Objective To observe the effects of combined penebyclidine hydrochloride-ketamine-propofoi intravenous anesthesia with local anesthesia in transcatheter occlusion of congenital heart diseases (CHD).Methods Eighty-six patients suffered in CHD scheduled for transcatheter Amplatzer occlusio were divided randomly and averagely into two groups with 43 cases each.Group A received combined ketamine--propofol ina'avenous anesthesia with local anesthesia. Group B received combined hydrochloride-ketamine-propofol intavenous anesthesia with local anesthesia.Results The rate of upper airway obstruction of child patient that was caused by increased oral secretion in group B (4.7%) was significantly lower than that in group A(14.0%) (P ＜ 0.05 ).The upper airway obsa-uction was removed by aspirating sputum and oxygen therapy in group A,while removed "by decreasing anesthetic depth in group B.The rate of arrhythmia in operation,the time of operation and wake-up time were not significantly different between two groups [37.2%,(2.65±1.85)h,(45.4±15.2)min in group A,but 34.9%,(2.58±1.74)h,(50.2±17.3)rain in group B (P＞0.05)].Conclusion The combined penehyclidine hydrochloride-ketamine-propofol intravenous anesthesia with local anesthesia is feasible and safe in transcatheter occlusion of congenital heart diseases.

Benzofurans ; analysis ; chemistry ; Dibenzofurans, Polychlorinated ; Dioxins ; analysis ; chemistry ; Humans ; Occupational Exposure ; prevention & control

Air Pollutants, Occupational ; analysis ; Gas Chromatography-Mass Spectrometry ; Halogenated Diphenyl Ethers ; analysis ; Workplace

Objective Clinical data of patients who received rotational atherectomy (RA) combined with drug-eluting stent implantation (DES) in TEDA International Cardiovascular Hospital were retrospectively analyzed to evaluate it's safety,short-term and long-term prognosis.Methods A total of 60 patients who underwent RA were consecutively enrolled in the study in TEDA International Cardiovascular Hospital from September 2012 to September 2015.Pre and post procedure coronary angiography and clinical information were collected.Long term outcomes were obtained by outpatient clinical follow-up or telephone interview.We analysed angiographic data.Results Among 60 patients with 65 lesions,RA combined with drug-eluting stent implantation was successful performed in 62(95.3%) lesions and postoperative stenosis degree drop from (90.7±6.2)% to (19.5±6.6)%.4 cases(6.7%)developed complications and were treated accordingly during procedure with satisfactory results.Overall incidence of in-hospital MACCE was 1.7% with one case (1.7%) of myocardial infarction.The mean follow-up time was (23.3±10.6) months.In stent restenosis occurred in 1 case(1.7%) 10 months after operation.Stent thrombosis occurred in 1 case(1.7%) 16 months after operation and myocardial infarction (MI) occurred in 1 case(1.7%) 7 months after operation.One patient died 14 months after operation and another patient died 17 months after operation.Both of them were considered as cardiac death.There was no mortality of other causes recorded.Long-term MACCE was 9.5% and TLR is 5.1%.Conclusions Rotational atherectomy combined with DES implantation in the treatment of severe coronary artery calcification lesions has high success rate, good safety profile and good short and long-term prognosis.

To assess the perinatal outcomes following selective feticide through radiofrequency ablation (RFA) in complex monochorionic pregnancies. Methods In this retrospective observational study, 34 cases of complex monochorionic pregnancies treated with RFA for selective feticide and delivered at the Shanghai First Maternity and Infant Hospital between January 1, 2012 and December 31, 2013, were included. Gestational age at RFA, the number of RFA cycles, maternal and fetal complications, gestational age at delivery, neonatal outcomes at 28 days after birth and neonatal development after birth were recorded. Fetal survival rate were defined as the number of survivors at 28 days after birth divided by the number of remaining fetuses after RFA. Factors affecting fetal survival rate were also analyzed. Statistical analysis was performed using Fisher's exact test. Results (1) The process for RFA:The gestatinal age for the procedure was (20.7±3.1) weeks(16+1-27+6 weeks). The successful rate of procedures was 100%(34/34) and the cycle number for RFA was 1-6 times. (2)Fetal complications and survival rate of remaining fetuses after RFA:there were six pregnant women suffering from premature rupture of membrane (PROM) before 28 weeks. Among those women, one had miscarriaged at 25 weeks, one chose to terminate at 26 weeks and the remaining four chose to continue the pregnancy. There were three remaining fetuses developing fetal severe anemia with hydrops after RFA. Two of them had fetal demises 2 days after the procedures and one chose to have termination. Another two cases with discordant fetal anomalies had fetal demises with unknown reasons one day after RFA. There were 27 remaining fetuses after RFA who survived until 28 days after birth. The mean gestational age at delivery was(36.4±4.1)weeks (26+4-40 weeks) and the mean birth weight was (2 913± 978) g (1 080-4 600 g). The overall fetal survival rate 28 days after birth was 79%(27/34). There were no abnormal findings in antenatal magnetic resonance imaging (MRI) four weeks after the procedure and no abnormal development of nervous system in the surviving neonates between 3 months old and 1.5 years old. (3) Factors affecting fetal survival rate :There were no significant differences identified in the rate of fetal severe anemia and fetal demise (2/15, 2/13 and 1/6), the rate of PROM before 28 weeks (1/15, 4/13 and 1/6) and survival rate of 28 days after birth (13/15, 10/13 and 4/6)among three groups with different gestational age (16+1-, 20- and 24-27+6 weeks) for RFA(all P>0.05). The indications for RFA included severe selective intrauterine growth restriction (50%, 17/34), discordant for fetal abnormalities(24%, 8/34) , twin reversed arterial perfusion sequence(18%, 6/34)and dichorionic or monochorionic triamniotic pregnancy (9%, 3/34). There were also no significant differences noted in the rate of fetal complications and fetal demise(3/17, 2/8, 0/6, 0/3), the rate of PROM before 28 weeks (3/17, 0/8, 2/6, 1/3)and survival rate of 28 days after birth among different groups (12/17, 6/8, 6/6, 3/3) with different indications for RFA(all P>0.05) . No significant differences observed in the rate of fetal complications and fetal demise(10% and 2/5)and the rate of PROM before 28 weeks (17%and 2/5)between two groups with different cycle numbers for RFA (<3 times and≥3 times, all P<0.05), while the group with cycle number ≥ 3 times had lower survival rate 28 days after birth than the group with cycle number<3 times for RFA (2/5 vs 86%, P<0.05). Conclusions RFA is one of effective and safe procedures for selective feticide in complex monochorionic pregnancies.

Electrolytes ; Therapeutic Irrigation ; methods

Objective To investigate the effects of angelica solution on chronic hypoxic pulmonary hypertension in rats.Methods Thirty SD rats were randomized into normoxic group,hypoxic group and angelica solution-protected group.The model of rat chronic hypoxic pulmonary hypertension was made by method of isobaric hypoxia.Angelica solution were injected before hypoxia,while the other two groups were injected normal saline.After 28d of hypoxia,pulmonary artery pressure were measured.Expressions of proliferating cell nuclear antigen (PCNA) and inducible nitric oxide synthase (iNOS) in pulmonary artery were detected by immunohistochemical staining.The index of wall thickness of rat pulmonary arteriole-percentage of the wall area in the total vascular area(wA%) were measured by a computerized image analyzer.Results The mean pulmonary artery pressure (mPAP) of normoxic group,hypoxic group and angelica solution-protected group were10.50±1.90,35.36±9.11,18.32±2.30 (mm Hg);wA% of the three groups were 52.71±5.16,82.38±8.43,64.58±9.54 (%),mPAP and wA% were significantly higher in the hypoxic group than those in the normoxic group (P<0.01) and angelica solution-protected group (P<0.01).PCNA expression of normoxic group,hypoxic group and angelica solution-protected group were 3.15±1.10,24.50±5.72,12.67±3.46 (%).The PCNA expression in the pulmonary artery was significantly higher in the hypoxic group than those in the normoxic group (P<0.01) and in the angelica solution-protected group (P<0.01).iNOS expression of normoxic group,hypoxic group and angelica solution-protected group were 2.13±1.01,17.33±3.53,37.50±7.04 (%).iNOS expression in the pulmonary artery was higher in the hypoxic group than those in normoxic group (P<0.01),and angelica significantly increased iNOS expression in comparison with the normoxic and hypoxic groups (P<0.01).Conclusion Angelica solution alleviates chronically hypoxia induced pulmonary hypertension in rats by inhibiting the espression of PCNA in pulmonary artery and up-regulating the expression of iNOS.

Objective To compare anti-inflammatory and hepatoprotective effects of Bupleurum marginatum Wall. ex DC. and Bupleurum chinense DC. Methods The anti-inflammatory effect of two kinds of radix bupleuri decoction were compared using the xylene-induced ear edema mice model and the egg white-induced foot swelling rats model. Acute liver injury in mice was induced through intraperitoneal injection of peanut oil with 0. 1%carbon tetrachloride. Alanine aminotransferase ( ALT ) , aspartate aminotransferase ( AST ) , and alkaline phosphatase ( ALP ) in serum, superoxide dismutase ( SOD ) , malondialdehyde ( MDA ) , and glutathione ( GSH ) in liver tissue homogenate were detected. Histopathological changes, transforming growth factor-β ( TGF-β) and nuclear factor-κB ( NF-κB) in hepatic tissues were also observed. Results Ear swelling experiment showed that the decoction of both Bupleurum marginatum Wall. ex DC. and Bupleurum chinense DC. had equal anti-inflammatory effects (P>0. 05). Similarly,the decoction of Bupleurum marginatum Wall. ex DC. and Bupleurum chinense DC. improved levels of ALT,AST,SOD,GSH,and MDA to the same extent compared with the model control group ( P<0. 05 or P<0. 01 ). There was no significant difference among all groups in ALP levels ( P > 0. 05 ). Histopathological and immunohistochemical experiments showed that expressions of TGF-β and NF- κB were similar between the two kinds of radix bupleuri. Conclusion Bupleurum marginatum Wall. ex DC. and Bupleurum chinense DC. have similar anti-inflammatory and hepatoprotective effects.

OBJECTIVE: To explore the effects of Salvia miltiorrhiza on renal morphology and renal function of rats with streptozotocin diabetes. METHODS: Thirty male Wistar rats were randomly divided into three groups, which were normal control group, untreated group and Salvia miltiorrhiza-treated group. Diabetic nephropathy was induced in rats of the last two groups by intraperitoneal injection of streptozotocin after unilateral nephrectomy. Then the rats in the normal control and untreated groups were fed with normal saline while those in the Salvia miltiorrhiza-treated group were fed Salvia miltiorrhiza preparation for 8 weeks. The glomerular volume (VG), kidney-to-body weight ratio (KW/BW), urinary albumin excretion rate (UAER) and creatinine clearance (Ccr) were observed. The expression levels of transforming growth factor-beta1 (TGF-beta1), connective tissue growth factor (CTGF), fibronectin (FN) and plasminogen activator inhibitor-1 (PAI-1) were detected by real-time quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) at the end of the experiment. RESULTS: UAER, Ccr, VG and KW/BW ratio were significantly higher in the untreated group than those in the normal control group (P<0.05). The expression levels of TGF-beta1, CTGF, PAI-1 and FN in the untreated group were also significantly higher as compared with those in the normal control group (P<0.05). UAER, Ccr, VG, KW/BW ratio and the levels of TGF-beta1, CTGF, PAI-1 and FN in the Salvia miltiorrhiza-treated group were obviously lower than those in the untreated group (P<0.05). CONCLUSION: Salvia miltiorrhiza can protect rats with streptozotocin diabetes from diabetic nephropathy by suppressing the over-expressions of TGF-beta1, CTGF, PAI-1 and FN in renal cortex.

Objective To investigate the biological mechanisms and feasibility of collagen/hydroxyapatite scaffolds for repairing articular cartilage and subchondral bone defects. Methods 45 New Zealand white rabbits were included. Full-thickness articular cartilage defect models were established in experiment and control groups and the biomaterial scaffolds were implanted in the experiment group. The animals were sacrificed in the 4th, 6th and 8th week after the operation respectively. Histological scores were performed by semi-quantity cartilage scoring system and the expressions of matrix metalloproteinases (MMPs)-2, 3, 9 and 13 mRNA in the synovialis were detected with RT-PCR. Results The repaired tissues were totally hyaline cartilages in the experiment group 2 weeks after operation and there were no repaired tissues in the control group. There were significant differences between these 2 groups in Wakitani scores (P<0.01). The activation and expression of MMP-2, 3, 9 decreased in the experiment group (P<0.05), but the activation of MMP-13 sustained and the expression of MMP-13 could be detected during the observed period (P>0.05). Conclusion The new biological scaffold can alleviate the inflammatory and protect the cartilages by inhibiting the expression of MMPS, which promote the reconstruction of articular cartilage in rabbits.