Objective:To explore th five year survivals and some prognostic factors for bres at cancer patients in the north areas of China,and the indentification or differ e nces on these variables among breast cancer patients between in China and in Can ada.Methods:All Data were collected from the hospital records of 1 002 breast cancer patients who were initially treated at the First Hospital of Jilin Uni versity (116 cases FTH,Changchun China) and the Sain t-Sacrement Hospital (886 cases in SSH,Quebec Canada) respectively by use of Historical Cohort survey,and the survival propotions were calculated and comp ared stradly by use of Kaplan-Meier method.Results:Age at diagnosis was substantially lower (average of age about 10 years less) among breast cancer patients seen at FTH compared to those treated at SSH (P<0.0001).Patients in the two hospitals differed in respect to tumor size at pathology (P=0.036).The proportion of women with lymph node involvement was greater at FTH (61.1%) than that at HSS(37.3%)(P<0.0001).Surgical treat ment of breats cancer was varied considerably:the radical mastectomy was frequen tly performed for andy stage of breast cancer patients in Changchun,but the part ial mastectomy was mainly used for patients with stage Ⅰ or Ⅱ in Quebec.The fi ve year survival was 74.2% among breast cacer patients seen at FTH compared to 7 6.3% among women treated at HSS,and there was no singnificant differrence (P =0.302). Conclusion:Five year survival of breast cancer patients treated surgically in C hangchun,China,was similar to that of patients treated surgically in Quebec,Can ada except for differences in age at diagnosis,tumor size and lymph node involve ment

Objective To investigate the efficacy and safety of tirofiban for emergency interventional therapy in patients with acute ST segment elevation myocardial infarction.Methods The 96 acute ST segment elevation myocardial infarction patients having accepted emergency percutaneous coronary intervention (PCI) were divided into treatment group and control group according to the treatment method with 48 cases each.The treatment group was given conventional standard treatment combined with tirofiban treatment [tirofiban intracoronary injection 10 μ g/kg and then intravenous 0.15 μ g/(kg· min) for 24-48 h].The control group was given conventional standard treatment only.The postoperative 60 min electrocardiogram ST segment recovery,the coronary blood flow TIMI grade,the major adverse cardiac events (angina,myocardial infarction,heart failure,death) and postoperative bleeding in 4 weeks were compared between the two groups.Results The patients having postoperative 60 min electrocardiogram ST segment recovery in treatment group was 45 cases (93.8％,45/48),in control group was 35 cases (72.9％,35/48),and there was statistical difference (P ＜ 0.05).The incidence rate of infarction vascular TIMI grade ≥ 3 grade flow in treatment group was 95.8％ (46/48),in control group was 75.0％ (36/48),and there was statistical difference (P ＜ 0.05).The incidence rate of the major adverse cardiac events 4 weeks in treatment group was significantly lower than that in control group,and there was statistical difference (P ＜ 0.05).There was no statistical difference in the incidence rate of bleeding between the two groups (P ＞ 0.05).Conclusion In patients with acute ST segment elevation myocardial infarction,the emergency interventional therapy with tirofiban is efficacy and safety.

Objective To explore the status,developing demands and directions of the education and training of military medical equipment.Methods The main problems of the PLA's medical equipment education and training were analyzed via being compared with those of foreign armies.According to the requirements on the campaign mode changing in the future war,the innovating mode under information-based military training,and the research and exploration of novel equipment and new technology,the developing directions in the future were ascertained.Results The interface was enhanced between new medical equipment development and educational training,and specifications were prepared for medical equipment application and maintenance.Conclutsion Exploring the pivot choke points and the developing directions will provide strategy guidance on the rapid and highly efficient elevation of military medical equipment supporting capacity.

ObjectiveTo investigate the feasibility of using pulse oximetry plethysmographic waveform (POP) to identify the restoration of spontaneous circulation (ROSC) during cardiopulmonary resuscitation (CPR).Methods An observational research was conducted. A porcine model of ventricular fibrillation (VF) arrest was reproduced. After 3 minutes of untreated VF, animals received CPR according to the latest CPR guidelines, providing chest compressions to a depth of 5 cm with a rate of 105 compressions per minute and instantaneous mechanical ventilation. After 2 minutes of CPR, animals were defibrillated with 100 J biphasic, followed by continuous chest compressions. Data of hemodynamic parameters, partial pressure of end-tidal carbon dioxide (PETCO2) and POP were collected. The change in POP was observed, and the characteristics of changes of the waves were recorded during the peri-CPR period using the time and frequency domain methods.Results VF was successfully induced in 6 pigs, except 1 death in anesthesia induction period.① After VF, invasive blood pressure waveform and POP of the animals disappeared. PETCO2 was (18.83±2.71) mmHg (1 mmHg=0.133 kPa), and diastolic arterial pressure was (23.83±5.49) mmHg in compression stage. Animals attained ROSC within 1 minute after defibrillation, with PETCO2 [(51.83±9.35) mmHg] and diastolic arterial pressure [(100.67±10.97) mmHg] elevated significantly compared with that of compression stage (t1 = 8.737,t2 = 25.860, bothP = 0.000), with appearance of arterial blood pressure waveform.② Characteristic changes in POP were found in all experimental animals. During the stages of induced VF, compression, ROSC, and compression termination, POP showed characteristic waveform changes. POP showed disappearance of waveform, regular compression wave, fluctuation hybrid and stable pulse wave in time domain method; while in the frequency domain method waveform disappearance, single peak of compression, double or fusion peak and single peak of pulse were observed.Conclusion Analysis of POP using time and frequency domain methods could not only quickly detect cardiac arrest, but also show a role as a feasible, non-invasive marker of ROSC during CPR.

OBJECTIVETo examine long-term efficacy of percutaneous transluminal coronary angioplasty (PTCA), coronary stenting and to assess the factors affecting its efficacy.

METHODSA total of 790 patients who underwent successful PTCA and PTCA + stent in this hospital were followed by direct interview or letter. The rate of follow-up was 84.2% and the period of follow-up was 0.9 - 12.7 (3.5 +/- 2.4) years.

RESULTSDuring follow-up, 4 (0.5%) patients died, 22 (2.8%) had nonfatal acute myocardial infarction, 10 (1.3%) had coronary artery bypass surgery, and 98 (12.4%) had repeat PTCA. The rate of recurrent angina pectoris was 31.1%. The cardiac event-free survival rate calculated by the Kaplan-Meier method was 88.2% at 1 year and 80.6% at 12.7 years. Cox regression analysis showed that there was a positive correlation between AMI history, stent implantation and the risk of cardiac events, and there was a negative correlation between the number of diseased arteries and the risk of cardiac events. Compared to the PTCA group, patients with PTCA + stent had significantly lower rates of total cardiac events.

CONCLUSIONThe long-term efficacy of PTCA, especially PTCA + stent in Chinese patients was very satisfactory, suggesting that PTCA + stent therapy should be the major treatment for revascularization in patients with coronary heart disease.

Adult ; Aged ; Angina Pectoris ; etiology ; Angioplasty, Balloon, Coronary ; adverse effects ; Coronary Stenosis ; mortality ; therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Myocardial Infarction ; etiology ; Retrospective Studies ; Stents ; adverse effects ; Survival Rate ; Treatment Outcome

OBJECTIVETo study the accuracy of pulse contour cardiac output (PCCO) during blood volume change.

METHODSHemorrhagic shock model was made in twenty dogs followed by volume resuscitation. Two PiCCO catheters were placed into each model to monitor the cardiac output (CO). One of catheters was used to calibrate CO by transpulmonary thermodilution technique (COTP) (calibration group), and the other one was used to calibrate PCCO (none-calibration group). In the hemorrhage phase, calibration was carried out each time when the blood volume dropped by 5 percents in the calibration group until the hemorrhage volume reached to 40 percent of the basic blood volume. Continuous monitor was done in the none-calibration group.Volume resuscitation phase started after re-calibration in the two groups. Calibration was carried out each time when the blood equivalent rose by 5 percents in calibration group until the percentage of blood equivalent volume returned back to 100. Continuous monitor was done in none-calibration group. COTP, PCCO, mean arterial pressure (MAP), systemic circulation resistance (SVR), global enddiastolic volume (GEDV) were recorded respectively in each time point.

RESULTS(1) At the baseline, COTP in calibration group showed no statistic difference compared with PCCO in none-calibration group (P >0.05). (2) In the hemorrhage phase, COTP and GEDV in calibration group decreased gradually, and reached to the minimum value (1.06 ± 0.57) L/min, (238 ± 93) ml respectively at TH8. SVR in calibration group increased gradually, and reached to the maximum value (5 074 ± 2 342) dyn · s · cm⁻⁵ at TH6. However, PCCO and SVR in none-calibration group decreased in a fluctuating manner, and reached to the minimum value (2.42 ± 1.37) L/min, (2 285 ± 1 033) dyn · s · cm⁻⁵ respectively at TH8. COTP in the calibration group showed a significant statistic difference compared with PCCO in the none-calibration group at each time point (At TH1-8, t values were respectively -5.218, -5.495, -4.639, -6.588, -6.029, -5.510, -5.763 and -5.755, all P < 0.01). From TH1 to TH8, the difference in percentage increased gradually. There were statistic differences in SVR at each time point between the two groups (At TH1 and TH4, t values were respectively 2.866 and 2.429, both P < 0.05, at TH2 - TH3 and TH5 - TH8, t values were respectively 3.073, 3.590, 6.847, 8.425, 6.910 and 8.799, all P < 0.01). There was no statistic difference in MAP between the two groups (P > 0.05). (3) In the volume resuscitation phase, COTP and GEDV in the calibration group increased gradually. GEDV reached to the maximum value ((394±133) ml) at TR7, and COTP reached to the maximum value (3.15 ± 1.42) L/min at TR8. SVR in the calibration group decreased gradually, and reached to the minimum value (3 284 ± 1 271) dyn · s · cm⁻⁵ at TR8. However, PCCO and SVR in the none-calibration group increased in a fluctuating manner. SVR reached to the maximum value (8 589 ± 4 771) dyn · s · cm⁻⁵ at TR7, and PCCO reached to the maximum value (1.35 ± 0.70) L/min at TR8. COTP in the calibration group showed a significant statistic difference compared with PCCO in the none-calibration group at each time point (At TR1-8, t values were respectively 8.195, 8.703, 7.903, 8.266, 9.600, 8.340, 8.938, 8.332, all P < 0.01). From TR1 to TR8, the difference in percentage increased gradually. There were statistic differences in SVR at each time point between the two groups (At TR1, t value was -2.810, P < 0.05, at TR2-8, t values were respectively -6.026, -6.026, -5.375, -6.008, -5.406, -5.613 and -5.609, all P < 0.05). There was no statistic difference in MAP between the two groups (P > 0.05).

CONCLUSIONPCCO could not reflect the real CO in case of rapid blood volume change, which resulting in the misjudgment of patient's condition. In clinical practice, more frequent calibrations should be done to maintain the accuracy of PCCO in rapid blood volume change cases.

Animals ; Blood Volume ; Calibration ; Cardiac Output ; Disease Models, Animal ; Dogs ; Humans ; Monitoring, Physiologic ; Shock, Hemorrhagic ; diagnosis ; Thermodilution

[This corrects the article DOI: 10.1016/j.apsb.2019.02.003.].

Aberrant activation of NLRP3 inflammasome has been implicated in the pathogenesis of diverse inflammation-related diseases, and pharmacological molecules targeting NLRP3 inflammasome are of considerable value to identifying potential therapeutic interventions. Cardamonin (CDN), the major active ingredient of the traditional Chinese medicinal herb , has exerted an excellent anti-inflammatory activity, but the mechanism underlying this role is not fully understood. Here, we show that CDN blocks canonical and noncanonical NLRP3 inflammasome activation triggered by multiple stimuli. Moreover, the suppression of CDN on inflammasome activation is specific to NLRP3, not to NLRC4 or AIM2 inflammasome. Besides, the inhibitory effect is not dependent on the expression of NF-B-mediated inflammasome precursor proteins. We also demonstrate that CDN suppresses the NLRP3 inflammasome through blocking ASC oligomerization and speckle formation in a dose-dependent manner. Importantly, CDN improves the survival of mice suffering from lethal septic shock and attenuates IL-1 production induced by LPS , which is shown to be NLRP3 dependent. In conclusion, our results identify CDN as a broad-spectrum and specific inhibitor of NLRP3 inflammasome and a candidate therapeutic drug for treating NLRP3 inflammasome-driven diseases.

Psoraleae Fructus (PF) is a well-known traditional herbal medicine in China, and it is widely used for osteoporosis, vitiligo, and other diseases in clinical settings. However, liver injury caused by PF and its preparations has been frequently reported in recent years. Our previous studies have demonstrated that PF could cause idiosyncratic drug-induced liver injury (IDILI), but the mechanism underlying its hepatotoxicity remains unclear. This paper reports that bavachin isolated from PF enhances the specific stimuli-induced activation of the NLRP3 inflammasome and leads to hepatotoxicity. Bavachin boosts the secretion of IL-1β and caspase-1 caused by ATP or nigericin but not those induced by poly(I:C), monosodium urate crystal, or intracellular lipopolysaccharide. Bavachin does not affect AIM2 or NLRC4 inflammasome activation. Mechanistically, bavachin specifically increases the production of nigericin-induced mitochondrial reactive oxygen species among the most important upstream events in the activation of the NLRP3 inflammasome. Bavachin increases the levels of aspartate transaminase and alanine aminotransferase in serum and hepatocyte injury accompanied by the secretion of IL-1β via a mouse model of lipopolysaccharide-mediated susceptibility to IDILI. These results suggest that bavachin specifically enhances the ATP- or nigericin-induced activation of the NLRP3 inflammasome. Bavachin also potentially contributes to PF-induced idiosyncratic hepatotoxicity. Moreover, bavachin and PF should be evaded among patients with diseases linked to the ATP- or nigericin-mediated activation of the NLRP3 inflammasome, which may be a dangerous factor for liver injury.
Adenosine Triphosphate ; Animals ; Chemical and Drug Induced Liver Injury/etiology* ; Flavonoids ; Humans ; Inflammasomes ; Mice ; NLR Family, Pyrin Domain-Containing 3 Protein ; Nigericin