Objective To discuss the application value of transesophageal echocardiography (TEE) in occluding procedure with cardiopulmonary bypass (CPB) for children muscular ventricular septal defects (mVSD).Methods Forty-nine mVSD patients for occluding procedure with CPB were performed guided and monitored by TEE,9 cases were simple mVSD,40 were mVSD combined with other cardiac malformations.The location,size,number,scope and the surrounding anatomy of mVSD were carefully observed before going into cardiac arrest,preparing the operator to choose appropriate occluder devices.The procedure was evaluated after the recovery of heart beat using TEE.Results In all of the 49 patients underwent occluding procedure,44 cases were implanted into one occluder,5 implanted into two occluders.The results of TEE after operation showed that the positions of all occluders were not shifted,2 had trace residual shunt,there were no complications worsening,such as mitral and aortic regurgitation,etc.One patient abandoned treatment for serious infection,the other patients' occluders were all in normal position followed up at 6 months to 2 years after operation,there were no tiny residual shunt and valves regurgitation except 1 patient.Conclusions The technique that TEE guiding and monitoring in occluding procedure with cardiopulmonary bypass for children muscular ventricular septal defects can shorten the time of cardiopulmonary bypass,significantly reducing complications and risks of the surgery,improving the successful rate.

Background and purpose:Remarkable advances have been made in cancer chemotherapy by developing new anticancer drugs and therapy strategies.However,multidrug resistance in human cancers remains a major clinical challenge for cancer treatment.Attempts in several clinical studies to reverse multidrug resistance protein (MDR) by using MDR modulators have not yet generated promising results.Our aim was to explored the mechanism of reversal of multidrug resistance in human leukemia K562 cells by PI3-K inhibitor.Methods:Trypanblue dye exclusion method was used to observe the drug sensitivity and the effect of LY294002 on the drug resistance.Western blot to analyze P-gp and p-Akt phenotypes,and flow cytometer was used to measure the intracellular drug accumulation. Results:K562/D induced by DNR was cross resistant to DNR,ADR,VCR and VP16 (Resistance Index:65,52,134 and 50 respectively).DNR induced over-expressions of P-gp and p-Akt in K562/D cells;LY294002 increased the intracellular drug accumulation,and then reversed the drug resistance to DNR,ADR,VCR and VPI6 in K562/D cells(Resistance Index:23,21,63 and 29 respectively),but not in the sensitive cells (K562/S).Conclusion:The multidrug resistance of K562/D cells can be induced by DNR which is related to the P-gp and p-Akt over-expressions, and LY294002 can reverse multidrug resistance in human leukemia cells in vitro via inhibits PI3-K/Akt pathway.

Objective To investigate the clinical features, therapeutic approaches, outcomes and alterations of peripheral lymphecytos subsets in cytomegalovirus (CMV) infections in patients with AIDS.Methods Ninety-six cases of AIDS were treated in Peking Union Medical College Hospital and 23 of them had CMV infection. We analyzed the clinical features, peripheral lymphocytes subsets, outcomes, CMV pp65 antigen and/or specific anti-CMV lgM. Results In the 23 CMV patients, nonspacific symptoms including fever,cough,chest distress and diarrhea occurred in 18, 11,9 and 8 patients, respectively. Thirteen patients had retinitis identified by ophthalmofundoscepy, 7 of them had blurred vision or floating as primary symptoms. Pneumocystis pneumonia, tuberculosis infection and other infection appeared in 18 patients.Fifteen(65. 2% )of the patients had positive serum tests. The positive rates for CMV pp65 and specific anti-CMV-IgM were 43.5% and 30. 4%, respectively. CD4+T cell count in CMV patients was remarkably decreased than that in non-CMV patients [14 (4,39) cells/μl vs (48 ( 12,128 ) cells/p J, P = 0. 005] and the proportion of CD8+ CD38+ T cells in CMV patients was higher than that in non-CMV patients,whereas the difference of CD8+T cell was not statistically different between the 2 groups. Conclusions CMV infection often occurrs in advanced AIDS patients. In HIV/AIDS patients with CD4+ T cell count ≤ 100 cells/μl,routine check for CMV pp65 antigen, specific anti-CMV IgM and ophthalmofundoscopy are recommended.Whenever encountering a young patient presenting with fever, blurred vision or floating, CMV complicating AIDS should be considered.

Objective Negative pressure aspirator clogging ( OSAC) frequently occurs in orthopedic surgery .This study was to investigate the frequency , location , and mechanisms of OSAC in China by analysis of the current status and clinical observation of OSAC so as to provide evidence for the solution of the problem . Methods Using the two-stage random sampling method , we conduc-ted a questionnaire survey on OSAC among 738 clinical orthopedists during the 16th and 17th Chinese Orthopedic Association Confer-ences.Totally, 160 out 1200 orthopedic surgeries were randomly selected in the time order of operation , including 38 cases of total hip arthroplasty ( THA) , 39 cases of total knee arthroplasty ( TKA) , 43 cases of extremity and spinal fractures surgery , and 40 cases of other orthopedic surgeries .We also obtained the satisfaction scores with the existing aspirators from related medical professionals . Results Among the 738 respondents included into the analysis , 706 (95.7%) thought that OSAC often occurred during surgery , 631 (85.5%) considered THA to be the leading cause of OSAC , and 714 (96.7%) regarded the tip and hose joint of the aspirator as the common causes . The mean satisfaction score with the existing aspirators was 7.62 ±0.74.Clinical observation showed the mean frequency of OSAC to be 2.55 ±1.62 in THA, 1.95 ±1.33 in TKA, 1.52 ±1.18 in extremity and spinal fracture surgeries , and 0.95 ± 0.68 in other orthopedic surgeries , and the satisfaction score to be 7.36 ±0.84. Conclusion OSAC has a high incidence rate during orthopedic surgeries in China , thus affecting orthopedic surgery and reducing orthopedists'satisfaction with the aspirators . The current negative pressure aspirator system demands prompt improvement .

BackgroundOscillatory potentials (OPs) has been used extensively in experimental research and clinical diagnosis,but it is well known that OPs are the summating potentials originated from retinal rod and cone.To separate the rod and cone OPs is helpful for us to diagnose some retinal diseases.ObjectiveThis study was to analyze the characteristics of cone-and rod-driven OPs. Methods The retinal cone degeneration ( RCD ) and congenital stationary night blindness(CSNB) rats were used in this study and SD rats served as control,and 6 rats for each kinds of animals.Scotopic and photopic OPs were recorded in each rat under the dark adaptation for 12 hours and light adaptation for 10 minutes at the stimulate light intensities of -35,-25,-15,-5,0,5 db respectively with RETIscan Visual Electrophysical System.The scotopic and photopic OPs were extracted from flash electroretinogram (FERG) with Maflab7.0 Butterworth filtering waves,and the frequency spectrum of the OPs was analyzed by fast Fourier transform.The characteristics of OPs from RCD rats and CSNB rats were assessed and compared.Results The a wave and b wave of ERG were showed under the dark adaptation condition in both SD and RCD rats,but the b wave was absent in CSNB rat.Under the light adaptation condition,b wave was seen in both SD and CSNB rats,but a wave and b wave of RCD rat were absent.Two peaks were exhibited in both SD and RCD rats under the darkadaptation condition and high intensity of stimulate light at the lower frequency( domain frequency) of 75-110 Hz,90-120 Hz and high frequency ( minor frequency) 90- 120 Hz,110- 135 Hz respectively.In various intensities of stimulate light,CSNB rats appeared a peak at 70-100 Hz.But in light-adaptation and various intensities of stimulate light,the frequency peaks were seen at 75-95 Hz and 70-85 Hz from both SD and CSNB rats respectively.However,under the light adaptation condition,only one peak was seen in SD and CSNB rats at the 75-95 Hz and 70-85 Hz respectively.Compared with SD rats,the mean implied time of b wave was delayed and the amplitude was lowed under the light adaptation (P＜0.05 ),however,no significant differences were found in the implied time and amplitude of b wave of scotopic ERG between SD rats and RCD rats( P＞0.05 ).The scotopic OPs showed the prolong implied time and depressed amplitudes in RCD rats and CSNB rats compared with SD rats( P＜0.05 ),and the photopic OPs presented the prolong implied time and lowed amplitude in CSNB rat in comparison with SD rats (P ＜ O.05 ).ConclusionsCone- and rod-driven OPs appear very different characteristics.The results of this study imply that rod pathway gives more contribution to OPs than cone pathway.Analysis of these results will be helpful for the exploration of the origin of OPs and the diagnosis of the related disease.

OBJECTIVETo evaluate the mechanical load of retropalatal airway in obstructive sleep apnea patients, and to investigate the contributions of pharyngeal anatomy to upper airway collapsibility.

METHODSStatic mechanical load of transpalatal pharynx was determined by opening pressure (Popen) of the segment during general anesthesia in 30 patients and 14 controls. Size of pharynx was measured while intraluminal pressure was controlled at 3-20 cm H2O (1 cm H2O = 0.09806 kPa) and the minimal intraluminal pressure that needed to compensate for the mechanical load of a retropalatal segment was determined.

RESULTSPharyngeal cavity collapse at the level of the hard palate was observed in only one of the 30 subjects (3.3%), and in none of the 14 controls. At tongue base level, 23 subjects had a Popen > 0 cm H2O (76.7%) while in 7 of the controls (50.0%) had a Popen > 0 cm H2O. And at the level of the uvual and soft palate, pharyngeal collapses was observed in all subjects except in 9 of the controls (64.3%). The median of Popen was 8.3 [5.9;11.5] cm H2O in the patients group and was 2.7 [-3.9;6.0] cm H2O in the control group. Differences of Popen were significant between patients and controls (U = 58.500, P = 0.000). The correlation between Popen and AHI was also significant at 0.05 level (r = 0.377, P = 0.044).

CONCLUSIONSPatients with sleep apnea have more collapsible passive upper airway than controls. Retropalatal and retroglossal airway are the most collapsible segments and positive pressures are needed to compensate for the mechanical loads.

Adult ; Case-Control Studies ; Female ; Humans ; Middle Aged ; Muscle Relaxation ; Palate, Soft ; anatomy & histology ; physiology ; physiopathology ; Pharyngeal Muscles ; physiology ; Pressure ; Sleep Apnea, Obstructive ; etiology ; pathology ; physiopathology ; Tongue ; anatomy & histology ; physiology ; Young Adult

To investigate the changes in bcl-2, bax expression and neuron apoptosis in the hippocampus after the blockade of cervical lymphatics, the model of lymphostatic encephalopathy was established by occluding and removing both the superficial and deep cervical lymph nodes in rats. The animals were sacrificed at 1, 2, 3, 5, 7 and 14 d after operation. H and E staining was used to observe the structure of brain tissues and TUNEL staining was used to detect in situ cell apoptosis in the hippocampus. The expression of bcl-2 and bax in the hippocampus were examined by RT-PCR. The results showed that cerebroedema appeared at day 2 and was most serious at day 5 after the blockade of cervical lymphatics. The number of TUNEL positive cells began to increase at day 2 and reached the maximum at day 5. The expression of bax began to increase at day 1 and reached the maximum at day 2. The expression of bcl-2 began to decrease at day 1 and dropped to the minimum at day 5. The items mentioned above recovered to control level at day 14. These results suggest that lymphostatic encephalopathy following the blockade of cervical lymphatics result in changes in bcl-2 and bax expression in the hippocampus and that apoptosis is the main form of neuron death.
Animals ; Apoptosis ; physiology ; Female ; Hippocampus ; metabolism ; pathology ; Lymph Node Excision ; Lymphatic System ; physiology ; Male ; Neck ; Neurons ; cytology ; Proto-Oncogene Proteins c-bcl-2 ; genetics ; metabolism ; Random Allocation ; Rats ; Rats, Wistar ; bcl-2-Associated X Protein ; genetics ; metabolism

OBJECTIVEGastric cancer cells are insensitive to tumor necrosis factor-related apoptosis-inducing ligand (TRAIL). To sensitize gastric cancer cells to TRAIL, we treated gastric cancer MGC803 cells with TRAIL and cisplatin.

METHODSCell proliferation was measured using MTT assay. Cell apoptosis was determined by flow cytometry. Expression of proteins was analyzed by Western blot. The distribution of lipid rafts and death receptors was analyzed by immunofluorescence microscopy. MGC803 cells were pretreated with 50 mg/L nystatin for 1 h, and followed by the treatment of cisplatin and TRAIL.

RESULTS100 µg/L TRAIL resulted in (8.51 ± 3.45)% inhibition of cell proliferation and caused (3.26 ± 0.89)% cell apoptosis in MGC803 cells. Compared with the treatment with cisplatin alone, treatment with TRAIL (100 µg/L) and cisplatin (8.49 mg/L, IC(50) dose of 24 h) led to a dramatic increase in both inhibition of cell proliferation [(52.58 ± 4.57)% vs. (76.43 ± 5.35)%, P < 0.05] and cell apoptosis [(23.10 ± 3.41)% vs. (42.56 ± 4.11)%, P < 0.05]. Moreover, cleavage of caspase-8 and caspase-3 was detected. TRAIL (100 µg/L) did not induce obvious lipid rafts aggregation and death receptor 4 (DR4) clustering, while cisplatin (8.49 mg/L) significantly promoted the localization of DR4 in aggregated lipid rafts. Pretreatment with 50 mg/L nystatin, a cholesterol-sequestering agent, triggered (3.66 ± 0.52)% cell apoptosis after 24 h. Pretreatment with nystatin for 1 h before the addition of 8.49 mg/L cisplatin for 24 h caused a decreased tendency to cell apoptosis [(25.74 ± 3.28)% vs. (22.76 ± 2.97)%]. While, pretreatment with nystatin before the addition of cisplatin and TRAIL, the proportion of apoptotic cells decreased from (43.16 ± 4.26)% to (31.52 ± 3.99)% (P < 0.05).

CONCLUSIONCisplatin enhances TRAIL-induced apoptosis in gastric cancer MGC803 cells through clustering death receptors into lipid rafts.

Antineoplastic Agents ; administration & dosage ; pharmacology ; Apoptosis ; drug effects ; Caspase 3 ; metabolism ; Caspase 8 ; metabolism ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Cisplatin ; administration & dosage ; pharmacology ; Dose-Response Relationship, Drug ; Humans ; Membrane Microdomains ; metabolism ; Nystatin ; pharmacology ; Receptors, TNF-Related Apoptosis-Inducing Ligand ; metabolism ; Stomach Neoplasms ; metabolism ; pathology ; TNF-Related Apoptosis-Inducing Ligand ; pharmacology

BACKGROUND:Autologous tissue-engineered bone marrow mesenchymal stem cel s (BMSCs) transplantation is one of the most common methods of treating early osteonecrosis of femoral head, but now there is stil no any special-purpose grafter available in the market. Such surgical transplantation is a laborious, time-consuming and tedious process, which goes against its clinical promotion. OBJECTIVE:To develop a supporting, efficient, special-purpose grafter, to solve the difficulty in stem cel s transplantation during core decompression of femoral head. METHODS:CAD software was used to perform solid modeling for this special-purpose grafter and print them by three-dimensional (3D) fast printing technology. The performance of this special-purpose grafter was tested by femoral head core decompression combined with BMSCs transplantation. It was compared with traditional surgical instrument in terms of duration of operation, intraoperative blood loss, visual analogue scale (VAS) of stem cel/biological fiber col agen complex omission amount and doctor’s satisfaction score. RESULTS AND CONCLUSION:(1) A kind of special-purpose grafter was developed by 3D printing technology rapidly. (2) Compared with the control group, duration of operation, intraoperative blood loss, VAS scores and doctor’s satisfaction scores were significantly improved in the trial group (P<0.05). (3) CAD software combined with 3D printing technology is a highly efficient means for front-line clinicians to perform independent development. The research and development of this special-purpose grafter provides a perfect solution to the laborious, time-consuming and tedious process of cel/biological col agen fiber transplantation.

Objective To evaluate the characteristics of 99Tcm-ciprofloxacin and explore its feasibility in early detection of secondary infectious foci of severe acute pancreatitis (SAP).Methods Ciprofloxacin was labeled with 99Tcm.The labeling efficiency and radiochemical purity of 99Tcm-ciprofloxacin were calculated and its biodistribution in normal pigs was measured.The recruited baby pigs were divided into three groups:normal control group (6), non-infected group (6) and infected group (16).370-400 MBq of 99Tcm-ciprofloxacin was injected into each pig intravenously.SPECT scanning was performed at 0.5, 1,2, 3, 4 and 6 h after administration.The differences of 99Tcm-ciprofloxacin uptake among groups were calculated and the tracer activity ratio of lesion-to-background was recorded at each time point.The diagnostic value of 99Tcm-ciprofloxacin SPECT imaging for the dectection of secondary infection of SAP was assessed using histopathological results as the gold standard.Variance analysis and least significant difference test were used to analyze the data.Results Both the labehing efficiency and radiochemical purity of 99Tcm-ciprofloxacin were over 90% within 6 h.Organs with rich blood supply, such as kidney, liver and spleen were the target organs for the accumulation of 99Tcm-ciprofloxacin; while no significant uptake was found in gastrointestinal tract or normal pancreas tissue of SAP.Rapid plasma clearance and renal excretion were observed.In the infected group, the lesion was visualized at 1 h after administration.The highest radioactivity ratio of lesion-to-background (3.36 ± 0.33) was at 3 h after administration, which was significantly higher than that of the other time point ( F =99.570, P ＜0.001 ).The sensitivity, specificity, positive and negative predictive values, Youden's index (YI) and Kappa value of 99Tc%ciprofloxacin imaging were 88.2% (15/17), 83.3% (5/6), 93.8% ( 15/16), 71.4% (5/7), 0.715 and 0.667 respectively.Conclusions The biodistribution of99Tcm-ciprofloxacin is suitable for imaging infectious focus of SAP.The optimal imaging time for the detection of secondary infection of SAP is 3 h after administration, with high sensitivity and specificity.