ve To compare the effects of coronary-artery-bypass (CAB) surgery with and without cardiopulmonary bypass(CPB) on hemodynamics and the function of the grafts. Methods Thirty-five patients undergoing elective CAB surgery were studied. CAB was performed either with hypothermic CPB (n = 15) or without CPB(off-pump, n = 20) . The patients were premedicated with intramuscular pethidine 50 mg and scopolamine O.3mg. Anesthesia was induced with intravenous midazolam 5-15mg, fentanyl 5-20?g?kg and pancuronium 0.1 mg?kg-1 or pipecuronium 0.1 mg?kg-1 and maintained with iv infusion of fentanyl 6-10?g?kg-1, propofol 2-4mg?kg-1?h-1 and intermittent boluses of pancuronium, midazolam supplemented with 1%-1.5% isoflurane inhalation. In off-pump group naso-pharyngeal T?was maintained at 37.2℃ during operation. The amount of heparin used was equal to about one-third of amount used during CPB and ACT was maintained above 250 seconds. MAP was maintained at 70-90 mm Hg. While blood vessel was being grafted onto the coronary arteries heart rate was maintained at 60-80 bpm, otherwise esmolol 10-20mg was given iv every 5 min until it was satisfactorily controlled. In CPB group, during CPB naso-pharyngeal T?was maintained at 32℃-34℃, MAP at 50-70 mm Hg and blood gases and electrolytes within normal range. Right radial artery was cannulated and 7.5F Swan-Ganz catheter was inserted via internal jugular vein into pulmonary artery for hemodynamic monitoring and blood gas analysis. ECG, SpO2 were continuously monitored during operation. At the end of operation in patients with internal mammary artery used as graft, the flow rate of grafts was measured with 3mm Doppler probe.Results (1) After CAB cardiac index (CT) increased significantly in off-pump group(P0.05) . (3) There was no significant difference in the blood flow of artery graft and myocardial oxygen delivery (MDO2), and consumption ( MVO2) as well as MDO2/MVO2 between the two groups. Conclusions Off-pump CAB surgery has less effects on hemodynamics but systemic and myocardial oxygen delivery and consumption are similar between the two groups.

brain and fatty. The accumulation excretion ratios within 96 h were 70.16% in urine and only 1.35% in feces after iv administration in rats, while within 24 h was 3.46% in bile. Conclusion The results of pharmacokinetics of novel r-hirudin in rats given by iv determined by RA are different from those determined by TCA-RA, but the trends indicated by the two methods are the same; urine excretion is the major excretion pathway.

BACKGROUND: Aerobic exercise is a popular and effective way of fitness. All kinds of changes occur in the human system, especially the changes in the cardiovascular system. Enhancing the cardiovascular system functions is the most important role in the aerobic exercise. OBJECTIVE: To sum up effects of aerobic exercise on blood indicators, cardio-vascular function. RETRIEVAL STRATEGY: A computer-based search was conducted in Pubmed for literatures related to aerobic exercise and cardiovascular system published between January 1998 and December 2006 with the key words of "aerobic exercise, cardiovascular" in English. Simultaneously, China Journal Full-text Database was looked for relevant articles published from January 2001 to December 2006 with the same key words in Chinese. The data were selected firstly. Inclusive criteria: ①the influence of aerobic exercise on cardiovascular function, ②influence of aerobic exercise on blood indexes. The exclusive criterion for deletion was the repetition of the same research. There were 81 literatures in accordance with the above-mentioned criteria. LITERATURE EVALUATION: 51 papers of repetitive research were excluded, 30 of them were accorded with the inclusive criteria and were included. DATA SYNTHESIS: Aerobic exercise plays the most important role in fitness. Enhancing the cardiovascular system functions is the most important role in the aerobic exercise. Epidemiological studies and experimental studies have indicated that aerobic exercise not only can increase energy consumption, improve vitality lipoprotein and lower blood lipid content, but also can reduce blood pressure in patients with hypertension and decrease the incidence of arteriosclerosis and other cardiovascular diseases, and can effectively enhance cardiac function. CONCLUSION: Appropriate aerobic exercise can lead to the enhancements of cardiac function and vascular function, and plays an important role in the prevention and treatment of cardiovascular diseases.

AIM: To prepare and purify the polyclonal antibodies against human myofibrillogenesis regulator 1 (hMR-1), then to characterize the purity, titer, specificity and the availability.METHODS: Two polypeptides named peptide 1 and 2 were synthesized based on the bioinformatics analysis of the sequence of hMR-1 by using software TMHMM and DNAStar, then coupled with keyhole limpet hemocyanin (KLH) for immunization. These peptides for immunization were mixed and injected into New Zealand rabbits to prepare antibodies specifically against hMR-1. ELISA assay was used to detect the titers of the antibodies. After purification by immunoaffinity chromatography, antibodies were identified by Western blotting and immunocytofluorescent assays. Applications of the antibodies on neonatal rat cardiomyocytes were also employed.RESULTS: (1)The titers of antibodies were 1:10~5. In WB assay, a specific 17kD band was detected, corresponding to the predicted molecular weight of hMR-1; the positive fluorescent signals were distinct. (2)On the neonatal rat cardiomyocytes model, we observed a peri-nucleus location. The fluorescent signal of hMR-1 overexpression group was much stronger than that in vector control and normal control groups.CONCLUSION: All these results indicate that the antibodies obtained from poly peptides mixture immunization have either human original or rat original antigens. The antibody is available for using in Western blotting or immunofluorescent assays.

Objective To review our clinical experience with primary surgical repair of tetralogy of Fallot in neonates and premature infants and to discuss the timing of repair and major factors in treating this patients perioperatively.Methods From January 2012 to September 2015,a series of 19 consecutive neonates and premature infants(M/F =12/7) with tetralogy of Fallot were admitted in our center to receive surgical treatment,with a mean age of(17.3 ± 5.5) days(12-28 days) and a mean body weight of(2.9 ±0.7) kg(2.1-4.3 kg).All the 19 cases were symptomatic with cyanosis,saturation on room air 0.79 ± 0.12 (0.48-0.92),and shortness of breath.Before operation,2 cases were receiving an infusion of prostaglandin E1,5 were mechanically ventilated.7 were more than moderate anemia with hemoglobin of 55-87 g/L.All the patients received echocardiography,ECG and chest X-ray.The McGoon ratio and Nakata index were 1.09 ± 0.30 (0.8 to 1.6) and (135.5 ± 54.2) mm2/m2 (63-212 mm2/m2) respectively.18 cases received one-stage surgical repair and 1 premature infant under two-stage operation with the VSD closure after right ventricular outflow tract(RVOT) transannular patch augmentation.All the VSDs in the 18 cases were closed with continuous suture and RVOT were enlarged with autologous pericardium patch transannularly or not.Balanced and modified ultrafiltration were applied in all the patients.Patients were strictly followed up with a standard protocol focusing on right ventricular function and arrythmia.Several characteristics(e.g.time of operating,mechanical ventilation and ICU stay,complications,hospital stay time,cost of hospitalization) were compared between this group of patients and other TOF patients during the same period in our center.Results All the one-stage operations were successful.There was no mortality and major complication.Mean CPB and aortic clamping time were(111.5 ± 31.6)min (76-153min) and (73.3 ± 11.6) min (64-89 min) respectively.10 VSDs were closed with transventricular approach,6 witht transatrial appraoch and 2 with transatrial-ventricular approach.12 cases (66.7 ％) had a transannular RVOT patch,4 (22.2 ％) with single RVOT patch and 2 (11.1％) with transannular RVOT and left pulmonary artery patch.Atrial communication were left open in 15 cases (83.3 ％).The time of mechincal ventilation and ICU stay were (123.7 ± 59.5) h (39-239 h) and (10.1 ± 3.2) days (5-19 days) respectively.All the patients were followed up for (31.8 ± 15.7) months (9-57 months).There was no mortality and major complication.ECG showed that there was no severe arrythmia except for 3 complete right branh bundle block.The latest echocardiography results showed that right heart function was normal in all the cases and RVOT grandients was less than 30mmHg except one with 35 mmHg.There were 2 cases with residual shunt less than 2 mm and 8 cases with pulmonary valvular regurgitation less than moderate degree.Compared with other TOF cases during the same period,there was no difference according to the data mentioned above except with more time of mechnical ventilation and ICU stay and more cost of hospitalization.Conclusion Primary repair of TOF can be performed safely in symptomatic neonates and premature infants,regardless of age and body weight,with favorable early and mid-term results.Excellent teamwork and accurate prenatal and postnatal diagnosis were the two major factors in yeilding good results in these patients.

AIM: To manufacture recombinant protein of the highly conserved domain in human bone morphogenetic protein-1(BMP-1) using gene engineering methods as antigen for making wide spectrum antibody to BMP-1. METHODS: We analyzed the gene sequences and protein structures of BMP-1 and its related proteins, and chose a highly conserved fragment as target gene. Total RNA was prepared from human osteosarcoma cell line Saos-2, then the target gene was amplified with RT-PCR. The PCR product was cloned into prokaryotic expression vector pMAL c2 to get recombinant vector BMP-1(322-588aa)-pMAL c2. After transforming the recombinant plasmid into DH5-alpha and screening, several prositive clones were got for sequencing. Finally the transformed cells was induced with IPTG to get fusion protein. RESULTS: The BMP-1 gene fragment was successfully cloned into vector pMAL c2, and was able to express efficiently with IPTG inducement. The amount of expressed fusion protein is about 66%-72% in total volume of bacterial proteins. CONCLUSIONS: The recombinant protein contains several key domains(2 CUB domains and 1 EGF domain), which are shared by BMP-1 and its related proteins. Specific wide spectrum antibody to human BMP-1 and its related proteins may be generated with this recombinant protein antigen.

Objective To establish a mouse model of acute necrotizing pancreatitis.Methods Thirty six male ICR mice were randomly divided into control group ( n =6) and experimental group ( n =30). Each of the animals in the experimental group received 7 intraperitoneal injections of caerulein (50 ?g/kg body weight) in 0.9% NaCl at hourly intervals over 6 hours. The animals in the experimental group were killed at 9,18,24,48 and 72 hours respectively after the first caerulein injection. The control animals received the same volume of 0.9% NaCl without caerulein. The animals in the control group were killed at the 18th hour after the first intraperitoneal injection. The severity of acute necrotizing pancreatitis was evaluated in terms of amylase level, pancreatic weight/body weight and the histological changes. Variance analysis was employed in the processing of these data. Results Both amylase level and pancreatic weight elevated 9 hours after the first caerulein injection, and correlated with the course of pancreatitis. The maximums of both alterations were observed at the same time point (18 hours after the first injection of caerulein). Prominent interstitial inflammation and acinar cell necrosis occurred at the 18th hour, and the histological score for pancreatitis reached a maximum ( P

The role of serum and glucocorticoid-induced kinase 1 (SGK1) pathway in the connective tissue growth factor (CTGF) expression was investigated in cultured human mesangial cells (HMCs) under high glucose. By using RT-PCR and Western blot, the effect of SGK1 on the CTGF expression in HMCs under high glucose was examined. Overexpression of active SGK1 in HMCs transfected with pIRES2-EGFP-S422D hSGK1 (SD) could increase the expression of phosphorylated SGK1 and CTGF as compared with HMCs groups transfected with pIRES2-EGFP (FP) under high glucose or normal glucose. Overexpression of inactive SGK1 in HMCs transfected with pIRES2-EGFP-K127N hSGK1 (KN) could decrease phosphorylated SGK1 and CTGF expression as compared with HMCs groups transfected with FP under high glucose. In conclusion, these results suggest that high glucose-induced CTGF expression is mediated through the active SGK1 in HMCs.
Cells, Cultured ; Connective Tissue Growth Factor/genetics ; Connective Tissue Growth Factor/*metabolism ; Glucose/*pharmacology ; Immediate-Early Proteins/metabolism ; Immediate-Early Proteins/*physiology ; Mesangial Cells/cytology ; Mesangial Cells/*metabolism ; Protein-Serine-Threonine Kinases/metabolism ; Protein-Serine-Threonine Kinases/*physiology ; Signal Transduction/drug effects

Objective To analyze the clinical features and risk factors of death in pediatric trauma,in order to provide preventing strategies and reduce mortality.Methods A retrospective study of 7936 traumatic children admitted to the emergency department of our hospital from April 2014 to March 2016 was conducted.We retrospectively summarized the clinical features and Logistic regression analysis was used to analyze the risk factors of death in children with trauma.Results Compared to females,male patients contributed higher percentages(1.73∶1).There were more migrant children(5535 cases) than local ones(2 401 cases)(χ2=14.314,P＜0.05).Children in infancy stage(2 024 cases)and toddler period(3 097 cases) were more than in the other periods.Limb[41.9%(3 324/7 936)] and skin injuries[38.5%(3 058 324/7 936)] were the most common.Children trauma causes varied with age,fall,tumble and traffic accidents were common causes of children trauma.Pediatric trauma score of surviving group(n=1933),death group(n=5),general ward group(n=1852) and ICU group(n=86) were 8.53± 2.17,3.17± 1.29,9.72± 1.25,5.23± 1.84,respectively.Shock decompensation,mechanical ventilation,Glasgow coma scale ≤7 and pediatric trauma score＜8 were the risk factors which caused the death of trauma.Conclusion Parents should improve the security sense,strengthen the care of children and obey the traffic rules to reduce the rate of children trauma.Clinicians should pay attention to shock decompensation,mechanical ventilation,Glasgow coma scale and pediatric trauma score in order to identify critically ill patients in early stage and improve the success rate of rescue.

ObjectiveTo classify chronic pancreatitis (CP) based on pathological features and evaluate the benefits of different surgical procedures according to the pathological forms. Methods Forty CP cases during recent 9 years who underwent surgical therapy were retrospectively reviewed in association with clinicopathological analysis. Results Postoperative pain-relief rate was 79.16% in patients treated with longitudinal pancreaticojejunostomy(LPJ). In cases without enlarged pancreatic head or diverticulum of duodenum, postoperative pain-relief rate was 86%.Postoperative pain-relief rate was high by Whipple′s procedure, pylorus-preserving pancreaticoduodenectomy or Beger duodenum-preserving pancreatic head resection,while postoperative diabetes mellitus developed in 22%.Conclusions Both pathological form and operative procedure were factors influencing outcomes of CP.LPJ is still a main surgery for most CP patients with pancreatic fibrosis and dilated pancreatic duct and pancreatic stone.Some patients of CP with enlarged pancreatic head, hyperplasia of pancreatic parenchyma and pancreatic duct epithelia or complicated with diverticulum of the duodenum should be treated with resections targeting at the head of the pancreas.