Objective To statistically analyze financing of subjects of TCM preparation of National Natural Science Foundation of China (NSFC);To guide subject election of TCM pharmaceutics PhD. Methods Investigation and analysis were raised in this article in terms of application projects, amount of money, winning bid, and main responsible units of TCM preparation subjects of NSFC. Results Totally 186 funding projects with 60.58 million yuan were funded in the past 13 years. Liposome, nanoparticle, and micelle appeared frequently as new medicine delivery system. Meanwhile, microdialysis and pharmacokinetics were the hotspots of winning bid. Conclusion Based on the key questions in the development of TCM pharmaceutics and technological means of cross disciplines, subject election of TCM pharmaceutics PhD was suggested to focus on evaluation technique and quality evaluation system of new medicine delivery system. Meanwhile, the balance among basic researches, applied researches, and sustainable researches is also important.

Arteriovenous Fistula ; therapy ; Child ; Embolization, Therapeutic ; Humans ; Male ; Pulmonary Artery ; abnormalities ; Pulmonary Veins ; abnormalities

Objective To explore and evaluate the micro-anatomic structure of posterior-middle cra nial fossa in the retrosigmoid keyhole approach for clinical application. Methods Ten formalin-fixed adult cadaver heads of 20 sides were used to apply the retrosigmoid keyhole approach to reach and observe the structure of posterior-middle cranial fossa.Results The retrosigmoid keyhole approach can reach petroclival region from post-lateral aspect and through this approach the lateral potion of cerebellar hemisphere、petrosal bone,CN Ⅴ,Ⅶ,Ⅷ,part of CN Ⅸ-Ⅻ,lateral potion of pons、vertebral artery and anterior inferior cerebellavar artery can be exposed cleady.Resecting part of supra-tubercle of IAM can enlarge the exposure of IAM and CN V.After cutting off the edge of tentorial part of CN Ⅳ and middle cranial fossa can be exposed.Conclusion Through retrosigmoid keyhole approach we can use the small but compatible bone hole to diminish the ineffective exposure of the cerebellum.Meanwhile the wound because of the approach and complication can be cut down.It's an effective,safe and convenience approach in clinical application to resect the tumor mainly located in posterior cranial fossa.

Objective To preliminary investigate fetal left heart function of fetuses in α-thalassemia using spatio-temporal image correlation (STIC).Methods 95 volumes from fetal hearts in singleton pregnancies at 20-28 weeks of gestation were collected.STIC datasets were frozen in end-systole and enddiastole.Ventricular volumes were measured using VOCAL,Inversion and SonoAVC.The stroke volume was calculated from these measurements.Results All data sets could be measured with all three techniques in this study.The intraclass correlation coefficients (ICCs) between techniques were all ＞ 0.90.The time necessary to measure the stroke volume was significantly shorter using SonoAVC than using VOCAL and Inversion.Bland-Altman plots showed no clinically significant mean percent differences between stroke volume measurements obtained from each ventricle using three techniques.The left ventricular end-systole volume(ESV),stroke volume(SV)and ejection fraction(EF)was significantly different than fetuses with normal heart (P ＜ 0.05).Conclusions This study shows the feasibility of measuring left ventricular volumes during either systole or diastole and thereby calculating stroke volumes with all three techniques.And there was a high degree of reliability for all three techniques,as shown by excellent ICCs.There was good accuracy of STIC techniques in measuring fetal left ventricular volumes with cardiomegaly.

Objective To observe the phosphorylation levels of extracellular signal-regulated kinase 5 (ERK5) in acute myocardial infarction (AMI) patients and the effects of ERK5 selective inhibitor XMD8-92 on human platelet activation in vitro,and to explore its mechanism.Methods Western blot was applied to detect the phosphorylation levels of ERK5,Akt473 and Akt308 in AMI patients (n =34) and stable angina patients (n =33,control).The effects of different concentration of XMD8-92 on human platelet aggregation induced by collagen was tested by aggregometer in vitro.The release of ATP was measured simultaneously by luciferase detection.The effects of XMD8-92 on integrin aIIbβ3 were detected by platelet spreading on immobilized fibrinogen and clot retraction.The effects of XMD8-92 on phosphorylation levels of Akt473,Akt308 PTEN370 and ERK5 were detected by Western blot.Results The levels of phosphor-Akt473,Akt308 and phosphor-ERK5 were significantly higher in AMI patients than that in control group (P＜0.05).ERK5 inhibitor XMD8-92 diminished collagen-induced platelet aggregation,ATP secretion,the average area of platelet spreading on immobilized fibrinogen and the clot retraction extent.The levels of phosphor-Akt (Ser-473/Thr-308) and phosphor-PTEN (Ser370) were significantly down-regulated in the presence of XMD8-92.Conclusions ERK5 plays a role in platelet activation in AMI process.It regulates platelet activation by regulating PTEN and Akt phosphorylation.Its specific inhibitor is hoped to be new antithrombotic drug.

Objective Cytomegalovirus (CMV) has remained the most significant pathogen that threatens the outcome of small bowel transplantation (SBTx). This paper To outline preliminary experience of prophylaxis and treatment of cytomegalovirus (CMV) in 15 cases subject to small bowel transplantation (SBTx) and also review current progress of diagnosis and treatment of CMV.Methods Fifteen cases of SBTx were divided into 3 eras: era Ⅰ (1994-1995)-3 SBTx treated with cyclosporine-based immunosuppression; era Ⅱ (2003-2006)-7 SBTx treated with tacrolimus-based immunosuppression; and era Ⅲ (2007-present)-5 SBTx treated with Alemtuzumab induction therapy and maintenance tacrolimus monotherapy. No antiviral prophylaxis after SBTx was applied during era Ⅰ; in era Ⅱ, ileoscopic and pathological diagnosis of CMV graft enteritis was defined, and plasma diagnosis tools including CMV-IgM, CMV pp65 and CMV DNA with PCR were introduced. 2-3 weeks intravenous ganciclovir prophylaxis of CMV was underway, followed by 3 months oral acyclovir; In era Ⅲ, more precise real-time PCR technique was used to detect CMV DNA copies, and the schedule of the CMV surveillance was set up, antiviral prophylaxis therapy was modified to 2-3 weeks intravenous ganciclovir and 3 months oral ganciclovir, and preemptive therapy to halt the progression of asymptomatic infection to clinical disease was also introduced.Results Two of 15 SBTx recipients suffered from CMV with the occurrence rate of 13.3%. One recipient in era Ⅱ suffered from CMV graft enteritis on postoperative day 45, and CMV pneumonia on postoperative day 64, he received intravenous ganciclovir and thymus peptide, paused tacrolimus maintenance, and finally he died from severe acute cellular rejection. 94 100 copies/ml of CMV DNA in periphery blood of a recipient in era Ⅲ was detected with real-time PCR at 3rd month after SBTx, and a preemptive therapy successfully halted the CMV infection.Conclusion Antiviral prophylaxis therapy and close surveillance of CMV infection after SBTx should be performed, and preemptive therapy can also halt the CMV infection. When CMV disease occurs, the recipient should receive effective antiviral therapy, and acute cellular rejection also should be closely monitored at same time.

Objective Invasive fungal infection (IFI) after small bowel transplantation (SBTx) is aggressive and associated with high mortality rates. This paper reviewed preliminary experience of treatment of IFI in 15 cases after SBTx. Methods Fifteen cases of SBTx were divided into 3 groups according to the eras. era Ⅰ (1994-1995)-3 cases of SBTx treated with cyclosporine-based immunosuppression, era Ⅱ (2003-2006)-7 cases of SBTx treated with tacrolimus-based immunosuppression, and era Ⅲ (2007-present)-5 cases of SBTx treated with Alemtuzumab induction therapy and maintenance tacrolimus monotherapy. During era Ⅰ and era Ⅱ, Fluconazole Ⅳ was used as prophylaxis and treatment protocol. If the IFI was aggressive, Amphotericin B or Amphotericin B Liposome were also given with initial dose of 1-5 mg/d (or 0.02-0.10 mg·kg~(-1)·d~(-1). During era Ⅲ, 2-weeks Arnphotericin B Liposome was used as prophylaxis therapy after SBTx, and the dose of 6 mg· kg~(-1)·d~(-1) of Amphotericin B Liposome was given to treat IFI after SBTx. The administration manner of Amphotericin B Liposome was also improved during era Ⅲ, and the initial dose achieved 6 mg without gradually increasing process. Closely surveillance of vital sign, liver and renal function, and electrolyte was also carried out, and the doses of Amphotericin B Liposome were titrated according liver and renal function. Results Four of 15 SBTx recipients suffered from IFI with the occurrence rate of 26.7%, 1, 2 and 1 recipient(s) suffered from IFI during different 3 eras, respectively. Three recipients died of severe IFI after SBTx during era Ⅰ and era Ⅱ. One SBTx recipient with IFI during the era Ⅲ totally recovered after 44-days treatment of Amphotericin B Liposome with the totally dose of 9100 mg, and the renal dysfunction was observed and.ameliorated after ceasing of Amphotericin B Liposome. The mortality of these 4 IFI after SBTx was 75%. Conclusion IFI after SBTx is associated with high mortality rate. Amphotericin B Liposome can effectively control IFI after SBTx. With closely surveillance of recipient renal function, high dose of Amphotericin B Liposome can be safely used.

Objective To summarize the timing and diagnostic value of endoscopic biopsy of intestinal graft after small bowel transplantation (SBTx).Methods Fifteen cases of SBTx were divided into 3 eras:era Ⅰ (1994-1995)-3 cases of SBTx treated with cyclosporine-based immunosuppression; era Ⅱ (2003-2006)-7 cases of SBTx treated with tacrolimus-based immunosuppression,and era Ⅲ (2007-present) than CVC group 5 cases of SBTx treated with Atemtuzumab induction therapy and maintenance tacrolimus monotherapy.The scheme of endoscopic surveillance was initially used in era Ⅲ, the first endoscopic biopsy was performed on postoperative day 3,2 times weekly during the first month, followed once weekly during months 2-3, once every other week during months 4-6 and once monthly thereafter.When clinical signs and symptoms of rejection were present, and during rejection episodes, the additional endoscopic biopsies were also performed.Results A total of 276 biopsies of these 15 SBTx recipients were obtained.Fifty-one biopsies (18.5%) were diagnosed as acute cellular rejection (ACR), which included IND to mild (n = 32,11.6 %), moderate (n = 9,3.3 %), and severe (n = 1 0, 3.6 %), two biopsies (0.7 %) were diagnosed as cytomegalovirus (CMV) enteritis and other 2 biopsies (0.7 %) bacteria enteritis.The ACR episodes verified by biopsy pathology and undergoing anti-rejection treatment were 20 (11 IND to mild,5 moderate,and 4 severe) ,and 1 episode of CMV enteritis and 1 episode of bacteria enteritis were observed.Conclusion Endoscopic surveillance and biopsy pathology is crucial diagnostic tool for ACR and sepsis.ACR surveillance after SBTx and early diagnosis of ACR could be made with scheming endoscopic biopsies.Endoscopic biopsy can be used to make differential diagnosis when clinical signs and symptoms were present, and to guide the treatment during anti-rejection episode.

This paper aims to retrospectively analyze the nursing management of one-stop hybrid procedures and to sum up the clinical experience.The key point of successful implementation of nursing management of one-stop hybrid procedures lies in the layout of hybrid operation room,in the intraoperative nursing cooperation and the professional nursing personnel training,and in the establishment of a new talent training mode that contains flexible allocation mechanism of nursing human resources as well as short-term post rotation of professional nursing staff.The one-stop hybrid operation is a minimally-invasive procedure for the treatment of complex diseases.Scientific nursing management is the strong guarantee to ensure a successful “one-stop” hybrid operation.

ObjectiveTo explore the effect of dressing-pretreatment on forepart inflammation in adjuvant arthritis (AA) rats.MethodsAA model was established by subcutaneous injection of Freund's complete adjuvant into the right hind-paw (0.1 ml/animal). 24 Wistar rats were randomly divided into the control group, model group and dressing-pretreatment groups. In dressing-pretreatment group, "Dazhui" (GV14) was applied by a kind of dressing invented by the researchers. The foot swelling rate, serum concentrations of interleukin-1 (IL-1), IL-6 and tumor necrotic factor-α (TNF-α) were assessed.ResultsCompared with the control group, the foot swelling rate and serum concentrations of IL-1, IL-6 and TNF-α of the model group and dressing-pretreatment group increased significantly (P<0.01); but the foot swelling rate and serum concentrations of IL-1 and IL-6 in dressing-pretreatment group decreased significantly compared with those of the model group (P<0.05～0.01), and there was a downtrend in TNF-α. HE stain showed soakage of phlogistic cell in cartilage and arthritis membrane, hyperplasia of vein and breakage of cartilage were better in dressing-pretreatment group compared with that in the model group.ConclusionDressing-pretreatment can decrease forepart inflammation and pathological damage of arthritis in AA rats, and can prevent the harm of consequent disease to some extent.