cells at different time points (1,6 and 24 hours) separately, then 50 mg/L tanshinone Ⅱ A was respectively added at different time point (0, 6 hours) when Ang Ⅱ was at 10-6 mol/L, and changes in NO production and eNOS gene expression were detected respectively at 1, 6 and 24 hours. Intracellular Ca2+ level was also detected with laser scanning confocal microscopy.MAIN OUTCOME MEASURES: ① NO content. ②eNOS mRNA expression. ③Intracellular Ca2+ level.RESULTS: ① NO production and eNOS mRNA expression were decreased with increase of Ang Ⅱ concentration and prolongation of time (P ＜ 0.01). ② NO production and eNOS mRNA expression in each tanshinone ⅡA-treated group were significantly higher than those in the Ang Ⅱ group. At 1 and 6 hours of tanshinone ⅡA treatment, production of NO and eNOS mRNA expression in the Ang Ⅱ + tanshinone ⅡA group were significantly higher than those in the Ang Ⅱ 6 hours + tanshinone ⅡA group (P ＜ 0.05); There were no significant differences in NO production and eNOS mRNA expression between two groups at 24 hours (P ＞ 0.05). ③Intracellular Ca2+ level in the Ang Ⅱ group was significantly higher than that of control group (P ＜ 0.01), and intracellular Ca2+ level in the tanshinone ⅡA + Ang Ⅱ was significantly lower than that in the Ang Ⅱ group (P ＜ 0.05).CONCLUSION: Tanshinone Ⅱ A has a protective effect on vascular endothelial cells and their functions by suppressing the inhibition of Ang Ⅱ on NO level and eNOS gene expression in cultured porcine aortic endothelial cells.

Objective: To explore the effect of ulinastatin on anti-inflammation and pulmonary function protection with its mechanism for infants at cardiopulmonary bypass surgery. Methods: A total of 38 infants with ventricular septal defect undergoing cardiac operation were randomly divided into 2 groups. Ulinastatin group, the patients received uliastatin 20 000 U/kg,n=20 and Control group, the patients received the same volume of normal saline,n=18. The serum levels of TNF-α, IL-2, IL-l0 were examined at 4 time points: 5 min before skin incision (T1), immediate opening of aorta (T2), 4 hours after operation (T3) and 24 hours after operation (T4). The expressions of CD4+CD45+ T cells and CD4+Foxp3+ T cells were measured at T4. The respiratory index and oxygenation index at 4 time points were compared between 2 groups. Results: Compared with Control group, Ulinastatin group had the lower levels of TNF-α, IL-2 and higher level of IL-l0 at T2, T3, T4; Ulinastatin group also had the higher oxygenation index and lower respiratory index at T2, T3, T4, allP<0.05. Ulinastatin group had less expression of CD4+CD45+ T cells (35.98 ± 3.67)% than Control group (41.94 ± 4.56)% , and more expression of CD4+Foxp3+ T cells (19.65 ± 3.45)% than Control group (6.45 ± 1.47)%,P<0.05-P<0.01. Conclusion: Ulinastatin may improve the differentiation from CD4+CD45+ T cell to Foxp3+CD4+ T cell, down regulating inlfammatory response and protecting pulmonary function for infants at cardiopulmonary bypass surgery.

Objective To investigate DNA methylation status as well as signal transducer and activator of transcription 3 (STAT3) gene expression in peripheral blood T-lymphocytes from patients with systemic lupus erythematosus (SLE),and to explore their relationship.Methods Peripheral blood samples were obtained from 34 patients with SLE and 23 healthy controls followed by the isolation of T-lymphocytes.Flow cytometry was performed to evaluate DNA methylation status using antibodies against 5-methylcytosine (5-me),reverse transcription (RT)-PCR to detect the mRNA expression of STAT3 in T-lymphocytes.Results Compared with healthy controls,17 patients with active SLE showed significantly decreased DNA methylation levels (8.50 ± 1.42 vs.11.31 ± 1.34,P ＜ 0.01),but increased STAT3 mRNA expression levels (1.34 ± 0.32 vs.1.02 ± 0.28,P ＜ 0.01).However,there were no significant differences between 17 patients with stable SLE and healthy controls in DNA methylation levels (11.30 ± 1.34 vs.11.31 ±1.34,P ＞ 0.05) or STAT3 mRNA expression levels (1.01 ± 0.27 vs.1.02 ± 0.28,P ＞ 0.05).Patients with active SLE also showed significantly reduced DNA methylation levels,but enhanced STAT3 mRNA expression compared with those with stable SLE (both P ＜ 0.01).As Pearson correlation analysis showed,SLE disease activity index (SLE-DAI) was negatively correlated with DNA methylation levels in patients with SLE (r =-0.78,P ＜ 0.01),but positively correlated with STAT3 mRNA expression (r =0.50,P ＜ 0.01),and no significant correlation was observed between STAT3 mRNA expression and DNA methylation levels (r =-0.13,P ＞ 0.05).Conclusion The aberrant expression of STAT3 in peripheral blood T-lymphocytes may be related to disease activity in SLE,but unrelated to DNA methylation levels.

Objective To investigate the correlation of possible risk factors with acute renal injury (AKI) after coronary artery bypass surgery (CABG) and explore if the incidence of AKI could be lower by off-pump CABG for kidney protection.Methods Two hundred and nine patients who underwent coronary artery bypass surgery in Nanjing First Hospital from September 2010 to November 2013 were recruited.The patients were divided into AKI group (fifty-five cases) and non-AKI group (one hundred and fifty-four cases) according to the AKI criteria and compared the possible risk factors between two the groups by univariate analysis and multivariate analysis.Results The index of female gender,body mass index,age,hypertension,basic serum creatinine,ejection fraction,the number of coronary atherosclerosis,cardiopulmonary bypass,IABP for circulatory support,postoperative low cardiac output,lactate in AKI group were higher than that in non-AKI group by univariate analysis (P ＜ 0.05).And basic serum creatinine,ejection fraction,cardiopulmonary bypass,postoperative low cardiac output showed a significantly statistical difference between two group by multivariate analysis.Conclusions Cardiopulmonary bypass,basic serum creatinine,ejection fraction,postoperative low cardiac output were independent risk factors.Off-pump CABG could benefit for kidney protection.