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 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

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.

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 investigate the impact of chronic disease self-management on motor function, activities of daily living, quality of life, and depression of patients in poststroke rehabilitation in community. Methods 120 stroke patients living in Gangdu community, Wuhan city were selected and randomly divided into self-management group (n=60) and control group (n=60). The control group experienced home rehabilitation and functional training by themselves, meanwhile they were asked to have regular outpatient referral and do the followup clinic when feeling indisposed. Self-management mode was used in the self-management group instructed by the professor and under the rehabilitation assessment by community doctors, therapist and family members. Also group separated instruction, individualized rehabilitation plan, home visit processes and patients' group activity had been organized. They were evaluated with Fugl-Meyer Assessment (FMA), modified Barthel Index (MBI), Hamilton Depression Rating Scale (HAMD) and the World Health Organization Quality of Life (WHOQOL-100) before and 6 months after intervention. Results There were no difference in FMA upper and lower limbs scores as well as the MBI score, HAMD score and WHOQOL-100 score before intervention (P>0.05). The FMA upper and lower limbs score, MBI score and WHOQOL- 100 score significantly improved in the self-management group and were better than in the control group 6 months after intervention (P<0.05). The control group also improved in the above items, however, the differences were not statistically significant (P>0.05). HAMD score significantly reduced in the self-management group and less than in the control group 6 months after intervention (P<0.05). The control group also reduced in the above scores, however, the differences were not statistically significant (P>0.05). Conclusion Chronic disease self-management for stroke patients in community can significantly improve their motor function, activities of daily living and quality of life, and reduce depression caused by stroke.

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.

Objective To analyze serum amyloid protein A (SAA) subtype and amino acid mutation sequence of the renal biopsy specimens from patients with renal amyloidosis secondary to ankylosing spondylitis (AS) by laser microdissection combined with mass spectometry.Methods Kidney biopsy formalin-preserved paraffin-embedded (FFPE) specimen slices were stained by Congo red,the positive areas of Congo red staining were selected by microdissection,after trypsin hydrolysis and filtration,peptide samples were subjected to liquid chromatography tandem mass spectrometry.Analysis softwares were used to evaluate the results,and the patient's amino acid sequence of SAA protein was compared to mutant amino acid sequence reported by literature or deduced from mutant SAA gene to determine whether there was a variation.Results SAA1 and SAA2 proteins with high abundance were identified by mass spectrometry,serum amyloid P and apolipoprotein E were also detected.No variation of SAA1 and SAA2 protein was detected.Conclusions The SAA1 and SAA2 proteins in AA amyloidosis secondary to ASwere identified for the first time,which enriched the pathogenesis of amyloidosis secondary to AS and provided a new method for the accurate classification of AA amyloidosis.