Objective To investigate the effects of eardiopulmonary bypass(CPB)on plasma nitric oxide (NO)and asymmetric dimethyl arginine(ADMA)concentrations in patients with congenital heart disease complicated with pulmonary hypertension undergoing open heart surgery.Methods Eighteen ASA Ⅱ or Ⅲ patients aged 11-40 yr weighing 26-59 kg undergoing open heart surgery under CPB were divided into 3 groups according to pulmonary arterial systolic pressure(PASP)(n=6 each):group Ⅰ PASP<30 mm Hg;group Ⅱ PASP 30-50 mm Hg and group Ⅲ PASP>50 mm Hg.Arterial blood samples were taken before induction of anesthesia (To,baseline),at the start and termination of CPB(T1,2)and 3,6,24 h after CPB(T3-5)for determination of plasma NO and ADMA concentrations.Results The three groups were comparable with respect to M/F sex ratio,age,body weight and CPB time.The plasma ADMA concentrations were significantly increased while NO concentrations were significantly decreased at termination of CPB(T2)and 3 and 6 h after CPB(T3,4)as compared with the baseline at T0 in group Ⅱ and Ⅲ.The plasma ADMA concentration were significantly higher and No concentrations were significantly lower at all time points in groupⅡand Ⅲthan in group Ⅰ.Conclusion CPB can increase plasma ADMA concentration and decrease plasma NO concentration in patients with congenital heart disease complicated with pulmonary hypertension undergoing open heart surgery.

Objective To observe the expression of stromal cell derived factor-1?(SDF-1?) in vessels after common carotid artery balloon injury. Methods Sixty male SD rats were randomly divided into control group(group C) and balloon injury group(group S).The latter was subdivided into group S0(just after surgery),group S1(1 d after surgery),group S4(4 d after surgery) and group S7(7 d after surgery).Rats in group S were performed left common carotid artery balloon injury.For all the rats,peripheral blood samples were taken,and CD34+CXCR4+cells were detected with flow cytometer.The left common carotid arteries were obtained to detect the expression of SDF-1? mRNA and protein by RT-PCR and Western blotting,respectively. Results The number of CD34+CXCR4+ cells increased significantly in peripheral blood(P

Objective To identify and investigate B(A)02 allele in a patient. Methods Serological tests were performed with standard serological methods in a patient with B(A)02 allele. DNA sequences of all seven exons and exon-intron boundaries of ABO gene were analyzed by polymerase chain reaction (PCR), direct DNA sequencing and sequencing after gene cloning. In order to analyze the allele, PyMOL software was used to establish 3D model of Glycosyltransferases B (GTB). Results The serological results showed the characteristics of B(A) phenotype. DNA analysis revealed that ABO gene of the individual was heterozygous of B(A)02/O01 allele. 700C>G mutation was identified in B101 allele, which resulted in the amino acid substitution P234A in GTB. Through the analysis of the 3D structure of GTB, it was speculated that the P234A replacement affected the intermolecular forces of the 234 amino acid and Met-266, thus changed the conformation of the donor-binding pocket of GTB,that made GTB capable of recognizing and tranferring the GalNac to the H antigen, which can lead to the formation of the weak A antigen on membrane of red blood cells. Conclusion The P234A replacement can affect the spatial conformation of the specific recognition region conformed by Met-266 and Ala-268 residues, which leads to the antigenicity change of the ABO blood group.

Objective To observe the effect of angiotensin-converting enzyme inhibitor(ACEI) on insulin sensiti-(vity) in dogs with acute myocardial infarction(AMI) after thrombolytic treatment. Methods Twenty dogs were made as AMI models and then underwent thrombolytic treatment.The dogs were divided into the control group(n=10) and the captopril group(n=10) randomly.Insulin,plasma glucose,erythrocyte insulin receptor(EIR),nitrogen(NO) and angiotensin Ⅱ(AT Ⅱ) were(detected) and insulin sensitivity index(ISI) was calculated.The changes of these values in the two groups were contrasted. Results After reperfusion for 120 min,in the control group,ISI and AT Ⅱgot much more rise while EIR and NO fell much more(P

To assess the drug utilization and tendency of progress of oral hypoglycemic agents in our hospital and to provide references for rational administration clinically. Methods: DDDs, sales quantities, sales expenses and the ratio of sales expenses sequencing to that of DDDs in our hospital during the period of 2003 ～ 2005 were analyzed statistically with the method of DDDs analysis. Results:The top two antidiabetic drugs according to DDDs were melbine ( dimethyl diguanide) and gliclazide three successive years. The DDDs of acarbose increased dramatically. Which blood glucose regulatsry drugs ranked lower, the ratio of sales expenses sequencing to that of DDDs of glipizide and gliclazide controlled release pellets was equal or about, whereas that of rosiglitazone, acarbose(glucobay) and glimepiride was less than 1. Conclusion:The study shows that the drug utilization of oral hypoglycemic agents in our hospital is basically rational and is in accordance with the trend of advancement and drug therapeutic strategies of diabetes mellitus.

The paper analyzes the current situation of chronic disease and the disadvantages of traditional chronic disease management mode in China,puts forward the building of the comprehensive "four-in-one" (inhabitant-community-hospital-disease prevention and control center) chronic disease management mode based on big data,discusses the connotation,building idea and research content,and provides reference for the research of chronic disease management.

Objective To develop a scoring system to determine peptic ulcer risks and to evaluate its screening efficiency.Methods A total of 862 people who underwent gastroscopy for the first time ranging from 18 to 45 years old were enrolled in this study.They were divided into two cohorts with the method of simple random sampling,514 in the original cohort and 348 in the validation cohort.Information such as demographic characteristics,dietary intake,lifestyle,symptoms relating to peptic ulcer was obtained.A multivariable logistic regression method was used to determine independent predictors of peptic ulcer.Based on the logistic regression model,a scoring system was developed with a regression coefficient-based scoring method.Then the scoring system was internally and externally validated.Each value of calibration,discrimination and accuracy were computed and then compared with those of original cohort to assess its screening efficiency.Results Three variables (gender,smoking and melena) composed the scoring system with scores ranging from 0 to 4 points.It had good calibration (P =0.956) and discrimination (area under the ROC =0.70,95％CI:0.65-0.76).With 2.5 points as the screening cutoff value,the sensitivity,specificity,accuracy rate,positive predictive value,negative predictive value,positive likelihood ratio and negative likelihood ratio were 49.5％,82.2％,75.5％,41.6％,86.4％,2.78 and 0.61,respectively.In the validation cohort,the sensitivity,specificity,accuracy rate,positive predictive value,negative predictive value,positive likelihood ratio and negative likelihood ratio were 27.2％,92.7％,71.3％,64.6％,72.3％,3.89 and 0.79.The results above indicated that the screening efficiency of the scoring system in the original cohort was similar to that in the validation cohort.Conclusion The scoring system to determine peptic ulcer risks,containing gender,smoking and melena,has good screening efficiency and can be applied to predict the risks of peptic ulcer.

Objective To investigate the values of three-dimensional visualization technology in the diagnosis and surgical treatment of hepatic hemangioma. Methods Thirty two patients with hepatic hemangioma who had been hospitalized during the period from July 2010 to January 2014 in our hospital were scanned by 64-slice spiral computerized tomography (CT) before surgical treatment. Three-dimensional (3D) reconstruction based on the CT data was carried out to achieve dignosis and surgical planning. Assisted with the 3D model , we chose the best surgical procedure for liver resection, protecting the major blood vessels near hemangioma and retaining normal liver tissue as far as possible. Results The location, size and shape of hepatic hemangioma, vascular variation, and spatial relationship with intrahepatic vessel were shown factually by three-dimensional reconstruction. All the hemangiomas were preoperatively assessed to be resectable. The compliance rate for preoperative surgical planning to actual surgery was 100%. Under assistance of the 3D model during surgery , 14 patients received laparoscopic hepatectomy and 18 underwent hepatectomy. Pringle′s maneuver was applied in 18 patients , with blocking time of (15.32 ± 7.12) min and blood loss of (188.63 ± 66.37) mL. The postoperative complications included pleural effusion in 5 patients and incision infection in one patients. Conclusions Three-dimensional visualization technology for the individualized diagnosis and treatment of hepatic hemangioma helps reduce surgical trauma and incidence of postoperative complications.

Two patients with typical Gitelman syndrome were diagnosed by gene and their clinical data and endocrine and metabolic status were evaluated.The etiology,clinical manifestation,laboratory findings,genetic diagnosis,and treatment for Gitelman syndrome were reviewed.

Objective To compare curve-tip angiography guide wire (loach guide wire) and ultrasmooth hydrophilic guide wire (zebra guide wire) in selective common bile duct (CBD) cannulation of endoscopic retrograde cholangiopancreatography (ERCP). Methods A total of 196 patients were randomly assigned to loach guide wire group to receive cannulation guided by loach guide wire first ( n = 98 ) and zebra guide wire group to use zebra guide wire first ( n =98). If cannulation was not successful after 10 minutes, a further attempt was made for an additional 10 minutes using the alternative guide wire. If still not successful after 10 minutes, other cannulation accessories would be used. The primary and overall selective cannulation time, success rate, and post-procedure abdominal pain and serum amylase were assessed. Results The primary success rate of selective CBD cannulation was higher in the loach guide wire group (93.9%) than that in zebra guide wire group (86. 7%, P ＜0. 05), while there was no significant difference in cannulation time between 2 groups (P ＞ 0. 05 ). The cannulation success rate after crossover was higher in loach guide wire group (76. 9% ) than that in zebra guide wire group (0. 0%, P ＜0. 05). There was no significant difference in post-procedure serum amylase or occurrence rate of post ERCP pancreatitis between 2 groups (P ＞ 0. 05 ).Conclusion Loach guide wire is superior to zebra guide wire in ERCP selective CBD cannulation, which can replace zebra guide wire in difficult cannulation.