Objective To sum up the experience of perioperative management of patients with heart transplantation.Methods In recent 3 years 24 cases of dilated cardiomyopathy,4 cases of(serious) valve disease,1 case of serious ischemic cardiomyopathy and 1 case of bi-ventricular assist(received) heart transplantation surgery.The mean by pass time was 75?24 min and the mean aortic clamp time was 72?8 min.Cyclosporine,MMF and prenisodone were adopted as anti-immune(response) strategy and the dose of cyclosporine was adjusted according to the serum concentration.(Intramyocardial) electrograms and tissue Doppler ultrasound technique were used to monitor the(immune) response situation.The myocardial biopsy was performed in case of the suspect of acute(rejection).Results In 5 postoperative deaths,3 cases died of low cardiac output,1 died of infection-(induced) multiple organ failure and 1 case died of serious bleeding.The postoperative complications(included) right heart failure in 6 cases,renal failure in 13 cases,and acute rejection in 4 cases.(Conclusion) The effective prevention and management of complications is the key point of success of heart transplantation.Application of comprehensive monitoring techniques is beneficial to the management of the immune rejection after transplantation.

The pharmaceutical ethynylestradiol (EE) is a potent endocrine modulator. Application enlargement of ethynylestradiol in clinics and abuse in livestock farming and fishing make it important to explore ethynylestradiol toxicological action on vertebrate embryonic development and to establish an in vivo method for EE toxicity detection efficiently and conveniently. In the present study, using a model animal zebrafish and 17alpha-ethynylestradiol as a representative compound, we have investigated EE2 teratogenicity, target tissues and target genes on zebrafish embryo. The results show that median teratogenesis concentration (TC50) of EE2 is 0.8 microg x mL(-1), and median lethal dose (LD50) is 3.3 microg x mL(-1). Targets of EE2 action were implicated in brain, eyes, heart, muscle, skeleton, pigment and viscera. Embryonic cardiac arrhythmia caused by EE2 is probably resulted from heart abnormal structure. The embryonic stage sensitive to EE2 mainly started at cleavage and last up to the organogenesis with time-accumulating effect. RT-PCR results indicate that EE2 treatment disturbed gene expression pattern at the early period of zebrafish embryonic development by suppressing transcription of gene boz that promotes brain development, upregulating genes for trunk and tail, such as ntl, spt, shh, and perturbing Nodal signal expression of TGFbeta superfamily, for example, cyc, sqt and oep. Using zebrafish, an efficient in vivo method for quick evaluation of EE toxicity on embryonic development has been developed.

Objective To observe the clinical effect and safety of propranololand imiquimod therapy for infantile hemangiomas of proliferative phase.Methods A total of 53 infantile patients with hemangiomas of proliferative phase that were treated in our department were collected.According to patient's condition,the patients were classified into treatment group and observation group.The treatment group consisted of 34 patients received propranolol and imiquimod treatment,and 19 cases belonged to the observation group.The changes of tumor were compared between the treatment group and the observation group.Pre-therapeutic and post-therapeutic heart rate,blood pressure,blood glucose were monitored in the treatment group,so were in post-treatment.Results After 6 months,the effective rate was 97.1％ (33/34) in treatment group,and the effective rate was 57.9％ (11/19)in observation group.There was significant difference between treatment group and observation group in effective rate (P＜0.05),and so did blood pressure and heart rate after medication in the treatment group,but not in blood glucose,heart rate six hours after medication (P＞0.05).Conclusions Propranolol and imiquimod therapy has a certain inhibitory effect on infantile hemangiomas of proliferative phase.Propranolol and imiquimod are safe in patients with infantile hemangioma,and adverse reactions are mild.

The clinical characteristics, therapeutic effects and complications of 32 incipient patients with acute Vogt-Koyanagi-Harada ( VKH) syndrome admitted in Wuxi Second Hospital during October 2010 to September 2013 were retrospectively analyzed.There were 15 males and 17 females with a mean age of (41.3 ±14.1) years (22 -71 years), the time from the disease onset to treatment ranged from 3 to 20 days.Among 32 cases, 30 ( 94%) had premonitory symptoms. The multifocal bullous neurosensory detachment, optic disk hyperemia and edema in posterior pole of fundus were found in all cases, and exudative retinal detachment was found in 4 cases (6 eyes).The results of optical coherence tomography ( OCT) showed the macula neurosensory detachment, thick retinal neuroepithelial layer and wavy RPE layer in all patients.Fundus fluorescein angiography ( FFA) showed that scattered hyperfluorescence dots and cystic fluorescein reservoir was observed in early phase and later period respectively.Patients received intravenous methylprednisolone with the onset dose of 80 mg per day for 3-7 days and oral administration followed, which would gradually decrease later;the average treatment duration was (52.9 ±14.6) weeks. The visual acuity of 40 eyes (22 cases) was recovered to more than 0.8, and no blindness occurred after the treatment.During the treatment hair loss, depigmentation of skin and hair were found in 12 cases (38%) , and 2 cases showed short-term elevated intraocular pressure.These symptoms disappeared after drug therapy ceased.And no recurrence was found during the follow-up of 6 months.However, sunset glow fundus was found in 13 patients (26 eyes).The study shows that the diagnosis of VKH syndrome is based on the typical signs of the fundus presented on OCT and FFA.Early and systemic administration of glucocorticoids is important treatment for patients with VHK syndrome, which could decrease systemic and local complications effectively.

In 4 602 subjects for routine check-up,blood uric acid,total cholesterol,triglyceride,high density lipoprotein-cholesterol,and low density lipoprotein-cholesterol were determined.Results showed that the overall prevalence of hyperuricemia in Nanning,Guangxi was 19.8％ (28.8％ in male,9.4％ in female).Blood uric acid and lipids in hyperuricemia group were higher than those in normal uric acid group(all P＜0.01).Serum uric acid had a positive correlation with total cholesterol,triglyceride,low density lipoprotein-cholesterol,but it was negatively correlated with serum high density lipoprotein-cholesterol.The prevalence of hypercholesterolemia was 30.8％,and that of hypertriglyceridemia was 22.2％.Logistic multi-factor regression analysis showed that men,high total cholesterol,triglyceride,and low density lipoprotein-cholesterol could be independent risk factors for hyperuricemia,and that high density lipoprotein-cholesterol was a protective factor.The prevalence of hyperuricemia in population of Nanning,Guangxi during health examination is high.Hyperuricemia is closely associated with dyslipidemia.Timely intervention of hyperuricemia can reduce the related diseases effectively.

Action Potentials ; Animals ; Female ; Heart ; physiology ; Male ; Membrane Transport Proteins ; genetics ; Mice ; Mice, Knockout ; Myocardium ; metabolism ; Patch-Clamp Techniques ; Sodium Channels ; physiology

Objective To investigate the change of the mitochondrial aspartate aminotransferase (mAST), and the ratio of m-AST and aspartate aminotransferase (AST) in rat orthotopic liver transplantation.Methods We used the rat autologous orthotopic liver transplantation modelin which liver was infused by portal vein. Group A: Autologous orthotopic liver transplantation. Group B: Sham control group of normal rats. To measure the m-AST, AST and ALT in rat serum at each time, the ratio of m-AST/AST was calculated to observe the changes after surgery. Results The ALT of group A after 1 h was 1149.2 U/L, while the ALT of group B was 111.3 U/L; The AST of group A ofter 1 h was 819.5 U/L, while the AST of group B was 128.2 U/L; The m-AST of group After 1 h was 290.8 U/L, while the m-AST of group B was 40.5 U/L. The levels of m-AST, AST and ALT in group A were significantly higher than group B (P ＜ 0. 05).Group A significantly increased the degree of liver damage compared with group B. The ratio of m-AST/AST in group A changed with time obviously. Because the haff-life of m-AST in serum was shorter than that of AST, and AST in this study returned to normal slowly, the ratio of m- AST/AST in A group decreased after 6 h and the number is 0. 12. It indicating that the damage of mitochondria in rat liver cells has been restored after 6h. Conclusions It will be better to judge the prognosis of liver transplantation from the changes of serum m-AST in rats. And it seems earlier to reflect the injury or recovery of liver cell compared with AST.It also has the guiding values to diagnose and treat the damage of liver cells and mitochondrial in the rat liver transplantation.

Objective To study the prognostic value of procalcitonin(PCT) and C?reactive protein ( CRP ) in critically ill patients with ventilator?associated pneumonia ( VAP )?Methods A single?center prospective observational study was conducted?A total of 67 cases patients with VAP admitted into intensive care unit(ICU) from November 2013 to October 2015 were enrolled and grouped as survivors(43 cases) and non?survivors(24 cases)?Blood samples for PCT and CRP were collected on the day of the pneumonia diagnosis,and the 4th and 8th day after the diagnosis?Results There were 24 cases(35?8 %) died among the 28 days after the pneumonia diagnosis?There was no significant difference between the survivor and non?survivor groups in terms of PCT on the day of the pneumonia diagnosis( P>0?05) ,or CRP on the day of the pneumonia diagnosis, and the 4th and 8th day after the diagnosis ( P>0?05)?But the PCT values on the 4th and 8th day were significantly higher in the non?survivor group than the survivor group(4 d:0?4(0?3,1?1) μg/L vs?4?7(2?3, 10?8) μg/L,P<0?05;8 d:0?2(0?1,1?7) μg/L vs?3?9(3?2,14?8) μg/L,P<0?05)?PCT levels decreased significantly from the day of the pneumonia diagnosis(0?7(0?4,4?2) μg/L) to the 8th day after the diagnosis (0?2(0?1,1?7) μg/L,P<0?05) in the survivor group?The PCT level above 1 μg/L on the 4th day after the diagnosis was the strongest predictor of mortality,with an odds ratio of 23?Conclusion PCT is found to be a more important prognostic marker compared to CRP in terms of predicting mortality in critically ill patients with VAP?The PCT level on the 4th day after the diagnosis is the strongest predictor of mortality in VAP.

Humans ; Lung Neoplasms ; therapy ; Medicine, Chinese Traditional ; methods ; trends

China ; Humans ; Respiratory System ; pathology