Objective Assessment of right ventricular function in patients with atrial septal defect (ASD) is difficult. The Doppler myocardial performance index (MPI) may provide a method of assessing function in these patients. The purposes of this study were to evaluate the right ventricular function and its changes in patients with ASD after transcatheter closure of ASD. Methods MPI, defined as the sum of isovolumic relaxation time and isovolumic contraction time derived by ejection time, was measured from tricuspid inflow and right ventricular outflow; Doppler velocity profiles recorded during routine echocardiography. Twenty nine patients ( 13 men, 16 women;mean age 25.28 ± 12.69, range 6 to 57 years) were diagnosed to secundum ASD [the stretched diameters of ASD were from 9 To 36 (24.91 ±7.98) mm], and had a successfully placed Amplatzer septal occluder (ASO) (the sizes of ASO were from 11 to 40 mm ); there were 81 sex-matched, age-matched healthy people (control group 41men, 40 women; mean age 29.02 ± 14.22, range 4 to 45 years).MPI was measured again on 3 days and 1 month after closure of ASD. Change in the study group was assessed and compared to the control subjects with structurally normal hearts. A complete 2- dimensional and Doppler echocardiographic examination was performed in all study groups. Results 1) The isovolumic relaxation and isovolumic contraction times [respectively(77.59 ± 14.39)ms vs (60.93 ± 12.94)ms, P＜0.0001; (28.28 ± 10.88)ms vs (23.64 ± 9.01)ms, P=0.027] were prolonged, and ejection time [(260.65 ± 21.86 )ms vs (271.85 ± 21.92)ms, P=0.033] was shortened in patients with ASD compared with that in control subjects, resulting in a marked increase in the MPI(0.40 ± 0.07 vs 0.31 ± 0.05, P＜0.0001) from normal values; 2) by Pearson's correlations, the MPI had no correlation with heart rate and blood pressure in control subjects and patients with ASD, but it correlated positively with age in patients with ASD; 3) by Pearson's correlations, the MPI correlated positively with the diameter of ASD and pulmonary artery pressure; 4) after transcatheter closure of ASD, the MPI decreased markedly. Conclusions 1) MPI is a conceptually new, simple, and reproducible Doppler index in patients with ASD; 2) MPI is free from the effect of age, heart rate and blood pressure; (3) MPI appears to be relatively dependent on changes in the diameter of ASD and pulmonary artery pressure; 4) the right ventricular function was improved after transcatheter closure of ASD.

Objective:To investigate the functional status of dendritic cells(DCs)in oral leukoplakia(OLK)tissues.Methods:The expression of DC-specific markers CD1 a,CD209,CD1 23 and CD83 in 20 cases of OLK with abnormal dysplasia,1 0 with simple dys-plasia and 1 0 of normal oral mucosa tissues was examined by immunohistochemistry.Results:CD1 a and CD209 positive DCs were found in all cases.More CD1 a positive Langehans cells(LCs)in lamina propria were found in OLK with abnormal dysplasia than in normal o-ral mucosa and OLK with simple dysplasia(P <0.01 ).A great mount of CD209 positive stromal DCs were recruited in OLK.There was no CD83 positive and CD1 23 positive cell in normal oral mucosa,however,CD83 positive mature DCs and CD1 23 positive plasmacytoid DCs(PDCs)were observed in OLK(P <0.01 ).Conclusion:OLK is characterized by the recruitment of different subsets of DCs,the different DC subsets may play an important role in the development of OLK.

Objective To investigate the effect of hypert riglyceridemia on vascular endothelial function. Methods With high-resolution ultrasound, flow and nitroglycerin-induced dilatation of the brachial artery were determined in thirty hypertriglyceridemic patients and thirty healthy subjects as controls. Serum lipid and plasma endothelin (ET) were determined. Results In patients with hypertriglyceridemia,flow-induced vasodilatation was much reduced compared with that in the control subjects[(2.7±2.0)% vs (15.0±8.0)%, P<0.001］.However, vasodilatation in response to nitroglycerin were similar in both groups［(15.0±5.0)% vs (16.8±9.0)%, P>0.05].Plasma ET level in the hypertriglyceridemic group was significantly higher than that in the control group［(106.22±19.16) μg/L vs (72.37±14.06) μg/L, P<0.001].ConclusionEndothelium-dependent vasodilatation was impaired in patients with hypertriglyceridemia.

Objective To study the therapeutic of anastomotic leakage in post-esophagogastrectomy. Meth-ods There were 18 cases of anastomotic leakage in 127 cases with cancer of the thoracic esophagus who underwent esophagectomy were retrospectively studied. There were ten cases had anastomotic leakage of 67 cases of esophagogas-trectomy from 1995 to 2001 (first phase),the intestines nutrition sustain treatment taked rice water,fish soup and broth, there were eight cases had anastomotic leakage of 60 cases of esophagogastrectomy from 2002 to 2007 (second phase) ,the intestines nutrition sustain treatment taked supportan,fresubin. Results There were six cases death of 10 cases of anastomotic leakage at first phase, and there was any not death in the second phase. Conclusion When anastomotic leakage of esophagogastreetomy,it can elevate the cure rate with early diagncsis and treatment and intes-tines nutrition sustain treatment choose by supportan or fresubin.

Objective To study the expression of long non-coding RNA (lncRNA)-urothelial carcinoma associated 1 (UCA1) and miR-34b in bladder cancer and its correlation to the clinicopathologic features of bladder cancer.Methods Between January 2011 and October 2012,the expression of UCA1 and miR-34b in 5 bladder cancer cell lines (T24,BIU-87,EJ,T24-MMC,T24-ADM) and 1 normal bladder cell lines (SV-HUC-1) were measured by real-time reverse transcription-polymerase chain reaction (RTPCR).Meanwhile,the 56 bladder cancer specimens and paraneoplastic normal bladder tissues,which diagnosed by pathology were collected from bladder cancer patients undergoing radical resection of bladder.Among them,41 cases were male and 15 cases were female.The mean age was (68.4 ± 7.5)years old,range 52 to 78 years.43 cases were older than 65 years old,and 13 cases were less than 65 years old.The pathological classification included non muscle-invasive bladder cancer (NMIBC) 18 cases,muscle-invasive bladder cancer 38 cases;low grade papillary urothelial carcinoma 22 cases,high grade papillary urothelial carcinoma 34 cases;12 cases were primary lesion,the other 44 cases were diagnosed as tumor recurrence.Real-time RT-PCR was performed to analyze the expression of UCA1 and miR-34b.Results The relative expression levels of UCA1 in the normal bladder cell lines (SV-HUC-1) and 5 bladder cancer cell lines (T24,BIU-87,EJ,T24-MMC and T24-ADM) were (0.0675 ± 0.0133),(0.2934 ± 0.0531),(0.4246 ± 0.0650),(0.4206 ± 0.0826),(0.6472 ± 0.0875) and (0.7165 ± 0.1032),respectively (P ＜ 0.05).Moreover,the expression levels of UCA1 were up-regulated in 2 drug resistant bladder cancer cells lines T24-MMC (0.6472 ± 0.0875)and T24-ADM (0.7165 ± 0.1032),as compared with the T24 bladder cancer lines (0.2934 ± 0.0531),respectively (P ＜ 0.05).However,the expression levels of miR-34b in 5 bladder cancer cell lines [T24 (0.1600 ± 0.0455),BIU-87 (0.1720 ± 0.0658),EJ (0.1150 ± 0.0352),T24-MMC(0.0576 ± 0.0087),T24-ADM (0.0510 ± 0.0125)] were decreased (P ＜ 0.05),as compared with normal bladder cell lines SV-HUC-1 (0.6384 ± 0.1083).Moreover,the expression levels of miR-34b were down-regulated in 2 drug resistant bladder cancer cells lines T24-MMC (0.0576 ± 0.0087) and T24-ADM(0.0510 ± 0.0125),as compared with the T24 bladder cancer lines T24 (0.1600 ± 0.0455),respectively (P ＜ 0.05).The relative expression levels of UCA1 and miR-34b in bladder cancer tissues and paraneoplastic normal bladder tissues were (0.4225 ± 0.0714) vs.(0.0532 ± 0.0192) and (0.0340 ± 0.0134)vs.(0.5643 ±0.0616),respectively (P ＜0.05).Statistical correlation analysis showed that UCA1 to be significantly negative correlated with miR-34b in bladder cancer specimens(r =-0.54,P ＜ 0.05).The high level of UCA1 and low level of miR-34b were significantly correlated with tumor malignant grade,invasiveness and recurrence.The 3-year overall survival rate (OS) in UCA1 (+)/miR-34b(-) group (27.6％) were significantly worse compared with non UCA1 (+)/miR-34b (-) group (73.7％).Conclusion High expression of UCA1 and low expression of miR-34b were associated with the occurrence and development of bladder cancer.

Objective To investigate the efficacy of high frequency jet ventilation via the nasopha?ryngeal catheter in assissting ventilation in patients with obstructive sleep apnea hypopnea syndrome ( OS?AHS) undergoing gastroscopy. Methods Eighty patients with OSAHS of both sexes, aged 40-64 yr, weighing 65-99 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, with an apnea?hy?popnea index 20-40 events∕h, scheduled for elective painless gastroscopy, were divided into control group and test group using a random number table, with 40 patients in each group. In control group, a nasopha?ryngeal catheter 6.0-7.0 mm in internal diameter was inserted, and oxygen was inhaled at 4 L∕min through the catheter. In test group, a nasopharyngeal catheter 4.0 mm in internal diameter was inserted, and a high frequency jet ventilator was connected ( inspiratory∕expiratory ratio 1. 0 ∶ 1. 5, frequency 150 bpm, peak pressure 0.4 kPa, tidal volume 180 ml) . Anesthesia was maintained with propofol in both groups. The oc?currence of hypoxemia during ventilation, and peak value of partial pressure of end?tidal CO2 before induc?tion of anesthesia and during ventilation, and occurrence of chin lift, mask ventilation, and epistaxis after insertion of the catheter during operation were recorded. Results Compared with control group, the inci?dence of hypoxemia, peak value of partial pressure of end?tidal CO2 during ventilation, and incidence of chin lift, mask ventilation and epistaxis during operation were significantly decreased in test group ( P<0.05) . Conclusion High frequency jet ventilation via the nasopharyngeal catheter can be safely and effec?tively used to assisst ventilation in patients with OSAHS undergoing gastroscopy.

Objective To assess the results of emergency endovascular stent-grafting for patients with acute Stanford type B aortic dissection(type B AAD)within 24 hours of onset.Methods Between June 2007 and October 2008,30 patients with acute type B aortic dissection underwent emergency endOVascular stent-grafting within 24 hours of presentation.Under general anesthesia,stent-graft was deploved at the proper position of first tear entry through femoral artery under X-ray monitering.Follow-up by CT was performed 1 w,1 m ,3 m,6 m,1 y postoperatively to observe the efficacy and complications such as endoleak,migration and fracture of stent-graft. Result The technical success rate was 100%;13.4%(4 cases) endoleak rate was identified immediately after deployment.Follow up was made between 1 month to 19 months,averaging at(12±8)months,3.3%type-1 endoleak Was observed after 6 months;One patient died within 30 days possibly of dissection rupture;One patient died of acute liver failure during the follow-up. Conclusion Endovascular repair with stent-graft within 24 hours of presentation was effectivefor the treatment of acute type B aortic dissection.

OBJECTIVETo investigate the effect of micronized fenofibrate on vascular endothelial function in patients with hypertriglyceridemia.

METHODSUsing high-resolution ultrasound, we measured flow- and nitroglycerin-induced dilatation of the brachial artery in 30 patients with hypertriglyceridemia before and after treatment with micronized fenofibrate at a dose of 200 mg once daily for 4 weeks. Simultaneously, both serum lipid and plasma endothelin (ET) levels were determined.

RESULTSAfter micronized fenofibrate therapy, serum triglyceride (TG) levels decreased significantly (P < 0.05). Plasma ET levels also decreased markedly [(82.66 +/- 15.46) microg/L vs. (106.22 +/- 19.16) microg/L, P < 0.001]. Flow-induced vasodilatation was much improved (11.0% +/- 9.0% vs 2.7% +/- 2.0%, P < 0.01). However, no significant changes in vasodilatation occurred in response to nitroglycerin (16.2% +/- 6.0% vs 15.0% +/- 5.0%, P > 0.05) in patients with hypertriglyceridemia.

CONCLUSIONSMicronized fenofibrate can improve impaired endothelium-dependent vasodilatation in patients with hypertriglyceridemia. Improving endothelial function may also be the mechanism responsible for the beneficial effects of micronized fenofibrate.

Adult ; Endothelium, Vascular ; drug effects ; physiology ; Female ; Fenofibrate ; pharmacology ; therapeutic use ; Humans ; Hypertriglyceridemia ; drug therapy ; Male ; Middle Aged ; Vasodilation ; drug effects

Objective To investigate the effect of restrictive intravenous fluid on the complications and quality of life in the advanced hepatocellular carcinoma patients.Methods Clinical data of Three hundred and fifty-seven cases with advanced hepatocellular carcinoma from Mar 2010 to Mar 2016 was retrospectively analyzed.One hundred and sixty-eight cases were recruited in the restrictive intravenous fluid (RIF) group,and One hundred and eighty-nine cases were involved in the control group.The average volume of intravenous fluid of each day,plasma albumin concentration,splanchnocoel hydrops rate,phlebitis,incidence of vomiting,cancer related pain degree,anxiety degree were compared in the two groups.Results The average volume of intravenous fluid of each day in the RIF group [(720.29 ± 106.84) ml] were much lower than that in the control group [(1 820.36±342.12)ml] (P ＜0.05).The plasma albumin concentration in the RIF group [(35.65 ± 2.21)g/L] were higher than that in the control group [(32.25 ±2.32)g/L] (P ＜0.05).The rate of splanchnocoel hydrops,phlebitis,vomiting,bedsores,and hypstatic pneumonia in RIF group were 6.25％,4.69％,8.59％,3.9％,11.72％ and those in the control group were 13.97％,10.92％,17.47％,10.04％,and 24.45％,respectively (P ＜ 0.05).Moreover,the scores of cancer related pain and anxiety were much lower in the RIF group (5.21 ± 1.09,39.12 ± 5.54) than those in the control group(5.68 ± 1.18,41.56 ± 6.78) (P ＜ 0.01).Conclusions Restrictive intravenous fluid therapy can decrease the cancer associated complications and improved the quality of life in the advanced hepatocellular carcinoma patients.

Objective: To prepare strains of influenza A (H7N9) pseudovirus derived from different districts of China for vaccine efficacy evaluation. Methods: Phylogenetic tree was built based on hemagglutinin (HA) amino acid sequence analyses from 29 influenza A (H7N9) virus strains and 6 influenza A (H7N9) virus strains with HA determinants variation were selected. 293FT cells were co-transfected with plasmid pNL4-3-Luc.R-E-, pVRC-HA and pVRC-NA with codon-optimized hemagglutinin (HA) and neuraminidase (NA) derived from the six influenza A (H7N9) virus strains, respectively. Transmission electron microscopy assay and Western blot analysis were performed to demonstrate morphology and specificity of these particles, luciferase activity assay and hemagglutinin titers detection were used to determine their infectivity and hemagglutinin activity. And finally, pseudovirus-based neutralization assays were evaluated with HA immunized mice serum. Results: Six influenza A (H7N9) peseudovirus particles derived from different districts of China were selected and prepared. All of the particles bearing HA and NA were characterized with classic influenza virus morphology, with TCID₅₀ titer ranged from 10⁴TCID₅₀/50 μl to 10⁵TCID₅₀/50 μl and with hemagglutinin activity ranged from 64 to 512. Neutralization efficacies on influenza A/Shanghai/1/2013(H7N9) HA vaccine serum against 100TCID₅₀ dose of these pseudovirus particles indicated their potential application in the vaccine cross-protective evaluation in future. Conclusions Six influenza A (H7N9) pseudovirus derived from different districts of China with potential antigenic variation on HA were constructed successfully, established foundation for their further application in vaccine cross-reactive efficacy evaluation.