AIM: To explore the influence of levosimendan on cardiac function, pulmonary hypertensions, renal function of the patients after severe heart surgery. METHODS: A total of 320 cases of patients with severe disease who underwent surgery in cardiac surgery department in our hospital from January 2014 to June 2019 were selected and divided into experiment group and control group using random number table method, 160 cases in each group. The prosthetic heart valve replacement or non-extracorporeal bypass surgery were underwent based on the specific condition of patient, the experiment group received levosimendan during the perioperation at the same time. The changes of cardiac, renal function parameters and pulmonary artery systolic pressure (PASP) at different times before and after operation were compared between the 2 groups. RESULTS: There was no significant difference in HR, MAP and CVP between the two groups 24 h after operation. LAC of the experimental group was significantly lower than that of the control group 12 h and 24 h after operation (P<0.05 or P<0.01). LVEDV and LVESV of the 2 groups showed a decreasing trend from 1 to 14 days after operation (P<0.05 or P<0.01), and the experiment group was significantly less than the control group at the same time point (P<0.05 or P<0.01); the CI and LVEF of the 2 groups showed an increasing trend (P<0.05 or P<0.01), and the experiment group was significantly higher than the control group at the same time point (P<0.05 or P<0.01). The levels of plasma NT-proBNP and PASP showed a decreasing trend of the 2 groups from 3 to 14 days after operation, and the experiment group was significantly lower than the control group at the same time point (P<0.05 or P<0.01); the levels of serum BUN, 24Upro and Scr had no significant change in the experiment (P>0.05), the levels of serum BUN, 24Upro and Scr increased first and then decreased in the control group, and the experiment group was significantly lower than the control group at the same time point (P<0.05 or P<0.01). Compared with the control group, the postoperative mortality, ICU stay, ventilator and IABP support time in the experimental group were significantly lower than those in the control group (P<0.05). CONCLUSION: Levosimendan after cardiac surgery can effectively improve the postoperative cardiac function of severe patients, protect renal injury caused by low perfusion, and reduce the incidence of early postoperative pulmonary hypertension, which is worthy of clinical reference.

OBJECTIVETo study the molecular action mechanism of active constituents desoxyrhaponticin (DES) and human serum albumin (HSA).

METHODUnder the simulated physiological condition, computer analog technology, fluorescent spectrometry and ultraviolet spectrum were combined to study the binding mechanism between drug and protein.

RESULTMolecular modeling was adopted to establish the binding model between DES and HSA, suggesting that the interaction force maintaining drug and protein is mainly the hydrophobic interaction with a hydrogen-bond interaction. The results from spectroscopy indicated that the interaction between DES and HSA is a dynamic binding process with a high intensity. The value of the binding distance (r) between DES and HSA was low, which demonstrate the occurrence of energy transfer. DES made an impact on HSA' structural domain microcell conformation, which resulted in hydrophobic changes in binding areas. According to the fluorescent phase diagram technical analysis, the changes in the DES-HSA reaction conformational pattern showed a "two-state" model. According to the obtained thermodynamic parameters for the DES-HSA interaction, the interactional force between DES and HSA was mainly a hydrophobic interaction. The fluorescence polarization proved that a non-covalent compound was generated during the interaction between DES and HSA.

CONCLUSIONThe spectrum experiment showed consistent results with the computer analog technology, which could provided certain reference for studies on the interaction between DES and HSA.

Humans ; Models, Molecular ; Protein Binding ; Protein Conformation ; Serum Albumin ; chemistry ; metabolism ; Spectrometry, Fluorescence ; Spectrophotometry, Ultraviolet ; Stilbenes ; metabolism ; Thermodynamics

Objective To systematically evaluate the application of problem-based learning (PBL)in the teaching process of health management major in China.Methods Databases including CNKI (1979 to December the 2015),VIP (1989 to December the 2015),Wanfang (1982 to December the 2015) and PubMed were systematically retrieved.Any literature about PBL of health management major was included.Seffdeveloped data extraction form was used for collecting the information.Data were input and analyzed using Excel 2007.Results 15 papers were included in the analysis.The first author mainly came from the northeast region of China (7).Most (10) papers did not get the funding support.No paper was published in the journals contained in the Guide to the Core Journals of China.6 papers of experimental studies compared the performance difference of students of the PBL and lecture-based learning (LBL),which was statistically significant.Conclusion PBL is superior to the LBL.However,due to the large difference in the quality of literature,more studies were needed to determine the effect of PBL.Moreover,we should pay attention to the combination of PBL and LBL.

Objective To investigate the distribution and drug resistance of clinical bacteria infection in the Second Affiliated Hospital of Kunming Medical University,so as to provide reference for the treatment of bacterial infections.Methods 4 802 strains of bacteria isolated from this hospital,from January 2013 to December 2013,were retrospectively analysed.The isolates were identi-fied by using VITEK-2 Compact bacterial identification system.Drug resistance was measured by using disc diffusion test,and its results were interpreted according to the breakpoints of Clinical and Laboratory Standards Institute(CLSI)2013.WHONET 5.6 was applied for analysis.Results These pathogens were mainly isolated from urine,sputum,blood,secretions and pus,accounted for 31.7%,21.4%,1 9.7%,1 1.7% and 7.0%,respectively.In the clinical isolates,gram negative bacilli accounted for 55.8%, which was mainly Escherichia coli(26.3%).Gram positive cocci accounted for 31.7%,,which was mainly coagulase negative staph-ylococcus(1 5.0%).Fungi accounted for 3.1%,which was mainly Candida albicans.Escherichia coli and Klebsiella pneumonia were most sensitive to carbapenem,resistance rate was less than 10.0%.The detection rates of Escherichia coli and Klebsiella pneumoni-ae producing extended-spectrumβ-lactamases(ESBLs)was 61.1% and 49.1%,respectively.Among non-fermentative gram nega-tive bacilli,excepting Pseudomonas aeruginosa had good sensitivity to Amikacin,Pseudomonas aeruginosa and Acinetobacter bau-mannii showed high resistance to most antibiotics(resistance rate was more than 50.0%).Among gram positive bacteria,the detec-tion rates of meticillin-resistant Staphylococcus aureus and methicillin-resistant coagulase negative Staphylococcus were 42.3% and 65.6%,respectively.The resistance rates of Enterococcus faecium to most of antibacterials were higher.Except for linezolid and teicoplanin,the resistances of Enterococcus faecium to other antibacterials were higher than those of Enterococcus faecalis.Only a strain of Enterococcus faecium resistant to vancomycin was isolated.Conclusion Resistance monitoring might have significance in guiding the clinical rational use of antimicrobial agents,and reducing the spread of antibiotic resistance in bacteria.

Objective To understand the drug resistance of Escherichiacoli in the bloodstream infections from community infec-tion and hospital infection,in order to provide the basis for clinical rational drug use.Methods According to the CLSI 2013 stran-dard,VITEK-2GN and AST-GN13 cards from France Bio-merieux company were used to identify the bacteria and analyze the drug susceptibility.The data was analyzed by SPSS 13.0.Results A total of 181 strains of Escherichiacoli were isolated from communi-ty-acquired and hospital-acquired bloodstream infections from January to December in 2014.There were 88 strains of community in-fection and 93 strains of hospital infection.The rates of ESBLs (+)strains isolated from community infection and hospital infection were 53.4% and 73.1% respectively.The ESBLs (+)rate of Escherichiacoli isolated from community infection was significantly lower than that from hospital infection (P =0.006).Antibiotics of resistance less than 10% in 181 strains of Escherichiacoli were Cefoperazone/Sulbactam,Piperacillin/Tazobactam,Ertapenem,Imipenem,Amikacin.The resistant rate of Hospital infection strains was generally higher than that of community infection strains.The ESBLs (+)rate of Escherichiacoli isolated from bloodstream in-fections of Urology Surgery wsa higher than that of other departments.Conclusion The drug resistance of Escherichiacoli in the bloodstream infections from hospital infection is higher than that from community infection.Using antibiotics rationally and strengthening the nosocomial infection surveillance of ICU and Surgery Ward are effective measures to control the bacterial drug re-sistance.

Gastric cancer is one of the most common malignancies and a leading cause of cancer mortality worldwide. The pathogenesis mechanisms of gastric cancer are still not fully clear. Inactivation of tumor suppressor genes and activation of oncogenes caused by genetic and epigenetic alterations are known to play significant roles in carcinogenesis. Accumulating evidence has shown that epigenetic silencing of the tumor suppressor genes, particularly caused by hypermethylation of CpG islands in promoters, is critical to carcinogenesis and metastasis. Here, we review the recent progress in the study of methylations of tumor suppressor genes involved in the pathogenesis of gastric cancer. We also briefly describe the mechanisms that induce tumor suppressor gene methylation and the status of translating these molecular mechanisms into clinical applications.
Apoptosis ; Cell Adhesion ; Cell Cycle ; CpG Islands ; genetics ; DNA Methylation ; DNA Repair ; Epigenesis, Genetic ; Genes, Tumor Suppressor ; Helicobacter Infections ; genetics ; Helicobacter pylori ; Humans ; Neoplasm Invasiveness ; Promoter Regions, Genetic ; genetics ; Stomach Neoplasms ; genetics ; metabolism ; microbiology ; pathology ; Tumor Suppressor Proteins ; genetics ; metabolism

OBJECTIVETo investigate the ultrastructure of myocardium and gene expression of calcium handling proteins in diabetic rat heart.

METHODSDiabetes was induced in male Sprague-Dawley rats by a single injection of alloxanm (40 mg/kg ) and the rats in control group were injected with normal saline. At the end of 2, 4, 6 weeks after the induction of diabetes, the animals were sacrificed. The expression of calcium handling proteins was detected by reverse transcription-polymerase chain reaction (RT-PCR) and actin mRNA was used as internal standard. Heart tissue at the apex was obtained for light and electron microscope study.

RESULTSAt the end of 4 and 6 weeks, cardiosomatic ratio of diabetic rats was higher than that of control. Electron microscopy revealed a spectrum of subcellular remodeling in myocardium which was characterized by damaged myofibrils and mitochondria, dilated and swollen sarcoplasmic reticulum. Expression of phospholamban mRNAs was significantly increased, but 1,4,5-trisphosphate inositol receptor type 2, ryanodine receptor type 2 mRNAs were significantly decreased compared with those in the age-matched control rats. In contrast, the expression of sarco/endoplasmic reticulum Ca(2+)-ATPase mRNAs was not affected.

CONCLUSIONIn diabetic rat heart, gene expression of calcium handling proteins was characterized by up-regulation of phospholamban and down-regulation of sarcoplasmic reticulum calcium release channel while electron microscopic analysis of myocardium revealed a spectrum of subcellular remodeling.

Animals ; Calcium ; metabolism ; Calcium Channels ; metabolism ; Calcium-Binding Proteins ; biosynthesis ; genetics ; metabolism ; Diabetes Mellitus, Experimental ; metabolism ; pathology ; Endoplasmic Reticulum ; metabolism ; ultrastructure ; Male ; Myocardium ; metabolism ; ultrastructure ; RNA, Messenger ; biosynthesis ; genetics ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Sarcoplasmic Reticulum ; metabolism ; ultrastructure

To investigate the effects of neuronal histamine on spatial memory acquisition impairment in rats with pentylenetetrazole-kindling epilepsy, and to explore its mechanisms.A subconvulsive dose of pentylenetetrazole (35 mg/kg) was intraperitoneally injected in rats every 48 h to induce chemical kindling until fully kindled. Morris water maze was used to measure the spatial memory acquisition of the rats one week after fully pentylenetetrazole-kindled, and the histamine contents in different brain areas were measured spectrofluorometrically. Different dosages of hitidine (the precursor of histamine), pyrilamine (H1 receptor antagonist), and zolantidine (H2 receptor antagonist) were intraperitoneally injected, and their effects on spatial memory acquisition of the rats were observed.Compared with control group, escape latencies were significantly prolonged on Morris water maze training day 2 and day 3 in pentylenetetrazole-kindling epilepsy rats (all<0.05); and the histamine contents in hippocampus, thalamus and hypothalamus were decreased significantly (all<0.05). Escape latencies were markedly shortened on day 3 by intraperitoneally injected with histidine 500 mg/kg, and on day 2 and day 3 by intraperitoneally injected with histidine 1000 mg/kg in pentylenetetrazole-kindling epilepsy rats (all<0.05). The protection of histidine was reversed by zolantidine (10 and 20 mg/kg), but not by pyrilamine.Neuronal histamine can improve the spatial memory acquisition impairment in rats with pentylenetetrazole-kindling epilepsy, and the activation of H2 receptors is possibly involved in the protective effects of histamine.
Animals ; Benzothiazoles ; pharmacology ; Brain Chemistry ; drug effects ; Epilepsy ; chemically induced ; complications ; Hippocampus ; chemistry ; Histamine H1 Antagonists ; pharmacology ; Histamine H2 Antagonists ; pharmacology ; Histidine ; pharmacology ; Hypothalamus ; chemistry ; Kindling, Neurologic ; physiology ; Memory Disorders ; drug therapy ; etiology ; Pentylenetetrazole ; Phenoxypropanolamines ; pharmacology ; Piperidines ; pharmacology ; Pyrilamine ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Receptors, Histamine H2 ; drug effects ; physiology ; Spatial Memory ; drug effects ; Spectrometry, Fluorescence ; Thalamus ; chemistry

Hand Strength ; Humans ; Lumbar Vertebrae ; Minimally Invasive Surgical Procedures ; Retrospective Studies ; Spinal Diseases/surgery* ; Spinal Fusion ; Technology ; Treatment Outcome

Bone Diseases, Metabolic ; Fractures, Compression/surgery* ; Humans ; Osteoporotic Fractures/surgery* ; Spinal Fractures/surgery* ; Treatment Outcome