BACKGROUND: Massive pulmonary embolism (MPE) and acute myocardial infarction are the two most common causes of cardiac arrest (CA). At present, lethal hemorrhage makes thrombolytic therapy underused during cardiopulmonary resuscitation, despite the potential benefits for these underlying conditions. Hypercoagulability of the blood in autoimmune disorders (such as autoimmune hemolytic anemia) carries a risk of MPE. It is critical to find out the etiology of CA for timely thrombolytic intervention. METHODS: A 23-year-old woman with a 10-year medical history of autoimmune hemolytic anemia suffered from CA in our emergency intensive care unit. ECG and echocardiogram indicated the possibility of MPE, so fibrinolytic therapy (alteplase) was successful during prolonged resuscitation. RESULTS: Neurological recovery of the patient was generally good, and no fatal bleeding developed. MPE was documented by CT pulmonary angiography. CONCLUSIONS: A medical history of autoimmune disease poses a risk of PE, and the causes of CA (such as this) should be investigated etiologically. A therapy with alteplase may be used early during cardiopulmonary resuscitation once there is presumptive evidence of PE. Clinical trials are needed in this setting to study patients with hypercoagulable states.

AIM: To study and analyze the clinical efficacy of diclofenac sodium eye drops combined with sodium hyaluronate eye drops in treating dry eyes after ophthalmic surgery.METHODS: Totally 94 eyes from 94 patients with dry eyes were slected, and they were randomly divided into orbervation group and control group.Fouty-seven patients in the control group using conventional treatment combined with sodium hyaluronate eye drops.Other 47 patients in orbervation group were treated with diclofenac sodium eye drops on the basis of control group.We compared symptoms, fluorescein station, tear film break time, Schirmer Ⅰ test between the two groups.RESULTS: Compared with before treatment, patients of both groups with sympotom, fluorescein station score, BUT, and Schirmer Ⅰ test were significantly improved(P<0.05).At the same time, sympotom, fluorescein station score, BUT and Schirmer Ⅰ test of control group were better than observation group(P<0.05).The cure rates of the orbervation group (98%) were more significant than control group (74%)(P<0.05).CONCLUSION: Diclofenac sodium eye drops combined with sodium hyaluronate eye drops have significant efficacy in treatment of dry eyes after ophthalmic surgery, which can effectively relieve clinical symptoms, improve BUT and Schirmer Ⅰ test.

OBJECTIVETo investigate the efficiency of Spanishneedles Herb eye drops in treating perimenopausal xerophthalmia in rabbits.

METHODTotally 36 rabbits (36 right eyes) were ovariectomized, and 2 months later divided into three groups: the experimental group (group A, n = 12) given Spanishneedles Herb eye drops, the control group (group B, n = 12) given PBS and the model group (group C, n = 12) given no drug. The Schirmer I test (SIT), fluorescent (FL), total tear protein, diastase activity, lactoferrin and lysozyme contents and confocal scanning microscopy were performed at before the treatment and at 1 w, 2 w, 1 mo, 2 mo after the treatment.

RESULTBefore the treatment, There was no significant difference in SIT, FL, total tear protein, lysozyme, lactoferrin and amylase activity between two groups. Two months later after the treatment, both the group B and the group A showed differences degrees of changes in SIT, FL, total tear protein, lysozyme, lactoferrin and amylase activity compared with that before the treatment, with statistical differences (P < 0.05); At each time point, both groups revealed statistical differences in SIT, FL, total tear protein, lysozyme, lactoferrin and amylase activity (1 < 0.05). Two months later alter the treatment, densities of basal epithelial cells and inflammatory cells in the group A were (4 122 ±416) cells/mm2 and (339 ± 131) cells/mm2, while that in the group B were (3 343 ± 424) cells/mm2 and (49 ± 17) cells/mm2, with statistical differences between them (P < 0.05).

CONCLUSIONSpanishneedles Herb eye drops could effectively treat perimenopausal xerophthalmia in rabbit caused by sex hormones decline.

Animals ; Asteraceae ; chemistry ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Ophthalmic Solutions ; administration & dosage ; Perimenopause ; drug effects ; metabolism ; Rabbits ; Tears ; secretion ; Xerophthalmia ; drug therapy ; metabolism

As a depot drug delivery system, injectable polylactide-polyglycolide (PLGA) sustained-release microspheres have been successfully used to treat many diseases since the first microsphere product Lupron depot was approved for marketing in the United States in 1989. It has the ability of long-term release in the body for several days to several months, which can not only reduce the times of administration, but also reduce the drug blood concentration fluctuations, significantly improve the safety and patient compliance. In vitro-in vivo correlation (IVIVC) makes the development of microspheres more possible. It can describe the dynamic information of drug release in vivo through the in vitro release behavior of microspheres, and can reduce the workload of each stage and shorten the time span while characterizing the performance of microspheres. IVIVC can provide guidance or support for drug development, production changes, supervision and management. This article summarizes the release mechanism of injectable PLGA sustained-release microspheres, common measurement methods and theories of in vitro and in vivo release. And we also focus on the establishment and application of IVIVC, especially A level IVIVC in the field of microsphere preparations, to provide a reference for further study on in vitro-in vivo correlation of microspheres.

Objective To investigate the effects of different depth of anesthesia on ScvO2 and ABL in elderly patients with gastrointestinal cancer. Methods Totally 55 elderly patients undergoing gastrointestinal sur-gery were randomly divided into deep anesthesia group(BIS40-49)(group D,n=27)and light anesthesia group (BIS50-59)(group S,n = 28). While SVV value was fixed,fluid management was conducted while monitoring CVP. HR,MAP,the change of central venous oxygen saturation and lactic acid index were recorded in different time points. Results Propofol dosage in group D and group S indicated statistical significance(P<0.05). ScvO2 in group S in T3~T5 was higher than that in T0 and the difference was statistically significant(P < 0.05). Com-pared with ScvO2 in T3 in group D,that in group S was significantly higher and the difference was statistically sig-nificant(P<0.01),but no significant difference was found in other time point in 2 groups(P>0.05). There was no significant difference between and within ABL groups in each time period(P>0.05). There was no significant difference in terms of other indicators between 2 groups. Conclusions For elderly patients with gastrointestinal surgery,shallow anesthesia can improve tissue oxygenation and reduce the amount of anesthetics.

OBJECTIVETo investigate the protective effect and action mechanism of petroleum ether extracts from Saussurea involucrate on brain tissues of hypoxia rats under constant pressure and closed conditions.

METHODThe PESI dosage-dependent experiment for hypoxia rats was conducted under constant pressure and closed conditions by intraperitoneally injecting 125, 250, 500 mg x kg(-1) to finalize that the optimum dosage is the high dose of PESI. Afterwards, 90 Wistar rats were randomly divided into the hypoxic model group, the acetazolamide 250 mg x kg(-1) group and the PESI high dose group. Each group was further divided into three subgroups according to different hypoxia times, with 10 rats in each subgroup. Under the same hypoxia and administration conditions, the rats were sacrificed after 0, 3, 6 h respectively. Their brain samples were collected for common pathological observation and immunohistochemical staining of HIF-1alpha. Real-time RT-PCR was used to detect HIF-1alpha, EPO, HO-1 and Caspase-3 gene expressions. And the Western blot assay was adopted to detect HIF-1alpha protein expression.

RESULTThe brain tissues of the hypoxia model group were severely damaged with the increase in the hypoxia time. The acetazolamide group and the PESI high does group were damaged in a much lower degree. According to the gene expression and the Western blot assay, high dose of PESI could inhibit HIF-1alpha expression. According to the pure gene expression test, high dose of PESI could increase EPO and HO-1 mRNA expressions, but inhibit Caspase-3 mRNA expression.

CONCLUSIONPESI's protective mechanism for brain tissues of hypoxia rats under constant pressure and closed conditions may be related to its effects in inhibiting HIF-1alpha expression, increasing EPO expression and resisting cell apoptosis.

Alkanes ; chemistry ; Animals ; Brain ; cytology ; drug effects ; metabolism ; Caspase 3 ; genetics ; Cell Hypoxia ; drug effects ; Cytoprotection ; drug effects ; Dose-Response Relationship, Drug ; Drugs, Chinese Herbal ; pharmacology ; Erythropoietin ; genetics ; Gene Expression Regulation, Enzymologic ; drug effects ; Heme Oxygenase-1 ; genetics ; Hypoxia-Inducible Factor 1, alpha Subunit ; genetics ; metabolism ; Male ; Rats ; Rats, Wistar ; Saussurea ; chemistry

To get high cell density,pH-stat fermentations of L.casei Zhang were carried out in the medium optimized previously under different cultural conditions.The influences of neutralizing agents,the concen-tration of buffer salts and glucose in the medium,pH,aeration and fed batch fermentation on the growth of L.casei Zhang were investigated.Based on the values of maximum specific growth rate,biomass and viable cells count in different cultural conditions,the optimal growth condition was regarded as follows:Glucose level of the medium was 80 g/L ～100 g/L;The pH was kept constant at 5.9 with aqua ammonia and anae-robic condition was kept by sparged with nitrogen periodically;The temperature was set at 37?C and cul-tured for 10 h ～12 h.The biomass and viable cells' number of L.casei Zhang under this culture conditions were 7 g/L and 3.5?1010 CFU/mL respectively,and were 7 times as high as that before optimized,which can meet the requirements of probiotics.

Objective To evaluate the application of Mammotome minimally invasive biopsy(MMIBS) in the diagnosis of non-palpable small lesions in breast. Methods A total of 42 patients with non-palpable small breast lesions and abnormal imaging findings were performed MMIBS.After MMIBS,21 patients received open operations,and the pathological diagnosis was compared and analysed. Results All these 42 patients were successfully performed MMIBS,with no severe complications,and the pathological diagnosis of MMIBS were breast cancer(8 patients) and benign pathological changes(34 patients).Among the 21 patients with open operations,the post-operative pathological findings of 20 patients were same as the results of MMIBS,with the sensitivity of 88.9% and specificity of 100%.The other 21 patients without operations were followed up for 6 to 12 months,and no abnormal mammographic and ultrasonographic findings were observed.Conclusion MMIBS boasts the characteristics of minimal invasion,safety,high sensitivity and high specificity,which can serve as the first choice in the diagnosis of non-palpable small lesions with abnormal imaging findings.

AIM: To observe the surgical effects of the taumatic lens subluxation and cataract after manual fragmentation and emulsification of nucleus and foldable intraocular lens implantation.
METHODS: A 3. 0mm tunnel limbus incision was operated through the predicted bulbar conjunctiva and sclera on 26 cases ( 26 eyes ) with taumatic lens subluxation ( suspensory ligament rupture range less than 120 ) and cataract (Ⅰ ~ Ⅲ) . And after the manual fragmentation and emulsification of nucleus, foldable intraocular lens was implantated. Intraocular lens loop was imbedded in the middle of the lens zonular ligament breakup to reset the pouch. The surgical complications and postoperative vision changes were observed.
RESULTS:Three month after operation, 22 eyes had a intraocular lens centric position taking up 85% of the whole. Four eyes had a slightly eccentric position ( 1 ~2mm), taking up 15% of the whole. 21 eyes had their visual acuity 0. 5~0. 8, taking up 81% of the whole. Five eyes of visual acuity was 0. 2~0. 8. Within 24h intraocular pressure of 12 eyes (46%) after operation were elevated, and returned to normal after 2~7d. There was no severe complication during operation and postoperation.
CONCLUSION: The manual fragmentation and emulsification of nucleus and foldable intraocular lens implantation of the traumatic lens subluxation and the cataract through the 3. 0mm corneal sclera limbus tunnel incision is a simple and effective surgery.

Background Choroidal neovascularization (CNV) is a main cause of visual impairment in many retinal diseases.To create an ideal CNV animal model is very important for the experimental and clinical study of CNV.The assessment method of repeatable and reliable for CNV model is still seldom.Objective This experiment was to explore the label value of fluorescent antibody for visualizing and quantifying the morphologic changes associated with laser-induced CNV.Methods Laser-induced CNV models were created in 30 eyes of 15 male SPF C57BL/6J mice by Krypton red laser irradiating fundus 2 spots around the optical disc with the wavelength 647.1nm,power 260 mW,spot diameter 50μm and exposure time 0.05 seconds.The CNV was evaluated at 5 minutes,4,7,14 and 28 days after laser injury by using fundus photography and fundus fluorescein angiography (FFA),and the successful models were identified as the rupture of Bruch's membrane.The mice were then immediately sacrificed and the eyeballs were enucleated to prepare the choroidal flatmounts.The posterior eye cups were fluorescently labeled with markers of cell nuclei (DAPI,4',6'-diamino-2-phenylindole),endothelial cells (isolectin-B4),and filamentous actin (phalloidin).The CNV areas from specimens were measured by Image pro plus 6.0.Two eyes from one matched mouse without receiving photocoagulation were used as the controlls.This study followed the Standard of Association for Research in Vision and Ophthalmology.Results No any CNV was seen in photocoagulated eyes in 5 minutes and 4 days after laser irradiation.The first sign of CNV appeared at 7 days following photocoagulation.The incidence of fluorescein leakage was 76.47% (26/34),81.81% (18/22),50.00% (5/10) at 7,14 and 28 days,respectively.The fluomicroscope examination showed that in unphotocoagulated areas,retinal pigment epithelial (RPE) cells were visualized with a uniform hexagonal array.Immediately after laser exposure,a circular area devoid of fluorescent labeling was observed,indicating disruption of the choroid-Bruch membrane-RPE complex.On the fourth day,cellular debris and fragmented nuclei were presented and an autofluorescent ring was visible at the site of Bruch's membrane disruption.The number of CNV vessels increased exponentially during the next 3 days.At 7 days,a well-defined isolectin-B4 labeled CNV network was exhibited and lasted for 28 days.The CNV areas were (7.99±0.42)×103μm2,(16.89±3.77)×103μm2,(14.37±4.02)×103μm2 at 7,14 and 48 days after photocoagulation respectively,showing a significant difference among these three groups (F=17.340,P=0.000),and the CNV area was significantly increased in the photocoagulating eyes in 14 days and 28 days compared with 7 days (q=16.46,q=15.54,P＜0.01).Conclusion Fluorescent antibody labeling allows the well identification and measurement of laser-induced CNV lesions in mouse choroid/RPE flatmounts.This technique offers excellent morphologic detail and facilitates the study of critical early events in CNV.CNV complexes are labeled at an early stage,providing a more accurate preclinical evaluation of antiangiogenic molecule.