The aim of this study was to investigate the effect of loading some small molecule carbohydrates into human platelets on ultrastucture and function. The ultrastructure of platelets were observed by transmission electron microscope (TEM); the platelet counts and mean platelet volume (MPV) were measured by hemocytometer, the maximal platelet aggregation rate was measured optically in an aggregometer; the surface marker of platelet membranes CD62p and phosphatidyl serine were analyzed by flow cytometry. The results showed that no significant changes of the ultrastructure of platelets loaded with small molecule carbohydrates were seen. The aggregation responsiveness of platelets loaded with small molecule carbohydrates reached to 60% of the fresh control platelets. The values of platelet counts and MPV showed no significant differences. The expression level of CD62p and the binding rate with Annexin V before and after loading small molecule carbohydrates into platelets were no different. It is concluded that the platelets after loading with small molecule carbohydrates remained fine ultrastructure and function.
Blood Platelets ; physiology ; ultrastructure ; Blood Preservation ; methods ; Carbohydrates ; pharmacology ; Freeze Drying ; Humans ; P-Selectin ; blood ; Platelet Aggregation

OBJECTIVETo report the initial clinical experience of endovascular thoracic branched stent grafts in the treatment of aortic arch dissections involving the left subclavian artery.

METHODSFrom February 2004 to June 2004, 14 patients were cured with the endovascular thoracic branched aortic stent-grafts made by Beijing YuHengJia SciTech Co. All patients had Stanford type B aortic dissection with the entry tears just beyond the origin of the left subclavian artery by an average distance of 8.7 mm. The branched stents were consisted of the aortic section and the branched section. The diameter of the stents was 15% to 20% larger than the diameter of the landing zones of native arteries. The repair procedure was performed in angiography laboratory. The branched stent grafts were delivered under fluoroscopic guidance and implanted into the aortic arch including the left subclavian artery.

RESULTSFourteen branched stent-grafts and 2 additional flexible stent-grafts were delivered successfully in all 14 cases. The entry tears were excluded completely, and the truth lumen of the dissection was revealed to the normal diameter in all patients. Neither peripheral complication nor death occurred. All 14 patients had recover the normal life.

CONCLUSIONIt demonstrates that it is possible to apply the technical feasibility of endovascular thoracic branched aortic stent graft to repair the intimal tear of dissection just beyond the left subclavian artery.

Adult ; Aged ; Aneurysm, Dissecting ; surgery ; Aortic Aneurysm, Thoracic ; surgery ; Blood Vessel Prosthesis ; Blood Vessel Prosthesis Implantation ; instrumentation ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Stents ; Treatment Outcome

The present study was designed to test the hypothesis that a medium-term simulated microgravity can induce region-specific remodeling in large elastic arteries with their innermost smooth muscle (SM) layers being most profoundly affected. The second purpose was to examine whether these changes can be prevented by a simulated intermittent artificial gravity (IAG). The third purpose was to elucidate whether vascular local renin-angiotensin system (L-RAS) plays an important role in the regional vascular remodeling and its prevention by the gravity-based countermeasure. This study consisted of two interconnected series of in-vivo and ex-vivo experiments. In the in-vivo experiments, the tail-suspended, hindlimb unloaded rat model was used to simulate microgravity-induced cardiovascular deconditioning for 28 days (SUS group); and during the simulation period, another group was subjected to daily 1-hour dorso-ventral (-G(x)) gravitation provided by restoring to normal standing posture (S + D group). The activity of vascular L-RAS was evaluated by examining the gene and protein expression of angiotensinogen (Ao) and angiotensin II receptor type 1 (AT1R) in the arterial wall tissue. The results showed that SUS induced an increase in the media thickness of the common carotid artery due to hypertrophy of the four SM layers and a decrease in the total cross-sectional area of the nine SM layers of the abdominal aorta without significant change in its media thickness. And for both arteries, the most prominent changes were in the innermost SM layers. Immunohistochemistry and in situ hybridization revealed that SUS induced an up- and down-regulation of Ao and AT1R expression in the vessel wall of common carotid artery and abdominal aorta, respectively, which was further confirmed by Western blot analysis and real time PCR analysis. Daily 1-hour restoring to normal standing posture over 28 days fully prevented these remodeling and L-RAS changes in the large elastic arteries that might occur due to SUS alone. In the ex-vivo experiments, to elucidate the important role of transmural pressure in vascular regional remodeling and differential regulation of L-RAS activity, we established an organ culture system in which rat common carotid artery, held at in-vivo length, can be perfused and pressurized at varied flow and pressure for 7 days. In arteries perfused at a flow rate of 7.9 mL/min and pressurized at 150 mmHg, but not at 0 or 80 mmHg, for 3 days led to an augmentation of c-fibronectin (c-FN) expression, which was also more markedly expressed in the innermost SM layers, and an increase in Ang II production detected in the perfusion fluid. However, the enhanced c-FN expression and increased Ang II production that might occur due to a sustained high perfusion pressure alone were fully prevented by daily restoration to 0 or 80 mmHg for a short duration. These findings from in-vivo and ex-vivo experiments have provided evidence supporting our hypothesis that redistribution of transmural pressures might be the primary factor that initiates region-specific remodeling of arteries during microgravity and the mechanism of IAG is associated with an intermittent restoration of the transmural pressures to their normal distribution. And they also provide support to the hypothesis that L-RAS plays an important role in vascular adaptation to microgravity and its prevention by the IAG countermeasure.
Angiotensinogen ; genetics ; metabolism ; Animals ; Aorta, Abdominal ; pathology ; physiopathology ; Carotid Artery, Common ; pathology ; physiopathology ; Hindlimb Suspension ; Male ; Muscle, Smooth, Vascular ; metabolism ; pathology ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Sprague-Dawley ; Receptor, Angiotensin, Type 1 ; genetics ; metabolism ; Renin-Angiotensin System ; physiology ; Weightlessness Simulation

Myelodysplastic syndromes (MDS) are a group of bone marrow failure diseases. The bone marrow microenvironment consists of bone marrow stromal cells (BMSC), growth factors and cytokines. The BMSC supporting haemopoiesis include mesenchymal stem cells (MSC), osteoblasts, endothelial cells and macrophages, but the adipocytes play a role in the suppression of hematopoiesis. Recently more and more researches indicate that the abnormality of bone marrow microenvironment involves in the pathogenesis and progression of MDS. In this review the abnormality of MDS bone marrow microenvironment is summarized briefly.
Bone Marrow ; physiopathology ; Cellular Microenvironment ; Cytokines ; Disease Progression ; Hematopoiesis ; Humans ; Intercellular Signaling Peptides and Proteins ; Mesenchymal Stromal Cells ; Myelodysplastic Syndromes ; physiopathology

BACKGROUNDHemodynamic evaluation is crucial for the management of patients with pulmonary hypertention. Clinicians often prefer a rapid and non-invasive method. This study aimed to examine the feasibility of transthoracic echocardiography for the measurements of hemodynamic parameters in patients with pulmonary hypertension.

METHODSA prospective single-center study was conducted among 42 patients with pulmonary hypertension caused by different diseases. Transthoracic echocardiography and right-heart catheterization were performed within 24 hours. Pulmonary artery systolic, diastolic and mean pressure (PASP, PADP and PAMP), cardiac output (CO), and pulmonary capillary wedge pressure (PCWP) were measured by both methods. A linear correlation and a Bland-Altman analysis were performed to compare the two groups of hemodynamic parameters.

RESULTSA good correlation was found between invasive and non-invasive measurements for PASP (r = 0.96), PADP (r = 0.85), PAMP (r = 0.88), CO (r = 0.82), and PCWP (r = 0.81). Further agreement analysis done by the Bland-Altman method showed that bias and a 95% confidence interval for PASP, PADP, and CO were clinically acceptable while great discrepancies existed for PAMP and PCWP.

CONCLUSIONSThe non-invasive measurements by PASP, PADP, and CO in patients with pulmonary hypertension correlate well with the invasive determinations. Transthoracic echocardiography (TTE) was inappropriate for estimating PCWP and PAMP.

Adolescent ; Adult ; Cardiac Catheterization ; Cardiac Output ; Echocardiography ; Female ; Hemodynamics ; Humans ; Hypertension, Pulmonary ; physiopathology ; Male ; Middle Aged ; Prospective Studies ; Pulmonary Wedge Pressure

OBJECTIVETo evaluate the effect of daily low-dose tadalafil on erectile dysfunction (ED) induced by pelvic fracture urethral disruption (PFUD).

METHODSThis study included 46 cases of PFUD-induced ED treated from Jan 2008 to Dec 2011. The patients were aged 33.9 +/- 7.2 years (range 25 -51 yr), and the interval between injury and treatment was 19.6 +/- 12.7 months (range 3 - 72 mo), all with normal erectile function before PFUD. Based on the nocturnal penile tumescence and rigidity (NPTR) recorded by erectometry without medication of phosphodiesterase type 5 inhibitor (PDE-5I), the patients were divided into an abnormal nocturnal erection group and a non-nocturnal erection group, and treated with tadalafil 10 mg once daily for 3 months. The therapeutic effect was evaluated by IIEF-5 scores and the rate of yes responses to questions 2 and 3 of the Sexual Encounter Profile (SEP).

RESULTSTotally 38 (82.6%) of the patients accomplished the treatment and follow-up, 26 (68.4%) in the abnormal nocturnal erection group and 12 (31.6%) in the non-nocturnal erection group. After 3 months of daily tadalafil treatment at 10 mg, the IIEF-5 scores were significantly improved in the abnormal nocturnal erection group than in the non-nocturnal erection group (P < 0.05), and the rate of yes responses to SEP2 and SEP3 was remarkably higher in the former than in the latter (76.9% vs 41.7% and 65.4% vs 25.0%, P < 0.05).

CONCLUSIONSDaily low-dose tadalafil can effectively improve the erectile function of PFUD-induced ED patients, particularly in those with nocturnal erection.

Adult ; Carbolines ; administration & dosage ; therapeutic use ; Dose-Response Relationship, Drug ; Erectile Dysfunction ; drug therapy ; etiology ; physiopathology ; Fractures, Bone ; complications ; Humans ; Male ; Middle Aged ; Pelvis ; injuries ; Penile Erection ; Tadalafil ; Treatment Outcome ; Urethra ; injuries

OBJECTIVETo observe the effects of two different therapies on patients whose cervical function were restricted due to cervical spondylotic radiculopathy.

METHODSForm April 2008 to October 2009, 71 cases with cervical spondylotic radiculopathy were divided into group A (36 cases) and group B (35 cases). Among them, 22 cases were male and 49 cases were female, ranging in age form 45 to 65 years with an average of 52.27 years, course of disease was from 3 days to 5 years. The patients in group A were treated with rotation-traction manipulation, neck pain particles and cervical rehabilitation exercises; and the patients in group B were treated with cervical traction, Diclofenac sodium sustained release tablets and wearing neck collar. Theapeutic time was two weeks. The cervical anteflexion, extension, left and right lateral bending, left and right rotative activity were measured by helmet-style activities instrument before and after treatment (at the 1, 3, 5, 7, 9, 11, 13 days and 1 month after treatment respectively).

RESULTSThere were no difference between two groups in cervical activity in all directions before treatment (P > 0.05). Compared with the beginning, cervical anteflexion and extension showed significant difference at the 5th day after treatment in group A (P < 0.01). In group B, cervical anteflexion showed significant difference at the 13th day after treatment (P < 0.05), but at the 1 month after treatment, the significant difference disappeared (P > 0.05); cervical extension showed significant difference at the 7th day after treatment compared with the beginning (P < 0.05). Compared with the beginning,left lateral bending showed significant difference at the 1st day after treatment in group A (P < 0.05) and at the 5th day after treatment in group B (P < 0.01). Both in group A or B, right lateral bending, left and right rotative activity showed significant difference at the same time after treatment, either the 3rd day (P < 0.05) or the 5th day (P < 0.05). Compared between groups, cervical anteflexion, left and right lateral bending, left and right rotative activity showed significant difference at the 1 month after treatment (P < 0.05).

CONCLUSIONThe rotation-traction manipulation and neck pain particles and cervical rehabilitation exercises in treating cervicalspondylotic radiculopathy have quick effect to improve the activities of cervical anteflexion, extension, left lateral bending, and have durable effect to improve the activities of cervical spine in all directions.

Aged ; Cervical Vertebrae ; physiopathology ; Exercise Therapy ; Female ; Humans ; Male ; Manipulation, Spinal ; methods ; Middle Aged ; Motion ; Neck ; pathology ; Neck Pain ; physiopathology ; therapy ; Pain Measurement ; Posture ; Radiculopathy ; physiopathology ; therapy ; Rotation ; Spondylosis ; therapy ; Traction ; methods

OBJECTIVETo evaluate anorectal dynamics, function and efficacy of ultralow rectal carcinoma patients undergone intersphincteric resection(ISR).

METHODSFrom January 2004 to August 2007, 30 patients with ultralow rectal carcinoma(2.5-4.0 cm distance from anal edge) underwent ISR. All the patients received anorectal manometry before and after operation. The postoperative anal function was evaluated by Williams continence standard and the treatment outcome was followed up.

RESULTSAfter ISR operation, anal resting pressure, maximum squeeze pressure and maximum tolerance volume of the rectum decreased significantly (all P<0.01) and restored gradually, but not to normal. The rectal anal inhibitory reflex disappeared in 27 patients(90.0%) and was not improved. According to Williams continence standard, 86.7%, 93.3% and 96.7% of patients obtained acceptable anal function in 3, 6, and 12 months after operation respectively. During follow-up of 12 to 44 months, all the patients were still alive and no patient developed pelvis or local recurrence, distant metastasis and anastomotic leakage. Fecal eczema of anus occurred in 10 patients, colonic mucosa prolapse in 2 patients and stenosis of anal canal in one patient.

CONCLUSIONISR for ultralow rectal carcinoma can not only attain radical treatment outcome, but also preserve anal sphincter.

Adult ; Aged ; Anal Canal ; physiopathology ; surgery ; Anastomosis, Surgical ; methods ; Digestive System Surgical Procedures ; Female ; Humans ; Male ; Middle Aged ; Rectal Neoplasms ; physiopathology ; surgery ; Rectum ; surgery ; Treatment Outcome

Objective:To understand the current status of quality control of medical X-ray diagnostic equipment in Tianjin, discuss the problems existing in the process of quality control, and provide technical basis for the relevant regulatory agencies.Methods:Using stratified random sampling, a total of 401 pieces of medical X-ray diagnostic equipment distributed over 111 medical institutions in Tianjin was used for this study. X-ray multifunctional dosimeters and other types of equipment were used to perform quality control testing and evaluation under the relevant health industry standards.Results:The initial testing pass rate of these equipment was 90.0%, with the pass rates of X-ray imaging equipment lower than those of X-ray fluoroscopy equipment, digital subtraction angiography (DSA) and X-ray computed tomography (CT) ( χ2=9.203, 3.383, 5.754, P<0.05). Among the imaging equipment, the screen X-ray equipment had the lowest pass rate, followed by the breast X-ray equipment and medical digital radiography (DR). The main unqualified items were output repeatability, deviation of tube voltage indication and limit spatial resolution. DR accounted for the highest percentage of X-ray equipment that were below testing condition. The unqualified proportion of X-ray imaging equipment was higher than that of X-ray fluoroscopy equipment ( χ2=8.216, P <0.05). Among the imaging equipment, the screen X-ray equipment was seen to have the highest unaqualified proportion, followed by computed radiography (CR). Among the 401 devices in this study, the initial testing pass rates of private medical institutions was not statistically different from those of public medical institutions ( P>0.05). The initial pass rates of domestic equipment was lower than those of imported equipment ( χ2=4.576, P<0.05). Conclusions:The performance of medical X-ray diagnostic equipment in Tianjin needs to be further improved. Medical institutions should pay attention to the quality control testing of medical X-ray diagnostic equipment. The relevant regulatory agencies should strengthen oversight and management of equipment that contains unqualified items, no baseline values and below the testing conditions.

Objective To evaluated the safety and feasibility of excimer laser atherectomy (ELA) combined with drug-eluting balloon angioplasty in treating chronic ischemia of lower limbs.Methods ELA combined with paclitaxel-eluting balloon angioplasty was adopted to treat chronic ischemia of lower limbs caused by arteriosclerosis occlusive disease of lower extremity in three patients.All three patients had arteriosclerosis occlusive disease of superficial femoral artery;in two of them the disease was primary occlusive lesion and in another patient the disease was in-stent re-occlusion lesion after sten implantation.Results After the treatment,the blood flow in the diseased arteries was unobstructed,the blood supply of the lower limbs was obviously improved.No procedure-related complications occurred.Two weeks after the treatment,no recurrence of ischemic symptoms was observed,the blood flow in superficial femoral artery kept unobstructed.The patients recovered smoothly.Conclusion For the treatment of chronic ischemia of lower limbs,which are caused by the primary arteriosclerosis occlusive disease of lower extremity or by the in-stent re-occlusion lesion after sten implantation,ELA combined with paclitaxel-eluting balloon angioplasty is clinically safe and feasible,although its long-term effect needs to be clarified with more studies.