Objective To explore the application value of right heart contrast echocardiography in patients with transient ischemic stroke (TIA) of unknow cause.Methods Totally 120 patients with TIA (TIA group) and 60 cases of normal healthy volunteers (normal group) were enrolled.Two groups underwent right heart contrast echocardiography to observe whether there was a foramen ovale arteriosus (PFO) or not.Diagnostic criteria were left ventricular internal appearing micro bubble≥5 that came from the right atrium to left atrium in three cardiac cycles.Results Small and medium amount of right to left shunt had no significant difference between TIA group and normal group (both P＞0.05),and large amount of right to left shunt had significant difference between the two groups (P＜0.01).Conclusion Contrast echocardiography can effectively diagnose of PFO,and amount of right to left shunt of PFO has relationship with the onset of TIA.

The basic principle,characters and applications of I 2 C bus protocol are introduced in this paper.Its application to implantable e lectrical stimulator is also described based on MAX5630,a DAC chip produced by M AXIM Corporation.

Objective To evaluate the efficacy and safety of pramipexole in treating restless legs syndrome (RLS).Methods A search for randomized,double-blind,and placebo-controlled clinical trials of pramipexole in treating moderate to severe RLS using CNKI,PubMed,Embase and Cochrane Library database was carried out. A meta-analysis of included clinical trials was performed with RevMan 5.0 software.The 2 outcomes that the weighted mean difference(WMD) of change from baseline in International RLS Study Group rating scale(IRLS) score and the relative risk (RR) of response based on the Clinical Global Impression-Improvement (CGI-I) scale score were calculated for efficacy.Safety was assessed with RR of the adverse event (AE).Results A total of 5 clinical trials were included in this meta-analysis,of which 1776 patients were randomly assigned (945 on pramipexole,831 on placebo).The records of patients were pooled.Overall WMD were - 6.34 ( Z =12.76,P ＜ 0.01 ) for the change from baseline in IRLS score,and RR of response based on CGI-I were 1.65 (Z =10.39,P ＜0.01).The overall RR of pramipexole versus placebo were 1.14 ( Z =1.87,P =0.06 ) for AE.Conclusion To treat RLS,pramipexole is an effective and safe drug.

Objective To evaluate the effect of dietary ω-3 polyunsaturated fatty acid (PUFA) supplementation on lipopolysaccharide (LPS)-induced acute lung injury in rats.Methods Totally 58 male SD rats were divided into control group (n =10),model group (n =12),ω-3 PUFA high-dose group (n =12),ω-3PUFA medium-dose group (n =12),and ω-3 PUFA low-dose group (n =12).Seven days before model establishment,rats in the three ω-3 PUFA groups were orally given ω-3 PUFA at 1,0.5,and 0.25 g/kg body weight once per day,respectively,for seven consecutive days.Twenty-four hours after the last administration,all rats except those in the control group were given intravenous injection of LPS (6 mg/kg) at caudal vein to establish the model of acute lung injury.Body temperature was measured at 0,6,and 24 hour.Blood samples were collected from the eye venous plexus for routine blood tests and blood biochemical tests 24 hours after modeling.After the rats were sacrificed,the left lung was harvested for measuring the wet weight and dry weight and calculating the wet/dry weight ratio (W/D).The right lung was harvested for pathological observation under light microscope and calculation of semi-quantitative pathological index (PI).Results Twenty-four hours after modeling,deaths were noted in all groups except the control group.After injection of LPS,rats curled with little movements.At 6 hour,the body temperature was significantly higher in the model group than in the control group [(37.4 ±0.27)℃ vs.(35.9 ±0.05) ℃,P =0.00] ; it was (36.2 ±0.38)℃,(36.3 ±0.30)℃,and (36.3 ± 0.32) ℃ in the ω-3 PUFA high-,medium-,and low-dose groups,which were significantly lower than that in the model group (all P =0.01).The amounts of white blood cells,neutrophils,and lymphocytes increased in the model group,but showing no significant difference compared with the other groups.The serum glutamic oxalacetic transaminase (GOT) and glutamic pyruvic transaminase (GPT) levels were significantly higher in the model group than in the control group [(353 ± 235) U/L vs.(157 ± 55) U/L,P =0.02 ; (141± 103) U/L vs.(54 ±23) U/L,P =0.03] ; the ω-3 PUFA high-dose group had significantly lower GOT and GPT levels than the model group did [(167 ±94) U/L vs.(353 ±235) U/L,P =0.03 ; (63 ±57) U/L vs.(141 ± 103) U/L,P =0.04].The model group had significantly higher lung wet weight [(371 ±38) mg vs.(281 ±24) mg,P=0.01] and W/D value (7.34±1.40 vs.5.41 ±0.84,P=0.01) compared with the control group.Compared with the model group,the W/D value was significantly lower in the ω-3 PUFA high-,medium-,and low-dose groups (6.17 ±0.58,P =0.03; 6.17 ± 0.76,P =0.03; 6.13 ± 1.23,P =0.04).Light microscopy showed that the lung alveoli of the model group presented congestion,obvious expansion,and scattered inflammatory cell infiltration in interstitium,along with significantly increased PI compared with the control group (3.9±0.9 vs.0.0±0.0,P=0.00).The PI value was (2.1 ±0.3),(2.1 ±0.3),and (2.3 ± 0.5) in ω-3 PUFA high-,medium-,and low-dose groups,respectively,all significantly lower than that in the model group (all P =0.01).Conclusions The acute lung injury model could be successful established by intravenous injection of LPS.ω-3 PUFA at different doses can improve the acute lung injury of rats.It is therefore supposed that early enteral administration of ω-3 PUFA can alleviate LPS-induced acute lung injury,although the optimal dosage and timing need further research.

An extracellular proteinase from Candida albicans WD27 was purified by (NH4)2SO4 fractionation and DEAE-Sephacel ion-exchange chromatography with 25.4 fold and 5.2% yield. This enzyme appeared to be aspartic proteinase since the enzyme activity could be inhibited by pepstatin which was specific inhibitor of this class of proteinase. The enzyme had an acidic proteolytic activity profile with the optimum pH of 4.0. The optimum temperature of the enzyme activity was 37℃. The proteinase had a broad substrate specificity with the highest susceptibility to bovine hemoglobin. The Km for bovine hemoglobin was determined to be 0.814mmol/L.

Objective To investigate the effets of three mood stabilizers on ouabain?induced ERK1/2 phosphorylation in astrocytes. Methods As?trocytes were treated with different agents and divided into different groups accordingly,namely,the control group with saline,the group with oua?bain,the group with mood stabilizers(lithium carbonate,carbamazepine,sodium valproate)and the group with ouabain+mood stabilizers. The phosphorylation of ERK1/2 in each group was analyzed by Western blot. Results Compared with saline and mood stabilizer groups,the phosphoryla?tion of ERK1/2 was increased in the ouabain group,with statistical significance(P<0.05). There was no significant difference in ERK1/2 phosphoryla?tion between the group with ouabain+mood stabilizers and the control or mood stabilizer group. Conclusion The three kinds of mood stabilizers can inhibit ouabain?induced ERK1/2 phosphorylation in astrocytes.

Objective To examine the effect of rapid infusion test guided by extravascular lung water index (EVLWI) on hemodynamics in critically ill patients at different states in order to guide volume resuscitation.Methods A prospective observation was conducted.Forty critically ill patients admitted to Department of Critical Care Medicine of Tianjin Third Central Hospital from June 2012 to April 2014 were enrolled.Based on the levels of EVLWI and pulmonary vascular permeability index (PVPI) and the cardiac function,the patients were divided into four groups:septic patients with normal EVLWI and PVPI (n =17),septic patients with increased EVLWI and PVPI (n =3),septic patients with increased EVLWI and normal PVPI (n =4),and coronary heart disease and heart failure patients with normal EVLWI and PVPI (n =16).The rapid infusion test was conducted in all patients using lactated Ringer solution 250 mL,followed by infusion of crystalloid with rate of 150 mL/h.The conditions of mechanical ventilation and vasoactive drugs were not changed during study.The changes in EVLWI,intrathoracic blood volume index (ITBVI),and cardiac index (CI) before capacity load,at immediate capacity load,and 15,45,105 minutes after load were determined by pulse indicator continuous cardiac output (PiCCO).On the base of volume status before and after the liquid infusion,the standard for the changes were:stroke volume (SV) increased by 12％-15％,central venous pressure (CVP) greater ≥ 2 mmHg (1 mmHg =0.133 kPa),CI ＞ 15％,and ITBVI change greater than 10％.Results There were no statistically significant differences in the observed indicators at the each time point before and after rapid infusion test among the four groups (all P ＞ 0.05).In septic patients with normal EVLWI and PVPI group,ITBVI was slightly increased by 5.4％-9.7％ from 15 minutes to 45 minutes after rapid infusion test.In coronary heart disease and heart failure patients with normal EVLWI and PVPI group,the EVLWI was increased by 11.9％,5.9％,and 14.7％ respectirely at 15,45,and 105 minutes,ITBVI was slightly increased by 6.4％ at 45 minutes,CI was increased by 29.5％ immediately after rapid infusion.In septic patients with increased EVLWI and PVPI group,CVP was increased by 8 mmHg immediately,EVLWI was increased significantly by 15.8％ at 45 minutes,ITBVI was slightly decreased by 10.0％ at 45 minutes,CI was increased by 24.7％ immediately,and increased by 17.0％ at 105 minutes,and PVPI was increased by 15.6％-28.1％ at 15-105 minutes after rapid infusion.In septic patients with increased EVLWI and normal PVPI group,CVP was increased by 1.5 mmHg at 15 minutes,EVLWI was increased immediately,which was increased by 17.4％,24.0％,and 31.4％ respectively at 15,45,and 105 minutes,ITBVI was increased by 13.9％ at 15 minutes,CI was increased by 16.1％ at 15 minutes after rapid fluid infusion.Conclusions Rapid fluid replacement in critically ill patients with crystalloid,regardless of whether the EVLWI was normal or increased,the short-term response was affected by the volume and cardiac function of patients.Different status of patients showed different volume effect curve:no significant changes in hemodynamic parameters were found in patients with normal EVLWI and volume parameters.In patients with potential cardiac dysfunction,CI and EVLWI increased significantly; regardless of PVPI increased or normal,EVLWI and CI were increased in patients with elevated EVLWI; two different changes could be found in the two types of pulmonary edema while ITBVI was increased.

Objective: To explore the correlation of plasma level N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with non-diabetic acute myocardial infarction (AMI) combining stress hyperglycemia.
Methods: A total of 327 non-diabetic AMI patients treated in our hospital from 2012-02 to 2014-05 were studied. The patients were divided into 2 groups according to fasting blood glucose level:Stress group, the patients with blood glucose≥7.0 mmol/L, n=182 and Non-stress group, the patients with blood glucose<7.0 mmol/L, n=145. The basic clinical condition, laboratory tests within 24 hours of onsets, echocardiography and 24 h dynamic electrocardiogram were examined;the incidence of major adverse cardiovascular events (MACE) including arrhythmia, heart failure, cardiac shock and sudden cardiac death in 2 weeks of onsets were analyzed and compared between 2 groups.
Results: The patients’ age, gender, history of hypertension, smoking, drinking, and blood levels of TC, TG, HDL-C, LDL-C were similar between 2 groups, P>0.05. Plasma levels of NT-proBNP, CK-MB, MYO, ultra-TnI, ALT, AST and blood glucose level were signiifcantly different between 2 groups P<0.01. NT-proBNP level was positively related to
ultra-TnI (r2=0.811, r=0.901, P<0.01). Stress group presented obviously higher incidence of MACE (P<0.05), lower LVEF (P<0.01), and signiifcantly increased left ventricular end diastolic diameter, left ventricular end systolic diameter (P<0.01) than those in Non-stress group.
Conclusion: Plasma levels of NT-proBNP may judge the severity and evaluate recent prognosis in patients with non-diabetic AMI combining stress hyperglycemia, it could be used as a risk indicator for relevant patients in clinical practice.

BACKGROUND:A preliminary experiment developed a double-chamber stirred bioreactor which can carry out osteogenic and cartilage induction at the same time.
OBJECTIVE:To explore the effects of double-chamber stirred bioreactor on the repair of goat knee cartilage defects with tissue-engineered cartilage.
METHODS:Twelve goats were selected to make bilateral femoral condyle osteochondral defects models and randomized to three groups:experimental group, implanted with the composites ofβ-tricalcium phosphate and bone marrow mesenchymal stem cells that were subjected to 2-week chondrogenic and osteogenic induction simultaneously in the double-chamber stirred bioreactor under mechanical stimulation;control group, implanted with the composites ofβ-tricalcium phosphate and bone marrow mesenchymal stem cells that were subjected to 2-week chondrogenic and osteogenic induction simultaneously in the double-chamber stirred bioreactor;blank control group, without treatment. After 12 and 24 weeks of implantation, general observation, Masson staining, II col agen immunohistochemical staining and histological scoring were performed.
RESULTS AND CONCLUSION:In the experimental and control groups, new cartilage tissue and bone tissue were visible, but the experimental group showed better repair effects than the control group (P<0.05). The blank control group had no cartilage formation. These findings indicate that under the mechanical stimulation by the double-chamber stirred bioreactor in vitro, the repair effect of tissue-engineered osteochondral complex on knee joint cartilage defects can be improved.

[ ABSTRACT] AIM:To explore the effect of dexmedetomidine ( DEX) on the CCAAT/enhancer-binding protein-homologous protein ( CHOP) pathway during lung ischemia-reperfusion ( I/R) in mice.METHODS:C57BL/6J male mice were randomly divided into sham operation group ( sham group) , lung ischemia/reperfusion group ( I/R group) , ischemia/reperfusion +normal saline group ( I/R+NS group ) and ischemia/reperfusion+dexmedetomidine group ( I/R+DEX group) .Dexmedetomidine was infused intraperitoneally with 25 μg/kg for 30 min prior to the ischemia period in I/R+DEX group, the normal saline was administrated with the same volume of dexmedetomidine in I/R+NS group.After fini-shed the 3 h-reperfusion period , the left lung tissues were harvested to determine lung wet/dry weight ( W/D) , the total lung water content ( TLW) , and index of quantitative evaluation for alveolar damage ( IQA) .Morphological observation and terminal-deoxynucleotidyl transferase mediated nick end labeling ( TUNEL) were applied to evaluate the structure changes and the apoptosis index (AI) of the lung tissues.The expression of CHOP and glucose-regulated protein 78 (GRP78) at mRNA and protein levels in the lung tissues was detected by Western blot and RT-PCR.RESULTS:Compared with sham group, the W/D, TLW, IQA, AI, the mRNA and protein expression of CHOP and GRP78 obviously increased, and the left lung tissues structure were damaged more obviously both in I/R group and I/R+NS group.Compared with I/R group, the W/D, TLW, IQA, AI and the protein and mRNA expression of CHOP in I/R+DEX group decreased, the injury of the left lung tissue structures induced by I/R in I/R+DEX group were also alleviated .CONCLUSION:DEX alleviates the
lung I/R injury, which may be related to inhibition of apoptosis mediated by CHOP pathway.