OBJECTIVE:To observe the effects of preoperative application of tirofiban on related indexes of patients with acute myocardial infarction. METHODS:In retrospective analysis,128 patients with acute myocardial infarction selected from our hospital during Jan. 2015-Jun. 2016 were divided into observation group (76 cases) and control group (52 cases) according to whether or not the tirofiban was used before PCI. Control group was given Aspirin enteric-coated tablets 300 mg,po+ Clopidogrel sulfate tablets 600 mg,po,before PCI,and given Heparin sodium injection 100 U/kg ,iv,during PCI. Observation group was ad-ditionally given Tirofiban hydrochloride injection 0.2 μg/(kg·min),iv,before PCI,on the basis of control group. ST-segment depres-sion and chest pain remission of 2 groups were observed after PCI. CK-MB level before surgery,CK-MB peak value,the time of CK-MB reaching the peak value,duration after surgery as well as TIMI blood flow grading after surgery were also observed in 2 groups. The levels of von Willebrand factor(vWF),ET-1 and NO were observed before and after surgery;the occurrence of ADR was recorded. RESULTS:After PCI,ST-segment depression rate(89.74%)of observation group was significantly higher than that (67.31%)of control group,the chest pain remission rate(89.47%)was significantly higher than that of control group(75.00%), the patients with TIMI blood flow grading grade 2-3 in observation group was more than control group,with statistical significance (P<0.05). Before PCI,there was no statistical significance in the levels of CK-MB,vWF,ET-1 and NO between 2 groups(P>0.05). After PCI,CK-MB peak value,the time of CK-MB reaching the peak value,duration in observation group were significant-ly lower or shorter than control group;the levels of vWF and ET-1 significantly decreased,while NO levels increased;the improve-ment of vWF,ET-1 and NO in observation group was significantly better than control group,with statistical significance (P<0.05). The incidence of mild bleeding in observation group was significantly lower than control group,while the incidence of mod-erate bleeding was significantly higher than control group,with statistical significance (P<0.05). There was no statistical signifi-cance in the incidence of death between 2 groups(P>0.05). CONCLUSIONS:The application of tirofiban before PCI can relieve clinical symptom,improve cardiac function,protect vascular endothelial and restore coronary artery perfusion. The attention should be paid to the risk of bleeding.

Objective To study the influence factors on detection coagulation factors Ⅸ activity in human prothrombin complex concentrates(PCC).MethodsUsing Chinese Pharmacopoeia(2010)as reference,factor Ⅸ deficient plasma from different manufacturers,different types of instruments,different methods of heparin neutralization,different sample pretreatment methods were used to determine the activity of coagulation factor Ⅸ in PCC.The influence on the results of coagulation factor Ⅸ was analyzed.ResultsThere was a significant difference between factor Ⅸ deficient plasma from different manufacturers for the activity of coagulation factors Ⅸ(P<0.05).There was no significant difference between the results of coagulation factor Ⅸ measured by different types of Automatic Coagulation Analyzer.When the dilution ratio was more than 60 times,the neutralization of heparin had little effect on the coagulation factor Ⅸ activity.When the dilution ratio is less than 60 times,the detection results of coagulation factor Ⅸ by neutralization of heparin are higher than no neutralization of heparin,and the difference is significant(P<0.05).Samples for pre-temperature or not and whether dissolution for 15minutes or not,the coagulation factor Ⅸ activity showed no significant difference.Conclusion The coagulation factor Ⅸ activity in PCC was affected by factor Ⅸ deficient plasma from different manufacturers,different dilution times of heparin neutralization method and sample pre-treatment methods.It must be paid attention to in the detection process.Strengthen the quality control of the factor deficient plasma and the standardization of operation process are necessary.The External Quality Assessment for the detection of coagulation factors in PCC products should be edtablished.

Objective To investigate the effect of dexmedetomidine pretreatment on the expression of caspase-12 in lung tissues undergoing one-lung ventilation (OLV) in rats.Methods Thirty male Sprague-Dawley rats, aged 6-8 weeks, weighing 180-220 g, were randomly allocated into 3 groups (n=10 each) using a random number table: two-lung ventilation (TLV) group, OLV group and dexmedetomidine group (Dex group).Bilateral lungs were ventilated for 2 h in group TLV.In OLV and Dex groups, unilateral lung was ventilated for 1.5 h followed by 0.5 h TLV.In group Dex, dexmedetomidine was infused intravenously at a rate of 3.0 μ g · kg-1 · h-1 over 60 min starting from 60 min prior to OLV.The equal volume of normal saline was given instead of dexmedetomidine in OLV and TLV groups.Peak airway pressure (Ppeak) and mean airway pressure (Paw) were recorded at 45 min of OLV and 15 min of TLV in OLV and Dex groups, and at 15 min of TLV in group TLV.The rats were then sacrificed, and left lungs were removed for microscopic examination of the pathologic changes (using HE staining) and the ultrastructure of lung tissues (with transmission electron microscope) and for determination of wet to dry lung weight ratio (W/D ratio), cell apoptosis in lung tissues (by TUNEL), caspase-12 mRNA expression (using real-time reverse transcriptase-polymerase chain reaction), and caspase-12 expression (by Western blot).Results Ppeak and Paw were significantly lower at 15 min of TLV than at 45 min of OLV in OLV and Dex groups (P＜0.05).Compared to group TLV, W/D ratio and AI were significantly increased, and the expression of caspase-12 protein and mRNA was up-regulated in OLV and Dex groups (P＜0.01).Compared to group OLV, W/D ratio and AI were significantly decreased, and the expression of caspase-12 protein and mRNA was down-regulated in group Dex (P ＜ 0.01).The pathologic changes of lung tissues were significantly alleviated in group Dex as compared with group OLV.Conclusion The mechanism by which dexmedetomidine pretreatment alleviates acute lung injury caused by OLV is associated with down-regulated expression of caspase-12 and inhibited cell apoptosis in rats.

Objectiye To improve the diagnosis and treatment of chromophobe renal cell carcinoma(CRCC). Methods The clinical dota of 25 patients of CRCC were reviewed.Thirteen were xmales and 12 were females and thirteen on the left and twelve on the right.The mean age was 51 years.Sixteen(64%)patients were asymptomatic.Gross hematuria,low back pain and discomfort and fever occurred in the other 9 patients.Laboratory investigations showed 1 patient had raised alanine aminotransferase and 1 had high erythrocyte sedimentation rate. Results B-ultrasound was mainly characterized by low echo renal mass with intact capsule and low blood flow signals.CT and MR of CRCC were typically well circumscribed,homogeneous(unenhanced CT was 70%,MR was 73%)with no necrosis and hemorrhage,homogenous enhancement(CT was 65%,MR was 67%)and mild enhanced(CT was 65%,MR was 67 %)renal mass.Twenty-two patients with tumors＞4.0 cm had radical nephrectomy and three with tumors≤4.0 cm had partial nephrectomy.The average diameter of tumors was 7.6 cm.The cross-sections of the tumors were grossly homogeneous,pale or dark brown solid.Light microscopy showed that the tumors were composed of trabeculae or sheets with voluminous cells in pale or eosinophilic cytoplasm.Immunohistochemical assay was positive of CK8 and negative of Vimentin.The pathologic TNM stages were 8 with T1a,9 with T1b,6 with T2 and 2 with T3a.Twenty-three patients were followed up.After mean follow-up of 28 months,22 cases were tumor free.One patient had pulmonary metastasis 58 months after operation and had no reaction to interferon-α and chemotherapy and died. Conclusions The majority of CRCC patients are asymptomatic and usually with low-stages.There are some features in CT and MR appearance of CRCC such as well circumscribed and homogenous.Surgical treatment should follow the treatment principles of renal cell carcinoma and carries an excellent prognosis for most localized tumors but there has been no effective measures to treat metastasis disease.The interval between operation and metastasis is relatively long and the time of follow-up should be prolonged in CRCC.

A model of experimental allergic asthma was induced by sensitizing and challenging guinea pigs with egg albumin. The changes on the concentrations and affinities of ?2,? adrenergic and muscarinic receptors as well as the content of cyclic adenosine monophosphate in lung tissue of the asthmatic animals were investigated and compared with the values obtained from normal animals respectively. The results showed that the maximal binding volume of ? receptor as well as the content of cAMP decreased significantly, while the concentrations of ?2, receptor and M receptor increased. It is well known that the ? receptor mediates a process resulting in the relaxation of bronchial smooth muscle by stimulating adenylate cyclase and therefore, increases the cytoplasmic concentration of cAMP. whereas the ?2, and M receptor mediate processes resulting in the contraction of smooth muscle through quite different mechanisms. The significance of the two kinds of change operating towards opposite direction in the pathogenesis of allergic asthma was discussed.

In recent years,assisted reproductive technology(ART)is developing rapidly,especially in vitro fertilization and embryo transfer(IVF-ET)technology.The rate of clinical pregnancy in our country is about 40％,and how to improve the rate of clinical pregnancy of IVF-ET has been the focus of the scholars research content.Environmental factors including culture system,temperature,humidity,pH value and volatile organic compounds,all of these can affect the success of IVF-ET.Now the common environmental factors affecting IVF-ET research progress were reviewed as follows.

Objective To evaluate the blood-saving effect of prophylactic tranexamic acid (TXA) use in the patients undergoing cervical spine surgery.Methods A total of 100 patients of both sexes,aged 55-75 yr,with body mass index of 19.0-25.0 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,undergoing elective cervical laminectomy and instrumentation,were divided into TXA group and normal saline group (group NS) using a random number table,with 50 patients in each group.TXA 15 mg/kg was intravenously injected at 30 min before skin incision in group TXA,and the equal volume of normal saline was given instead in group NS.Hemoglobin was measured before operation and on postoperative days 1,3 and 5.The intraoperative,postoperative,total blood loss,hidden blood loss and requirement for blood (allogeneic and autologous blood) transfusion were recorded.The development of complications such as epidural hematoma,deep vein thrombosis and pulmonary embolism was also recorded.Results Compared with group NS,the postoperative blood loss,total blood loss and blood transfusion rate were significantly decreased,the postoperative hemoglobin was increased (P＜0.05),and no significant change was found in the intraoperative blood loos or hidden blood loss in group TXA (P＞0.05).No patients developed complications such as epidural hematoma,deep vein thrombosis or pulmonary embolism in the two groups.Conclusion Prophylactic TXA use produces blood-saving effect to some extent in the patients undergoing cervical spine surgery.

AIM: To clarify the modulation of autophagy in ischemic penumbra by hydroxysafflor yellow A ( HSYA) after cerebral ischemia/reperfusion ( I/R) injury.METHODS:Male SD rats subjected to transient middle cere-bral artery occlusion for 90 min were randomly divided into 4 groups:sham-operation (sham) group, cerebral I/R (I/R) group, I/R+HSYA group and sham+HSYA group.Modified neurological severity score (mNSS) was used to evaluate the neurological deficits of the rats at 6 h, 1 d, 3 d and 7 d after reperfusion , accompanied by the detection of autophagy , apoptosis and mRNA expression of IFN-βin ischemic penumbra .RESULTS:Compared with sham group , upregulation of LC3-Ⅱand degradation of SQSTM1/P62 were observed in I/R group, indicating the activation of autophagy after I/R.The activation of autophagy in I/R+HSYA group was significantly enhanced by HSYA on day 1 and day 3, and inhibited on day 7, as compared with I/R group (P<0.05).Besides, the mRNA expression of IFN-βin I/R group was significantly upregulated at 6 h, then downregulated on day 1 and day 3, and returned to basal level on day 7, as compared with sham group (P<0.05).In I/R+HSYA group, the mRNA expression of IFN-βwas significantly upregulated on day 1 and day 3, accompanied by the inhibition of apoptosis on day 3 and the significantly decreased mNSS from day 4, as compared with I/R group (P<0.05).CONCLUSION:HSYA alleviates cerebral I/R injury by dynamically modulating the activation of autophagy and the expression of IFN-βin ischemic penumbra .

AIM:To observe the Toll-like receptor 9 (TLR9) activation in microglia BV-2 cells after oxygen-glucose deprivation and reoxygenation ( OGDR) , and its effects on neuronal apoptosis.METHODS:The BV-2 cell super-natants were collected after the corresponding treatment and added to mouse primary cortical neurons after OGDR for 4 h, followed by normal culture for 24 h.The cells were divided into normal BV-2 group, NC-siRNA group, TLR9-siRNA group, OGDR group, OGDR+NC-siRNA group, OGDR+TLR9-siRNA group and control group (without adding BV-2 cell supernatant) .The changes of the neuronal morphology were observed under an inverted phase-contrast microscope, and the neuronal apoptosis was detected by TUNEL.The protein expression of cleaved caspase-3 was detected by Western blot-ting.RESULTS:After OGDR, the axon turned thin, twisted and broken, and neuronal swelling, decrease in refraction and vacuolar degeneration were observed.The green-stained apoptotic bodies in the neurons in all groups were positive. Compared with control group, the caspase-3 protein levels in other groups were increased.Compared with the normal BV-2 group, the caspase-3 protein in OGDR group and TLR9-siRNA group was increased.Compared with OGDR+TLR9-siRNA group, the caspase-3 protein in TLR9-siRNA group and OGDR group was decreased.CONCLUSION: After OGDR, TLR9 activation in BV-2 cells induces neuronal apoptosis with the increase in caspase-3 protein level.Inhibition of TLR9 expression reduces neuronal damage.

Objective To explore the effect of extracellular regulated protein kinases (ERK) signaling pathway on early brain injury and autophagy of nerve cell in hippocampus area in rats with subarachnoid hemorrhage (SAH). Methods Forty-eight adult male Sprague-Daw-ley rats were randomly divided into sham group, SAH group, SAH+dimethyl sulfoxide (DMSO) group and SAH+U0126 group, with 12 rats in each group. The SAH model was established with puncture of internal carotid artery. The SAH+U0126 group was injected with U0126 0.05 mg/kg;the sham group and SAH group were injected with normal saline, and the SAH+DMSO group was injected with DMSO 30 min-utes before modeling. They were sacrificed 24 hours after modeling. The brain water content was measured with wet and dry method. The morphology changes of neural cells in hippocampus CA1 were observed by HE staining. The expression of phosphorylation ERK (p-ERK), Beclin-1 and LC3-Ⅱwere detected with immunohistochemical method and Western blotting. Results Compared with the sham group, the brain water content increased (P<0.05), the number of survival neurons decreased (P<0.05), the expression of p-ERK, Beclin-1 and LC3-Ⅱincreased in SAH group (P<0.05). Compared with SAH group, the brain water content increased, the number of survival neurons decreased (P<0.05), the expression of p-ERK, Beclin-1 and LC3-Ⅱ decreased in SAH+U0126 group (P<0.05); and no significant difference was found in SAH+DMSO group (P>0.05). Conclusion The activation of ERK signaling pathway may alleviate early brain injury after SAH by regulation of autophagy.