The donated organ after cardiac death would undergo warn ischemia injury inevitably,and the incidences of primary non-function of donated organs,transplanted organ loss and ischemic-type biliary lesions were increased.It is a paramount research dilemma to devise how to avert,lessen and recover the warm ischemia organs after donation of cardiac death (DCD).Since February 2009,the Liver Transplantation Center of Guangzhou General Hospital of Guangzhou Military Command of PLA has applied the extracorporeal membrane oxygenation (ECMO) to protect the organs of DCD.The mechanism of recovering the donors from warm ishemia by ECMO has good prospects in the field of international organ donation,and it is an important method to solve the problem of donor shortage in China.Spreading the application range of ECMO in DCD and establishing the standard procedures and techniques in China is of great importance.

The incidence of early neurological deterioration in acute ischemic stroke is higher, and the clinical prognosis is poor. There is no effective specific prevention and treatment now. This article reviews the advances in research on early neurological deterioration in acute ischaemic stroke in recent years.

Tissue plasminogen activator(tPA) had been used clinically as a choice drug for the therapy of ischemic shock.Evidence in animal experiments suggests that tPA may play a neurotoxic role in central nervous system(CNS) via the induction of microglial activation,degradation of laminin matrix and enhancement of the N-methyl-D-aspartate(NMDA) receptor-mediated signaling in neurons,other reports imply tPA could protect rat neuronal cells from zinc-induced toxicity.

Objective The mechanism of delaying flap with the minimal invasive surgery was approached to understand its effects on the whole delayed survival of skin flaps thoroughly so as to provide the rationale for its clinical use.Methods 80 male or female Wistar rats were randomly subdivided into two groups:delayed by the minimal invasive surgery,and immediately transfer without delay.Flaps in each group delayed were cut at 1,2,3 and 4 weeks,respectively.The flap was designed at the lower back of rat,with the size of 5 cm × 1 cm,crossing the middle area for 2.5 cm and including stem of iliac branch from iliolumbar artery.2 weeks after second operation,the survival area,capillary density and content of lactic acid of the flaps in each group were examined,and the survival of the falps delayed by the minimal invasive surgery was compared.Results The longer delaying time,and the higher survival rate were observed in the experimental group.Delaying for 3 weeks and 4 weeks,the survival rate was (86.13 ±1.13) ％,(93.49 ± 1.15) ％,respectively,in the experimental group.While in control group,the survival rate was no more than 63％.The longer delaying time,the higher the capillary density were noted in two groups,but 3 weeks delayed group equally matched to the 4 weeks delayed group.In the experimental group,the content of lactic acid increased peaked in 1 week delayed group,then fell-down gradually,but kept steady in 3 and 4 weeks delayed group.The content of lactic acid in the control group kept steady.Conclusions The experimental model is selected as cross-area axial flap on the lower back of rats.The minimal invasive surgery plays the same role as in delaying flaps,which causes vasoconstriction,resulting in disorder of internal environment,ischemia and hypoxia,finally vasodilatation.The more ramus anastomosis,the more survival rate of the flap.

Calculation of cardiac hemodynamic parameters is based on accurate detection of feature points in impedance cardiogram. According to these parameters, doctors can determine heart conditions, so it is very important to accurately detect the feature point of impedance differential signals. This article presents a process in which we used wavelet threshold method to de-noise signals, and then detected the feature points after six layers wavelet decomposition by using bior3. 7. The experimental data were collected from healthy persons in our laboratory and twenty two clinical patients in Chongqing Daping Hospital by using KF_ICG instrument. The results indicated that this method could precisely detect feature points whether it was from healthy people or clinical patients. This helps to achieve the application of noninvasive detection cardiac hemodynamic parameters in clinical treatments by using impedance method.
Cardiography, Impedance ; Electric Impedance ; Heart ; physiology ; Hemodynamics ; Humans ; Wavelet Analysis

Adolescent ; Bronchoscopy ; Child ; Child, Preschool ; Female ; Foreign Bodies ; surgery ; Humans ; Male ; Respiratory System ; Treatment Outcome

Objective To investigate the effect of acteoside on injury PC12 cells induced by glutamate. Methods PC12 cells were assigned into normal control group, model control group, positive drug group and acteoside(AS) treated group. Every group was treated by 1. 5 mmol·L-1 glutamate for 24 hours except for the control group, and the injury was antagonized by 10 μmol·L-1 Vit E and acteoside at different concentration(15. 625, 31. 25, 62. 5, 125 and 250 μmol·L-1 ). Cell morphology was observed by inverted microscope, cell survival was determined with MTT, LDH activity was measured by enzyme label kit, the MDA content and SOD activity were measured by TBA kit and WST kit, and the ROS was measured by Elisa kit. Results Compared with the model control group, all doses of acteoside could significantly improve the PC12 cell morphology and survival (P<0. 05), inhibit LDH activity and production of MDA and ROS (P<0. 05), increase the activity of SOD (P<0. 05), except for the lowest dose group. Conclusion Acteoside has protective effects on PC12 cells injured by glutamate.

Objective To study the diagnosis and treatment of non-anastomotic biliary stricture (NABS) after liver transplantation.Methods The clinical data of 403 patients who underwent liver transplantation in the past 10 years in our department were analyzed retrospectively,compared different methods to find out the most appropriate method in the diagnosis and management of NABS.Results NABS occurred in 13 out of 403 patients (3.2％),almost the same incidence as in patients who received DCD donor livers (4.16％,2/48).The clinical signs of NABS were frequent cholangitis and high TBil,r-GT and AKP (P ＜0.01).All these cases were finally diagnosed by cholangiography and they could be classified into 3 types:hepatic bile duct stricture (4 patients,type Ⅰ),multiple extrahepatic and intrahepatic biliary strictures (7 patients,type Ⅱ),intrahepatic biliary strictures (2 patients,type Ⅲ).NABS were mainly treated by interventional therapy,Roux-en-Y anastomosis and retransplantation in our centre.All type Ⅰ patients were successfully managed with interventional therapy/ERCP and Roux-en-Y anastomosis,but 44.4％ (4/9) of type Ⅱ and Ⅲ patients required retransplantation.The TBIL,r-GT and AKP decreased significantly in 12 patients (P ＜ 0.05) and the total curative rate of NABS was 92.3％ (12/13) with one patient who died after retransplantation.Conclusions Cholangiography was an effective way to diagnose NABS which is common among patients after liver transplantation.Interventional therapy/ERCP,Roux-en-Y anastomosis and retransplantation were our 3 ways to treat this problem.We proceeded from easy to difficult and chose a suitable way to deal with NABS according to the different types of biliary stricture from cholangiography.Type Ⅰ patients had much better prognosis than Type Ⅱ and Ⅲ patients who should receive retransplantation if interventional therapy/ERCP failed.

Objective To investigate the role of nurses in civil cardiac death organ donation work.Methods Cooperating,propagating and promoting in civil cardiac death organ donation; building a bridge between the families of organ donation,donor coordinators,physicians and hospital ethics committees; participating in organ donation medical ethics assessment work; cooperating with the doctors do intend to maintain organ donation,access and preservation; protecting donors remains.Results During the time of July 2011 to November 2013,we successfully completed 52 cases of civil cardiac death organ donation cooperating with doctors,and got 41 liver,which entered the national organ allocation system for distribution.Conclusions The nurses will play a more and more important role in work of civil cardiac death organ donation cooperating with doctors.

Aim To investigate the effect of acteoside (AS)on the expression of caspase-3 in cerebral cortex of mouse models of Alzheimer’s disease(AD).Meth-ods Kunming (KM)strain mice were assigned into control group,model group,positive control group (VitE)and acteoside group.Every group was induced by a combination of D-galactose(i.p.60mg·kg -1 · d -1 )and AlCl3 (i.g.5mg·kg -1 ·d -1 )for 60ds ex-cept for control group,then mice were treated by dif-ferent concentrations(30,60,1 20 mg·kg -1 ·d -1 )of acteoside for 30ds.During the time,mice were in-duced continuously by a combination of D-galactose and AlCl3 .The learning and memory of mice were de-tected by step-down test,the activity of AChE in serum and brain of mice was measured by chemical colorime-try,the structure changes in cerebral cortex were ob-served by HE staining,and the expression of caspase-3 in cerebral cortex was analyzed through the immunohis-tochemical staining.Results Compared with model group,acteoside could improve the learning and mem-ory abilities(P <0.05 or P <0.01 ),decrease the ac-tivity of AChE in serum and brain(P <0.05 or P <0.01 ),and improve the morphology and number of neuron in cerebral cortex(P <0.01 ).Moreover,acte-oside could significantly inhibit the expression of caspase-3 in cerebral cortex (P <0.05,P <0.01 ). Conclusion Acteoside has significantly protective effects on brain damage of mice induced by a combina-tion of D-galactose and AlCl3 , and it′s protective mechanism probably relate to inhibiting the expression of caspase-3 and maintainings the normal morphology and number of neuron in cerebral cortex.