AIM: To investigate the protective effect of onychin on the endothelial cells injured by oxidative stress. METHODS: The injured model was established by endothelial cells treated with menadione. The growth inhibitory rate of endothelial cell was determined by MTT assay; NO - 2/NO - 3 concentration in the medium was determined by nitrate reductase assay; eNOS and caveolin-1 protein levels were determined by Western blot. RESULTS: Onychin significantly decreased the growth inhibitory rate of endothelial cells injured by menadione, increased NO - 2/NO - 3 concentration in the medium and eNOS activity and up-regulated caveolin-1 expression. CONCLUSION: Onychin possesses a protective effect against endothelial cell injury induced by menadione via caveolin-1/eNOS pathway.

AIM To investigate the protective action of onychin aganist the growth inhibition of endothelial cell injured by menadione and its mechanism. METHODS The injured model was established by endothelial cell treated with menadione.Protective effect of onychin aganist growth inhibition of injured endothelial cell was determined by MTT assay and cell counting method; NO concentration in the medium was determined by nitrate reductase assay; eNOS and phosph ERK1/2 protein levels were determined by Western blot. RESULT Onychin significantly decreased the growth inhibitory rate of injured endothelial cells,increased NO concentration in the medium and eNOS activity and up regulated phosph ERK1/2 expressing. CONCLUSION Onychin has protective action and against the growth inhibition of endothelial cell injured by menadione may be via NO and ERK1/2 signal pathway.

This article analyzes the concept,the formation process,the main content of the United States food defense plan,the duties of stakeholders and the key points of the implementation.This article also summarizes the characteristics,similarities and differences between China and the United States in terms of food defense system,discusses the difficulties and put forward some suggestions for the food defense plan in China.

Objective To evaluate the protective value of cardioplegia solution plus metformin in different cardiac arrest time and concentration of metformin in isolated rat hearts .Methods There were 36 male Sprague–Dawley rats divided into six groups randomly, according to the duration of cardioplegic arrest(30 min or 60min) and the concentrations of metformin(50μmol/L or 100 μmol/L) .Langendorff-perfused Sprague-Dawley rat hearts were perfused for 20 minutes with Krebs-Henseleit buffer followed by 30 or 60 minutes of crystalloid cardioplegia or plus metformin (50 or 100 μmol/L) and 60 minutes of reperfu-sion.The left ventricular performance was recorded at 5 time points.The expressions of AMPKαand phosphorylation of AMPKαwere detected by western Blot.The changes of myocardial mitochondria were observed under transmission electron mi-croscope.Results There were no significant differences in Con(A), 50(A) and 100(A) groups in LVDP, ±dp/dtmax and HR.Compared with Con(B) group subjected to 60 minutes of ischemia followed by 60 minutes of reperfusion, the 100(B) group significantly improved myocardial performance , and the ratio of p-AMPKα/AMPKαwas the highest in all 6 groups.The structure of myocardial mitochondria in 100(B) group was better protected than that of Con(B) group.Conclusion These findings suggested that the left ventricular performance was protected in rat heart perfused by cardioplegia plus 100 μmol/L after 60 minutes cardioplegic arrest .The mechanism may be the activation of AMPK and the protection of structures of myocardial mitochondria.

Objective To investigate the risk factors of severe hemolysis during extracorporeal membrane oxygenation (ECMO). Methods The clinical data of adult patients undergoing ECMO after cardiac surgery admitted to Fuwai Hospital from December 2010 to October 2015 were retrospectively analyzed. Demographic characteristics, renal function, primary disease, operation data, ECMO related data and outcomes were recorded. Patients were divided into normal free hemoglobin (FHB) group (FHB ≤ 500 mg/L) and severe hemolysis group (FHB > 500 mg/L) according to the FHB level during ECMO support. The parameters before and after ECMO support were compared between the two groups. Logistic regression was used to identify the independent risk factors of severe hemolysis. Results A total of 81 patients including 19 patients with severe hemolysis was enrolled, and 62 in normal FHB group. There was no difference in cardiopulmonary bypass (CPB) time, clamping time, lactate level before ECMO, cardiopulmonary resuscitation, intra-aortic balloon pump use and central catheter insertion between two groups. The maximums of serum creatinine (SCr) and FHB levels were higher in severe hemolysis group as compared with those in normal FHB group [maximal SCr (μmol/L): 281.02±164.11 vs. 196.67±87.31, maximal FHB (mg/L): 600 (600, 700) vs. 200 (100, 300)], the incidence of clots in circuit or oxygenator, infection, and hemofiltration in severe hemolysis group was increased [26.3% (5/19) vs. 4.8% (3/62), 31.6% (6/19) vs. 12.9% (8/62), 36.8% (7/19) vs. 14.5% (9/62), all P < 0.1]. As well as outcomes including the rate of site of surgery or intubation bleeding and acute renal failure [ARF, 57.9 % (11/19) vs. 30.6% (19/62), 94.7% (18/19) vs. 41.9% (26/62)], and the survival rate was lowered [10.5% (2/19) vs. 51.6% (32/62), all P < 0.05]. As result of univariate analysis, clots in circuit or oxygenator, infection and hemofiltration were associated with severe hemolysis. It was showed by logistic regression analysis that the clots in circuit or oxygenator was a risk factor of severe hemolysis during ECMO [odds ratio (OR) = 6.262, 95% confidence interval (95%CI) = 1.244-31.515, P = 0.026]. Conclusions The clots in circuit or oxygenator were independent risk factors of severe hemolysis during ECMO. Severe hemolysis can induce the increase of the rate of bleeding in the operation site or intubation and the rate of ARF, and decrease of the survival rate.

Objective: To explore the safety and strategy of thoracic endovascular aortic repair (TEVAR) combining coronary artery bypass grafting (CABG) as one-stop performance in treating the patients with coronary artery disease (CAD) and thoracic aorta disease. Methods: A total of 20 patients received one-stop treatment of TEVAR combining CABG in our hospital from 2009-04 to 2016-01 were retrospectively analyzed. There were 18 male and the mean age of patients was (65.2±8.5, 51-82) years. The performance strategy and peri-operative management were studied. Results: There were 1/20 patient received 2 stents implantation in thoracic aorta and 19 received 1 stent in thoracic aorta those including 1 case with endovascular repair of abdominal aortic aneurysm, 1 with right iliac artery stent implantation and 1 with carotid endarterectomy at meanwhile. The average number of coronary artery bypass branch was (2.4±0.94, 1-4) and 10 (50%) patients received internal mammary artery grafting. The average in-hospital time in all 20 patients was (22.4±11.6, 8-58) days. There were 6 (30%) patients received blood transfusion; 1 (5%) having low cardiac output syndrome received extracorporeal membrane oxygenation (ECMO), then received the second thoracotomy for hemostasis due to excessive pleural effusion; 2 (10%) patients died at 30 days post-operation. 1 patient lost contact and 17 received clinical or telephone follow-up visit at the average of (13.4+13.6, 1-49) months; 2 patients died for cerebral hemorrhage at 12 and 49 months post-operation, the rest 15 had disappeared symptoms and improved quality of life, no operation related death occurred. Conclusion: TEVAR combining CABG as one-stop performance presented good mid-term effect in treating the patients with CAD and thoracic aorta disease; in otherwise, the operative time and risk might be increased by two step performance.

Objective:To investigate the clinical efficacy of botulinum toxin A in the treatment of hand hyperhidrosis.Methods:One hundred patients with hand hyperhidrosis were treated with botulinum toxin A (BTXA, Lanzhou Biotechnology Development Co., Ltd., Botulinum Toxin Type A for Injection Hengli) injection, a total of 200 U. Each hand was injected with 100 U respectively. The curative effect was evaluated by self-made questionnaire. The scores of the two were added. The subjective and objective evaluation were carried out before and after injection, and the patients were rechecked 2 weeks, and 1, 4 and 6 months after injection. Efficacy, patient satisfaction and adverse reactions were evaluated.Results:Compared with before treatment, the effective rate increased 2 weeks after injection, 1 month after injection, 4 months after injection and 6 months after injection, and the difference was statistically significant (Chi-square value was 31.54, 36.33, 28.34, 25.23, respectively, P<0.05). After 6 months of follow-up, the effect gradually decreased, and the curative effect could be maintained for about 10 months. After recurrence, the symptoms of hand sweating were still reduced. Satisfaction 96%; Adverse reactions were mild, subcutaneous blood stasis, 27% hand muscles were slightly weak, and returned to normal after 2-3 weeks. Conclusions:Botulinum toxin A injection has certain curative effect, high safety and less adverse reactions. It is an ideal method for the treatment of hand hyperhidrosis.

Objective To summarize the preliminary clinical outcomes of combination therapy with molecular targeted agents/immunological agents and to explore the potential value of multidisciplinary therapy in the treatment of postoperative refractory recurrent hepatobiliary tumor.Methods 52 cases of postoperative refractory recurrent hepatobiliary tumor during June 2016 to January 2019 from outpatient and inpatient departments at the First Medical Center of PLA General Hospital were prospectively collected,including 37 males and 15 females,with a mean age of (56.2 ± 8.5) years.Referring to the results of next-generation sequencing (NGS) and other-omics,we designed individualized therapy options for each patient.Follow-ups were done regularly and tumor responses were assessed by modified response evaluation criteria in solid tumors (mRECIST).Results Of 52 patients,median follow-up was 10 months (range 3-31 months).14 (26.9％) patients achieved a complete response (CR).8 (15.3％) patients achieved a partial response (PR).14 (26.9％) patients had stable disease (SD).16 (30.8％,including 4 deaths) had progressive disease (PD).Objective response rate and disease control rate were 42.3％ (22/52) and 69.2％ (36/52),respectively.The median progression-free survival (PFS) was 7 months.6-and 12-month overall survival rates were 100％ (48/48),87.5％ (21/24),respectively.Conclusions Precision medicine has good guidance on the treatment of refractory recurrence of hepatobiliary tumors.The combination therapy of multi-target tyrosine kinase inhibitors and immune checkpoint inhibitors may achieve better disease control and deserve further promotion in clinical application.

Objective To explore the application of Lux1540 nm non-stripping array laser in fa-cial rejuvenation .Methods A total of 100 patients were collected for Lux1540 nm non stripped lattice laser treatment in patients with facial skin aging ,once a month ,totally four times treatment ;1 month after the treatment ,the skin of patients was analyzed by skin image analyzer VISIA for quantitative e-valuation .Results After 4 treatments ,the skin wrinkles ,texture ,pores ,skin roughness ,brown spots ,erythrocyte and purple spots were all improved ,with statistically significant differences (P <0 .05) ,while the changes of ultraviolet spots were not obvious ,and the differences were not statistical-ly significant (P > 0 .05) .After treatment ,80 patients were satisfied ,17 were comparatively satisfied , and 3 were dissatisfied ,with a satisfactory rate of 97％ .All patients had needle-like pain during the treatment ,which could be tolerated without local anesthesia ointment .Ice compress was given after treatment ,which significantly alleviated the discomfort after treatment .Only 3 cases had mild pig-mentation .During the treatment and follow-up ,no adverse events such as skin redness and swelling , pigmentation and pruritus were found .Conclusions Lux1540 nm non-ablative dot array laser has posi-tive efficacy ,high safety and few side effects in facial rejuvenation ,and it is an effective method to treat facial skin aging .