OBJECTIVE: To evaluate the dose-effect relationship of reptilase in hemostasis. METHODS: The effects of different doses of reptilase on bleeding time (BT), Blood coagulation and hemorheology in New Zealand rabbits were examined. RESULTS: Reptilase showed a significant hemostatic effect at the dosages of 0.023, 0.07, 0.21 and 0.63KU?kg-1, respectively, with the hemostatic effect lower in 0.63KU?kg-1 group than in 0.21KU?kg-1 group; and at the 4 different dosages, reptilase showed no significant effect on fibrinolysis system. At a dosage of 1.90 or 5.71KU?kg-1, reptilase showed a significant anticoagulation efficacy and enhanced fibrinolysis function. There was no significance in hemorheology among groups. CONCLUSION: At a dosage range of 0.21～0.63KU?kg-1, reptilase has an optimal hemostatic effect in New Zealand rabbits.

OBJECTIVE:To provide reference for improving the teaching quality of pharmaceutical analysis course. METH-ODS:WeChat public platform was registered firstly,and supplement teaching was provided before class,during class and after class. RESULTS:WeChat public platform named Pharmaceutical Analysis of Chongqing Medical and Pharmaceutical College was registered and included 2 first-level-modules of"excellent resource"and"learning interaction",and 6 second-level-modules of"classic courseware""pre-course lesson plan""classic video""classroom exercises""question answering""classic case". Before class, students could preview through the platform;during class,the teachers could review teaching according to the platform;after class,the teachers could test students'learning results and answer questions for students,and students could consolidate classroom knowledge. Post-course effect evaluation showed that there was statistical significance in pass rate of student's grade between teach-ing reform class and control class (P<0.05). And the students of teaching reform class had good satisfactory degree (87.07%). CONCLUSIONS:WeChat mobile learning model supplements pharmaceutical analysis course,improves students'enthusiasm for learning and students,academic records. Students are satisfied with it. It can provide reference for improving the teaching quality of the course.

Objective To improve the diagnosis and treatment of infective endocardits(IE)by exploring the causes,pathogenic microorganism,clinical characteristics and therapeutic results of patients with IE.Methods From January 2006 to January 2016,89 cases with IE in Ganzhou People's Hospital were collected,and the clinical charac-teristics were analyzed retrospectively.Results Among the IE patients,40.5%had congenital heart diseases,33.7%had rheumatic heart diseases,18.0% were post－PCI or operative endocarditis,and patients without basic cardiac diseases accounted for 7.9%.The most common clinical manifestations were fever (86.5%),followed by anemia (85.4%).The blood culture positive rate was 63.4%.Streptococci viridians were the most common causative organ-isms(44.2%),followed by coagulase －negative staphylococci(21.2%).Eighty－six patients received echocardio-graphy examination,vegetation was observed in 61cases (68.5%).The hospital mortality rate was 10.1%,mostly due to refractory congestive heart failure and sepsis.Conclusion Congenital heart disease showed an upward trend, rheumatic heart disease decreased significantly.Intermittent fever,anemia are the main clinical manifestations.Blood culture positive rate is not high,Streptococcus viridians is the most common causative organism.Echocardiography is the main basis for the diagnosis.

OBJECTIVETo summarize anesthetic management of low birth weight infants undergoing surgical intervention of congenital heart disease without cardiopulmonary bypass.

METHODSFifty-three low birth weight infants (including 49 premature infants) with congenital heart disease underwent surgical treatment without cardiopulmonary bypass during the period from June, 2003 to July, 2013. The mean gestational age of the infants was 30.96∓3.09 weeks (26-40 weeks) with a mean age on the operation day of 32.81∓20.76 days (4-87 days), birth weight of 1429.90∓455.08 g (640-2460 g), and weight on the operation day of 1750.20∓481.59 g (650-2460 g). All the infants underwent cardiac operations without cardiopulmonary bypass under general anesthesia. The respiratory parameters and acid-base and electrolyte balance were adjusted according to blood gas analysis. The inotropic drug was used to maintain the hemodynamic stability.

RESULTSForty-seven of the infants received patent ductus arteriosus (PDA) ligation. Of these infants, 1 had cardiac arrest before the operation with failed cardiopulmonary resuscitation, and in another case, PDA ligation was aborted due to severe hypoplasia of the aortic valve and ascending aorta found intraoperatively by transesophageal echocardiography. Two infants underwent coarctation of the aorta (CoA), and 1 of them died during the operation due to cardiac arrest. The total mortality of these infants was 3.77% and the early postoperative mortality (<72 h) was 5.66%.

CONCLUSIONSNon-cardiopulmonary bypass surgery can be performed in low birth weight infants in early stage, and effective anesthetic management can reduce the perioperative mortality and improve the postoperative survival rate.

Anesthesia ; methods ; Anesthetics ; Birth Weight ; Cardiac Surgical Procedures ; Cardiopulmonary Bypass ; Gestational Age ; Heart Defects, Congenital ; surgery ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Ligation

OBJECTIVE:To study the inhibitory effect and mechanism of Inula helenium ethyl acetate extract(IHE)on prolif-eration of human pancreatic cancer Capan-2 cells. METHODS:MTT was used to determine the cell proliferation inhibition rate af-ter treated by 0,0.5,1,2,4,8 μg/mL IHE;clone formation test was used to observe the effects of 0,1,2 μg/mL IHE treating for 1 week on cell clone formation;Hoechest 33342 staining was used to observe the changes of nuclear morphology after treated by 0,2,4 μg/mL IHE for 48 h;flow cytometry was used to detect the cell apoptosis rate after treated by 0,4,8,16 μg/mL IHE for 48 h;JC-1 staining was used to observe the changes of intracellular mitochondrial membrane potential after treated by 0,4,8, 16 μg/mL IHE for 24 h;Western blot was used to detect the expressions of mitochondrial apoptosis-related proteins Bcl-2,Bax, Mcl-1,p53 up-regulated modulator of apoptosis (PUMA),and polymerase (PARP) after treated by 0,4,8,16 μg/mL IHE for 48 h. RESULTS:2,4,8 μg/mL IHE had obvious inhibitory effect on cell proliferation,showing concentration-dependent relation-ship,with IC50 of 6.6 μg/mL;1,2 μg/mL IHE can obviously inhibit the clone formation of cells;4 μg/mL IHE can obviously cause cell nuclear condensation;8,16 μg/mL IHE can obviously promote the cell apoptosis,and the cell apoptosis rate reached 45.53% after treated by 16 μg/mL IHE for 48 h;16 μg/mL IHE treating for 24 h can cause the decrease of 82.47% cells'mito-chondrial membrane potential;8 μg/mL IHE can obviously down-regulate the protein expressions of Bcl-2,Mcl-1,PUMA and PARP,and 16 μg/mL IHE can obviously down-regulate the expressions of Mcl-1 and PUMA. CONCLUSIONS:IHE may show its inhibitory effect on proliferation of human pancreatic cancer Capan-2 cells by causing the decrease of mitochondrial mem-brane potential in cells and down-regulating the protein expres-sions of Mcl-1 and PUMA to cause cell apoptosis.

Objective To summarize anesthetic management of low birth weight infants undergoing surgical intervention of congenital heart disease without cardiopulmonary bypass. Methods Fifty-three low birth weight infants (including 49 premature infants) with congenital heart disease underwent surgical treatment without cardiopulmonary bypass during the period from June, 2003 to July, 2013. The mean gestational age of the infants was 30.96±3.09 weeks (26-40 weeks) with a mean age on the operation day of 32.81 ± 20.76 days (4-87 days), birth weight of 1429.90 ± 455.08 g (640-2460 g), and weight on the operation day of 1750.20±481.59 g (650-2460 g). All the infants underwent cardiac operations without cardiopulmonary bypass under general anesthesia. The respiratory parameters and acid-base and electrolyte balance were adjusted according to blood gas analysis. The inotropic drug was used to maintain the hemodynamic stability. Results Forty-seven of the infants received patent ductus arteriosus (PDA) ligation. Of these infants, 1 had cardiac arrest before the operation with failed cardiopulmonary resuscitation, and in another case, PDA ligation was aborted due to severe hypoplasia of the aortic valve and ascending aorta found intraoperatively by transesophageal echocardiography. Two infants underwent coarctation of the aorta (CoA), and 1 of them died during the operation due to cardiac arrest. The total mortality of these infants was 3.77%and the early postoperative mortality (<72 h) was 5.66%. Conclusion Non-cardiopulmonary bypass surgery can be performed in low birth weight infants in early stage, and effective anesthetic management can reduce the perioperative mortality and improve the postoperative survival rate.

Objective To investigate the effect of Keap1?Nrf2 pathway on cell proliferation, metastasis and drug resistance of human lung cancer A549 cell line. Methods A549?Keap1 cell line, constantly expressing wild type Keap1, was established by lentiviral transfection. Real?time RT?PCR and western blot were used to determine the expression of Nrf2 and its target gene in A549 cells. Sulforhodamine B ( SRB) assay, flow cytometry, colony formation assay, transwell assay, and cell wound?healing assay were performed to explore the effect of wild type Keap1 expression on the proliferation, invasion, migration and drug resistance of A549 cells. Results Over?expressed Keap1 decreased the expression of Nrf2 protein and
the mRNA level of its downstream target genes and inhibited the ability of cell proliferation and clone formation of A549 cells. Keap1 overexpression induced G0/G1 phase arrest. The percentage of A549?Keap1 cells in G0/G1 phase was significantly higher than that of A549?GFP cells (80.2±5.9)% vs. (67.1±0.9%) (P<0.05). Compared with the invasive A549?Keap1 cells (156.33±17.37), the number of invasive A549?GFP cells was significantly higher (306.67±22.19) in a high power field. Keap1 overexpression significantly enhanced the sensitivity of A549 cells to carboplatin and gemcitabine ( P<0.01) . The IC50s of carboplatin in A549?Keap1 and A549?GFP cells were (52.1±3.3) μmol/L and (107.8±12.9) μmol/L, respectively. The IC50s of gemcitabine in A549?Keap1 and A549?GFP cells were (6.8±1.2) μmol/L and (9.9±0.5) μmol/L, respectively. Conclusion Keap1 overexpression significantly inhibits the expression of Nrf2 and its downstream target genes, suppresses tumor cell proliferation and metastasis, and enhances the sensitivity of A549 cells to anticancer drugs.

Objective To investigate the effect of Keap1?Nrf2 pathway on cell proliferation, metastasis and drug resistance of human lung cancer A549 cell line. Methods A549?Keap1 cell line, constantly expressing wild type Keap1, was established by lentiviral transfection. Real?time RT?PCR and western blot were used to determine the expression of Nrf2 and its target gene in A549 cells. Sulforhodamine B ( SRB) assay, flow cytometry, colony formation assay, transwell assay, and cell wound?healing assay were performed to explore the effect of wild type Keap1 expression on the proliferation, invasion, migration and drug resistance of A549 cells. Results Over?expressed Keap1 decreased the expression of Nrf2 protein and
the mRNA level of its downstream target genes and inhibited the ability of cell proliferation and clone formation of A549 cells. Keap1 overexpression induced G0/G1 phase arrest. The percentage of A549?Keap1 cells in G0/G1 phase was significantly higher than that of A549?GFP cells (80.2±5.9)% vs. (67.1±0.9%) (P<0.05). Compared with the invasive A549?Keap1 cells (156.33±17.37), the number of invasive A549?GFP cells was significantly higher (306.67±22.19) in a high power field. Keap1 overexpression significantly enhanced the sensitivity of A549 cells to carboplatin and gemcitabine ( P<0.01) . The IC50s of carboplatin in A549?Keap1 and A549?GFP cells were (52.1±3.3) μmol/L and (107.8±12.9) μmol/L, respectively. The IC50s of gemcitabine in A549?Keap1 and A549?GFP cells were (6.8±1.2) μmol/L and (9.9±0.5) μmol/L, respectively. Conclusion Keap1 overexpression significantly inhibits the expression of Nrf2 and its downstream target genes, suppresses tumor cell proliferation and metastasis, and enhances the sensitivity of A549 cells to anticancer drugs.

Objective To summarize anesthetic management of low birth weight infants undergoing surgical intervention of congenital heart disease without cardiopulmonary bypass. Methods Fifty-three low birth weight infants (including 49 premature infants) with congenital heart disease underwent surgical treatment without cardiopulmonary bypass during the period from June, 2003 to July, 2013. The mean gestational age of the infants was 30.96±3.09 weeks (26-40 weeks) with a mean age on the operation day of 32.81 ± 20.76 days (4-87 days), birth weight of 1429.90 ± 455.08 g (640-2460 g), and weight on the operation day of 1750.20±481.59 g (650-2460 g). All the infants underwent cardiac operations without cardiopulmonary bypass under general anesthesia. The respiratory parameters and acid-base and electrolyte balance were adjusted according to blood gas analysis. The inotropic drug was used to maintain the hemodynamic stability. Results Forty-seven of the infants received patent ductus arteriosus (PDA) ligation. Of these infants, 1 had cardiac arrest before the operation with failed cardiopulmonary resuscitation, and in another case, PDA ligation was aborted due to severe hypoplasia of the aortic valve and ascending aorta found intraoperatively by transesophageal echocardiography. Two infants underwent coarctation of the aorta (CoA), and 1 of them died during the operation due to cardiac arrest. The total mortality of these infants was 3.77%and the early postoperative mortality (<72 h) was 5.66%. Conclusion Non-cardiopulmonary bypass surgery can be performed in low birth weight infants in early stage, and effective anesthetic management can reduce the perioperative mortality and improve the postoperative survival rate.

Background::In vitro fertilization (IVF) has emerged as a transformative solution for infertility. However, achieving favorable live-birth outcomes remains challenging. Current clinical IVF practices in IVF involve the collection of heterogeneous embryo data through diverse methods, including static images and temporal videos. However, traditional embryo selection methods, primarily reliant on visual inspection of morphology, exhibit variability and are contingent on the experience of practitioners. Therefore, an automated system that can evaluate heterogeneous embryo data to predict the final outcomes of live births is highly desirable. Methods::We employed artificial intelligence (AI) for embryo morphological grading, blastocyst embryo selection, aneuploidy prediction, and final live-birth outcome prediction. We developed and validated the AI models using multitask learning for embryo morphological assessment, including pronucleus type on day 1 and the number of blastomeres, asymmetry, and fragmentation of blastomeres on day 3, using 19,201 embryo photographs from 8271 patients. A neural network was trained on embryo and clinical metadata to identify good-quality embryos for implantation on day 3 or day 5, and predict live-birth outcomes. Additionally, a 3D convolutional neural network was trained on 418 time-lapse videos of preimplantation genetic testing (PGT)-based ploidy outcomes for the prediction of aneuploidy and consequent live-birth outcomes.Results::These two approaches enabled us to automatically assess the implantation potential. By combining embryo and maternal metrics in an ensemble AI model, we evaluated live-birth outcomes in a prospective cohort that achieved higher accuracy than experienced embryologists (46.1% vs. 30.7% on day 3, 55.0% vs. 40.7% on day 5). Our results demonstrate the potential for AI-based selection of embryos based on characteristics beyond the observational abilities of human clinicians (area under the curve: 0.769, 95% confidence interval: 0.709–0.820). These findings could potentially provide a noninvasive, high-throughput, and low-cost screening tool to facilitate embryo selection and achieve better outcomes. Conclusions::Our study underscores the AI model’s ability to provide interpretable evidence for clinicians in assisted reproduction, highlighting its potential as a noninvasive, efficient, and cost-effective tool for improved embryo selection and enhanced IVF outcomes. The convergence of cutting-edge technology and reproductive medicine has opened new avenues for addressing infertility challenges and optimizing IVF success rates.