Objective To evaluate the outcomes of cardiac surgery in neonates weighing less than 2500g and premature infants. Methods From January 2000 through March 2005, 36 consecutive critically symptomatic neonates (26 males, 10 females) weighing less than 2500g underwent cardiac surgery at our center. Median gestational age was 34 weeks with 24 (70.6%) premature (≤37 weeks). Median age at operation was 15.5 days (from 4 days to 68 days). Median weight was 2120g (from 700g to 2500g). Indications for surgery were: persistent ductus arteriosus (PDA, n=15), coarctation of the aorta (CoA, n=3), transposition of great arteries with severely hypoplastic aortic arch (TGA/HAA, n=1), ventricular septal defect (VSD, n=10), pulmonary atresia with intact ventricular septum (PA/IVS, n=5), total abnormal pulmonary venous return (TAPVR, n=2). The heart functions of all patients were assessed in NYHA class IV and 7 patients (19.4%) were intubated pre-operatively. 18 cases (50%) needed extracorporeal circulation and deep hypothermia with circulatory arrest was used in 6 patients. Results The overall mortality was 11.1%. The causes of death were left heart failure in 1 patient and multiorgan failure in 2 and hypoxmia in 1. Mean extracorporeal circulation time was 92 min (from 72 min to 198 min). Mean aortic cross-clamping time was 76 min (from 46 min to 158 min). Mean deep hypothermia with circulatory arrest Peritoneum dialysis was carried out in 5 cases. Mean follow-up period was 22. 3 months (from 2 months to 46 months). 2 patients underwent reoperation and catheter intervention respectively. The heart functions of 26 patients (81.4%) were in NYHA class I at the latest clinical examination. Conclusion This study suggests that complete repair of simple and complex congenital heart diseases can be performed effectively in low birth weight neonates with acceptable mortality and morbidity. Low weight alone should not be considered as a contraindication to surgery in these patients. It is recommended that such neonates undergo early surgical correction rather than prolonged conservative palliation.

Objective To observe the effects of salvianolic acid B on the stem cells factor(SCF) secretion and mRNA expression of mesenchymal stem cells(MSCs) in vitro.Methods MSCs were isolated,cultured and purified in vitro by adherent culture.The 3rd passage of MSCs was chosen to undergo the experiments.MSCs were cultured in five groups of lower glucose DMEM media containing different concentration of salvianolic acid B as follows: group of control(no salvianolic acid B added),four groups of salvianolic acid B treatment(0.03?g/ml,0.3?g/ml,3?g/ml and 30?g/ml of salvianolic acid B were added,respectively,into the lower glucose DMEM media).The quantities of SCF were measured by ELISA in the supernatant of cultured MSCs harvested at 24h,48h and 72h culturing.The expression of SCF mRNA in the supernatant of cultured MSCs harvested at 24h,48h and 72h culturing were analyzed with reverse transcription-polymerase chain reaction.Results RT-PCR assay displayed that dissolvent and membrane type of SCF mRNA expressed in MSCs basically.The expression of SCF mRNA and the quantities of SCF increased significantly(compared with the control group,P0.05).Conclusion Salvianolic acid B may promote the secretion of SCF and reinforce the expression of SCF mRNA of MSCs,implying that SCF might play an important role on the treatment of myocardial ischemia with the traditional Chinese medicine Salviae miltiorrhizae.

Objective To evaluate the clinical effect of integrated traditional and western medicine in the treatment of serious ulcerative colitis. Methods Salicylate and cortical hormone were given to patients in acute phase, supplemented by oral administration of herbal medicine and retention enema of Kushenhuaihua concoction. During the period of remission, the patients were treated mainly with Jianpiling supplemented with salicylate for at least half a year. Results In 55 patients receiving conservative treatment, 35(63.6%) recovered completely, 18(32.7%) showed effective result, only 1 patient died and another showed ineffective result (1.8%). Five patients underwent surgical treatment, among them 4 were completely relieved. Long-term follow-up showed that in 67.4% of patients the symptoms were completely relieved, and in 2.3% of patients malignant degeneration occurred, 4.7% of the patients died, and 6.9% of the patients underwent operative treatment. Conclusion The effects of integrated traditional and western medicine treatment in patients with serious ulcerative colitis is superior to western medicine aloner as evidenced by a decrease in mortality and necessity of operation.

As the third-generation bisphosphonate,zoledronic acid (ZOL) has been widely used for the treatment of skeletal-related events in breast cancer.Previous studies have demonstrated that ZOL has antitumor activitie in breast cancer.ZOL can induce direct and indirect antitumor activities through inducing apoptosis,inhibiting the proliferation,adhesion and invasion formation of bone microenvironment which is conducive to tumor growth,besides inhibiting angiogensis and modulating immune response.Also evidences of synergistic antitumor effects are found when ZOL combines with radiotherapy and chemotherapy,endocrine,and targeted drugs.The observed improvement in antitumor effects by using combination therapy with ZOL in breast cancer is currently being verified through additional clinical trials.

Objective To explore the changes in angiotensin Ⅱ(AngⅡ)produced by Langerhan islets of Syrian hamsters after blockage of renin-angiotensin system(RAS)by different inhibitors.Methods Islet cells from Syrian golden hamster were isolated and purified,and angiotensin Ⅰ was added.The experiment was then divided into six groups:control group(PBS was added),captopril group,chymostatin group,aprotinin group,?-antitrypsin group,and captopril+chymostatin group(according to inhibitors added).The content of AngⅡ in supernatant was detected by enzyme-linked immunosorbent assay(ELISA).Results Compared with control group,the AngⅡ content decreased by 42.50% and 50.94% in captopril group and chymostatin group,respectively(P

AIM:To evaluate treatment value of Xihuang Pill combined gemeitabine for advanced pancreatic cancer patients.METHODS:Thirty-two patients with advanced pancreatic cancer were randomly divided into A group and B group,treated with gemcitabine chemotherapy and traditional Chinese medicine Xihuang Pill+chemotherapy treatment,respectively.The changes of the solid tumor,serum CA19-9,physical status,clinical symptoms and toxicity were observed.RESULTS:B group(Xihuang Pill combined with gemcitabine)clinical return ratio (CR+PR+NC)was better than A group(gemcitabine).There was significant difference between two groups in the reduction of serum CA19-9 level,Karuofsky score increased,the rate of symptom improvement,Leukopenia reduction(P＜0.05).CONCLUSION:Integrating Xihuang Pill and gemcitabine in the treatment of advanced pancreatic cancer:delaying of tumor growth,reducing of CA19-9 level,improving of the clinical symptoms and life quality of patients,reducing of neutropenia in patients(chemotherapy-induced toxicity),shows good clinical benefit response.

Objective To investigate the energy expenditure of mechanically ventilated patients,compare the measured energy expenditure (MREE) with the energy expenditure expected from the Harris-Benedict equation adjusted with correction factors (PREE). Methods Twenty-four critically ill adult patients who were mechanically ventilated in the intensive care unit were enrolled in this study. Data during the 72 hours of mechanical ventilation were collected for computation of severity of illness. Resting energy expenditures were derived at 72hours after mechanical ventilation by indirect calorimetry. Predicted basal energy expenditure was obtained at the same time using the Harris-Benedict equation and predicted resting energy expenditure was calculated using the Harris-Benedict value adjusted with correction factors for illness. Results The Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ)scores and Marshall scores were 14 ± 5 and 6 ± 3, respectively. MREE and PREE were (6 793.64 ± 1 197.15) and (8 041.02 ± 1 971.54) kJ/day, respectively. There was no correlation between MREE and PREE (r2 = 0. 28, P = 0. 07), and the difference between MREE and PREE was statistically significant (t = 7.62, P = 0.04). No statistically significant correlations were observed between both MREE or PREE and APACHE Ⅱ score or Marshall score (r2 = 0. 14, P = 0. 08; r2= 0. 08, P = 0. 63; r2 = 0. 05, P =0. 65; r2 = 0.03, P = 0. 87, respectively). Conclusions In mechanically ventilated patients, the energy expenditure is not correlated with the severity of illness. The Harris-Benedict prediction modified with correction factors for severity of illness systematically overestimates the total energy expenditure.

Objective To investigate the effect of microRNA-1 (miR-1) on the fibrosis of cardiac fibroblasts induced by high glucose. Methods The primary cultured fibroblasts from 1-3 days old Sprague-Dawley (SD) rats, were randomly divided into 4 groups (n = 3): normal glucose + lentivector-vehicle (CON+Lv-Vehicle group), normal glucose + lentivector-miR-1 (CON+Lv-miR1 group), high glucose + lentivector-vehicle (HG+Lv-Vehicle group), high glucose + lentivector-miR-1 (HG+Lv-miR1 group). Fibroblasts were cultured in glucose concentration 5.5 mmol/L and 25 mmol/L DMEM culture, and were injected lentiviral vector carrying miR-1 silencer sequence or the same volume of lentiviral vector. After 12 hours, the medium was replaced with fresh complete medium. After 3 days when transfection efficiency was up to 90%, the cellular miR-1 content was detected by real-time reverse transcription-polymerase chain reaction (qRT-PCR). The secretion of collagen Ⅰ and Ⅲ were measured by enzyme linked immunosorbent assay (ELISA). Expression of collagen Ⅰ and Ⅲ, matrix metalloproteinase 2 and 9 (MMP-2, MMP-9), autophagy related protein LC3B-Ⅱ, P62/SQSTM1 and Cathepsin D were assessed by Western Blot. Results Compared with the CON+Lv-Vehicle group, the content of miRNA in the CON+Lv-miR1 group had no statistical significance. Compared with the CON+Lv-Vehicle group, high glucose increased the amount of miR-1 (2-ΔΔCt: 1.82±0.17 vs. 1.00±0.04), collagen Ⅰ and Ⅲ secretion (mg/L: 14.55±0.33 vs. 7.28±0.22, 157.50±13.22 vs. 61.25±8.54) and expression (gray value: 432.35±56.00 vs. 100.00±15.00, 320.35±47.00 vs. 100.00±15.00), the level of MMP-2, MMP-9 and the expression of autophagy related protein LC3B-Ⅱ and P62/SQSTM1 (gray value: 249.0±21.0 vs. 100.0±15.0, 142.3±20.0 vs. 100.0±16.0, 178±19 vs. 100±14, 378.3±20.0 vs. 100.0±15.0), decreased the expression of lysosomal associated protein Cathepsin D (gray value: 60±14 vs. 100±10), and the differences were statistically significant (all P < 0.01). Compared with the HG+Lv-Vehicle group, the amount of miR-1 in the HG+Lv-miR1 group was significantly decreased (2-ΔΔCt: 1.21±0.10 vs. 1.82±0.17), collagen Ⅰ and Ⅲ secretion (mg/L: 10.68±0.54 vs. 14.55±0.33, 87.25±13.55 vs. 157.50±13.22) and expression (gray value: 179.41±45.00 vs. 432.35±56.00, 173.41±50.00 vs. 320.35±47.00), the level of MMP-2, MMP-9 and the expression of autophagy related protein LC3B-Ⅱ and P62/SQSTM1 (gray value: 172.0±23.0 vs. 249.0±21.0, 90.0±17.0 vs. 142.3±20.0, 138±15 vs. 178±19, 265.0±17.0 vs. 378.3±20.0) in the HG+Lv-miR1 group were decreased and the expression of lysosomal associated protein Cathepsin D was higher (gray value: 110±17 vs. 60±14), and the differences were statistically significant (all P < 0.05). Conclusions The expression of miRNA-1 was up-regulated in cardiac fibroblasts cultured in high glucose, and miRNA-1 silencing inhibited cardiac fibroblast induced fibrosis in high glucose. The mechanism may be related to the recovery of autophagy flux, up-regulation of Cathepsin D expression and inhibition of collagen production.

BACKGROUND:Spinal cord ischemia-reperfusion injury is a serious secondary injury of the spinal cord. Multifactor could contribute to the mechanism of this injury, and many therapeutic measures emerge, but the therapeutic effect is not ideal.
OBJECTIVE:To investigate the protective effects and mechanism of hydrogen-rich saline on spinal cord ischemia-reperfusion injury in rabbits.
METHODS:ZIVIN method was adopted to prepare the model of spinal cord ischemia-reperfusion injury. The rabbit models were randomly divided into model group, sham operation group, and hydrogen-rich saline group.
RESULTS AND CONCLUSION:Improved Tarlov scores for the evaluation of motor function were significantly increased in hydrogen-rich saline group compared with the model group at 6, 12, 24, 72 hours after reperfusion (P<0.01). The contents of malondialdehyde were significantly lower (P<0.05), while catalase activity was significantly higher (P<0.05) in hydrogen-rich saline group than that in model group at 72 hours after reperfusion. Hematoxylin-eosin staining revealed that, spinal cord anterior-horn motor neurons maintained intact structure in sham operation group;more necrotic spinal cord anterior-horn motor neurons were found in model group, and granular-vacuolar degeneration occurred in the endochylema. In hydrogen-rich saline group, the structure of spinal cord anterior-horn motor neurons was basical y intact, only a smal amount of spinal cord anterior-horn motor neurons appeared vacuolar degeneration. TUNEL staining showed no apoptotic spinal cord anterior-horn motor neurons in sham operation group. Many inflammatory cel s and apoptotic neurons were found in model group. There were few inflammatory cel s and apoptotic neurons in hydrogen-rich saline group. Hydrogen-rich saline can prevent the apoptosis of spinal cord anterior-horn motor neurons in rabbits with spinal cord ischemia-reperfusion injury, and the underlying mechanism is associated with antioxidative effect.

ObjectiveTo assess and compare the resting energy expenditure measured by indirect calorimetry (MREE) and calculated with Harris-Benedict formula adjusted with correction factors (CREE) in critically ill surgical patients receiving mechanical ventilation,and to evaluate the relationship between resting energy expenditure and the severity of diseases.MethodsFrom August 2008 to February 2010,21 patients fitting the inclusion criteria were selected into the present study.The data of the patients were collected to calculate acute physiology and chronic health evaluation Ⅱ score ( APACHE Ⅱ score) and multiple organ dysfunction score ( Marshall score).MREEs were measured using indirect calorimetry of a MedGraphics CCM/D System,and CREEs were calculated at the same time with the Harris-Benedict formula.ResultsWithin the week of nutrition support,the mean CREE of the 21 patients was significantly higher than the mean MREE [ ( 8305.09 ± 1392.76 ) kJ vs.(6544.84 ±2079.65) kJ,P =0.000].The differences between MREE and CREE were statistically significant on the 0 ( P =0.000),1 ( P =0.000 ),2 ( P =0.000 ),and 4 day ( P =0.003 ) of nutritional support.There was no correlation between MREE and CREE (r =0.064,P =0.408 ),nor between MREE and APACHE Ⅱ ( r=-0.045,P =0.563 ).There was a correlation between MREE and Marshall score (P =0.001 ),but the correlation coefficient was low ( r =0.263).ConclusionsThe Harris-Benedict prediction modified with correction factors for severity of diseases overestimates the resting energy expenditure of critically ill surgical patients.Indirect calorimetry is a more accurate method for determining resting enenrgy expenditure.