BACKGROUND:Drug eluting stents and endothelium stents for clinical treatment of vascular stenosis can lead to delayed endothelialization and restenosis. A rapamycin eluting stent combined with CD34 antibody can play a synergistic role to offset delayed endothelialization and intimal hyperplasia due to antiproliferative drugs, but it is stil in the pilot phase. OBJECTIVE:To observe the ability of rapamycin eluting stent combined with CD34 antibody to capture endothelial progenitor cels, and to observe the differentiation characteristics of the captured cels. METHODS:Scanning electron microscope and indirect immunofluorescence were used to observe the morphology and differentiation characteristics of captured endothelial progenitor cels. Under a fluorescence microscope, we observed the captured endothelial progenitor cels and the degree of endothelialization after implantation of the rapamycin eluting stent combined with CD34 antibody into rabbit ear vein. RESULTS AND CONCLUSION:Under the scanning electron microscope, fusiform-like cels with a diameter of 6-8 μm were captured by the composite stent, and 24 hours later, the cels became ful-shaped. The captured cels had the appearance characteristics of endothelial progenitor cels. Results from indirect immunofluorescence observation showed that there were a lot of red fluorescent spots on the coating which represented adherent cels positive for vascular endothelial growth factor receptor-2; the composite stent was largely covered with vascular endothelial cels at 24 hours after stent implantation, and fuly covered at 48 hours, but there was no abnormal cel cluster. These findings indicate that the rapamycin eluting stent combined with CD34 antibody can be specific to rapidly capture endothelial progenitor cels in the peripheral blood, and the stent can be completely covered with vascular endothelial cels at 48 hours after stent implantation, thereby achieving rapid endothelialization and promoting the repair of endothelial cels.

The DNA microarray study showed that in STZ-induced diabetic rats the elevatedexpression of 42 genes in artery were depressed markedly after atorvastatin treat ment .This suggeststhat atorvastatin may have the protective effects on the diabetic vascular lesion.

Objective: To explore influence of trimetazidine on cardiac function, levels of inflammatory factors, brain natriuretic peptide (BNP) and homocysteine (Hcy) in patients with congestive heart failure (CHF) and its therapeutic effect.Methods: A total of 120 patients diagnosed as CHF in our department were selected.According to random number table, they were randomly and equally divided into routine treatment group and trimetazidine group (received trimetazidine based on routine treatment group, 20mg/time, twice/d), both groups were treated for six months.Left ventricular relaxation time (LVRT), E peak decrease time (EDT), early diastolic peak velocity/late diastolic peak velocity (E/A), left atrial diameter (LAD), levels of interleukin (IL)-6, tumor necrosis factor (TNF)-α, BNP and Hcy were measured and compared between two groups before and after treatment.Results: After six-month treatment, total effective rate of trimetazidine group was significantly higher than that of routine treatment group (93.3% vs.80.0%, P=0.032);compared with routine treatment group after treatment, there were significant reductions in LVRT [(92.1±4.6)ms vs.(74.5±2.7)ms], EDT [(165.3±5.1)ms vs.(139.2±3.9)ms] and LAD [(41.1±2.6)mm vs.(33.1±1.8)mm], and significant rise in E/A [(0.89±0.21) vs.(1.16±0.51)] (P<0.01 all);and significant reductions in serum levels of IL-6 [(16.3±2.8) ng/ml vs.(11.3±1.3) ng/ml], TNF-α [(3.17±0.99) ng/ml vs.(2.01±1.12) ng/ml], BNP [(311.4±27.9)pg/ml vs.(278.2±31.3) pg/ml] and Hcy [(15.6±4.2) pg/ml vs.(11.3±2.7) pg/ml] in trimetazidine group, P<0.01 all.Conclusion: Trimetazidine can significantly improve heart function, reduce inflammatory factor levels and inhibit atrium remodeling in patients with congestive heart failure, and the therapeutic effect is significant.

[Abstract ] Objective Bone marrow mesenchymal stem cells(BMSCs) can be induced to the differentiation into vascular smooth muscle cells in many induction conditions.We sought to explore the possibility of the differentiation of mesenchymal stem cells into vascular smooth muscle cells by continuous cell culture in vitro. Methods Rat BMSCs were isolated from the bilateral tibial and femoral bones by the method of whole bone marrow adherence, followed by ex vivo expansion.BMSCs were identified by flow cytometry and three-lineage differentiation.After continuous five days'cell culture of BMSCs, the specific surface antigens of VSMCs were detec-ted by immunofluorescence, western blot and real-time PCR. Results BMSCs expressed CD29、90, in contrast, they did not express CD45、34、49d.After induction of osteogenesis, adipogenesis and chondrogenesis, alizarin red、oil red and alcian blue staining pro-duced a strong reaction in cells.The expressions ofα-SMA、Calponin1、SM-MHC and SM22 in the cells of experimental group were no-tably increased, which indicated that BMSCs were differentiating towards VSMCs. Conclusion In the absence of exogenous stimula-tion, BMSCs can be successfully induced to differentiate into VSMCs by continuous cell culture.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Humans ; Immunophenotyping ; Leukemia ; diagnosis ; immunology ; therapy ; Male ; Middle Aged ; Neoplastic Stem Cells ; immunology ; Prognosis ; Treatment Outcome ; Young Adult

primer.Conclusion The present reaction system could provide clear bands,abundant polymorphisms,and reliable reaction.It is proved to be suitable for molecular biology research of D.nobile.

Objective:Explore the education content and method for the accompanying persons to enhance the capacity of taking care of patient .Methods:Life satisfaction index ( LSR-A) Scale and accompanying persons chaperone capability questionnaire are the tools of this research .This research trained the 45 accompanying persons care ability, and used before and after comparison .Results:Before the intervention , Most of the persons′life satis-faction levels was at a low level (41 persons′≤13), only 4 (8.9%) at a medium level.After the intervention, life satisfaction levels was improved (27 persons′≥14).Life sat!sfaction was improved (P<0.05).Chaperone capability situation was improved , for the P values in all the examination were <0 .05 .Conclusion:The manage-ment could strengthen the support for accompanying persons , could effectively improve their life satisfaction and im-prove their ability to accompany , thus improving the quality of patient care .The hospital should also consider the nursing ethical problems in accompanying persons education .

Objective To summarize the basic experience of robotic-assisted Thoracic Surgery using da Vinci Robotic system and to evaIuate its value in clinical application.Methods From Jan 2009 to Sep 2012,the clinical data of 25 patients who underwent robotic-assisted Thoracic Surgery using da Vinci Robotic system were analyzed.Results All 25 patients were successfully operated and no conversion to thoracotomy occurred,including 10 cases of pulmonary lobectomy,14 cases of rumor mainly in anterior mediastinum and a cases of esophageal carcinoma.The operative time of pulmonary lobectomy was 180-390min,mean(241 ± 90.98)min,the estimated blood loss was 150-300 ml,mean (195 ± 43.78)ml,and the post-operative 24 h drainage was 250-300 ml,mean(305 ± 28.38)ml.The operative time of rumor from thymus mainly in anterior mediastinum was 70-210 min,mean (116.36 ± 45.23)min,the estimated blood loss was 50-100 ml,mean (63.64 ± 23.36)ml,and the post-operative 24 h drainage was 20-270 ml,mean (123.64 + 69.93) ml.No other major complications were experienced,no peri-opermive mortality occurred.Conclusion Da Vinci robotic-assisted thoracic surgery is a feasible and safe surgical procedure with clear operation field,precise dissection,minimal trauma and fast recovery.

Objective To investigate the clinical value of a new anvil inserting method for esophagogastrostomy or esophagojejunostomy during laparoscopic radical proximal gastrectomy or radical total gastrectomy for gastric cancer.Methods The clinical data of 21 patients with gastric cancer who received laparoscopic radical proximal gastrectomy or radical total gastrectomy at the Southwest Hospital from March 2010 to February 2011 were retrospectively analyzed.Five trocars were inserted through the abdominal wall of the patients.After perigastric lymphadenectomy and mobilization of esophagus,an incision was made on the esophagus above the tumor,and then the anvil with drawn wire attached was inserted into the esophagus.An endo-cutter was applied to cut the esophagus adjacent to the incision left the drawn wire untouched,and then the stem of the anvil was pulled out by the drawn wire for laparoscopic anastomosis. Results The operations were successfully accomplished under the laparoscope with no conversion to open surgery.Fifteen patients received laparoscopic radical total gastrectomy and 6 received laparoscopic radical proximal gastrectomy. The mean operation time,volume of blood loss,time to off-bed activity,passage of flatus and postoperative duration of hospital stay were (257 ± 38) minutes,( 119 ± 32) ml,(2.5 ± 0.5 ) days,( 3.7 ± 0.8 ) days and (7.5 ± 2.6) days,respectively.No perioperative mortality,anastomotic bleeding or anastomotic fistula was detected.One patient was complicated with pulmonary infection + pleural effusion and was cured by conservative treatment; 1 was complicated with anastomotic stenosis which was alleviated by gastroscopic balloon dilation; 1 was complicated by incisional infection and was cured by medical treatment after drainage.No cancer cells were detected at the anastomotic ring or resection margin of the specimen.There were 4 patients with well-differentiated adenoma,8 with moderate-differentiated adenoma and 9 with poor-differentiated mucinous adenoma.There were 5 patients in stage Ⅰ,10 in stage Ⅱ and 6 in stage Ⅲ (UICC staging).Twenty-one patients were followed up for a mean period of (11 ±4) months (range,6-17 months ),no tumor recurrence or metastasis was detected. Conclusions The new technique for anvil insertion is safe,effective and easy for manipulation and learn.It offers a new approach for laparoscopic digestive tract reconstruction.

Objective To investigate the effect of early enteral nutrition.Methods 248 patients with esophageal and gastric carcinoma were randomly divided into two groups,and received enteral nutrition(EN)and parenteral nutrition(PN)each continuously for 6 days after operation.The body weight,blood routine test,liver function,and postoperative day 8 were compared with those before operation.Results The body weight,red blood cell count,and the levels of hemoglobin,serum albumin and transaminase decreased less in EN group than those in PN group(P＜0.01).The complication rates of anastomotic fistula,pulmonary infection,and delayedincision healing and average volume of pleural effusion were 0,13.8%,0,780ml in EN groups,while 3.2%,28.2%,7.2%,1842ml in PN group.Conclusion Early postoperative enteral nutirtion after esophageal carcinoma surgery can improve nutritional status and reduce complications in comparision with parenteral nutrition.