Objective To evaluate the effect of HTK solution on myocardial protection during valve replacement surgery.Methods 42 patients with rheumatic heart disease were randomized to receive 4∶1cold blood (control group,n =21 ) and HTK ( protective gronp,n =21 ) cardioplegic solution during valve replacement.The changes of CO and CI were collected at different time points including pre-operation,postoperative 6 hours,12 hours and 24 hours.Aortic clamping time,the ratio of spontaneous cardiac rhythm recovery and inotropic drugs application were calculated,and mechanical ventilation support time and the incidence of arrhythmia were recorded.Results The measurements of CO and CI showed that there was significant higher level in protective group at postoperative 12 hours and 24 hours [ 12 h:(4.82 ± 0.18 ) L/min vs ( 3.50 ± 0.32 ) L/min,( 3.80 ± 0.48 ) L/( min · m2 ) vs (2.79 ± 0.39) L/( min · m2 ) ;24 h:(4.97±0.45)L/min vs ( 3.81 ±0.19)L/min,(4.22±0.17)L/(min · m2) vs (2.91 ±0.21)L/(min·m2 ),P ＜ 0.05].The clinical parameters including aortic clamping time,incidence of cardiac arrhythmia,inotropic support,duration of mechanical ventilation and length was lower than in control group [ (53.6 ±24.3 ) min vs ( 68.9 ± 26.1 ) min ; ( 1.8 ± 1.3 ) min vs ( 2.3 ± 1.2 ) min ; ( 33 ± 11 ) min vs ( 42 ± 13 ) min ;(10.2±2.1) μg/(kg · min) vs (15.7 ±3.8) μg/(kg · min);(14.6 ±4.8)h vs (20.7 ±5.1)h,P ＜0.05].The auto-beating rate was higher than in control group (90％ vs 67％,P ＜0.05).Conclusions HTK solution is better than classical blood cardioplegia in myocardial protection during valve replacement.

Objective To determine the changes in phosphorylation of conventional protein kinase C?(cPKC?)-interacting extracellular signal regulated kinase 1/2(ERK1/2) in the hippocampus of hypoxic preconditioned(HPC) mice.Methods Healthy male BalB/c mice were used to develop "auto-hypoxia"-induced HPC mice and randomly divided into 3 groups as follows: normoxic control(H0),early(H3) and delayed hypoxic preconditioned groups(H6).Co-immunoprecipitation and Western blot were applied to quantitatively analyze the phosphorylation level of cPKC?-interacting ERK1/2 in cytosolic and particulate fractions of hippocampus of HPC mice.ResultsERK1/2 was co-immunoprecipitated by cPKC? in hippocampus of mice.The phosphorylation level of cPKC? interacting ERK1/2 at tyrosine 204 decreased significantly in the hippocampus of H3 and H6 groups as compared with that of the H0 group(P

Objective To observe the effect of rosuvastatin and memantine on EPC and learning or memory ability in VaD rats .Methods Forty adult male SD rats were randomly divided into sham operation group ,VaD model group ,memantine treatment group ,rosuvastatin treatment group , and memantine+rosuvastatin treatment group (combined treatment group) (8 in each group) .A VaD model was established by permanent ligation of bilateral common carotid arteries .The ani‐mals in rosuvastatin treatment group ,memantine treatment group and combined treatment group received gastric rosuvastatin 10 mg/(kg · d) ,memantine 10 mg/(kg · d) and memantine 10 mg/(kg · d)+rosuvastatin 10 mg/(kg · d) for 4 weeks while those in model group received gastric normal saline .Five weeks after operation ,the learning or memory ability was tested by Morris water maze test ,the escape latency and percentage of target quadrant were calculated ,the circulat‐ing EPC were detected by flow cytometry ,and the MVD in hippocampaus was assyed with vWF immunostaining .Results Five weeks after operation ,the learning or memory ability was signifi‐cantly lower in model group than in sham operation group (P< 0 .01) whereas the learning or memory ability ,the percentage of circulating EPC and the MVD in hippocampus were significantly higher in 3 treatment groups than in model group (P<0 .05) .Conclusion Rosuvastatin and me‐mantine can effectively improve the learning or memory ability of VaD rats by mobilizing their cir‐culating EPC and increasing the MVD in their hippocampus .However ,the effect of memantine or rosuvastatin does not differ greatly w hen they are used alone .

Objective To establish a digital segmentational data set of larynx based on Chinese visible human (CVH). Methods Magnetic lasso and polygon tools of Photoshop were used to segment the small organs and structures of larynx of CVH to establish the segmentational data set of larynx. After conversion of the image format, the segmentational structures were extracted automatically with Thresholding Method and presented 3-D visualized, and then were checked up by its result of 3D reconstruction with Amira 4.1 software. Results Many small structures of larynx were segmentated, such as laryngeal cartilage, laryngeal muscles, vocal cords and so on. Then the segmentational data set of larynx based on CVH was established, which can be used to 3-D reconstruction accurately. Conclusion The segmentational data set of larynx is accurate and integrated, which is helpful to establish the elaborate model of larynx and can provide the method of color image segmentation.

Objective To investigate the influence of different timing of surgery on patients with poor-grade intracranial aneurysm. Methods The clinical data of 86 patients with aneurysmal subarachnoid hemorrhage (Hunt-Hess gradeⅣ toⅤ)were analyzed retrospectively. The patients were divided into an ultra-early treatment group (the operative time within 24 h after onset;n=40),an early treatment group, (24 to 72 h after onset;n=27),and middle and late treatment group (>72 h after onset;n=19)according to the different timing of surgery. The prognosis of patients at 6 months after procedure was evaluated with the modified Rankin Scale (mRS)scores. The differences of the rate of good prognosis (mRS 0 to 2)and mortality in patients of the 3 groups were compared. Results (1 )The ratios of good prognosis in the ultra-early treatment group,early treatment group,and middle and late treatment group were 55. 0%(n=22),33. 3%(n=9),and 21. 1%(n=4),respectively. There were significant differences (P<0. 05). The mortality rate of the ultra-early treatment group (7. 5%)was lower than that of the early treatment group (25. 9%) or middle and late treatment group (42. 1%). There were significant differences (P<0. 05). (2)There were significant differences in the rate of good prognosis in different timing of surgery in patients with gradeⅣ(P<0. 05);there was no significant difference in the rate of good prognosis in patients with grade Ⅴ(P>0. 05). The mortality ratios in patients of the 3 groups were 2/18,4/11,and 6/11,respectively. There were significant differences (P<0. 05). Conclusion Ultra-early operation may benefit part of the patients with poor-grade aneurysm,particularly in patients with gradeⅣ. As for the patients with grade Ⅴ, ultra-early operation may help to reduce short-term mortality rate,however,the rate of vegetative state is high.

Objective To confirm the diagnosis and to localize the pathogenic gene of ectodermal dysplasia in a family SUffering from only hair and nail abnormalities.MethodsBlood samples were collected from 7 affected patients and 15 unafiected individuals in the family.Genomic DNA was extracted from blood samples by routine phenol-chloroform methods.The whole coding regions of candidate genes K16,K17,K6a,K6b and GJB6 were amplified by PCR followed by direct sequencing.Then,the gene mutation was further confirmed at mRNA level by RT-PCR.ResultsA heterozygous missense mutation 3 1G→A in the GJB6 gene.which leads to the substitution of glycine by arginine at codon 11(G11R)on the N-terminal of the protein,was detected in all the patients.but in none of the 15 normal individuals in this family.The mutation was also confirmed in the CDNA originating from the proband's skin biopsy.Conelusionn A missense mutation G31A.which has been shown previously to cause hidrotic ectodermal dysplasia(HED),is localized in the GJB6 gene of patients in this family.

ObjectiveTo observe the expression of bone sialoprotein(BSP) and matrix metalloproteinase-9 (MMP-9) in calcified valves of patients with rheumatic heart disease.MethodsA total of 150 mitral valves which were resected by surgery were divided into rheumatic group ( 120 valves) and nonrheumatic group (30 valves).Immunohistochemical staining was taken by SP method and the expressions of BSP and MMP-9 in two groups were observed and compared.ResultsThe positive expressions of BSP and MMP-9 in rheumatic group were 91.7％(110/120) and 90.8％(109/120),respectively,which were significantly higher than those in non-rheumatic group [23.3％(7/30) and 20.0％(6/30) ](P＜ 0.01 ).Conclusions The expressions of both BSP and MMP-9 are higher in the valves of patients with rheumatic heart disease.The calcification of rheumatic mitral valves is closely related with the degradation and remodeling of extracellular matrix caused by MMP-9,and osteoblast-like bone formation induced by BSP.

Objective To investigate the expression and significance of bone sialoprotein and matrix metalloproteinase-9 in calcified mitral valves in patients with rheumatic heart disease.Methods A total of 150 mitral valves were divided into the rheumatic group (n =120) and the non-rheumatic group (n =30 ).Expressions of bone sialoprotein and matrix metalloproteinase-9 were determined by immunohistochemistry.Results Expressions of bone sialoprotein ( 91.6％,x2 =56.6354 ) and matrix metalloproteinase-9 ( 90.8％,x2 =59.4272) in the rheumatic group increased significantly than in the non-rheumatic group (P ＜ 0.01).Conclusion Both bone sialoprotein and matrix metalloproteinase-9 are highly expressed in the calcified rheumatic group.This suggests that caficify of rheumatic mitral valves is related with the degradation and remodeling of extra cellular matricx by matrix metalloproteinase-9,as well as osteoblastlike bone formation by bone sialoprotein.

Thyroid emergency is a rare but potent ially life-threatening condition if not recognized early and managed properly. It is usually due to a severe exacerbation of a preexisting thyrotoxicosis, which later leads to decompensation in different organ systems. The treatment of thyroid emergency remains challenging even with the armamentarium of modern intensive care technologies, especially in patients with cardiac failure and major organ dysfunction.[1–3] Herein, the authors described a case of thyroid emergency with cardiac arrest (CA) supported by extracorporeal membrane oxygenation (ECMO).

OBJECTIVE To evaluate the long-term toxicity of fully human anti-human tumor necrosis factor-α monoclonal antibody(anti-hTNF-α FHMA)for injection in cynomolgus monkeys. METHODS Forty cynomolgus monkeys were randomly divided into 5 groups (4 males and 4 females in each group):negative control group,adalimumab 10 mg·kg-1 group,anti-hTNF-αFHMA 2,10 and 50 mg·kg-1 groups. Cynomolgus monkeys in each group were injected sc once a week for 5 consecutive times, followed by 4 weeks of recovery. During the test,general clinical observation,body mass,body temperature,electrocardiogram(ECG),hematology,coagulation function,blood biochemistry,urine, ophthalmology,immune index,and pathological changes in organs and tissues were observed. At the same time,plasma drug concentrations were detected and the toxicokinetics parameters were analyzed. RESULTS No significant toxicological changes related to drugs were observed in general clinical observation,body mass,body temperature,ECG,ophthalmic examination,blood cell counts,coagu?lation function,blood biochemistry,urine analysis,lymphocyte subsets,cytokines,serum immuno?globulin,serum complement. Neutralizing anti-drug antibody(ADA)could be detected in adalimumab group and anti-hTNF-αFHMA groups. Anti-hTNF-αFHMA showed linear dynamic characteristics in cyno?molgus monkeys. At the same dose(10 mg·kg-1),anti-hTNF-αFHMA had similar immunogenicity and kinetics characteristics to adalimumab. CONCLUSION The level of anti-hTNF-α FHMA at which no adverse effect was observed was 50 mg · kg-1,which is equivalent to 75 times clinical dosage of quasi (0.67 mg·kg-1),which suggests that anti-hTNF-αFHMA be safe in clinical use.