Objective Study the expressions of intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) in rat models of cerebral ischemia reperfusion and the protective effect of ?-Sodium Aescinate.Methods Rat models of cerebral ischemia-reperfusion were made using an intraluminal monofilament method and ?-Sodium Aescinate was given peritoneally to observe its protective effect. The histochemical change and the expression of ICAM-1, VCAM-1 were detected by HE staining and immunohistochemistry ways.Results (1) ?-Sodium Aescinate could obviously reduce the brain damage after ischemia reperfusion. (2) The expressions of ICAM-1, VCAM-1 in endothelial cells in ischemic territory increased after cerebral ischemia reperfusion. ICAM-1 immunoreactivity peaked at 24 h after reperfusion and VCAM-1 immunoreactivity peaked at 24～48 h after reperfusion. Both of them decreased gradually, but remained a higher level than normal 72 h after reperfusion. (3) ?-Sodium Aescinate could decrease the expressions of ICAM-1, VCAM-1 remarkably 24 h and 48 h after reperfusion.Conclusions High expressions of ICAM-1, VCAM-1 may be involved in the mechanism of cerebral ischemia reperfusion injury. ?-Sodium Aescinate may play its protective role by reducing the expressions of ICAM-1 and VCAM-1.

Objective:To evaluate the curative effect and safety of fasudil hydrochloride injection in the prevention and treatment of aneurysm postoperative cerebral vasospasm by meta-analysis. Methods: The randomized controlled trials were retrieved from PubMed, EMBASE, Cochrane Library, VIP, Wangfang, CNKI and so on. Meta-analysis was conducted using RevMan 5. 0 software. Results:Totally 418 reference studies were screened, from which 11 ones were chosen including 786 patients in all. In the treatment of cerebral vasospasm (CVS), there was no significant difference between the groups (OR=1. 56, 95%CI:0. 95-2. 58, P>0. 05). While in the prevention of CVS, the incidence rate of CVS in fasudil group was significantly lower than that in nimodipine group ( OR=0. 43, 95%CI:0. 23-0. 81, P=0. 008). However, the incidence rate of ADR in fasudile group was higher than that in nimodipine group (OR=0. 43, 95%CI:0. 25-0. 75,P=0. 003). Conclusion:In the prevention of CVS, fasudil may be better than nimodipine, while the incidence of ADR is higher.

Objective:To evaluate the effectiveness and safety of anticoagulant therapy with rivaroxaban in atrial fibrillation( AF) pa-tients after radiofrequency catheter ablation( RFCA) . Methods:A retrospective analysis was performed in the study. Totally 141 AF pa-tients with RFCA in our hospital were enrolled from January 2014 to October 2015. The patients were divided into rivaroxaban group(70 patients)and warfarin group (71 patients). In rivaroxaban group,rivaroxaban(10 mg, po,qd)was given for at least 3 months after RFCA. In warfarin group,low molecular heparin (100 IU·kg-1,ih) was given before RFCA, and standard dose of warfarin (3-5 mg,po,qd) was given for at least 3 months by adjusting the INR within the range of 2. 0-3. 0 after RFCA as bridging therapy. The death rate, throm-boem bolism events and bleeding events between the groups were evaluated and companed groups. Results: There were no significant differences in baseline characteristics between the groups except the diastolic pressure. There were no significant differences in the death and thromboembolism events(transient cerebral ischemia , ischemic encephalopathy, 2/70 vs 4/71,P>0. 05)between the groups. There were no TIMI major bleeding events in both groups. There were no significant differences in minor bleeding events between the groups (3/70 vs 4/71,P>0. 05). Conclusion: Compared with those of warfarin,the effectiveness and safety of rivaroxaban show the similar effect in AF patients after RFCA. Rivaroxaban can be safely and effectively used in AF patients with low or middle risk of thromboembo-lism after RFCA.

Objective To perform the chromosome detection in 1 237 infertile patients for analyzing the karyotypes results and investigating the relationship between infertility and chromosome abnormalities .Methods The peripheral venous blood samples in 1 237 infertile patients in our hospital from March 2010 to December 2014 were collected ,performed the lymphocyte culture ,ob‐tained cells ,fixed under hypotonic condition ,prepared the section and observed them by microscope after G‐banding treatment .Re‐sults Among 1 237 patients ,111 cases abnormal karyotypes were detected with the total abnormal detection rate of 8 .9% ,in which ,57 cases were sex chromosomes abnormality ,54 cases were euchromosomes abnormality .Conclusion Chromosome abnor‐mality is one of the important causes leading to primary infertility .Infertility caused by chromosome abnormalities is irreversible ,so the chromosome cytogenetic examination is especially important in the diagnosis and treatment process of infertile patients .

Objective To evaluate the effects of electromagnetic irradiation of 2000 μW/cm2 exposure on mRNA and protein expression levels of immunoreactive protein and mRNA of NMDAR1 in rats hippocampal,and to explore the impaired mechanism of electromagnetic irradiation on learning and memory.Methods Rats were randomly divided into normal control group, sham-radiated group, and 1 h/d, 2 h/d, and 3 h/d radiation groups.The rats in the radiation groups were fixed and recieved microwave exposure of 2000 μW/cm2, then their learning and memory abilities were tested by Morris water maze experiment, the change of NR1 protein in hippocampal neurons of each group of rats was measured with immunohistochmistry and western blot techniques, and the expression of NR1 mRNA in hippocampus was determined by RT-PCR.Results In the water maze test,compared with the normal control group (8.8 ± 1.66 ), the escape latency of three radiated groups rats ( 1 h/d ( 12.29 ±1.36) s,2 h/d ( 17.99 ±2.25) s,and 3 h/d (24.66 ±5.56) s) were significantly longer (P＜0.05).In the radiation group,the hippocampal neurons of rats showed evident reduction in the ratio of NR1 positive cells,irregular,and arrayed in disorder.Moreover,compared with the normal control group ( (0.70 ±0.11 ), (0.68 ±0.11 ) ) ,the expession of NR1 protein ( 1 h/d (0.122 ±0.026) ,2 h/d (0.102 ±0.023) ,and 3 h/d (0.060 ± 0.009) ) and its mRNA ( 1 h/d (0.46 ±0.07) ,2 h/d (0.35 ±0.05) ,and 3 h/d (0.12 ±0.02) ) in hippocampal neurons was significantly decreased (P＜0.05).Among the indicators, there was no significant difference between sham-radiated group and normal control group.Conclusions Electromagnetic irradiation of 2000 μW/cm2 exposure can impair the learning and memory abilities of rats possibly through a mechanism correlated with the lower expression of NR1 protein and its mRNA in hippocampus.

BACKGROUND: Intrapulmonary vascular abnormalities result in the right-to-left shunting and severe hypoxemia in liver transplantation candidates. Currently, a convenient, sensitive and effective method is absent to screen the intrapulmonary vascular dilatations.OBJECTIVE: To evaluate the role of contrast-enhanced echocardiography on clinical diagnosis of intrapulmonary shunting in liver transplantation candidates.DESIGN, TIME AND SETTING: The experiment, prospective controlled observation based on cases, was performed at the Hepatology Unit of the 458 Hospital of PLA (Guangzhou, Guangdong, China) from February 2004 to February 2006.PARTICIPANTS: Twenty-four consecutive liver transplantation candidates were recruited from the Hepatology Unit of the 458Hospital of PLA.METHODS: Routine examination was conducted under the condition without any regimen of vascular dilatation drugs.Contrast-enhanced echocardiography was applied to detect the prevalence of right-to-left shunting in the patients with end-stage liver disease. The microvesicle of the left ventricle in patients was qualitatively assessed by a score from 1+ to 3+. Accordingly, all patients were divided into two groups: intrapulmonary shunting and non-intrapulmonary shunting.MAIN OUTCOME MEASURES: The prevalence of right-to-left shunting and clinical characteristics of liver transplantation candidates were determined.RESULTS: Ten (41.7%) of 24 patients with positive contrast-enhanced echocardiography were proved to develop the intrapulmonary right-to-left shunting, including 6 for l+ and 4 for 2+ by left ventricle abnormality, which emerged after 6-10 cardiac cycles of right ventricle abnormality. There were no significant differences in age, gender, arterial blood gas analysis and liver function tests between the two groups (P > 0.05). Echocardiography results demonstrated that, the upper digestive tract hemorrhage,spleen thickness that indicated portal hypertension, pulmonary artery systolic pressure and Tei index were significandy higher in the patients of intrapulmonary shunting than in those of non-intrapulmonary shunting (P<0.05-0.01 ).CONCLUSION: Intrapulmonary vascular dilatation occurs frequently in liver transplantation candidates associated with intrapulmonary shunting but without hypoxemia. Contrast-enhanced echocardiography is a sensitive and non-invasive method for the early diagnosis of intrapulmonary vascular dilatation. The pathogenic cause is portal hypertension. Tel index can be used as an important parameter for evaluating right ventricular function in patients of intrapulmonary vascular dilatation.

OBJECTIVE:To compare the efficacy and safety of dabigatran and warfarin respectively used in atrial fibrillation patients after radiofrequency ablation(RFCA). METHODS:Data of 141 nonvalvular atrial fibrillation patients,who scheduled for RFCA,were retrospectively analyzed and divided into warfarin group(71 cases)and dabigatran group(70 cases)by different med-ication. Patients in warfarin group should stop warfarin if they took before,then changed to Low molecular weight heparin calcium injection 100 U/kg,subcutaneous injection,taking RFCA when INR was lower than 1.5,stopping low molecular weight heparin 12 h before surgery;Low molecular weight heparin calcium injection 100 U/kg was intravenously injected when surgery;orally tak-ing Warfarin sodium tablet 4.5 mg after 4-6 h,once a day,meanwhile bridged overlapping treated at least 3-5 d with low molecu-lar weight heparin;monitoring once INR every 3 d after surgery,maintaining INR 2.0-3.0,taking warfalin at least 3 months. Pa-tients in dabigatran group stopped taking the anticoagulant drugs when admission,then changed to Dabigatran etexilate capsule 110 mg(age≥70 years old or body mass<60 kg)or 150 mg(age<70 years old or body mass≥60 mg),twice a day;stopping dabig-atran 24 h before surgery,the same medication as warfalin group when surgery;orally taking dabigatran after 6 h,taking at least 3 months. The total mortality rate,incidence of stroke(transient cerebral ischemia,ischemic encephalopathy),peripheral thrombosis rate and incidence of bleeding after 1 and 3 month(s)in 2 groups were observed. RESULTS:There were no significant differences in the total mortality rate,incidence of stroke,peripheral thrombosis rate and incidence of bleeding after 1 and 3 month(s) in 2 groups(P>0.05). CONCLUSIONS:Dabigatran has similar anticoagulant efficacy and safety with warfarin in atrial fibrillation pa-tients after RFCA.

Objective: To discuss the pharmaceutical care experience of clinical pharmacists in the antibacterial agents application in one patient with infection after coronary artery bypass graft ( CABG) . Methods:The clinical pharmacist participated in the treatment of the patient after CABG. According to the relevant laboratory indices and the extent of the infection combined with the vital signs of the patient, the pharmacist formulated and adjusted the anti-infection therapeutic regimen. The therapeutic effects and adverse reactions were observed as well. Results: Safte and high-quality individualized pharmaceutical service was provided to the patient by the pharmaceutical care of the clinical pharmacist in anti-infection treatment. Conclusion:Through the above practice, clinical pharmacists have played a positive role in reasonable using of anti-infective drugs in patients with cardiac surgery.

Objective To investigate the changes and significance of ubiquitination of Foxp3 pro-tein during the acute phage of Kawasaki disease ( KD) .Methods Forty-eight children with KD and twenty-eight age-matched healthy children were recruited in this study.Co-immunoprecipitation and Western blot assays were performed to determine the poly-ubiquitination status of Foxp3 in CD4+T cells.The percentages of CD4+CD25high Foxp3+regulatory T cells ( Treg) and the levels of IL-10, transforming growth factor-β( TGF-β) , cytotoxic T lymphocyte-associated protein-4 ( CTLA4 ) , STIP1 homology and U-Box containing protein 1 (STUB1), heat shock protein 70 (HSP70), ubiquitin-specific-processing protease 7 (USP7) and pSTAT3 were analyzed by flow cytometry analysis.Quantitative real-time PCR was used to evaluate the tran-scription levels of TLR1-10, IL-1R1, IL-1RAP, IL-6Rα, gp130, TNFR1, MyD88 and RIP1 in CD4+T cells.Plasma concentrations of IL-1β, IL-6 and TNF-αwere measured by enzyme-linked immunosorbent as-say.Results (1) The percentages of Treg cells and the levels of IL-10, TGF-β, CTLA4 and forkhead box P3 (Foxp3) in patients with acute KD were lower than those of healthy subjects (P<0.05), while the poly-ubiquitination of Foxp3 protein was significantly enhanced in patients with acute KD [(0.52 ±0.19) vs (0.08±0.02),P<0.05].Meanwhile, the four former items in KD patients with coronary artery lesions (KD-CAL+) were lower than those of KD patients without coronary artery lesions (KD-CAL-) (P<0.05), while the polyubiquitination level of Foxp3 protein in KD-CAL+group was much higher than that of KD-CAL-group [(0.70±0.28) vs (0.43±0.17), P<0.05].The levels of Treg cells, IL-10, TGF-βand CTLA4 in patients with KD were increased and the ubiquitination of Foxp3 protein was inhibited [(0.24±0.10) vs (0.52±0.19), P<0.05] upon the treatment with IVIG.(2) The levels of STUB1 and HSP70 in CD4+T cells were significantly elevated during acute KD, while the levels of USP7 were decreased (P<0.05).The ratios of STUB1/USP7 in patients with acute KD were much higher than those of the control group [(2.65± 0.92) vs (1.09±0.37), P<0.05], but were significantly decreased after IVIG therapy [(1.46±0.53) vs (2.65±0.92), P<0.05].A negative correlation was found between STUB1/USP7 ratio and Foxp3 level during acute KD (r=-0.56, P<0.05).Moreover, KD patients with CAL+showed higher levels of STUB1 and HSP70 and higher ratios of STUB1/USP7 (P<0.05), but lower levels of USP7 as compared with those of KD-CAL-group (P<0.05).(3) The plasma concentrations of inflammatory cytokines (IL-1β, IL-6 and TNF-α), the levels of surface receptors ( IL-1R1/IL-1RAP/TLR4, IL-6Rα/gp130 and TNFR1) and its downstream molecules ( MyD88, pSTAT3 and RIP1) in CD4+T cells were up-regulated during acute KD ( P<0.05), especially in patients with CAL+, but were down-regulated upon the IVIG therapy (P<0.05).No significant differences with other TLRs were found among the groups (P>0.05).Conclusion Hyper-ubiq-uitination of Foxp3 protein might be involved in the immune dysfunction during Kawasaki disease.

Objective To investigate the angiographic manifestations of renal artery injury caused by percutaneous nephrolithotomy, and to evaluate the therapeutic effect of super-selective renal arterial embolization in treating renal artery injury. Methods A total of 22 patients with persistent or intermittent gross hematuria that occurred after percutaneous nephrolithotomy, who were encountered at authors’ hospital during the period from Jan. 2010 to June 2014, were included in this study. The diagnosis was confirmed by renal angiography in all patients, and super-selective renal arterial embolization with steel micro-coils was carried out in all patients. The patients were followed up for three months. The results were analyzed. Results Of the 22 patients, DSA examination showed that renal artery pseudoaneurysm (RAP) was found in 14 (63.6%), renal arteriovenous fistula (RAVF) in 5 (22.7%) and RAP associated with RAVF in 3 (13.6%). Renal angiography performed after super-selective renal arterial embolization showed that complete obstruction of the bleeding arteries was achieved in all patients, and the active bleeding stopped. Both the technical success rate and the hemostasis rate were 100%. During the follow-up period lasting for three months, no recurrence of hematuria or severe complications occurred. In 20 patients, different degree of embolism syndrome was observed after the treatment. Conclusion Renal artery pseudoaneurysm and renal arteriovenous fistula are the main types of renal artery injury after percutaneous nephrolithotomy. Super-selective renal arterial embolization with micro-coils can be used as the treatment of choice for patients who has failed to respond to conservative therapy.