Objective To examine the clinical effects of intravenous lyophilize recombinant human brain natriuretic peptide (rhBNP) in patients with refractory heart failure caused by coronary artery disease.Methods Seven patients with refractory heart failure caused by coronary artery disease were treated with rhBNP.The rhBNP nea grade,symptoms and signs,24 hours urine output,heart rate,blood pressure and central venous pressure were evaluated at 0,15,30 min and 1,2,4,8,12,24,and 48 h.Serum potassium,sodium,creatinine and plasma BNP before and after treatment were measured.Results After rhBNP therapy,dyspnea grade were improved in 5 patients.Symptoms and signs got better in 6 patients.Systolic blood pressure at 15 min of treatment distolic blood pressure was decreased slightly from (112.00±10.42) mm Hg to (105.14±7.76) mm Hg (P＜0.05) and became (108.71±6.63)mm Hg at 30 rain which was the same with that before treatment.There was no statistical significance in heart beat[ ( 88.57±16.92 ) vs.( 86.00±16.21 ) ] beat/min,serum sodium [ ( 133.57±5,38 ) mmol/Lvs.( 133.57±8.16) mmol/L ],serum potassium [ (3.83±0.37) mmol/L vs.(4.19±0.58 ) mmol/L ],ereatinine [ (93.11±27.90) μmol/L vs ( 123.01±93.01 ) μmol/L ] before and after treatment,and BNP[ ( 1218.43±847.83) vs.(1433.71±676.08)ng/L] before treatment and at24 h treatment,as well as urine output [(2329±1573 ) vs.(2126±1074) ml ] ( P ＞ 0.05 ).Urine output was increased during the treatment,but the usage of diuretic was remarkably decreased.Central venous pressure was gradually decreased from 30 rain to 48 h( P ＜ 0.05 ).Condusion rhBNP can decrease central venous pressure and increase urine output with exerts little side effects on electrolytes and renal function.Therefore rhBNP has positive clinical effects on refractory heart failure which is caused by coronary artery disease.

Objective To analyze causes of death and risk factors of acute myocardial infarction(AMI)、Methotis 118 AMI patients who died f selected from 1252 hospitalized patients with AMI from January 2003 to June 2008)were retrospectively enrolled for analysis of risk factors and death causes.Resuits The overall mortality of hospitalized patients with AMI was 9.42%(118/1252).The mortality rate in the males was 8.91%(84/943)while in the females was 11.00%(34/309)which was higher than the males but there was no statistical difieFence (P=0.2739).Mortality rate rose along with age and showed significant statistical difference(P＜0.0001)among different age group[＜40 yrs:6.45%(2/31),40～54:2.56%(6/234),55～64:5.11%(16/313),≥65:13.95%(94/674)].Pump failure occurred in 77 cases(65.25%)which was the main cause of death,cardiac arrest occurred in 21 cases(17.80%)and heart rupture in 13 cases(11.02%).There existed other causes of death including cerebral hemorrhage.digestive tract bleeding and pneumonia in 7 cases(5.93%).The mortality of patients with PCI was 4.24%(39/920)while23.80%(79/332)of those witbout PCI(P＜0.0001).Rate of cardiac rupture was 1.04%(13/1252),2.91%(9/309)in females and 0.42%(4/943)in males(P＜0.0001).The time was＜24 h(23.72%.28/118)when death occurred from onset,24 h～1 week(55.93%,66/118)and 1～4 week (20.34%,24/118).There was no statistical difference of mortality related to different infarction locations[antior 12.47%(59/473),anteroseptal 9.23%(12/130),inferior 6.73%(28/416),lateral 8.70%(4/46),ventricle postwall 5.97%(4/67),and ST-segmental elevated myocardial infarction 9.17%(11/120)(P=0.0852)].Conclusions There is a high mortality in aged patients with AMl with heart failure as the most common cause of death which usually occurs at early stage of AMI.The females have more cardiac ruptures than the males.PCI significantly decreases rates of mortality and cardiac rupture.Moreover.gender and location of AMI might be another important risk factor which affect mortality.

Objective To study the effects of fluorine and aluminum on index of hematologic tests of rats. Methods According to body mass,56 Wistar rats of 130-200 g were randomly divided into control,low-fluorine (F),middle-F,high-F,low-F + aluminum(Al),middle-F + Al,high-F + Al group,8 rats in each group were given a series of doses of fluoride and aluminum,which were (0 + 0),(100 + 0),(200 + 0),(300 + 0),(100 + 10),(200 + 10),(300 + 10)mg/L After 90-day intragastrie administration,blood samples were collected on eyes of rats to undergo blood routine test,including red blood cell (RBC),lymphocyte (LYM),platelet (PLT),hemoglobin (HGB),white blood cell (WBC),hematocrit (HCT),mean corpuscular hemoglobin (MCH),mean corpuscular-hemoglobin concentration(MCHC),mean corpuscular volume(MCV),and at the same time some blood biochemistry indicators related to functio ns of liver and kidney were determined such as aspartic acid aminotransferase(AST),alanine aminotransferase(ALT),alkaline phosphatase(ALP),Crea(Cr) and Urea. Organ coefficient of liver and kidney were calculated. Results The difference of RBC,HCT,MCV among all groups of rats was statistically significant(F = 3.202,3.316,2.915,P < 0.05). The RBC,HCT of the low-F group[(7.59± 2.40)×10~(12)/L,0.51±0.11],the middle-F group[(8.60±1.16)×10~(12)/L,0.55±0.05],the high-F group[(9.23± 0.60)×10~(12)/L,0.54±0.03],the low-F + Al group[(9.25±0.79)×10~(12)/L,0.53±0.04],the middle-F + Al group[(7.98±2.14)×10~(12)/L,0.49±0.08]and the high-F + Al group[(7.61±3.17)×10~(12)/L,0.49±0.16]were significantly higher than that in the control group[(4.46±3.10)×10~(12)/L,0.31±0.16,P< 0.05 or < 0.01)]. The MCV of the middle-F group[(64.06±6.51)fl],high-F group[(58.67±1.13)fl],low-F + Al group[(57.78± 1.57)fl]and the middle-F + Al group[(63.04±10.64)fl]were significantly higher than the control group[(78.54± 15.57)fl,P < 0.05 or < 0.01]. The difference of AST and Urea among all the groups of mrs serum was statistically significant(F= 2.847,5.549,P < 0.05 or < 0.01). The serum AST of low-F group[(399.00±54.99)U/L],the middle-Fgroup[(465.60±76.99)U/L],the high-F group[(465.80±75.41)U/L],the low-F + Al group[(346.00±69.26) U/L],the middle-F + Al group[(437.40±68.31)U/L]and the high-F + Al group[(403.00±30.61)U/L]were all significantly higher than that in the control group[(336.67±94.34)U/L,P < 0.05],and the high-F group significantly higher than the high-F + Al group(P < 0.05). The serum Urea of the middle-F group[(7.70±0.52)mmol/L],the high-F group[(8.44±1.30)mmol/L],the low-F + Al group[(7.83±0.62)mmol/L],the middle-F + Al group [(7.73±0.47)mmol/L],and the high fluoride + aluminum group[(7.70±0.21)mmol/L]were all significantly higher than that in the control group[(6.55±0.50)mmol/L,P< 0.05 or < 0.01],and the low-F group was significantly lower than the low-F + Al group(P < 0.01),however the high-F group was significantly higher than that in the high-F + Al group(P< 0.05). The liver organ coefficient of the low-F group(2.94±0.36) was higher than the low-F + Al group (2.60±0.15,P < 0.05). Conclusions Fluorine and combination of aluminum and fluorine have toxicity on rats to a certain extent,including the proliferation of crythrocytes of rat,while the cell size gets smaller and the cell quality is deteriorated,meanwhile functions of liver and kidney are impaired. Aluminum shows different joint action in different concentrations of fluorine.

Objective To prospectively study the difference of urinary N-acetyl-β-D-glucosaminidase( UN-AG) and retinol binding protein(URBP) in contrast-induced nephropathy (CIN). Methods The clinical data of 150 patients undergoing coronary angiography were documented. The urine and blood samples before,24 hours after and 48～72 hours after the procedure were collected;Serum creatinine (SCr) and urinary ereatinine (UCr)were tested by enzymic method. UNAG and URBP were tested by ELISA in CIN and control group. CIN was defined as an increase in SCr of ≥44 μmol/L or >25% from baseline 48 ～72 h after the procedure. 27 age- , sex- , results of coro-nary angiography-matched cases were taken as control group. Results CIN was diagnosed in 13 of 150 patients (8.7%). In CIN group, UNAG/UCr were significantly higher than that in control group[ 1.97 (1.06,2.64) U/mmol vs 1.07 (0, 68,1.88 ) U/mmol, Z = 2.076, P = 0.039 ] before ;24 hours after the procedure, UNAG/UCr was signifi-cantly up-regulated in CIN group from baseline level [ 2.82 ( 1.88 ,4.26) U/mmol vs 1.97 (1.06,2.64) U/mmol, Z =2.607,P =0. 009]. ROC curve analysis showed that baseline UNAG could be used as an early predictor for CIN, the AUC =0. 776 ,P =0.023 ;when cut off value = 8.08 U/L,the sensitivity and specificity of UNAG were 0. 771 and 0. 713 respectively. The percentage of patients of UNAG over 8.08 U/L in CIN group was significantly higher than that in control group[77.1% (10/13) vs 29.6% (8/27) ,Z =2. 564,P =0. 011 ] ,the related risk factor is 5.58,95% CI was 1.24 ～ 25.08. Conclusion UNAG could be used as a predictor of CIN before the procedure and its postprocedure 24 h level maybe useful in early diagnosis after the procedure.

Objective To evaluate the surgical treatment for renal cell carcinoma with inferior vena cava tumor thrombus and the clinical significance of multidisciplinary treatment. Methods Two cases of renal cell carcinoma with inferior vena cava thrombus diagnosed by Doppler ultrasonography and CT were included in this retrospective analysis. The tumor thrombus was in level Ⅱ in one case and in level Ⅳ in the other. Coagulation test and complete blood count were done again before surgery. Human albumin, fibrinogen, prothrombin complex, plasma, platelet, UW and irrigating solution were prepared before the operation.Under general anesthesia, surgery was performed using abdomen inverted Y shaped incision. Right radical nephrectomy was finished by the urological surgeon; the vena cava was completely dissected from the renal vein level to the secondary porta of the liver by the hepatobiliary surgeon, the vena cava and the surrounding branch vein were blocked in the upper and lower vena cava tumor thrombus; tumor thrombus was removed completely by the vascular surgeon. In one case (patient with level Ⅳ thrombus ) where the tumour thrombus invaded the wall of the vena cava, the thrombus was found to be extending to the cavo-atrial junction but not into the right atrium. The left femoral venous-right atrial bypass was established, the cardiopulmonary bypass lasted for 241 mia, and the aorta was blocked for 18 min. Salvage autotransfusion was used during surgery, and the hepatic vein of the secondary liver porta was anastomosed to artificial vascular graft.The data for surgical indication, operation time, operative blood loss and postoperative hospital stay were analyzed. Results Right radical nephrectomy and inferior vena cava thrombectomy were performed successfully, and the two patients were discharged on the 15th and 27th day after surgery, respectively. The two patients were followed up for 1 and 16 months after surgery, respectively, and both survived without local recurrence and distant metastasis. Conclusion Radical nephrectomy and inferior vena cava thrombectomy is the preferred method for patients without metastasis, and multidisciplinary cooperation could shorten the operation time, reduce the tumor recurrence and increase the survival rate of patients.

OBJECTIVETo investigate a new method of genioplasty for treatment of a prominent mandibular angle with mandibular malformation.

METHODSAccording to the different types of the mandible, the prominent mandibular angle was grinded with the masseter muscle kept intact. Autologous micromorselized bone of the grinded mandibular angle was collected and implanted into the chin for augmentation mentoplasty, and the chin was fixed with gypsum after operation.

RESULTSFifteen patients receiving the surgery were followed up for 6 -12 months, and satisfactory effects were achieved in 12 patients. One patient requested modification of the shape of the chin 10 days after the operation, and another two sustained chin distortion due to external forces and underwent subsequent shape adjustment of the chin.

CONCLUSIONThe procedure described avoids graft rejection and causes less complications for genioplasty with easy moulding and satisfactory outcome.

Adolescent ; Adult ; Bone Transplantation ; methods ; Female ; Humans ; Mandible ; surgery ; Osteotomy ; Surgery, Plastic ; methods ; Transplantation, Autologous ; Treatment Outcome

OBJECTIVETo observe the effect of intense pulsed light (IPL) on transforming growth factor-beta1 mRNA (TGF-beta1 mRNA) expression in rat skin and explore the molecular mechanisms of photorejuvenation.

METHODSFifteen SD rats were exposed to IPL in 3 dermal regions with triple pulses (duration of 4, 5, and 6 ms) at the energy density of 34 J/cm2 and pulse delay of 20 or 25 ms. On days 1, 3, 5, 7, 15, and 30 after the treatment, skin specimens from the treated and non-treated areas were obtained to detect TGF-beta1 mRNA expression with in situ hybridization.

RESULTSIn the UPL-exposed skin areas, TGF-beta1 mRNA expression was detected in the epidermal keratinocytes and dermal cells 1 day after the exposure, reaching the highest expression level on day 7 followed by gradual decrement since day 15, and till day 30, only weak expression was found in the dermal cells. In the non-exposed regions, the cells remained negative for TGF-beta1 mRNA.

CONCLUSIONIPL can enhance TGF-beta1 mRNA expression in the skin, suggesting that TGF-beta1 plays an important role in dermal remodeling in photorejuvenation.

Animals ; Female ; Male ; Phototherapy ; adverse effects ; methods ; RNA, Messenger ; genetics ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Rejuvenation ; Skin ; metabolism ; radiation effects ; Transforming Growth Factor beta1 ; genetics ; metabolism ; radiation effects

This study was aimed to prepare the polyclonal antibody against the soluble proliferation-inducing ligand (sAPRIL) antigen and to investigate its effects in suppressing sAPRIL mediated lymphocyte proliferation. Mutated recombinant sAPRIL protein, which lacks biological activity but maintains immunogenicity, was used as antigen to immunize humanized SCID mice. Sera were obtained at 6 weeks after immunization. Indirect ELISA and Western blot were used to detect the antibody titer and specificity. The inhibition of polyclonal antibodies on Raji and Jurkat cell proliferation stimulated by sAPRIL was assessed by the MTT assay. The results showed that the mutant of sAPRIL could induce the production of polyclonal antibodies against human sAPRIL. Western blot and indirect ELISA analyses indicated that the anti-serum had higher specificity with a titer of 1:640. Functional analysis revealed that these polyclonal antibodies significantly inhibited the proliferation of Raji and Jurkat cell stimulated by sAPRIL (p < 0.05). It is concluded the polyclonal antibody against human sAPRIL is successfully prepared, which can inhibit the proliferation of Raji and Jurkat cells stimulated by sAPRIL in vitro.
Animals ; Antibodies ; genetics ; immunology ; pharmacology ; Antibody Specificity ; immunology ; Cell Proliferation ; drug effects ; Cloning, Molecular ; Humans ; Immune Sera ; analysis ; immunology ; Jurkat Cells ; Mice ; Tumor Necrosis Factor Ligand Superfamily Member 13 ; genetics ; immunology

Adult ; Aged ; Amiodarone ; therapeutic use ; Atrial Fibrillation ; surgery ; Catheter Ablation ; Chronic Disease ; Female ; Heart Atria ; Heart Valves ; surgery ; Humans ; Male ; Middle Aged ; Rheumatic Heart Disease ; surgery

OBJECTIVETo evaluate the clinical efficiency of circumferential ablation around orifice of pulmonary vein by radiofrequency (RF) energy in the cure of chronic atrial fibrillation (AF) in patients with rheumatic valvular disease.

METHODSRadiofrequency catheter ablation was performed in 20 patients with rheumatic valvular disease and chronic AF who underwent heart valve surgery. The ablation temperature was 50 - 60 degrees C and the linear RF ablations were performed encircling the four openings of pulmonary veins and connecting the posterior mitral annulus with the probe made by ourselves especially for this ablative procedure. And amiodarone was given from the third day before the surgery and lasted for 3 months thereafter. Twenty patients with chronic AF who underwent valvular surgery but refused RF ablation were considered as the control group.

RESULTSSinus rhythm (SR) restored in 19 patients either spontaneously or after intraoperative direct current cardioversion, immediately after the operation, as compared with 16 patients in the control group. During the follow-up (24 +/- 3) months, 16 of 20 patients (80%) remained in sinus rhythm in patients received ablation, but in control group, SR was presented in only 7 of 20 patients (35%).

CONCLUSIONSCircumferential ablation around orifice of pulmonary vein by RF energy is safe and effective in restoration and maintenance of SR in patients with rheumatic valvular disease and chronic AF.

Adult ; Aged ; Amiodarone ; therapeutic use ; Anti-Arrhythmia Agents ; therapeutic use ; Atrial Fibrillation ; etiology ; therapy ; Catheter Ablation ; Chronic Disease ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Heart Valve Prosthesis Implantation ; Humans ; Male ; Middle Aged ; Pulmonary Veins ; surgery ; Rheumatic Heart Disease ; complications