AIM:To observe the changes in plasma rennin activity(PRA)and angiotensin Ⅱ(AngⅡ)level and the cytoskeletons in dorsal hippocampus(DH)in male and female stressed rats.METHODS:The adult Sprague-Dawley male and femal rats were stressed for 6 h per day.Three days later,the levels of PRA and AngⅡin plasma were determined by radioimmunoassay,and the expression of nestin and NF200 in dentate gyrus(DG)and CA3 regions were observed with immunohistochemical staining.RESULTS:①The levels of PRA in plasma of male or female rats were decreased in stressed rats compared with control groups(P

BACKGROUND: Ventilation dysfunction caused by bronchomalacia induced bronchostenosis following high-risk heart transplantation is an acute clinical disease, which seriously impairs the function of transplant heart. The case of emergency bronchial stent placement following heart transplantation with high-risk multi-complication has not been reported yet.OBJECTIVE: To investigate the curative effect of emergency stent placement for worse left main bronchial malacia, stenosis and collapse following orthotopic heart allotransplantation.DESIGN: A case analysis.SETTINGS: National Ministry of Health Transplantation Engineering and Technical Research Center, the Third Xiangya Hospital, Central South University; Department of Cardiosurgery, Zhongshan Hospital affiliated to Xiamen University.PARTICIPANTS: An 18-year-old female patient with dilated cardiomyopathy accompanied by moderate to severe pulmonary artery hypertension, who sequentially carried out orthotopic heart allotransplantation, was selected from the Department of Cardiosurgery, Zhongshan Hospital affiliated to Xiamen University in April, 2004. She had suffered from dilated cardiomyopathy for 15 years, and the mean pulmonary artery pressure (MPAP) was 50-51 mm Hg, she was also accompanied by left main bronchial malacia, stenosis and collapse, mixed (mainly central-) sleep apnea syndrome, left inferior pulmonary sequestration, right emphysema, and rheumatoid arthritis for half a year.METHODS: After heart transplantation, bronchus inflammation, congested edema aggravated the severity of bronchial malacia, stenosis and collapse, tenosis reduced to 4/5, and led to obstructive type of ventilation, and the patient was also accompanied by supraventricular tachycardia, ventricular extrasystole, and hypofunction of transplant cardiac systolic function (peak E＜peak A, ejection fraction reduced to 40%, inharmonious motion of ventricular wall). Attempted with inotropic agents and ventilator/support were not relieved, which resulted in the aggravation of illness. In order to improve the post-transplant cardiac function, to relieve bronchial collapse and stenosis, and correct the obstructive type of ventilation, an emergency bronchial stent placement surgery was carried out on the sixth day after heart transplantation. Under monitoring of electrocardiogram (EGG) and percutaneaous oxygen saturation (SpO2), patient was awake and in supine to relieve left main bronchial stenosis with a nickel-titanium shape memory alloy stent (Diameter: 12 mm; length: 20 mm) by D20 fiberoptic bronchoscope. Fibrobronchoscopy was used to observe the proximal end of bronchostenosis and set the proximate location mark by using video fluoroscopy; the patency of distal end was explored by stricture, and set the distal location mark; guidewire was inserted into working path of bronchofibroscope and led through the stricture; then loaded the Ni-Ti stent on a special placement apparatus, and led in bronchial stent implantation apparatus along guidewire. When targeting well, the stent was slowly released and adjusted properly. When it was completely released, the stent implantation apparatus was drawn out. Bronchofibroscope was performed postoperatively to observe the adherence of stent; immediately photographed to observe its unfolding. Synchronized intermittent mandatory ventilation (SIMV) was given postoperatively as supportive treatment.MAIN OUTCOME MEASURES: Ameliorations of the cardiac and pulmonary functions of the patient.RESULTS: ①Carbon dioxide retention and hypercapnia were remarkably improved as compared with those preoperatively; hypertensive pulmonary vascular disease was alleviated gradually, and MPAP reduced to 30 mm Hg. One week later, re-examination of bronchofibroscopy was carried out, and the results showed that bronchi of left upper lobe, lingual lobe as well as left lower lobe could be seen distinctly, mucous membrane had slightly congested edema, and lumens were unobstructed.②Supraventricular tachycardia and premature ventricualr contraction disappeared, and the transplant cardiac function recovered well (peak E ＞ peak A, ejection fraction 70%, FS41%), and the heart rate fluctuated at 100-110 beats per minute. ③The chest-radiography and CT postoperatively indicated the relief of left main bronchial stenosis. When the ventilation function of the patient was improved, the parameters of breathing machine were reduced gradually, and replaced by low-flow oxygen. There was no recurrence of obstructive ventilatory disorder. The sleep apnea syndrome of the patient was moderated.CONCLUSION: Emergency treatment with stent placement for bronchial malacia, stenosis and collapse occurring after orthotopic heart allotransplantation cAN improve ventilation dysfunction caused by bronchial malacia and stenosis,and increase the survival rate of heart transplantation.

Objective To examine the relationship between traditional Chinese medical (TCM)constitution and chronic diseases in order to provide suggestions to TCM health care and health management among community residents.Methods 3100 residents over 50 years old in 4 communities from Jiangdong district were selected by random sampling method. TCM constitution and prevalence of chronic diseases of residents were investigated by physical examination and questionnaire.Results 34.57% of the residents were living with the constitution of yin -yang harmony,while the constitution of phlegm -dampness was 21.38% which accounted for the most part of 8 biased constitutions.The percentages of constitution of blood stasis and phlegm-dampness among residents with chronic diseases were 22.77%and 2.57% respectively,which were significantly higher than those without (15.77% and 0.33% respectively).The percentage of constitution of blood stasis or phlegm-dampness among residents with hypertension was higher than those without.While among hyper-lipidemia residents,the positive rates of constitution of blood stasis,phlegm-dampness and allergic were higher,among residents with diabetes or cardio-cerebro-vascular diseases the positive rate of constitution of blood stasis was higher.Exercise,smoking and sleeping behavior were related to TCM constitution.The proportion of constitution of qi asthenia,damp-heat and qi stagnation among residents with low body mass index (BMI<18.5)was significantly larger.Conclusion TCM constitution among the middle -aged and the elderly was correlated to chronic diseases.Lack of exercise,smoking,irregular sleeping and low or high BMI were positively related to biased constitutions.