Objective To investigate the effects of enalapril on tachycardia induced acute atrial electrical remodeling in human.Methods 27 patients with paroxysmal supraventricular tachycardia undergoing radiofrequency catheter ablation were randomly divided into control group (16 patients) and enalapril group (11 patients). After autonomic blockade, atrial effective refractory period (AERP) in multiple sites, AERP rate adapting feature, AERP dispersion (AERPd) and inducibility of atrial fibrillation were measured before and after rapid atrial pacing with maximal atrial capture rate(349?37bpm)in both groups. Results ①In control group, AERP shortened significantly after rapid atrial pacing, but it did not change dramatically in enalapril group; ② Before and after rapid atrial pacing, curve estimation showed that the slope values were 0 062 and 0 018 in control group. In enalapril group the slope values were 0 059 and 0 053 respectively; ③After rapid atrial pacing, the inducibility and duration of atrial fibrillation increased significantly in control group, which did not change dramatically in enalapril group. Conclusion Enalapril can prevent acute atrial electrical remodeling and reduce the inducibility of atrial fibrillation after rapid atrial pacing.

Objective To analyze the surgical and pathologic features of isolated ascending aortitis without evidence of rheumatologic or autoimmune diseases by comparing that of Takayasu's arteritis.Methods Consecutive 965 excised ascending aortas were reviewed and 40 cases with aortitis were selected from the pathological archives of past 20 years in Fuwai Hospital.The clinical history,laboratory and angiographic data,surgical findings,steroid therapy and followup results of these 40 cases were reviewed.Pathological parameters included the thickness of aortic wall and its various layers,inflammation activity,multinuclear giant cells,inflammatory necrosis,laminar necrosis and atheroselerosis.The t test and Chi square analysis were used to compare the means and the rates between the two groups.Results Twenty-five of 40 cases were diagnosed with isolated aortitis and its prevalencei was 2.6%(25/965),while 8 cases with Takayasu's arteritis and 7 cases with other vasculitis were confirmed.The age of isolated ascending aortitis was older than that of Takayasu's arteritis[(46±12)y vs(34±14)y,t=2.30,P>0.05] while the male/female ratio was similar in both groups(1.1 vs 1.0,t=0.01,P>0.05).Their main clinical manifestation was aortic aneurysm with a bigger aortic diameter in isolated aortitis than that in Takayasu's arteritis [(59±18)vs(46±12)mm,P>0.05].The asymptomatic cages mostly were found in isolated ascending aortitis (28%vs 0,x2=2.98,P>0.05).The erythrocyte sedimentary rate was normal in isolated aortitis but increased in Takayasu's arteritis[(15±17)mm/1 hvs[27±25)mm/1 h,U=48.50,P<0.05 ].Inflammatory edema,thickening and calcification were noted in more than half cases of both groups.but slighter thickening of aortic wall was foand in isolated ascending aortitis in contrast to the remarkable thickening in Takayasu artefifis[(2506±493)vs (3300±430)μm,t=-3.00,P<0.01].Giant cells,inflammatory necrosis,laminar necrosis and accompanied atherosclerosis were more common in isolated ascending aortitis.Aortic regurgitation was common but inflammatory invasion wege found in few aortic valves. Steroid was prescribed in 5 cases with isolated ascending aortitis and none of them was reported with complications while aortic perivalvular leakage occurred in 3 of 20 cases without steroids therapy. In the Takayasu's arteritis cases, new aneurysm of abdominal aorta was found in 1 of 3 cases with steroid therapy. Meanwhile, perivalvular leakage and subclavian artery stenosis occurred in 2 of 5 cases without steroid. Conclusion Isolated aortitis is more common than Takayasu's arteritis in ascending aortic diseases and there is some definite difference in clinical and pathological aspects between these two diseases. Since the effect of steroid therapy is uncertain and in order to avoid overtreatment, we suggest that steroid should not be given to cases with isolated ascending aortitis after surgery and clinical and angiographic follow-up should be emphasized.

BACKGROUND:To design and fabricate a novel three-dimensional thermoresponsive polymer cel scaffold is one of the hot topics in the research of polymer science. OBJECTIVE: To prepare three different kinds of thermoresponsive acelular carriers and to evaluate their performance. METHODS:The copolymer N-isopropylacrylamide temperature acelular scaffold, macroporous copolymer N-isopropylacrylamide temperature acelular scaffold and macroporous copolymer N-isopropylacrylamide crosslinking aldehyde sodium alginate thermoresponsive acelular scaffold were prepared. The specific surface area, thermoresponsive performance, porosity, pore size and biocompatibility of these three groups of scaffolds were determined. RESULTS AND CONCLUSION: The specific surface area of copolymer N-isopropylacrylamide thermoresponsive acelular scaffold, macroporous copolymer N-isopropylacrylamide thermoresponsive acelular scaffold and macroporous copolymer N-isopropylacrylamide crosslinking aldehyde sodium alginate thermoresponsive celular scaffold was respectively 135, 386, 421 m2/g. The lower critical solution temperature was 30, 28.5, 29.5℃. The cel toxicity reaction was respectively grade 2, 2, 1. These indicators showed that the three kinds of scaffolds were provided with a temperature-sensitive characteristics and similar lower critical solution temperature. The biocompatibility of macroporous copolymer N-isopropylacrylamide crosslinking aldehyde sodium alginate thermoresponsive acelular scaffold was significantly better than the other two scaffolds. The porosity and pore size of macroporous copolymer N-isopropylacrylamide thermoresponsive acelular scaffold and macroporous copolymer N-isopropylacrylamide crosslinking aldehyde sodium alginate thermoresponsive acelular scaffold were greater than those of the copolymer N-isopropylacrylamide thermoresponsive acelular scaffold (P < 0.05). These results demonstrate that macroporous copolymer N-isopropylacrylamide thermoresponsive acelular scaffold and macroporous copolymer N-isopropylacrylamide crosslinking aldehyde sodium alginate thermoresponsive acelular scaffold have more obvious pore structure.

Aim To investigate the inhibitory effects of urocortin2 (UCN2) on ventral tegmental area (VTA) nervous activity of morphine addiction rats and the mechanism. Methods Morphine addiction rats and the microiontophoresis method were used to observe the effects of UCN2 on VTA neuron′s spontaneous dis-charge changing rule, as well as the inhibitory effects of UCN2 on DA neuron′s cluster spontaneous dis-charge, to identify UCN2 and DA on the same VTA neuron. Morever, the inhibitor of corticotropin-regula-ting factor′s receptor ( CRF-2 R ) and the blocker of protein kinase A ( PKA ) , AST-2 B and H89 , were used to investigate the effects of UCN2 on VTA neuron′s of morphine addiction rats. Results UCN2 could inhibit the firing rate 82% (31/38) of the tested VTA neuron ( P<0. 01 ) , the discharge frequency changed from (20. 89 ± 2. 86) Hz to (13. 66 ± 3. 93) Hz (P<0. 01). Further, the inhibitor of PKA, AST-2B and H89 could ablolish the inhibitory effects of UCN2 . Morever, the excitatory firing of VTA neurons was at-tenuated by addition of UCN2 , while AST application could inhibit the UCN2′s inhibitory effects. Conclu-sion UCN2 could regulate the effects of VTA via PKA pathway and may thereby contribute to the improvement of drug addiction.

Objective To observe the protective and regeneration-promoting effects of Ruyi Zhenbao Pill (RZP) on nerve injury in zebrafish.Methods The zebrafish model of central nervous injury was induced by mycophenolate mofetil,the model of peripheral motor nerve and axonal injury was induced by ethanol,and the model of myelin damage was induced by ethidium bromide.The variations of central nerve,axon and myelin sheath fluorescence intensity,and peripheral motor nerve length in zebrafish,which exposed to the different concentration (10.0,33.3,and 100.0 μ.g/mL) of RZP,were observed with fluorescence microscope.The effective protection rates of RZP on zebrafish central nerve and axone,and the regeneration-promoting effect on peripheral motor nerve and myelin sheath were analyzed and calculated with the image processing software NIDS-Element's.Results In 10.0,33.3,and 100.0 μg/mL RZP groups,the zebrafish central nervous injury protective rates were 2％,24％,and 50％ (P ＜ 0.001),respectively,the peripheral nerve regeneration promoting rates were 44％ (P ＜ 0.05),49％ (P ＜ 0.01),and 93 ％ (P ＜ 0.001),the axonal injury recovery rates were 3％,29％ and 48％ (P ＜ 0.05),and the myelin sheath regeneration promoting rates were 36％ (P ＜ 0.01),37％ (P ＜ 0.001),and 41％ (P ＜ 0.001),compared with model group.Conclusions RZP could not only protect the central nervous and axonal injury,but also promote the regeneration of peripheral nerve and myelin sheath in zebrafish.

Objeetive:To investigate the epidemiology of EBV in adenoidal hypertrophy and chronic tonsillitis and discuss the effection of EBV on the nosogenesis of adenoidal hypertrophy and tonsillitis of children.Method:Fifty-two children with chronic tonsillitis and/or adenoidal hypertrophy had the operations of the tonsillectomy and/or the adenoidectomy.These tissues reseeted and plasma of all cases were detected to find EBV-DNA by RQPCR.Result:The infection rate of EBV in the tissues of adenoidal hypertrophy and tonsillitis of childen was 51.9%.The boys'infection rate of EBV was 50.0%,and the girls'infection rate of EBV was 55.6%,which had not significantly different.The EBV infection rate in the tissues of tonsillitis was 40.4%,The EBV infection rate in the tissues of adenoidal hypertrophy was 48.9%,which had not significant difference.The school age group(7to 14 years old)presented higher infection rate of EBV in the tissues of adenoid and tonsil(65.5%)than the preschool children group(2 to 6 years old)(34.8%).Comparing the copies numbers of BV-DNA in the different degrees of adenoidal hypertrophy,we found that the copies numbers of EBV-DNA in the severe hypertrophy group were higher than the midrange and slight hypertrophy groups(P＜0.05).Meanwhile we detected EBV-DNA in these childrens'blood plasma by RQ-PCR.No blood plasma was detected EBV-DNA copies higher than normal(＜1×10~3 copies/ml).Conclusion:The tissues of adenoidal hypertrophy and tonsillitis had same sensitivity to EBV.There was not significant difference between the infection rates of the boys and girls with adenoidal hypertrophy and/or tonsillitis.With these children growing up and the course of diseases prolonging,the infection rate of EBV increased correspondingly.There was a certain correlation between the hypertrophy of adenoid and EBV.There were NO EBV-DNA fragments in blood plasma of the children with adenoidal hypertrophy and/or tonsillitis.So there were essential different between benign hyperplasy and nasopharyngeal carcinoma.

Objective To quantitatively analyze the histological and MR images of repaired tissue (RT) following microfracture for knee joint osteochondritis dissecans (OCD) in rabbit models at different time points,make comparisons with the RT performances of joint debribement,explore the efficiency of the microfracture treatment for OCD.Methods Twenty-seven New Zealand rabbits were randomly assigned into 3 groups (sacrificed at the end of 3,5 and 7 weeks post-operation respectively),with 9 in each group.For each rabbit,one knee joint was made into an OCD model.In each group,6 were for microfracture treatment,and the other 3 were for joint debridement as control.MR scan,which mainly included sequences of 3D double echo steady state sequence (3D-DESS) and T2-mapping,was taken at 3,5 and 7 weeks postoperation.The thickness index and T2 value index of RT were calculated and T2-mapping of repaired region was drafted.Then the operation sites were removed to make histological sections of HE and Masson staining.The modified O' Driscoll score system was employed to make semi-quantitative evaluation for the histological performance of RT.Comparisons were made with respect to MR and histological findings between two treatments at each time point using unpaired Student t test.Effects of two treatments were evaluated longitudinally by comparing the results of three time points using one-way ANOVA.Results The post-operation thickness indexes of two groups increased gradually (F =33.940,28.841,P ＜ 0.05),T2 value indexes decreased (F =80.183,206.206,P ＜ 0.05),and O'driscoll scores increased gradually (F =29.867,17.167,P ＜ 0.05).At each time point,the thickness index of microfracture was higher than that of debridement group(3-week:0.743 ±0.048 vs 0.624 ±0.013,t =4.077 ;5-week:0.813 ±0.031 vs 0.734 ±0.015,t =4.107 ; 7-week: 0.972 ± 0.064 vs 0.777 ± 0.039,t =4.782 ; P ＜ 0.05),and the defects of microfracture in 7-week group were almost fully recovered while the defects of the debridement in 7-week group were not.The T2 value index of microfracture group was lower than that of debridement group at 3-week point(1.338 ±0.043 vs 1.510 ± 0.009,t =6.583,P ＜ 0.05),but it was higher than that of debridement group at 5-week and 7-week points (5-week: 1.284 ± 0.097 vs 1.116 ± 0.068,t =2.663 ; 7-week: 0.916 ± 0.036 vs 0.843 ± 0.016,t =3.283 ; P ＜ 0.05).The O'Driscoll score of microfracture group was higher than that of joint debridement at every time point(3-week:7.167 ±0.753 vs 4.667 ±0.577,t =5.000;5-week: 9.833 ± 1.169 vs 7.667 ± 0.577,t =2.960 ; 7-week: 11.167 ± 0.753 vs 8.333 ± 1.155,t =4.520 ; P ＜ 0.05).For microfracture group,the RT was mainly repaired by fibrocartilage and got matured gradually with more production of well-distributed collagen fibrils ; while for joint debridement group,the RT was mainly repaired by fibrous and scar tissue.Conclusions The post-operation repairing thickness and tissue composition of microfracture for OCD are superior to that of joint debridement.MR 3D-DESS and T2-mapping can show the thickness and tissue composition of the RT after OCD treatments,provide effective evaluation of repairing conditions,and they are of great importance on the OCD post-op follow-up.

10.3969/j.issn.2095-4344.2013.25.014

Objective To study the ultrastructural features of myocytes in uterine junctional zone (JZ).Methods From August 2010 to August 2013,there were 16 pre-menopause patients who suffered from cervical neoplasm to be performed hysterectomy.Samples of JZ and outer myometrium (OM) of hysterectomy specimens were collected.There were 8 specimens from the proliferative-phase and 8 specimens from the secretory-phase of endometrium.Ultrastructural features of JZ and OM were examined by using transmission electron microscopy and the related indices of myocytes were compared by using Student's t test.Results At JZ,there were more cytoplasmic process in the myocytes.The myocytes of JZ exhibited significant difference compared with those of OM.Firstly,the contractile structural components,such as the dense patches,dense bodies and the myofilaments were less abundant.In contrast,the perinuclear cell organelles were more distinct.The mitochondria,endoplasmic reticulum and Golgi apparatus were more prominent,denoting active protein synthesis.Secondly,the mean diameter of cell and nuclei demonstrated cyclic change.In proliferative phase of endometrium,the cell diameters of JZ and OM were (4.70_±0.52) and (4.69± 1.20) μm,respectively,which there were no significant difference(P=0.987).While in secretory phase,the cell diameters of JZ and OM were (3.75±0.36) and (4.92±0.51) μm,which there were significant difference (P=0.006).In proliferative phase,the nuclei diameters of JZ and OM were (3.24±0.41) and (2.90±0.62) μm,and in secretory phase,the nuclei diameters of JZ and OM were (2.44±0.27) and (2.92±0.44) μm.There were no significantly different in both phases (P=0.374,P=0.097).The diameters of cell and nuclei had cyclical changes (P ＜ 0.05).However,the cyclical changes were absent in OM (P＞ 0.05).Thirdly,the myofilaments/cytoplasm ratio of JZ in proliferative and secretory phases were 0.27±0.04 and 0.34±0.03,which were significantly less than those of OM in respective phases (0.49±0.03and 0.54±0.03;P=0.000,P=0.000).The myofilaments/cytoplasm ratio exhibited cyclical changes in JZ (P=0.029),but in OM,the cyclical changes were absent (P=0.083).Conclusions Compared with OM,ultrastructures associated with synthetic organelles are prominent,whereas the contractile organelles are reduced.And there are the cyclical changes in ultrastructural characteristics.The ultrastructural features of JZ are the basis of its physiology.

Objective To compare the efficiency and safety of aspirin-dipyridamole and warfarin in the prevention of thromboembolism in patients with nonvalvular atrial fibrillation(NVAF)and high risk factors.Methods One hundred and forty NVAF patients with high risk factors were randomly divided into two groups.Warfarin group[78 cases international normalized ratio(INR)2.0-3.0,for the patients older than 75 years,INR ranging from 1.6 to 2.5]and combination group(62 cases received aspirin 160 mg once every day plus dipyridamole 160 mg 3 times every day).The incidence of death,thromboembolism(including stroke and peripheral arteries embolism)and hemorrhage events were observed.Results Followed-up 12-28 months.In warfarin group,3 cases lost,2 cages had stroke,2 cases suffered from serious bleeding events,6 cases had minor bleeding events.In combination group,2 cases lost,6 cases had stroke,and 2 cases suffered from peripheral arteries embolism events,3 cases had minor bleeding events,but no serious bleeding events occurred.The incidence of thromboembolism in warfarin group wag,lower than that in combination group[2.7%(2/75)vs 13.3%(8/60),P<0.05].There was no significant difference of the bleeding rate between the two groups[10.7%(8/75)vs 5.0%(3/60),P>0.05].Conclusions Warfarin anticoagulative therapy is more effective than aspirin and dipyridamole antiplatelet dual therapy for the prevention of thromboembolism events in patients with NVAF and high risk factors.The major bleeding events in warfarin group occurs in patients with INR>3.0,so under intensive monitoring(INR 2.0-3.0),warfarin therapy is effective and safety.