Six patients with ST segment elevated acute myocardial infarction (AMI), who were 52.5 years old in average, were enrolled and performed the treatment at Tongren Hospital from November 2003 to June 2004. Following percutanecus transluminal coronary angioplasty and stent revascularization, autologous bone marrow stem cell (BMSC) transplantation was performed after informed consent was obtained. Patients were subcutaneously injected with granulocyte colony-stimulating factor (G-CSF) at 1 week before transplantation. When CD34+ cells going up to 1%-3% in peripheral blood, mononuclear cells in peripheral blood were harvested,purified, and further infused into the infarcted related coronary artery with an over-the-wire balloon catheter. Following up was performed every half a year. Four years later, the infarcted area of these patients was further decreased by 8.03%, in the basic descent of 42.7% at 3 months averagely; total infracted area descent was 50.73%, but ejection fraction increased by 4.6% from 50.8%. There was no serious coronary artery restenosis and/or stenosis formation which need revascularization upon angiography.

Objective To compare in-vitro percutaneous absorption and pharmacodynamic actions of anti-inflammation and inhibiting delayed-type hypersensitivity of Chinese herbal compound cremor for eczema (CHCCE) with different mass concentrations of synthetic borneol. Methods By adopting modified Franz diffusion device add with isolated BALB/cnude mice skin as a barrier, in vitro percutaneous absorption effectiveness of CHCCE with different mass concentrations of borneol was compared by in vitro percutaneous test after the content of matrine was determined with high performance liquid chromatography(HPLC). Meanwhile, the effects of CHCCE with different mass concentrations of synthetic borneol on reducing dimethylbenzene-induced auricular edema and suppressing delayed-type hypersensitivity induced by 2,4-dinitrochlorobenzene(DNCB) in mice were compared. Results Cumulative permeation amount of matrine in CHCCE with synthetic borneol was higher than that in CHCCE without synthetic borneol 2～ 48 h after administration (P < 0.05). There was no significant difference of cumulative permeation amount (P>0.05) among CHCCE groups with different mass concentrations of synthetic borneol after 48 h. In vitro percutaneous absorption behavior of matrine arrived to the steady state and the cumulative permeation amount of matrine presented a decreasing trend in all medication groups 12 h after administration. Within 12 h of the medication, the permeation rate of CHCCE with different mass concentrations of borneol was in the sequence of 3％ borneol > 1％ borneol > 2％ borneol > 0.5％ borneol > no borneol. The content of matrine was decreased with the increase of mass concentration of synthetic borneol after 12 h. The results of pharmacodynamic actions of CHCCE showed that compared with the blank control group, CHCCE with 1％, 3％ synthetic borneol could significantly suppress the acute inflammation induced by dimethylbenzene and inhibit contact dermatitis induced by dinitrochlorobenzene (DNCB) in mice(P < 0.05). Compared with Triamcinolone Acetonide Acetate and Miconazole Nitrate and Neomycin Sulfate Cream, CHCCE with 1％, 3％synthetic borneol could decrease the serum level of IL-4, but the difference was insignificant(P>0.05). Conclusion CHCCE with 1％ synthetic borneol has good effects on in vitro transdermal absorption, and can suppress inflammation and delayed-type hypersensitivity effectively.

Objective To compare the clinical efficacy of double-lumen tube intubation between McGrath-5 video-laryngoscope and McCoy laryngoscope in patients with difficult airway. Methods Sixty patients who were predicted as difficult double-lumen tube intubation were divided into two groups using random number table method:McGrath-5 video-laryngoscope group (group A, n = 30) and McCoy laryngoscope group (group B, n = 30). All patients were intubated by two laryngoscopes correspondingly after conventional induction. The success rate of the first intubation, intubation time, the ratio of right positioning, the number of SpO2 < 90% within intubation time, the number of pressing the cricoid, the incidence of intubation complications and hemodynamic parameters [The changes in systolic pressure and heart rate and BIS were recorded before induction (T0), glottic exposure upon laryngoscope insertion (T1), immediately after intubation (T2), 3 min (T3) after intubation]. Results The number of pressing the cricoid was smaller in group A than in group B (P < 0.05), whereas the intubation time in group A was significantly higher than that in group B (P < 0.05). The systolic pressure and heart rate at T3 were dramatically reduced compared with those measured at T0 in both groups (P < 0.05). The systolic pressure and heart rate at T1 and T2 in group A were considerably lower in group A than those in group B (P < 0.05). Conclusions Compared with the McCoy laryngoscope, double-lumen tube intubation by McGrath-5 video-laryngoscope can less impact on hemodynamics, less intubation complications, intubation time although prolonged but not for influence the patient's oxygen supply, for difficult airway double-lumen tube intubation provides a good choice.

Objective To investigate the mechanism of drug resistance mediated by micF gene and outer membrane porin F ( OmpF) in Shigella strains. Methods Shigella strains were isolated from stool samples of patients who presented to the Second Hospital of Tianjin Medical University with acute diar-rhea in 2015. Antibiotic susceptibility test was performed to screen out the multidrug-resistant and non-multi-drug-resistant strains. The ompF gene was amplified by PCR. The micF and ompF genes at transcriptional levels in the two groups of strains were detected by quantitative real-time RT-PCR. Intracellular concentra-tions of ciprofloxacin in the two groups of Shigella strains were measured by automatic microplate reader. Re-sults According to the result of antibiotic susceptibility test, 13 strains that were resistant to 3 or more than 3 antibiotics were classified into the multidrug-resistant group, while the other 8 strains that were sensitive to all antibiotics used in this study or only resistant to 1 or 2 antibiotic were classified into the non-multidrug-re-sistant group. All of the 21 Shigella strains carried the ompF gene. Compared with the non-multidrug-resist-ant strains, the multidrug-resistant strains showed higher expression of micF gene, but lower expression of ompF gene. The differences in micF and ompF genes between the two groups were statistically significant. The result of correlation analysis suggested that there was a negative correlation between micF and ompF genes (r=-0. 244). The intracellular concentrations of ciprofloxacin in multidrug-resistant strains were low-er than those in the non-multidrug-resistant strains (P<0. 001). Conclusion The decreased expression of OmpF was one of the possible mechanisms of multidrug-resistance in Shigella strains. The micF gene was negatively related to the expression of OmpF. Moreover, the decreased intracellular concentrations of cipro-floxacin in multidrug-resistant strains might be related to the decreased expression of OmpF.

Objective To investigate functional role and clinical significance of the methylation in the promoter of TPAP gene in the development and progression of pancreatic cancer.Methods Surgically resected specimen from 68 patients who were pathologically diagnosed as pancreatic cancer in Changhai Hospital from July 2006 to August 2009 were collected.The methylation in the promoter of TPAP gene in tumor and nontumor adjacent tissue was detected by methylation specific PCR.Results The methylation rate of tumor and non-tumor adjacent tissue was (0.214 ± 0.057) ％ and (0.084 ± 0.096) ％,respectively,and pancreatic cancer tissue had significantly higher methylation rate than the adjacent tissue.Hypermethylation of TPAP gene was not correlated with age,gender,tumor differentiation,lymphatic metastasis,serum CEA and CA19-9,but was positively correlated with distant metastasis.Conclusions Hypermethylation in the promoter of TPAP gene may participate in the invasion and metastasis of pancreatic cancer and the hypermethylation of the promoter is closely associated with the tumorigenesis and development of pancreatic cancer.

Objective To compare the clinical efficacy,adverse reactions,and management effect of postoperative intravenous analgesia for patients with postoperative intravenous analgesia with digital information technology and electronic analgesia pump system.Methods Totally 100 patients with postoperative intravenous analgesia (PCIA) were selected from April 2015 to September 2015 with postoperative intravenous analgesia and randomly divided into Wireless analgesic pump system Group (A group) and electronic analgesia pump group (group B),n =50 each group.Pain score (NRS),sedation score (OAA/S),comfort score (BCS),the total number of times and the number of effective press were pressed in patients were observed and compared between two groups after postoperative analgesia 1 hour (T0),4 hour (T1),10 hour (T2),16 hour (T3),and 24 hour (T4).Patients with early adverse reactions,patients and ward medical staff satisfaction,pain pump failure found in the medical staff and effective treatment of adverse events were also observed and compared in two groups.Results There were no significant difference of patients with NRS,OAA/S and BCS in two groups (P ＞ 0.05).Adverse reactions after postoperative analgesia,total number of times and the number of effective press had also no significant difference in two groups (P ＞ 0.05).Two groups of patients with air blockage,incomplete analgesia rate of adverse events was not significantly different (P ＞ 0.05).Medical workers in time [(1.0 ± 0.5) min vs (3.0 ± 2.1) min,P ＜ 0.05],effective processing time [(4.0-± 2.1) min vs (8.0 ± 5.1) min,P ＜ 0.05] in group A was significantly shorter than group B.The patient satisfaction in group A was significantly higher than group B(12.0 ± 4.2 vs 9.0 ± 3.1,P ＜ 0.05).The satisfaction degree of medical staff in group A was also significantly higher than group B(13.0 ±3.1 vs 10.0 ±2.1,P ＜0.05).Conclusions The digital information technology of wireless analgesic pump is applied to postoperative analgesia for medical workers to standardize management,improve the work efficiency,and increase the satisfaction of patients and medical staffs.

Objective To study the change of rats serum malondialdehyde (MDA) and the expression levels of 4-hydroxy acid nonene (4-HNE) and 8-hydroxy uridine (8-OHdG) of articular cartilage under low selenium (Se) and T-2 toxin poisoning,to explore oxidative damage of articular cartilage in rats.Methods Thirtytwo healthy male SD rats were divided into two groups by weight which were normal diet group and Se-deficiency group,16 rats in each group.Rats in normal diet group was fed with selenium 101.5 μg/kg diet,and rats in Sedeficiency group was fed with selenium 1.1 μg/kg diet for 30 d.Normal diet group was divided into control group and T-2 toxin group,and low selenium diet group was randomly divided into Se-deficiency group and Se-deficiency plus T-2 toxin group,8 rats in each group.After that,rats in T-2 toxin and Se-deficiency plus T-2 toxin groups were administrated intragastrically with T-2 toxin (100 mg/kg) everyday for 30 d.Rats were put to death,the left knee was taken and stained with hematoxylin-eosin and Safranin-Fast green,pathological changes of rat's knee joint cartilage were observed under light microscopy,expression levels of 8-OHdG and 4-HNE in rat's articular cartilage cells were determined by immunohistochemical method and rat's MDA content was determined by glucosinolates barbituric acid method.Results Chondronecrosis in deep zone of articular cartilage of knee joint stained with hematoxylin-eosin was seen in Se-deficient plus T-2 toxin diet group under light microscope.Significantly less Safranin-Fast green staining was observed in the cartilage of knee joints in the Se-deficient plus T-2 toxin diet group compared to the control group.Compared with control group [(3.41 ± 2.48)％,(2.28 ± 1.74)％],8-OHdG and 4-HNE in Se-deficient plus T-2 toxin group [(62.61 + 10.97)％,(75.03 ± 7.92) ％] positive expression rate increased significantly (F =16.24,18.61,all P ＜ 0.05).Comparison of serum MDA content in each group,the difference was statistically significant (F =4.32,P ＜ 0.05).The Se-deficiency group [(2.803 ± 0.163) μmol/L] was compared with control group [(1.873 ± 0.475) μmol/L] that the contents of serum MDA were increased.The T-2 toxin group [(2.890 ± 0.453) μmol/L] was compared with control group [(1.873 ± 0.475) μmol/L] that the content of serum MDA was increased (P ＜ 0.05).The Se-deficiency plus T-2 toxin group [(3.521 ± 0.292) μmol/L] was compared with Sedeficiency group and control group that the contents of serum MDA were increased (all P ＜ 0.05).Conclusions The marker of peroxidation products are increased in articular cartilage of SD rats under the condition of Sedeficiency and T-2 toxin poisoning.The cartilage damage and chondronecrosis due to Se-deficiency and T-2 toxin poisoning are related to oxidative damage.

Objective To compare the effect of conventional and hyperoxia management strategy during deep hypothermia in patients with DeBake type 1 aortic dissection or aortic arch aneurysm undergoing total aortic arch replacement.Methods 32 adult patients undergoing total aortic arch replacement were randomly allocated to one of two groups(n=16 each):conventional(C)and hyperoxia group(H).The patients had no history of cerebral vascular disease.Left radial artery and dorsal artery of left foot were cannulated for monitoring of blood pressure of upper and lower limbs.Right internal jugular vein was cannulated for CVP monitoring and administration of drug and fluid.Anesthesia was induced with etomidate 10-15 mg,fentanyl 5-10 ?g?kg~(-1) and pancuronium 0.1 mg?kg~(-1) and maintained with fentanyl(total amount was＜20 ?g?kg~(-1)),isoflurane and pancuronium after tracheal intubation.Intermittent i.v.boluses of diazepam,sodium thiopental or propofol were given during cardiopulmonary bypass(CPB).Another catheter was inserted into right internal jugular vein eephalad until resistance was met.The tip of the catheter was at the level of mastoid process.The hyperoxia management involved the following steps:FiO_2 was gradually reduced with decreasing body temperature(T_0)from 70%(36～ 37℃)to 60%-40%(35.9-34℃),38%-30%(32-26℃),30%(26-24℃)and finally to 21%.When nasopharyngeal T_0 was reduced to 22℃ or 5-10 min before selective cerebral peffusion(SCP),FiO_2 was raised to 60%-100% to maintain PjvO_2＞20 mm Hg or SjvO_2＞60%.FiO_2 was maintained at 60%-100% during SCP until T_0 was rewarmed to 22℃,then reduced to 30%.FiO_2 was then gradually increased to 40%(when T_0 reached 28℃),to 50%-70% (34-37℃)and finally to 80%(T_0＞37℃).Blood samples were taken from jugular venous bulb and arterial port of oxygenator for determination of PjvO_2,SjvO_2 and PaO_2 before skin incision (T_1),at 15 min of CPB(T_2),10 min of SCP(T_3),5 min after descending aorta unclamping(T_4),5 min after left subclavian artery unclamping(T_5),5 min after left common carotid artery unclamping(T_6),anonymous artery unclamping(T_7),when nasopharyngeal To returned to 35℉(T_8)and 10 min after CPB was terminated(T_9).The awakening time and the duration of ICU stay(days)were recorded.Pre- and postoperative neurological examination and brain CT scan were performed.Results All patients survived the operation and were discharged from hospital.No new brain infarction occurred.Transient neurologic dysfunction occurred in 2 patients in group H and 3 patients in group C.There was a positive linear relationship between PaO_2 and PjvO_2 during deep hypothermia in group H (r=0.541,P＜0.01).The PjvO_2 and SjvO_2 were significantly higher in group H than in group C.The awakening time and the ICU stay were significantly shorter in group H than in group C.Conclusion The hyperoxia management strategy can provide clinical prognosis than the conventional management strategy during deep hypothermia for total aortic arch replacement by supplying more dissolved oxygen.

Objective This is the first study to explore clinical application value of serum Dickkopf-1 (DKK-1) detection in diagnosis of heptocellular carcinoma (HCC) by magnetic solid phase chemiluminescent immunoassay.Methods The level of serum DKK-1 and AFP in 205 cases of HCC,40 cases of liver cirrhosis,and 200 cases of healthy control were quantitatively detected by Magnetic solid phase chemiluminescent immunoassay.The area under ROC curve,sensitivity and specificity of DKK-1 and AFP for diagnosing HCC were calculated.Results The serum level of DKK-1 in HCC group was significantly higher than those of the liver cirrhosis group and healthy control group (P<0.01).DKK-1 maintained diagnostic sensitivity for patients with HCC who were alpha-fetoprotein (AFP) negative (66.3%).ROC curves showed optimum diagnostic cut-off value was 2.4 ng/mL,area under curve (AUC) was 0.822 (95% CI:0.783-0.856),sensitivity 65.9%,and specificity 87.5%).Moreover,measurement of DKK1 and AFP together improved diagnostic accuracy for HCC versus all controls compared with either test alone [AUC 0.915,95%CI:0.886-0.940),sensitivity 81.5 %(P<0.05)].Conclusion Serum DKK-1 detection has an important clinical value for diagnosis of HCC,especially for HCC with AFP negative.The combined detection of serum DKK-1 and AFP can greatly increase sensitivity and accuracy for diagnosing HCC.

Objective To understand genetic distribution, drug resistance, molecular typing and the epidemiological relativeness between strains of the Shigella boydii virulence. Methods Nine Shigella boydii strains were isolated form stool samples of patients with diarrhea from the Enteric Disease Clinic of the Second Hospital of Tianjin Medical University in June-October 2015. The strains were identified by biochemical test and serum agglutination test. Antibiotics susceptibility test was carried out using the Kirby-Bauer method. Polymerase chain reaction was used for detecting virulence genes. Pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) technique were used to determine the epidemiological relationship between nine Shigella boydii strains. Results There were three subtypes in nine isolated Shigella boydii samples, including one, three and five isolates inⅠ,Ⅱ,Ⅳsubtypes respectively. All of the 9 isolates were multi-drug resistant. The resistant rate of these strains for ampicillin was 100%(9/9), and then the resistant rates of these strains for ceftazidime, streptomycin, gentamicin, trimethoprim/sulfamethoxazole, cefotaxime, ceftriaxone, norfloxacin and levofloxacin were 1/9, 4/9, 4/9, 4/9, 5/9, 5/9, 6/9, 6/9 and 6/9, respectively. All of these strains were sensitive to amikacin, cefperazone-sulbactam and imipenem. The ipaH was carried by all the testing strains, and none of the strains carried the sen, set1A, set1B, ial, virA, icsA and SigA. The detective rates of pic, sepA and sat were 4/9, 5/9 and 7/9 strains, respectively. Nine shigella boydii strains were divided into 8 PFGE types. The similarity between the spectrums of PFGE was 63.21%-100%. Multilocus sequence typing showed that six isolates were belonged to ST648, two isolates were ST131 and one isolate was ST10. Conclusion Nine isolates of Shigella boydii (divided into three subtyping) isolated from our hospital are multi-drug resistant and they have distant relationships, belonging to the dissemination of case.