Objective To investigate the feasibility and the perioperative treatments of repairing atrial septal defects and bilateral lung transplantation in treatment of ASD with Eisenmenger's syndrome.Methods On May 24th,2016,one case of atrial septal defect with Eisenmenger's syndrome underwent repair for the atrial septal defect with bilateral sequential lung transplantation aided by extracorporeal circulation ECMO in Zhongshan People's Hospital.In strict accordance to the procedure,the lung was collected and preserved with the HTK solution.The operation went smoothly,the cold ischemic time for the right lung was 120 min and that for the left lung was 260 min.Postoperatively,Tacrolimus (FK506) + Mycophenolate Mofetil (MMF) + adrenal cortical hormone Sanlian immunosuppression was used.Results At 60th h post-operation the patient was hemodynamically stable,with good oxygenation after removal of the ECMO.At 7th day post-operation the patient was extubated.At 12th-20th day post-operation bacterial culture of the sputum was found to be positive and the patient was treated with the corresponding sensitive antibiotics and recovered.Cardiac ultrasound before discharge showed that there was no residual shunt.One month after discharge the cardiopulmonary function of the patient was quite good,chest X-ray showed that the bilateral transplanted lungs were clear and the patient's quality of life was much better.Conclusion Cardiac malformation repairs with bilateral lung transplantation is a feasible treatment for patients with end-stage Eisenmenger's syndrome with bi-directional shunts.The key to success is sufficient preoperative preparation,and a smooth operation with the timely and effective treatment of postoperative complications.

Objective:To analyze the value of renal color Doppler ultrasound examination and clinical indicators in evaluating the severity and prognosis of acute organophosphorus pesticide poisoning (AOPP) complicated by acute kidney injury (AKI) .Methods:In November 2019, 86 AOPP patients complicated by AKI who were admitted from May 2018 to May 2019 were selected as the observation group, and they were divided into AKI stage 1 group ( n=37) , AKI stage 2 group ( n=32) and AKI stage 3 group ( n=17) . 40 healthy people were selected as the control group. The differences in power Doppler ultrasound (PDU) score, renal interlobular artery resistance index (RI) value and related clinical indicators of each group were measured and analyzed, and the correlations between the indicators were analyzed. At the same time, binary logistic regression was used to analyze the risk factors of death in AOPP patients complicated by AKI. Results:There were statistically significant differences in Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱscore, mean arterial pressure (MAP) , serum creatinine (SCr) and the length of continuous renal replacement therapy (CRRT) between different groups ( P<0.05) . Compared with the control group, the APACHE Ⅱscores and SCr of patients in the AKI stage 2 and resistance index AKI stage 3 groups increased, while the MAP decreased ( P<0.05) . Compared with the control group, AKI stage 1 group and AKI stage 2 group, the PDU score of patients in the AKI stage 3 group was significantly decreased, and the renal interlobular artery RI value was significantly increased ( P<0.05) . SCr was positively correlated with the RI value of renal interlobular arteries and CRRT days ( r=0.435, 0.713, P<0.05) , and was negatively correlated with renal PDU score ( r=-0.643, P<0.05) . The renal PDU score was negatively correlated with the RI value of renal interlobular arteries and CRRT days ( r=-0.350, -0.556, P<0.01) . Binary logistic regression analysis showed that SCr ( OR=1.017, 95% CI: 1.004-1.041) and APACHE Ⅱ score ( OR=1.289, 95% CI: 1.019-1.827) were risk factors for death in patients with AOPP complicated by AKI ( P<0.05) . Conclusion:Both PDU score and the RI value of renal interlobular artery can reflect the severity and stage of patients with AOPP complicated by AKI to a certain extent, but neither of them is a key factor affecting the death of patients.

Objective:To analyze the value of renal color Doppler ultrasound examination and clinical indicators in evaluating the severity and prognosis of acute organophosphorus pesticide poisoning (AOPP) complicated by acute kidney injury (AKI) .Methods:In November 2019, 86 AOPP patients complicated by AKI who were admitted from May 2018 to May 2019 were selected as the observation group, and they were divided into AKI stage 1 group ( n=37) , AKI stage 2 group ( n=32) and AKI stage 3 group ( n=17) . 40 healthy people were selected as the control group. The differences in power Doppler ultrasound (PDU) score, renal interlobular artery resistance index (RI) value and related clinical indicators of each group were measured and analyzed, and the correlations between the indicators were analyzed. At the same time, binary logistic regression was used to analyze the risk factors of death in AOPP patients complicated by AKI. Results:There were statistically significant differences in Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱscore, mean arterial pressure (MAP) , serum creatinine (SCr) and the length of continuous renal replacement therapy (CRRT) between different groups ( P<0.05) . Compared with the control group, the APACHE Ⅱscores and SCr of patients in the AKI stage 2 and resistance index AKI stage 3 groups increased, while the MAP decreased ( P<0.05) . Compared with the control group, AKI stage 1 group and AKI stage 2 group, the PDU score of patients in the AKI stage 3 group was significantly decreased, and the renal interlobular artery RI value was significantly increased ( P<0.05) . SCr was positively correlated with the RI value of renal interlobular arteries and CRRT days ( r=0.435, 0.713, P<0.05) , and was negatively correlated with renal PDU score ( r=-0.643, P<0.05) . The renal PDU score was negatively correlated with the RI value of renal interlobular arteries and CRRT days ( r=-0.350, -0.556, P<0.01) . Binary logistic regression analysis showed that SCr ( OR=1.017, 95% CI: 1.004-1.041) and APACHE Ⅱ score ( OR=1.289, 95% CI: 1.019-1.827) were risk factors for death in patients with AOPP complicated by AKI ( P<0.05) . Conclusion:Both PDU score and the RI value of renal interlobular artery can reflect the severity and stage of patients with AOPP complicated by AKI to a certain extent, but neither of them is a key factor affecting the death of patients.

OBJECTIVETo investigate the chemical constituents of the roots of Periploca forrestii and evaluate their cytotoxicity activities.

METHODSilica gel column chromatography was employed for the isolation and purification of chemical constituents. The structures were identified on the basis of spectral data and the cytotoxicities of compounds 2-4 were investigated by several tumors cell lines including blood tumor (HL-60, CCRT-CEM), prostate tumor (PC-3, DU-145) and Melanoma (UACC-62).

RESULTFour compounds were isolated and identified as follows, lupeol-20(29)-en-3-nonadecanoate (1), peroiforoside I (2), 3beta,5beta,14beta-3OH-8beta-H-car-20(22)-enolide (3), perplocin (4).

CONCLUSIONCompound 1 is a new lupane triterpene fatty acid ester. Compounds 2-4 showed notable cytotoxicity against all tumor lines.

Cell Line, Tumor ; Cell Survival ; drug effects ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; pharmacology ; HL-60 Cells ; Humans ; Inhibitory Concentration 50 ; Molecular Structure ; Periploca ; chemistry ; Plant Roots ; chemistry ; Triterpenes ; chemistry ; isolation & purification ; pharmacology