Equipment Design ; Humans ; Nebulizers and Vaporizers

The purpose of this study was to investigate the effects of phytoestrogen genistein (GST) on delayed after depolarization (DAD) and triggered activity (TA) induced by ouabain in guinea pig papillary muscles. Action potentials (APs) were recorded from the guinea pig papillary muscles with standard glass microelectrode technique. The results are as follows: (1) DAD and TA induced by ouabain (1 micromol/L) were markedly inhibited by pretreatment with GST (10, 50, 100 micromol/L) in a concentration-dependent manner. (2) NG-nitro-L-arginine methyl ester (L-NAME, 1 mmol/L), an NO synthase inhibitor, failed to affect the above effects of GST. (3) 5 micromol/L 17beta-estradiol (E2) or 10 micromol/L GST alone showed no effects on DAD and TA, whereas GST combined with E(2) at the same doses exerted significant inhibitory effects on DAD and TA. Since GST is known to reduce the calcium influx, it is suggested that GST might have antiarrhythmic effects, possibly by reducing calcium influx. The antiarrhythmic effects of GST may contribute to its cardioprotective action.
Action Potentials ; drug effects ; Animals ; Genistein ; pharmacology ; Guinea Pigs ; Male ; Neuromuscular Depolarizing Agents ; pharmacology ; Ouabain ; pharmacology ; Papillary Muscles ; drug effects ; physiology ; Phytoestrogens ; pharmacology

OBJECTIVETo investigate the expression and the role of secreted frizzled-related protein 2 (SFRP2) in the earlobe keloid and find a valid way to treat the keloid with gene therapy.

METHODSThe expression of SFRP2 mRNA and protein was tested with in situ hybridization and Western Blot Analysis method in the different period of earlobe keloid.

RESULTSThe SFRP2 mRNA and protein expression at the keloid edge was significantly high in 12 month group than in 3 or 6 month groups (P < 0.01), but not than in 24 month group. The SFRP2 expression started to decrease in the keloid center 12 month later (P < 0.01). The SFRP2 expression was always higher in edge than in center during all the period (P < 0.05, P < 0.01).

CONCLUSIONSThe results suggest that SFRP2 may play an important role in the development of keloid, especially at the keloid edge. The high SFRP2 expression in endothelial cells and surrounding tissue is also important. It may be a new way for gene therapy of keloid by decreasing the SFRP2 expression.

Adolescent ; Adult ; Ear ; Female ; Humans ; Keloid ; metabolism ; Male ; Membrane Proteins ; metabolism ; Middle Aged ; Young Adult

OBJECTIVETo investigate the incidence of lymph node metastasis (LNM) in the right para-tracheal triangle (RPT) of esophageal carcinoma patients and the technique of dissection.

METHODSOn the top of double mediastinal and abdominal lymphadenectomy, 333 esophageal carcinoma patients received RPT lymphadenectomy through the right pleural apical approach from 1990 to 2001.

RESULTSIn these 333 patients, the lymph node metastasis (LNM) rate in the RPT was 36.40%. A total of 457 nodes among 2 159 nodes removed gave a metastasis degree of 24.96%. The LNM rates in RPT for cervical, upper third, middle third, and lower third segments of esophagus were 66.67%, 45.45%, 34.19% and 15.79% (P < 0.05), while their respective metastasis degrees were 44.44%, 27.04%, 24.32% and 18.92% (P > 0.05). The frequency of positive nodes in the RPT for PTI, PT1, PT2, PT3 and PT4 was 0, 17.24%, 28.7%, 45.16% and 53.57%, while those of metastasis degree were 0, 8.77%, 17.62%, 33% and 41.17% (P < 0.01). The frequency of LNM in the RPT in papillary, erosive, patch-like and covert type of early tumor was 40%, 3.85%, 0 and 0 (P < 0.05), while those of the metastasis degree were 29.41%, 1.82%, 0 and 0 (P < 0.01). Higher rate of LNM in progressive stenotic esophageal carcinoma was observed compared with those of the other gross types (56.52%, P < 0.05), so was the degree (P < 0.01). The frequency of LNM in the RPT for mono-focal and multi-focal tumor was 34.98% and 70% without significant difference (P > 0.05), while the degree was 24.29% and 53.33% (P < 0.05). Postoperative complications were: leak (0.6%), and recurrent laryngeal nerve injury (1.2%). No injury of vein or infra-clavicular artery, tracheal damage or mortality occurred.

CONCLUSION1. The lymph node metastasis from esophageal carcinoma has a tendency of wide spread and right para-tracheal triangle is an important region to be doomed. 2. With location, depth of tumor invasion and differentiation of tumor as major factors affecting LNM of esophageal carcinoma, dissection of this region should be paid more emphasis. 3. In early lesions, higher frequency of LNM in the RPT is found in papillary and erosive lesions than in the other macroscopic types. 4. Exposing the RPT, lymph node by dissection through a right pleural apical approach is very important and significant.

Adult ; Aged ; Cardia ; Esophageal Neoplasms ; pathology ; surgery ; Esophagectomy ; methods ; Esophagus ; pathology ; Female ; Humans ; Lymph Node Excision ; methods ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Mediastinum ; Middle Aged ; Neck ; Neoplasm Invasiveness

Objective To develop a new isotope dilution gas chromatography mass spectrometry method (ID/GC/MS) for the measurement of serum cholesterol.Methods Serum was mixed with an isotope labeled internal standard ([3,4-~(13)C]-cholesterol) and treated with alcoholic sodium hydroxide to hydrolyze cholesterol ester to cholesterol.Cholesterol and internal standard was extracted and derived by N, O-Bis(trimethylsilyl) trifluoroacetamide to trimethylsilyl ethers.The derivation products were analyzed by capillary column GC combined with electron impact MS using scan and selected ion monitor (SIM) modes. Signals of cholesterol internal standard were corrected for the contributions from cholesterol and the signal ratio of cholesterol to internal standard for the calibrators were linearly regressed against cholesterol concentrations.The resulted regression equation was used for the calculation of serum cholesterol concentrations.Results The new ID/GC/MS method showed a mean within-run coefficient variance (CV) of 0.04%-0.81%.Comparison with two levels of standard reference material (SRM1951a) of National Institute of Standards and Technology (NIST) displayed a bias of 0.19% and 0.90% respectively.Conclusion A time-gaining ID/MS method has been established that is highly precise and accurate and can be used for the measurement of serum cholesterol.

BACKGROUNDSerum uric acid (UA), the final product of purine degradation, has been proposed to be a marker for the severity and a possible predictor of mortality in patients with pulmonary arterial hypertension (PAH). The objectives of this study were to elucidate whether serum UA level correlates with the clinical features and the hemodynamic variables in Chinese patients with PAH and to compare the difference of the correlates in patients associated with different etiologies.

METHODSSerum UA was assessed in 228 patients with three types of PAH (idiopathic PAH (IPAH), congenital heart disease related PAH (CHD-PAH) and connective tissue disease related PAH (CTD-PAH)) together with other clinical features. After the individualized treatment for at least 6 months, the UA levels and clinical features were re-evaluated in 88 patients.

RESULTSSerum UA was significantly elevated in patients with PAH compared with age-matched control subjects ((350.40 +/- 108.73) micromol/L vs (266.91 +/- 81.38) micromol/L), P < 0.001). Serum UA negatively correlated with cardiac output and mixed venous saturation (SvO(2)) in all three types of PAH (all P < 0.05), positively correlated with the size of right ventricle in IPAH (P = 0.002) and CTD-PAH (P = 0.013) patients and with pulmonary vascular resistance just in CTD-PAH patients (P = 0.001). Serum UA significantly decreased from (365.80 +/- 120.46) micromol/L to (333.67 +/- 117.56) micromol/L in 88 patients (P = 0.006) with vasodilator therapy for at least 6 months, accompanied with a reduction in pulmonary vascular resistance from (15.13 +/- 6.96) Woods unit to (12.00 +/- 5.04) Woods unit (P = 0.001) and an increase in cardiac output from (2.63 +/- 0.98) L/min to (3.08 +/- 1.04) L/min (P = 0.005).

CONCLUSIONSSerum UA increases in proportion to the clinical severity of all the three types of PAH, especially the CTD-PAH had a stronger correlations compared with IPAH and CHD-PAH. The serum UA levels also could partly reflect the response to the treatment in patients with PAH.

Adolescent ; Adult ; Case-Control Studies ; Female ; Hemodynamics ; physiology ; Humans ; Hypertension, Pulmonary ; blood ; pathology ; Male ; Multivariate Analysis ; Uric Acid ; blood ; Young Adult

OBJECTIVETo investigate the safety and efficacy of rotational atherectomy followed by drug-eluting stent implantation for treating patients with heavily calcified coronary lesions.

METHODSFrom March 1, 2010 to September 1, 2012, 65 cases with 78 heavily calcified coronary lesions which were treated with rotational atherectomy followed by drug-eluting stent implantation in Peking University People's Hospital were included, and 36 cases also underwent intravascular ultrasound to guide the rotational atherectomy procedure and drug-eluting stent implantation.All patients were followed up in hospital and post discharge. Procedure parameters, complications and major adverse cardiovascular events (cardiac death, non-fatal myocardial infarction, percutaneous coronary intervention related myocardial infarction, target vessel revascularization, recurrent angina, intra-stent restenosis and stent thrombosis) were analyzed.

RESULTSDirect rotational atherectomy was performed in 64.6%(42/65) patients, rescued rotational atherectomy in 35.4%(23/65) patients, drug-eluting stents implantation was applied to all cases after rotational atherectomy. The immediate procedural success rate was 100% (78/78). The average burr/artery ratio was 0.50 ± 0.04, the average number of burr used per case was 1.15 ± 0.36. The average burr/artery ratio was 0.52 ± 0.03 and the average number of burr used per cases was 1.19 ± 0.40 in 36 cases guided with intravascular ultrasound. Five cases (7.7%) developed complications and were treated accordingly during procedure with satisfactory results. The incidence of major adverse cardiovascular events was 13.8% (9/65) during (17.6 ± 8.5) months follow-up.

CONCLUSIONRotational atherectomy followed by drug-eluting stent implantation is a safe and efficient technique for treating heavily calcified coronary lesions.

Aged ; Atherectomy, Coronary ; methods ; Coronary Artery Disease ; surgery ; Drug-Eluting Stents ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo summarize the surgical effect and clinical application value of esophagectomy with extended 2-field lymph node dissection for patients with esophageal carcinoma.

METHODSFrom June 1987 to December 2008, 1690 patients with esophageal cancer underwent esophagectomy with extended 2-field (thoracic and abdominal) dissection of lymph nodes. Patients with the middle and lower thoracic esophageal cancer underwent Ivor-Lewis esophagectomy, and patients with upper thoracic esophageal cancer underwent Akiyama esophagectomy. 2-field (thoracic and abdominal) lymph node metastases information and the 1, 3, 5, 10-year survival rates were analyzed retrospectively.

RESULTSLymph node metastases were found in 713 patients. The lymph node metastases rate was 42.2% (713/1690).Thoracic lymph node metastasis rate was 39.3% (665/1690), among which in the right pleural apical para-tracheal triangle was 20.7% (349/1690), in the posterior upper mediastinum was 26.3% (444/1690), in the lower mediastinum was 18.2% (307/1690). Abdominal lymph node metastasis rate was 20.1% (339/1690). THE Postoperative complication rate was 16.4% (278/1690), among which the pulmonary complication rate ranking the first, was 43.6% (136/312). The operative mortality rate was 0.2%. The 1-year, 3-year, 5-year and 10-year survival rates were 88.2% (1388/1574), 63.5% (868/1367), 54.8% (705/1287) and 30.8% (232/754), respectively. The 5-year survival rate in patients without lymph node metastasis was 76.2% (448/588), but that in patients with lymph node metastases was 36.8% (257/669).

CONCLUSIONThe results of this study demonstrated that Ivor-Lewis and Akiyama esophagectomy with two-field lymph node dissection exposes the operation fields clearly and make radical lymphadenectomy thoroughly, especially the lymph nodes in the posterior upper mediastinum around the recurrent laryngeal nerve and in the right pleural apical para-tracheal triangle. It is essential that patients with esophageal carcinoma with lymph node metastases should undergo esophagectomy with extended 2-field dissection of lymph nodes. This can elevate the postoperative 5-year survival rate remarkably.

Adenocarcinoma ; mortality ; pathology ; surgery ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; mortality ; pathology ; surgery ; Esophageal Neoplasms ; mortality ; pathology ; surgery ; Esophagectomy ; adverse effects ; methods ; Female ; Humans ; Lymph Node Excision ; adverse effects ; methods ; Lymphatic Metastasis ; Male ; Middle Aged ; Respiratory Insufficiency ; etiology ; Retrospective Studies ; Survival Rate

OBJECTIVE: To develop a high-performance liquid chromatographic method for determination of ketamine and norketamine in blood and urine. METHODS: The compounds were extracted from blood or urine by liquid-liquid extraction using toluene after blood or urine was adjusted pH to 14. The extracts were analyzed by HPLC. RESULTS: Linear limits of ketamine and norketamine determination in blood ranged from 0.05 microg/mL to 10 microg/mL (R2 > 0.9993) and in urine ranged from 0.01 microg/mL to 200 microg/mL (R2 > 0.9995). Limits of detection (LODs) for ketamine and norketamine were 0.006 microg/mL and 0.003 microg/mL (S/N > or = 3), respectively. The mean extraction recovery was over 82.4% and its coefficients of variation were less than 10.0% for ketamine and norketamine. Concentration-time curves and urinary drug velocity curves of ketamine norketamine were obtained by determinations of them in blood and urine in rat using the developed method. CONCLUSION The method is sensitive, simple, rapid and suitable for determination of ketamine and norketamine in blood and urine for toxicological and clinical pharmaceutical analysis.
Animals ; Chromatography, High Pressure Liquid ; Female ; Ketamine/urine* ; Male ; Rats ; Rats, Wistar

BACKGROUNDHemoglobin A1c (HbA1c) measurement is of great value for the diagnosis and monitoring of diabetes. Many manufacturers have developed various experiments to determine the HbA1c concentration. However, the longitudinal use of these tests requires strict quality management. This study aimed to analyze the quality of HbA1c measurement systems in China using six sigma techniques to help improve their performances.

METHODSA total of 135 laboratories were involved in this investigation in 2015. Bias values and coefficients of variation were collected from an HbA1c trueness verification external quality assessment program and an internal quality control program organized by the National Center of Clinical Laboratories in China. The sigma (σ) values and the quality goal index (QGI) were used to evaluate the performances of different groups, which were divided according to principles and instruments.

RESULTSThe majority of participants (88, 65.2%) were scored as "improvement needed (σ < 3)", suggesting that the laboratories needed to improve their measurement performance. Only 8.2% (11/135) of the laboratories were scored as "world class (σ ≥ 6)". Among all the 88 laboratories whose σ values were below 3, 52 (59.1%) and 23 (26.1%) laboratories needed to improve measurement precision (QGI <8.0) and trueness (QGI >1.2), respectively; the remaining laboratories (13, 14.8%) needed to improve both measurement precision and trueness. In addition, 16.1% (5/31) and 15.0% (3/20) of the laboratories in "TOSOH" and "ARKRAY" groups, respectively, were scored as "world class", whereas none of the laboratories in "BIO-RAD" group were scored as "world class".

CONCLUSIONSThis study indicated that, although participating laboratories were laboratories with better performance in China, the performances were still unsatisfactory. Actions should be taken to improve HbA1c measurement performance before we can include HbA1c assays in diabetes diagnosis in China.

China ; Diabetes Mellitus ; blood ; metabolism ; Glycated Hemoglobin A ; metabolism ; Humans ; Quality Assurance, Health Care ; methods