AIM: To research the effect of serum from patients with blood stasis syndrome(BSS) associated with hypertension disease on vWF、TM、EPCR excreted by ECV-304 and Tanshinone Ⅱ_A's intervention. METHODS: Cultivated human umbilical vein endothelial cells(CRL-1730) were divided into four groups,according to different serum of patients with BSS associated with hypertension disease,BSS(model) group,non-blood stasis group,health group and control group.The incubation time was 24 h.Tanshinone Ⅱ_A was of different concentrations(40、20、10、5 ?g/mL),all Tanshinone Ⅱ_A groups' cells were incubated by patients' serum and Tanshinone Ⅱ_A for 24 h.vWF,TM and EPCR were assayed by enzyme-linked immunosorbent assay(ELISA). RESULTS: vWF,TM and EPCR secreted were higher in the model group,the non-blood stasis group and the health group than those in the control group;vWF,TM and EPCR secreted were higher in the model group,the non-blood stasis group than those in the health group;Thereinto,the difference was distinct between the model group and the health group(P

AIM: To study the effects of Shenghua Decoction on the expression of adhesion molecules in vascular endothelial cells (VECs) of blood-stasis rats. METHODS: The expression of VCAM-1, ICAM-1, PECAM-1, iNOS and their corresponding mRNA in VECs were assayed by immunohistochemistry, image analysis and RT-PCR under the function of different Shenghua Decoction doses (high, middle, low). RESULTS: Immunohistochemistry and image analysis indicated: the expression of VCAM-1, ICAM-1, PECAM-1 and iNOS were higher in the model group than in the control group, Shenghua Decoction could decrease the expression of VCAM-1, ICAM-1, PECAM-1 and iNOS in the model group, moreover as the dose decreased, the expression of these molecules increase, it was of dose-effect relation. CONCLUSION: Shenghua Decoction can downregulate the expression of adhesion molecules in vascular endothelial cells of blood-stasis rats, and the dose-effect relation is obvious.

Objective To evaluate the accuracy of remifentanil target-controlled infusion (TCI) system in children.Methods Thirty ASA Ⅰ patients, aged 3-12 yr, weighing 10-40 kg, scheduled for elective ear-nosethroat or urological surgery, were randomly divided into 2 groups with 15 patients in each group:2 ng/ml remifentanil group (group Ⅰ) and 4 ng/ml remifentanil group (group Ⅱ). Anesthesia was induced with iv injection of propofol 2 mg/kg and TCI of remifentanil. Remifentanil was administered with a specific TCI system incorporating the pharmacokinetic parameters of Minto.The target plasma concentrations of remifentanil were set at 2 or 4 ng/ml. Tracheal intubation was facilitated with vecuronium 0.1 mg/kg after the children lost consciousness. The children were mechanically ventilated.Anesthesia was maintained with TCI of remifentanil, iv infusion of propofol and intermittent iv boluses of vecuronium. The target plasma concentration of remifentanil remained unchanged and bispectral index value was maintained at 45-65 or auditory evoked potentials index value ＜ 30 by adusting the infusion rate of propofol.Arterial blood samples were taken at 5, 10, 20, 30, 40, 50 and 60 min after TCI remifentanil was stared for determination of blood remifentanil concentrations by high performance liquid chromatography. Median prediction performance error (MDPE),median absolute performance error (MDAPE) and wobble of remifentanil TCI system were calculated. Results The measured concentrations of remifentanil were significantly higher than the target plasma concentrations in both groups (P＜0.05). The MDPE, MDAPE and wobble were 20.0% , 30.0% and 25.0% respectively in group Ⅰ , and 17.5%, 17.5% and 12.5% respectively in group Ⅱ . TheMDAPE and wobble were significantly decreased in group Ⅱ compared with group Ⅰ(P＜0.05).Conclusion When remifentanil is administered using a specific TCI system incorporating the pharmacokinetic parameters of Minto in children of 3-12 years old, the accuracy is not high.

Objective: Giant left ventricle is one of the important dangerous factors impacting the results of valve replacement operation.In order to improve the efficiency of operation,we summarized our experience in valve replacement surgery for patients with giant left ventricle(LVEDD ≥ 7.0 cm).Methods: We retrospectively analyzed the clinical data of 138 cases of giant left ventricle treated by valve replacement operation in our hospital from June 1996 to April 2008.The preoperative left ventricular end diastolic dimension(LVEDD),left ventricle end systolic dimension(LVESD),left ventricular ejection fraction(LVEF) and left ventricular fractional shortening(LVFS) were 7.38-10.51 cm(mean 7.98?0.39),5.20-7.93(mean 5.88 ? 1.03),0.21-0.66(mean 0.43 ? 0.11) and 0.10-0.45(mean 0.25 ? 0.07),respectively.Eighty-nine of the patients had the heart function(NYHA) of class Ⅲ,and the other 49 class Ⅳ.Mitral valve replacement(MVR) was performed for 57 cases,aortic valve replacement(AVR) for 26,double valves replacement(DVR) for 40,and Bentall operation for the other 15.Meanwhile,78 of them underwent tricuspid valve plasty(TVP),and another 17(LVEDD ≥8.5 cm and LVEF ≤ 25%) partial left ventriculectomy(PLV).Results: The early postoperative mortality rate was 5.8%,mainly due to postoperative multiple organ failure,severe low cardiac output syndrome and ventricular fibrillation.Compared with the preoperative data,postoperative echocardiography showed that LVEDD and LVESD were decreased slowly at 2 weeks,and LVEF and LVFS significantly improved at 6 months.In the 17 patients who underwent PLV,LVEDD and LVESD were significantly reduced at 2 weeks,and LVEF and LVFS markedly improved.Conclusion:The key to the efficiency of valve replacement for giant left ventricle was proper choice of the blood containing stop-beating fluid during the operation,preserving the posterior valve of the mitral valve and the structure beneath it,shortening aortic cross-clamping time as much as possible,and perioperative prevention and management of arrhythmia.The short-term effect of valve replacement with simultaneous PLV is satisfactory,while its long-term effect is yet to be further investigated.

Objective To evaluate the accuracy of remifentanil target-controlled infusion (TCI) system in children.Methods Thirty ASA Ⅰ patients (aged 3-12 years and weighing 10-40 kg) scheduled for elective ear-nose-throat or urological surgery were randomly divided into two groups (n =15 each):2 ng/ml remifentanil group (group Ⅰ) and 4 ng/ml remifentanil group (group Ⅱ).Anesthesia was induced with intravenous injection of propofol 2 mg/kg and TCI of remifentanil.Remifentanil was administered with a specific TCI system incorporating the pharmacokinetic parameters of Minto.The target plasma concentration of remifentanil was set at 2 or 4 ng/ml.Tracheal intubation was facilitated with vecuronium 0.1 mg/kg after the children lost consciousness.The children were mechanically ventilated.Anesthesia was maintained with TCI of remifentanil,intravenous infusion of propofol and intermittent intravenous injection of boluses of vecuronium.The target plasma concentration of remifentanil remained unchanged and bispectraI index value was maintained at 45-65 or auditory evoked potentials index value ＜ 30 through adjusting the infusion rate of propofol.Arterial blood samples were taken at 5,10,20,30,40,50 and 60 minutes after TCI of remifentanil was started for determination of blood remifentanil concentrations by high performance liquid chromatography.Median prediction performance error (MDPE),median absolute performance error (MDAPE) and wobble of remifentanil TCI system were calculated.Results The measured concentrations of remifentanil were significantly higher than the target plasma concentrations jn both groups (P ＜ 0.05).The MDPE,MDAPE and wobble were 20.0％,30.0％ and 25.0％ respectively in group Ⅰ,and 17.5％,17.5％ and 12.5％ respectively in group Ⅱ.The MDAPE and wobble were significantly decreased in group Ⅱ compared with group Ⅰ (P ＜ 0.05).Conclusion When remifentanil is administered using a specific TCI system incorporating the pharmacokinetic parameters of Minto in children of 3-12 years old,the accuracy is not high.

Objective To evaluate the incidence and mortality of acute kidney injury (AKI) in coronary care unit (CCU),and to identify the risk factors of the incidence of AKI and the mortality of CCU patients.Methods A total of 414 patients in CCU from January 1,2014 to June 1,2015 at Zhongnan Hospital of Wuhan University were enrolled.Based on the KDIGO-AKI criteria,these patients were classified into two groups:NAKI group (patients without AKI) and AKI group.Clinical characteristics and laboratory data of two groups were compared.The risk factors of the incidence of AKI and the mortality of CCU patients was analyzed by logistic regression,and then the receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of these risk factors.Results (1) Among 414 patients,136(32.9％) patients fulfilled the criteria for AKI,and 14.0％ patients in AKI stage 1,10.9％ in AKI stage 2 and 8.0％ in AKI stage 3.(2) The total CCU mortality was 15.0％.Mortality of AKI patients in the CCU was 33.3％,higher than 6.1％ in patients without AKI (OR=7.735,95％CI 4.215-14.196,P ＜ 0.001).The mortality worsened with increasing severity of AKI (22.4％ for AKI stage 1 group,37.8％ for AKI stage 2 group,45.4％ for AKI stage 3 group).(3) Anemia (OR=8.274,95％ CI 4.363-15.689),history of chronic illness (OR=2.582,95％ CI 1.400-4.760),APACHE]Ⅱ seores (OR=1.813,95％CI 1.739-1.895),male (OR=3.666,95％CI 1.860-7.226) were the independent risk factors for AKI,while the normal mean arterial pressure (MAP) (OR=0.292,95％CI 0.153-0.556) and normal estimated glonerular filtration rate (eGFR) (OR=0.166,95％CI 0.090-0.306) are the protective factors for AKI (all P ＜ 0.05).(4) AKI was the most powerful independent factor associated with the mortality of CCU patients (OR=7.050,95％ CI 2.970-16.735,P ＜ 0.001).Other independent risk factors for CCU mortality included history of chronic illness,ejection fraction and APACHE Ⅱ ≥ 15 scores (all P ＜ 0.05),while the normal MAP and normal eGFR were the protective factors (all P ＜ 0.05).(5) For predicting AKI,eGFR displayed an excellent areas under the ROC curve (AUC=0.815,P ＜ 0.001),and for CCU mortality,APACHE Ⅱ scores had the highest overall correctness of prediction (AUC=0.757 P ＜ 0.001).Conclusions CCU patients have high morbidity of AKI,which is the most powerful independent factor associated with the increased CCU mortality.The eGFR is the best predictor for AKI,and then through the evaluation of eGFR for CCU patients,we can evaluate high-risk groups,make early interventions and then improve the prognosis of CCU patients.

Objective To evaluate the efficacy and safety of 650 nm,810 nm diode laser on the treatment of moderate to severe acne.Methods A total of 87 patients with moderate to severe acne were divided into diode laser group (group A) and medication group (group B).In group A,the patients were irradiated with 650,810 nm diode laser at the fluence of 400-450 mW distance of 2-3 cm.In group B,the patients were treated with roxithromycin combined with vitamin B6 and gel lincomycini.Clinical follow-up was performed every week for 4 months.All the adverse effects were recorded.Results There was no significantly statistical difference in the cure rate between the two groups (group A versus group B at 2 weeks:65.0 ％ versus 42.6 ％,P＞0.05; at 4 weeks:92.5 ％ versus 76.5 ％,P＞0.05).However,the recurrence rate of group A was much lower than that of group B (30.0 ％ versus 61.7 ％,P＜0.01).There were no severe adverse effects in both groups during the period of the follow-up.Conclusions Compared to the medication,650,810 nm diode laser appears to be associated with lower recurrence rate in the treatment of moderate to severe acne.

Objective To evaluate the value of mean platelet volume (MPV) in identifying the location of infarct at left circumflex artery (LCX) in patients with non-ST-elevation myocardial infarction (NSTEMI).Methods In this retrospective study,184 consecutive patients with NSTEMI were eligible to be enrolled from January 1,2009 to June 30,2011 and laboratory examinations including platelet count,B-type natriuretic peptide (BNP),troponins test (TnI),C-reactive protein and serum creatinine (SCr) were done.The demographics and detailed history of patients were documented.In addition,left ventricular ejection fraction (LVEF) test and coronary angiography to determine the culprit vessel implicating in infarction were carried out in all enrolled patients.The patients were categorized into LCX group and N-LCX group according to culprit vessel.Results Of 184 patients,68 patients were in LCX group and 116 patients had left anterior descending artery (LAD) lesion or right coronary artery (RCA) lesion.High percent of LCX infarction were found in patients with high MPV level and low BNP level,and in smokers.And lower proportion of those patients had previous percutaneous coronary artery intervention.The results showed that MPV was larger in patients with LCX infarction than that in patients with LAD or RCA.Receiver operating characteristic curve showed the area under curve was 0.75 (95％ CI:0.675-0.826).An optimized cut off point at 9.15 fL of MPV showed 83.8％ sensitivity and 63.8％ specificity for prediction of LCX infarction.Multivariate analysis also showed that MPV was the only independent predictor of a LCX infarction in patients with NSTEMI [OR=1.32,(95％ CI:1.031-1.688),P＜0.05].Conclusions MPV was the only independent factor associated with LCX infarction in patients with NSTEMI.

AIM: To study the effects of xijiao dihuang decoction, a Chinese medicine, on the expression of adhesion molecules in vascular endothelial cells (VECs) of adrenine and hypothermia-treated rats. METHODS: The expression of VCAM-1, ICAM-1, PECAM-1, iNOS and their corresponding mRNA in VECs was assayed by immunohistochemistry analysis and RT-PCR, respectively. RESULTS: Immunohistochemistry analysis showed the expression of VCAM-1, ICAM-1, PECAM-1 and iNOS are higher in adrenine and hypothermia-treated rats than that in controls, xijiao dihuang decoction decreased the expression of VCAM-1, ICAM-1, PECAM-1 and iNOS in a dose-dependent manner in adrenine and hypothermia-treated rats. CONCLUSION: Xijiao dihuang decoction can down-regulate the expression of adhesion molecules in vascular endothelial cells of adrenine and hypothermia-treated rats.

Objective To study the effect of Buyang Huanwu Decoction (BHD) on adhesion molecules in vascular endothelial cells (VECs) of blood stasis rats. Methods Expression of ICAM-1, VCAM-1, PECAM-1, iNOS in vascular endothelial cells of blood stasis rats receiving different doses of BHD was observed by immunohistochemical method and RT-PCR.Results The expression of ICAM-1, VCAM-1, PECAM-1, iNOS was increased in model group, while was decreased by BHD. There was an increase tendency on the expression of molecules and significant dose-effect relationship along with the decrease of the BHD doses. Conclusion The increased expression of adhesion molecules in vascular endothelial cells of blood stasis rats could be reduced by BHD in a dose dependent manner.