AIM: To study the protective effects of shenfu injection on myocardial ischemia/reperfusion (I/R) injury in rats and its potential mechanisms. METHODS: Myocardial ischemia/reperfusion was produced by tying and untying of left anterior descending coronary artery. Ischemia lasted for 30 min and reperfusion for 60 min. Twenty-four healthy male SD rats weighing 230-280 g were randomly divided into three groups (n=8 in each): sham-operation group, I/R group, and shenfu group which the shenfu injection (10 ml?kg -1) were injected intraperitoneally 30 min before ischemia. The plasma concentration of tumor necrosis factor-? (TNF-?), interleukin-6(IL-6) were measured by ELISA. The heart was harvested and levels of the nuclear factor kappaB (NF-?B) activity were determined by Ecl-western blot analysis and ultrastructures were observed by electron microscopy. RESULTS: NF-?B binding activity in myocardial nuclear and the plasma concentration of IL-6, TNF-? were significantly increased in I/R group than that in the sham-operation group (P

Objective To investigate the protective effects of Shenfu injection on myocardium against ischemia and reperfusion injury in rats. Methods Twenty-four healthy male SD rats weighing 230-280 g were randomly divided into three groups (n = 8,each): sham-operation group(Sham), ischemia and reperfusion group (I/R), Shenfu injection group(SF) . In Sham group, the anterior descending branch of left coronary artery was exposed and a piece of silk thread was placed around the artery but untied. The ischemia and reperfusion injury models in I/R and SF groups were made by temporary ligation of the anterior descending branch of left coronary artery,ischemia lasted for 30 min and reperfusion for 60 min. In SF group, the Shenfu injection(10 ml/kg) was intraperitoneally injected 30 min before ischemia. In Sham and I/R groups, normal saline (10 ml/kg) was intraperitoneally injected. After 60 min reperfusion, the blood samples of all rats in each group were collected from the left carotid arterial catheter for determination of the concentrations of plasma TNF-?, IL-6 ( ELISA) . The myocardium samples were obtained for ultrastructure observation (Electron-microscope) .Results Compared with that in Sham group, the plasma concentrations of TNF-? and IL-6 in I/R group significantly increased( P

ObjectiveTo investigate the effect of reduced ghtathione (GSH) pretreatment on inflammatory factors and oxygen free radical in patients during one-lung ventilation (OLV).MethodsThirty patients with lung cancer undergoing lung resection were divided into GSH group(15 cases) and control group ( 15 cases) by random digits table.In GSH group,GSH 30 mg/kg in normal saline 100 ml was infused after induction of anesthesia before OLV,while in control group equal volume of normal saline was infused instead of GSH.Blood samples were collected before induction of anesthesia (T0) and at 30 min(T1),60 min (T2) of OLV and 60 min of two-lung ventilation (T3) and at 2 h after operation(T4) for determination of serum tumor necrosis factor(TNF)-α,interleukin(IL)-8 and malonaldehyde(MDA) concentrations and superoxide dismutase(SOD) activity.ResultsThe serum MDA concentrations at T2-T4 were higher than those at T0 in two groups (P＜ 0.05) [GSH group:(3.5 ± 0.6),(3.8 ± 0.8),(4.7 ± 1.1 ),(6.1 ± 1.2),(6.4 ± 0.9) mol/L at T0-T4;control group:(3.7 ±0.5),(4.1 ±0.6),(5.9 ± 1.2),(7.4 ± 1.0),(7.8 ± 1.1) mol/L at T0-T4],but GSH group was lower than control group(P＜ 0.05 ).The serum SOD activity at T2-T4 was lower than that at T0 in control group (P＜ 0.05),and lower than GSH group(P＜ 0.05).The serum TNF-α,IL-8 concentrations at T1-T4 were higher those that at T0 in two groups(P ＜ 0.05 ),the serum TNF- α concentrations at T2-T4 and IL-8 concentrations at T1-T4 in GSH group were lower than those in control group (P ＜0.05).Conclusion Pretreatment with GSH 30 mg/kg can decrease inflammatory response and lipid peroxidation during OLV.

CD40 pathway plays an important role in occurrence and development of acute and chronic allograft rejection.Further research on immune characteristics of CD40 pathway will explore new field for investigation of early monitoring,prevention and control of rejection.sCD30 as the active component of CD30 activation and release into blood has good correlation with CD30.Expression of CD30 provides a high sensitive and specific non-traumatic examination method for early diagnosis of acute rejection and its identification with acute tubular necrosis in renal transplantation.It also provides the basis for immunosuppressive therapy after transplantation.Through the above research on factor associated with renal transplant rejection,the rejection can be effectively predicted and prevented,transplantation immunoreaction can be solved,successful rate of renal transplantation will be increased,and long-term survival of graft will be improved.

Objective To investigate the effect of Shenfu injection (SFI) on hypoxia and reoxygenation (H/R)-induced apoptosis and the expression of Bcl-2 and Caspase-3 in cultured neonatal rat cardiomyocytes and to explore the possible molecular protective mechanisms of SFI from hypoxia and reoxygenation injury in cardiacmy-ocytes in vitro. Method The experiment was performed in Research Center for Cardiovascular Regenerative Medicine, Cardiovascular Institute and Fuwai Hospital in Beijing. Ventricular myocytes from the hearts of neonatal Sprague-Dawley rats (1- to 2-day old) were cultured. The model of hypoxia and reoxygenation injury was devel-oped in primary cultured neonatal rat cardiacmyocytes. The cultured cells were randomly divided into four groups: (1) Control group (Con group), without any treatment; (2) Hypoxia and Reoxygenation group (H/R group),4 h hypoxia followed by 16 h reoxygenation; (3) Low-dose SFI group (L-SFI group),cardiacmyocytes were pretreated with a low dose (50 μL/mL) of SFI for 30 min followed by H/R; (4) High-dose SFI group (H-SFI group),car-diacmyocytes were pretreated with a high dose (100 μL/mL) of SFI for 30 min followed by H/R. Apoptosis was quantified by fluoreacence-activated cell sorter (FACS) analysis after staining with Fluorescein isothiocyanate (FITC)-labled Annexin-V (Annexin V-FITC) and propidine iodide (PI). The expressions of Bcl-2 and Caspase-3 were detected by ECL-Western blot analysis. All data are expressed as mean±S.E.M. One-way analysis of vari-ance (ANOVA) was performed followed by Student-Newman-Keul test using SSPS 11.5 software. A p value less than 0.05 were considered as statistically significant. Results The results of FACS analysis indicated that the rate of different apoptotic process in cardiomyocytes was significantly increased after H/R, while after SFI treatment the occurrence of cell apoptosis induced by H/R was decreased significantly. The results of ECL-Western blot analysis showed that cells' exposure to H/R induced proteolytic cleavage of caspases,as revealed by the appearance of the characteristic fragment at 17 000 of Caspase-3 and this proteolytic activation was nearly completed with difference concentration SFI incubation. The anti-apoptotic protein Bcl-2 in cardiomyocytes was decreased after H/R insult and was increased in cells with SFI pretreatment. Conclusions SFI has protective effects on cardiacmyocytes a-gainst apoptosis that could be induced by H/R injury, the mechanisms of which probably involve the inhibition of down-regulation of Bcl-2 protein level and sequential activation of Caspase-3.

Objective To evaluate the effects of different doses of dexmedetomidine on lung injury in pediatric patients undergoing open heart surgery under cardiopulmonary bypass (CPB).Methods Forty-eight pediatric patients,aged 7 months-3 yr,of ASA physical status Ⅱ or Ⅲ,scheduled for elective repair of ventricular septal defect under CPB,were randomly divided into 4 groups (n =12 each) using a random number table:control group (group C) and 3 different doses of dexmedetomidine groups (D1-3 groups).Anesthesia was induced with midazolam,fentanyl and vecuronium.The patients were endotracheally intubated and mechanically ventilated.In D1-3 groups,dexmedetomidine 0.5μg/kg (initial dose) was given over more than 10 min,followed by continuous infusion at 0.1,0.3 and 0.5 μg· kg-1 · h-1,respectively,until the end of operation.The equal volume of normal saline was given instead of dexmedetomidine in group C.Before administration (T1),and at 2,6 and 12 h after termination of CPB (T2-4),blood samples were collected for determination of plasma tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6) and IL-8 concentrations and for blood gas analysis.Respiratory index (RI),oxygenation index (OI) and lung compliance (CL) were calculated.Results The plasma concentrations of TNF-α and IL-8 at T2-4 and IL-6 at T3,4 were significantly lower in D2,3 groups than in group C.Compared with group D1,the plasma concentrations of TNF-α,IL-8 and RI were significantly decreased,and OI and CL were increased at T2-4 in D2-3 groups,and the plasma IL-6 concentrations at T3,4 in group D2 and at T2-4 in group D3 were decreased.The plasma concentrations of TNF-α and IL-6 were significantly lower,while OI and CL were higher at T2,3,and the plasma concentrations of IL-8 and RI were lower at T2-4 in group D3 than in group D2.Conclusion Dexmedetomidine can reduce lung injury in pediatric patients undergoing open heart surgery under CPB and promote the lung function after CPB possibly through inhibiting inflammatory responses to CPB dosedependently.

ObjectiveTo investigate the effects of cardioplegic solution enriched with different doses of glutathione on myocardial injury in children undergoing cardiac surgery under cardiopulmonary bypass (CPB).MethodsForty-eight ASA [Ⅱ or Ⅲ patients aged 2-5 yr undergoing repair of ventricular septal defect under CPB were randomly divided into 4 groups (n ＝ 12 each):control group (group C) and cardioplegic solution containing 3 different-dose of glutathione groups ( group G1-3 ).Glutathione 50,75,100 mg/kg were added to cardioplegic solution in group G1-3 respectively.Blood samples were collected before operation (T0),at 30 min after release of aortic cross-clamp (T1),at 6,12,24 h after termination of CPB (T2-4) for determination of plasma cTnI concentration.Myocardial specimens were obtained from right auricle before aortic cross-clamp and 15 min after release of aortic cross-clamp.The ultrastructure of myocardium was examined with scanning electron microscope.A mitochondrial FlaMeng semiquantitative analysis was done.ResultsThe plasma concentration of cTnI at T3,4 were significantly lower in groups G1,2 than in group C.The plasma concentration of cTnI at T1-4 were significantly lower in group G3 than in group C and group G1,2.The quantization score of myocardial mitochondria at 15 min after release of aortic cross-clamp were significantly lower in group G3 than in group C and group G1,2.Micorscopic examination showed that the injury to myocardial ultrastructure was attenuated in group G3 compared with group C.Conclusion Cardioplegic solution enriched with glutathione can reduce myocardial injury induced by CPB in a dose dependent manner.Glutathione 100 mg/kg can exert a visibly protective effect on myocardium.

Objective:To establish the cut-off value of tetradecenoyl carnitine (C14∶1)/dodecenoyl carnitine(C12∶1) based on non-derivatized tandem mass spectrometry (MS/MS), and to explore the application value of C14∶1/C12∶1 to screen newborns for very long chain acyl-CoA dehydrogenase deficiency (VLCADD), determining the best combination of indicators for screening VLCADD.Methods:This retrospective study included data from 17 newborns with VLCADD detected by MS/MS and confirmed by acyl-CoA dehydrogenase very long chain ( ACADVL) gene detection, and 423 507 newborns with normal MS/MS results. The data from these newborns were collected from January 2014 to December 2021 as the newborns received neonatal screening in Nanjing Neonatal Disease Screening Center and Suzhou Neonatal Disease Screening Center. All newborns were divided into 3 groups: all newborns group, full-term newborns group and normal-birth-weight newborns group, and the cut-off values of C14∶1/C12∶1 for VLCADD in these 3 groups were determined by their receiver operating characteristic (ROC) curves individually. With these results, a total of 5 interpretation schemes were composed using different indicators alone or jointly: scheme 1 being C14∶1/C12∶1, scheme 2 being C14∶1, scheme 3 being C14∶1+C14∶1/C2+C14∶1/C16, scheme 4 being C14∶1/C12∶1+C14∶1, and scheme 5 being C14∶1/C12∶1+C14∶1+C14∶1/C2+C14∶1/C16. The detection rate, false-positive rate and positive predictive value of each scheme were calculated, and their screening efficiencies were statistically compared by Chi-square tests. Results:The cut-off values of C14∶1/C12∶1 for VLCADD in the 3 newborn groups were all 2.80. The detection rates of VLCADD with all 5 interpretation schemes were 17/17. Scheme 1 had the highest false positive rate [26.15‰ (11 075/423 524)] and the lowest positive predictive value [0.15% (17/11 092)]. Scheme 4 (Scheme 5) had the lowest false positive rate [0.02‰ (10/423 524)] and the highest positive predictive value [62.96% (17/27)]. Comparing scheme 4 (Scheme 5) with scheme 1, scheme 2 and scheme 3, the differences of false positive rate (χ2=302.30,11 191.50,32.06) and positive predictive value (χ2=102.51,3 485.61,13.83) were statistically significant (all P<0.001). Conclusion:C14∶1/C12∶1 was an effective auxiliary interpretive indicator for VLCADD in newborn screening, and the combination of C14∶1/C12∶1+C14∶1 was tested to be the best indicator for VLCADD screening based on non-derivatized tandem mass spectrometry.

OBJECTIVETo investigate the correlation of gestational age and birth weight with 17α-hydroxyprogesterone (17α-OHP) levels, and with results of adrenal hyperplasia newborn screening.

METHODUsing time-resolved fluorescence immunoassay, the authors measured concentrations of heel blood 17α-OHP by newborn dried blood spots on filter paper which included 29 hospitals newborns of Wujiang, Taicang, Zhangjiagang, Kunshan, and Suzhou, where there were 118 050 infants in total who had accurate gestational age and birth weight (62 490 males, 55 560 females). According to the classification by gestational age, there were 4 693 premature infants, 113 300 term infants and 57 overdue infants. According to the classification by birth weight, there were 4 172 infants with weight < 2 500 g, and 113 878 infants weight ≥ 2 500 g. And, in all premature infants, gestational age of 189 infants was < 32 weeks, 2 277 infants less than 36 weeks but ≥ 32 weeks, and 2 227 infants less than 37 weeks but not less than 36 weeks. Neonatal heel blood concentration of 17α-OHP was measured by dissociation enhanced lanthanide fluorescence immunoassay (DELFIA), and the correlation between 17α-OHP and gestational age or birth weight was retrospectively analyzed by using Spearman test.

RESULTThe distribution of 17α-OHP levels was skew. The 17α-OHP levels decreased significantly from very preterm births, moderately preterm, later period preterm to term infants [19.21 (8.07, 24.00), 12.35 (6.81, 18.00), 8.58 (5.66, 13.80), 5.60 (3.57, 8.51) , 3.34 (2.58, 5.23) nmol/L; 479.42, 62.25, 36.24, 23.30, 13.73 nmol/L;P all = 0.000]. The 17α-OHP levels decreases from very low birth weight (VLBW), extremely low birth weight (ELBW), low birth weight (LBW), normal birth weight to macrosomia [5.24 (3.24, 8.96) , 11.30 (6.84, 22.95) , 8.50 (5.28, 14.90) , 5.66 (3.61, 8.62) , 5.38 (3.40, 8.11) nmol/L; 485.26, 125.18, 39.50, 23.80, 22.15 nmol/L; P = 0.000 for all comparison]. Neonatal 17α-OHP levels and gestational age, body weight was significantly negatively correlated respectively -16.40 and -10.10 (P both = 0.000) by using Spearman test. Neonatal 17α-OHP levels and gestational age, body weight were binomially distributed, and the formulae were y = 0.105 5x²-2.457 6x + 17.689, R² = 0.980 3 and y = 0.411x²-3.988x+14.75, R² = 0.983. Little preterm infants, preterm infants and term infants in low birth weight infants 17α-OHP levels were significantly higher than non-low birth weight infants [11.20 (6.01, 18.90) vs 9.05 (5.85, 14.90) nmol/L, 9.76 (4.32, 10.35) vs 5.59 (3.56, 8.48) nmol/L, P all = 0.000].

CONCLUSIONNeonatal 17α-OHP levels and gestational age, body weight was significantly negatively correlated; in order to improve the accuracy and sensitivity, cut-off value of neonatal 17α-OHP should be adjusted according to gestational age and weight.

17-alpha-Hydroxyprogesterone ; blood ; Adrenal Hyperplasia, Congenital ; blood ; diagnosis ; Birth Weight ; Female ; Fluoroimmunoassay ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature ; blood ; Infant, Very Low Birth Weight ; blood ; Male ; Neonatal Screening ; Retrospective Studies ; Sensitivity and Specificity