Objective To discuss the application of implantation temporary cardiac pacing by balloon-tipped floating catheter for peroperative period patients. Method Thirty-three patients with severe bradyarrhythmia were received the balloon-tipped floating catheter to RV by Seldinger puncture technique.Meantime, the pacing signals of ECG were observed. The threshold and QRS waves to ensure the electrode position were determined. Result All of 33 cases were successfully punctured and 32 cases get paced, except 1 case had the electro - mechanical dissociation (EMD). Pacing threshold was less than 0. 9V, and mean remaining time was 12.47 ～ 161 (67. 05 ±34. 48) hours. Apical pacing was operated in 23 patients,and right ventricular outflow tract pacing in 10 patients. No severe complications were occurred. Conclusion The implantation method of temporary cardiac pacing by balloon-tipped floating catheter was convenient and safe. It could help the patients get safety in anesthesia and peroperative period.

Background Human retinal pigment epithelial (RPE) cell transplantation treating retinal degenerative diseases is a researching topic,and the source of human RPE cells is a key problem.Many biological carriers can be used for the preparation of RPE cell layer.However,some advantages,such as cytotoxicity,lack of stability and immunologic reaction etc.are still existed.To study an ideal biological carrier is very important.Objective This experimental was to determine the effects of amniotic membrane on the proliferation and differentiation of human RPE cells and the possibility as a scaffold for RPE cell transplantation.Methods ARPE19 cell line cells were cultured and passaged in DMEM/F12 medium with 10％ fetal bovine serum,and 8-12generation of cells were used.The cells were divided into two groups.One group of cells were incubated on the denuded amniotic membrane,and the other group of cells were cultured in the medium (control group).MTT was performed to detect the A492 value of RPE cells for the evaluation of cell proliferation ability 24,48,72,96 hours after culture.Cell morphology was compared by histopathological examination 3 weeks after culture.The mRNA expression of pigment epithelium-derived factor (PEDF),N-cadherin,β-catenin and cell connection related proteins in the cells of both groups were assayed using reverse transcription polymerase chain reaction (RT-PCR).Ultrastructure of the cells was observed under the transmission and scan electronic microscope 3 weeks after culture.Results The number of ARPE-19 cells cultured on denuded amniotic membrane was decreased significantly in comparison with the normal culture plate(F=41.760,P =0.000).Histopatholy also showed that the cell density on amniotic membrane was lower than of normal cells on plate surface.Moreover,the expression level of claudin 1 mRNA,N-cadherin mRNA and PEDF mRNA were significantly up-regulated in denuded amniotic membrane group in comparison with control group (t=15.828,P=0.000 ;t=6.839,P=0.002 ;t=14.667,P=0.000),but the expression of Connexin 43 mRNA was down-regulated in denuded amniotic membrane group compared with control group(t=3.358,P=0.024).Ultrastructural examination revealed that ARPE-19 cells cultured on amniotic membrane exhibited a polygonal epithelial phenotype with cilium on the apical side,however,the cells cultured on normal culture plate displayed fusiform shape and uneven thickness.Conclusions Amniotic membrane plays a promoting effect on the differentiation of ARPE-19 cells and a inhibitory effect on the proliferation of ARPE-19 cells,suggesting that amniotic membrane might be an useful scaffold for the preparation of functionally mature RPE cells for clinical transplantation.

Hip Joint ; Humans ; Ischium/diagnostic imaging* ; Magnetic Resonance Imaging

OBJECTIVETo evaluate incidence of postoperative delirium after hip surgery in elderly patients by meta-analysis.

METHODSFrom January 1, 2014 to December 31, 2013, clinical literatures about postoperative delirium after hip surgery in elderly patients,were searched from the Pubmed. Literature extract table were formed according to inclusion and exclusion criteria. Stata-12.0 was applied for Meta-analysis. P was used to test heterogeneity of study, random-effect model was performed when I2 > 50%. Subgroup analysis was used according to stage of age, assessment scale of delirium and statistical area of literature. Begg test was used to test publication bias.

RESULTSTwenty-one literatures were included. Incidence of postoperative delirium after hip surgery in elderly patients by weighted and combination was 17% [95% CI (16%, 18%)]. Incidence of postoperative delirium after optional hip surgery was decreased more than emergency operation in included 5 literatures [OR = 0.32, 95% CI (0.22, 0.45)]. Incidence of postoperative delirium in patients less than 80 years old was 21% [95% CI (19%, 23%)], while 21% [95% CI (19%, 24%)] in patients more than 80 years old. Incidence of postoperative delirium in CAM evaluation scale was 23% [95% CI (21%, 26%)], while 19% [95% CI (17%, 21%)] in other evaluation scales. Incidence of postoperative delirium in Asian area was 17% [95% CI (15%, 20%)], while 23% [95% CI (21%, 25%)] in European and American area. There was no publication bias tested by Begg test (P < 0.05).

CONCLUSIONIncidence of postoperative delirium after hip surgery in elderly patients increases higher, especially in emergency operation. A standardizing research method is benefit for evaluate incidence of postoperative delirium after hip surgery in elderly patients, decreasing heterogeneity and publication bias.

Aged ; Delirium ; epidemiology ; Hip Fractures ; surgery ; Humans ; Incidence ; Postoperative Complications ; epidemiology ; Publication Bias

Objective To investigate the influence of uremic serum on the monocyte chemoattractant protein 1 (MCP-1) expression of human umbilical vascular endothelial cells (HUVECs) in vitro and the effect of up-regulation of berne oxygenase 1 (HO-1) on the synthesis of MCP-1 of HUVECs in uremic milieu. Methods HUVECs were incubated to confluence and then preineubated with heroin and/or protoporphyrin zinc IX (ZnPP)for 6 hours.The cultures were subsequently incubated with M199 cell medium containing 10% serum of healthy people or with medium containing 10% serum of maintenance hemodialysis (MHD) patients.HO-1 protein and mRNA expression was detected by immunohistochemistry and semi-quantitative RT-PCR.MCP-1 mRNA expression was measured by semi-quantitative RT-PCR,and MCP-1 protein was quantified by ELISA. Results Up-regulated expression of MCP-1 mRNA and protein was detected in HUVECs incubated with medium containing 10% serum of MHD patients.The protein synthesis was 2.95 folds of the control.Heroin induced expression of HO-1 mRNA and protein,and concurrently inhibited the up-regulated MCP-1 expression induced by uremic serum.Such effects of heroin could be blocked by ZnPP. Conclusions Uremic serum induces the expression of MCP-1 in HUVECs.Up-regulated expresson of endothelial HO-1 induced by heroin inhibits the enhancement of MCP-1 synthesis.HO-1 may be beneficial to the alleviation of endothelial cell injury in uremic milieu.

Objective To investigate the respective effects of highly concentrated amino acids, highly concentrated glucose and mixture of the above two on the proliferation and extracellular matrix synthesis of glomerular mesangial cells. Methods Mesangial cells were cultured with mannitol (13.3 mmol/L ), highly concentrated amino acids (13.3 mmol/L), highly concentrated glucose (30.5 retool/L) and the mixture of highly concentrated amino acids and highly concentrated glucose repectively. Mesangial cell proliferation was examined by MTT and flow cytometry. The mRNA expression of TGF-β1,ColⅣ and fibronectin (FN) was detected by semi- quantitative RT-PCR, and the protein expression was detected by ELISA, Western blot and radioimmunoassay. Results (1) Cellular proliferation was increased in response to amino acids and was further enhanced by increased levels of both amino acids and glucose in a time-depentent manner. And the most prominent action occured at 48 hours. (2) Among the three group, mesangial cell cycle was affected, and the number of G0/G1 mesangial cells was reduced, but the number of cycle S cells was improved. (3) In the three group, the mRNA and protein expression of TGF-β1 was improved [protein unit: ng·ml-1·(105 cells)-1, 3023±85, 3163±80, 3321+85 vs 1506±63, P< 0.05]. (4)In the three group, the mRNA and protein expression of Col Ⅳ and FN was enhanced [protein unit: ng'ml-1(105 cells)-1, Col Ⅳ:16.78±2.56, 18.65±2.56, 22.83±2.45 vs 10.22±2.54, P<0.01; FN:18.47±2.34, 13.58±3.13, 17.98±2.56 vs 8.22±2.54, P<0.05]. The expression of Col Ⅳ mRNA and protein was stronger when the cells were cultured with the mixture of highly concentrated amino acids and highly concentrated glucose. Conclusions Highly concentrated amino acid can promote cell proliferation similarly to highly concentrated glucose, which may be through increasing the activity of mesangial cells and the synthesis of extracellular matrix via TGF- β1 signaling way. Highly concentrated amino acid has the synergism with highly concentrated glucose.

Objective To compare the difference of protein and lipid metabolism between patients with inflammatory bowel disease and healthy controls,and to investigate the association of these changes with disease activity and location of the lessions.Methods The retrospective cohort study was carried out.The data of protein and lipid metabolisms collected from 195 patients with ulcerative colitis,76patients with Crohn's disease and 97 healthy controls during 1995 to 2007 were analyzed.Disease activity were evaluated using simple clinieal colitis activity index and simple index of Crohn's disease activity.The erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)were measured.Results Serum levels of ESR in patients with ulcerative colitis were negatively linear correlated with serum levels of albumin/globulin ratio(β=-0.521,P＜0.01)and positively linear correlated with serum levels of α2globulin(β=0.319,P＜0.01).Serum levels of globulin in patients with Crohn's disease were positively linear correlated with serum levels of ESR(β=0.558,P＜0.01)and CRP(β=0.424,P=0.01).In ulcerative colitis,serum levels of albumin/globulin ratio,albumin and total cholesterol were significantly higher in patients with proctosigmoiditis than those in patients with lesions at other locus(P=0.003,0.005,0.038,respectively).In Crohn's disease,serum level of globulin was significantly higher in patients with lesions only at colon than that in patients with lesions only at small bowel(P=0.029).Conclusions Serum levels of albumin/globulin ratio and α2-globulin can be predictors of inflammatory activity in patients with ulcerative colitis.The increasing serum globulin may predict the progression of disease activity in patients with Crohn's disease.The nutritional deficiency is more critical in patiens with small bowel involvement than those with colon involvement.

Objective Percheron artery is an uncommon anatomic variant. Percheron artery infarction with unilateral embryonic posterior cerebral artery ( PCA ) was rarely reported.The aim of this study was to characterize the clinical and imaging patterns of Percheron artery infarction with the unilateral embryonic PCA for early diagnosis and treatment.MethodsClinical and imaging data of 2 patients with Percheron artery infarction were reviewed retrospectively.ResultsTwo patients presented acute coma and one had paroxysmal blurred before coma.On neurological examinations,one patient had vertical gaze palsy besides two were unconsciousness. MRI showed symmetrical high signal intensity on diffusion weighed imaging (DWI)in bilateral paramedian thalami in two patients and a distinct pattern of V-shaped hyperintensity on DWI andFLAIR was present on the midbrain in one patient. Digital subtraction angiography and magnetic resonance angiography demonstrated unilateral embryonic PCA in two patients.ConclusionsThe classical clinical symptoms,symmetrical high signal in bilateral paramedian thalami and V-shaped sign in midbrain on DWI can improve recognition,evaluation and management of Percheron artery infarction.The unilateral embryonic PCA may be underlying risk factor of Percheron artery infarction.

Objective To explore the effect of therapeutic touch(massage)on the neuTobehavior of preterm infants.Methods Sixty preterm infants( gestafional age in 31-36 weeks),through natural delivery or caesarean section were randomly assigned to therapeutic touch group(n=30)and control group(n=30).Both groups re-ceived routine pharmacothempy and nursing care and followed up for half a year from discharge.Touch group re-ceived additional whole-body massage.All subjects were evaluated with neonatal behavioral neurological assessment (NBNA)in one month after birth-and mental development index(MDI), psyehomotor development index(PDI)in 3 months and 6 months after birth.Results The NBNA scores(P<0.01),as well as MDI and PDI(P<0.05)were significantly higher in therapeutic touch group than the control.Conclusion Therapeutic touch intervention im-proves nervous system of preterm infants.

Objective To study the role of hematopoietic growth factor(HGF)of placenta chorionic villus in fetal hematopoiesis during embryo ontogeny by observation of the appearance time and the content changes with the fetal growth, which was compared with HGF in cord blood. Methods Thirty embryo villus (2 g each) and 30 cord blood (2 mL each) were collected separately from early pregnant stage(6- 8 weeks), middle pregnant stage(16-22 weeks)and late pregnant stage (37-42 weeks). The levels of HGF were detected by enzyme - linked immunosorbent assay. Results HGF were produced on the early pregnant stage and the content of FL-T3,IL-3 increased gradually.There were significantly differences at different stages(P