Objective To investigate the effect of ?-blockers on spatial dispersion of ventricular repolarization following acute myocardial ischemia.Methods Twenty sheep were randomized into control(normal saline i.v.)and atenolol group.Acute myocardial ischemia was induced by occlusion of the obtuse marginal coronary artery.Unipolar ECG was simultaneously acquired from 64 epicardial sites in both ischemic and non-ischemic regions.Activation-recovery intervals(ARI)were determined from the epicardial ECGs.The difference between the longest and shortest ARI was defined as ARI dispersion.Results Ischemic zone in the atenolol group was less than that of the control group[(13?2)% vs (19?3)%,P

ObjectiveTo evaluate the effect of high frequency oscillation ventilation (HFOV) vs. conventional mechanical ventilation (CV) on the treatment and prognosis of adult patients with acute respiratory distress syndrome (ARDS).Methods Published articles concerning randomized controlled trials (RCTs) about the effect of HFOV vs. CV on the prognosis of adult patients with ARDS published before May 2014 were retrieved from PubMed, EMBase, Cochrane central registry of controlled trials, CNKI and Wanfang Data. The mortality and data of physiological parameters were analyzed with STATA 12.0, and the mortality rate was also analyzed by trial sequential analysis with TSA 0.9, and the line chart was drawn with Microsoft Office Excel 2003.Results Seven trials with 1 731 patients met the criteria, all of them recorded the physiological parameters data, and mortality rate was mentioned in 6 trials (1 705 patients). Compared with CV, HFOV did not show any statistically significant beneficial effects on mortality [relative risk (RR) = 0.93, 95% confidence interval (95%CI) = 0.70-1.24,P = 0.63], and other clinical outcomes, including survival without mechanical ventilation (RR = 1.05, 95%CI = 0.72-1.54,P = 0.80), survival on mechanical ventilation (RR = 1.23, 95%CI = 0.65-2.35,P = 0.52), or treatment failure (RR = 0.89, 95%CI = 0.50-1.56,P = 0.67). The risk factors of adverse events including hypotension (RR = 0.89, 95%CI = 0.07-10.99,P =0.93), acidosis (RR = 1.05, 95%CI = 0.43-2.56,P = 0.91), and air leakage from ventilator (RR = 0.74, 95%CI = 0.31-1.80,P =0.51) were similar. But the physiologic parameters of patients and parameters of ventilator in HFOV group, including oxygenation index, positive end-expiratory pressure, tidal volume, mean airway pressure, arterial pH, partial pressure of arterial carbon dioxide, fraction of inspired oxygen, ratio of partial pressure of arterial oxygen to fraction of inspired oxygen, were better than those in the CV group. Methods adapted from formal interim monitoring boundaries applied to cumulative Meta-analysis showed that the evidence failed by a considerable degree to meet the standards for forgoing studies, and the necessary sample was 3 874 patients. Trial sequential analysis also showed that the accumulatedZ-score did not cross the traditional boundary (P = 0.05) and interim monitoring boundaries. This result indicated that there was no significant difference between CV and HFOV on mortality before the number of needed sample reached (3 874 cases). We could not get a definitive conclusion with current evidences.ConclusionsCompared with CV, the use of HFOV in ARDS was not associated with a significant reduction in mortality. But the physiologic parameters of patients in HFOV group were better than those in the CV group. More RCTs are needed to draw a definitive conclusion.

BACKGROUND:Adipose-derived stem cels are regarded as the potential seed cels for tissue engineering. Colagenase digestion is used to isolate adipose-derived stem cels from fat pads currently. However, there are some problems, such as cumbersome operation and high cost.
OBJECTIVE: To study the basic biological characteristics of adipose-derived stem cels by tissue explants culture and to explore the differentiation potential into osteoblasts, adipocytes and endothelial progenitor cels in vitro.
METHODS:Adipose-derived stem cels were isolated by tissue explants technique from the bilateral groin fat pads of rats under aseptic conditions, and cultured in vitro. Cel counting kit-8 was used to detect the proliferative activity, and flow cytometry was employed to analyze the expression of cel surface markers. Passage 4 adipose-derived stem cels were cultured in osteogenic medium, adipogenic medium and endothelial progenitor cel medium for 2-3 weeks, and then the cels were identified.
RESULTS AND CONCLUSION:Adipose-derived stem cels that were isolated by tissue explants culture were easily cultured, and after subculture, cels were mainly spindle-shaped and grew in clone-like manner with swirling arrangement. Cels that experienced repeated subcultures stil kept stronger proliferative ability and the cel growth curve was shaped as a parabola. Immunochemical staining analysis revealed that adipose-derived stem cels were positive for CD44, CD90 and CD29, but negative for CD31, CD45. After adipogenic/osteogenic induction, the cels were respectively positive for oil red O staining and alizarin red staining. Induced endothelial progenitor cels were identified with CD34 and the ability to uptake Dil-ac-LDL and FITC-UEA. These findings indicate using the using tissue explants culture, high-purity adipose-derived stem cels easy to proliferate can be harvested, highly express stem cels-related antigens, and have the ability to differentiate into osteoblasts, adipocytes and endothelial progenitor cels, which meet the needs of seed cels in tissue engineering research.

Objective To reveal the effect of lutein on the status of oxidative stress in rats with high homocysteine levels (HHcy) and relevent molecular mechanisms.Methods The wistar rat HHcy model was established by intra-gastric administration with L-methionine suspension and treated with lutein.The oxidative stress status and the gene expression changes of transcription Nf-E2-related factor2 (Nrf2),a regulation factor of down stream antioxidant protein gene expression,were detected in HHcy rats and lutein intervention rats.Results Compared with the rat serum SOD activities (134.32 ± 12.65) U/mL in the control group,the serum SOD activities in the HHcy model group (95.6 ± 10.92) U/mL were significantly lower (P ＜ 0.05).The serum glutathione peroxidase (GPx) activities in the HHcy model group (121.66 ± 18.64) U/mL were also significantly lower as compared with the the control group (183.17 ± 21.29) U/mL,P ＜ 0.05.However,the serum SOD (126.75 ± 11.26) U/mL and GPx activities (167.18 ± 19.66) U/mL in the lutein intervention group were significantly higher as compared with the HHcy model group.As compared with the rat serum malondialdehyde (MDA) content (5.11 ± 0.68) μmol/L as well as the hydroxyl free radical levels (0.53 ± 0.05) U/L in the control group,the serum MDA content (7.65 ± 0.87) μmol/L and the hydroxyl free radical levels (0.92 ± 0.09) U/L in the HHcy model group were significantly higher.The serum MDA content (6.44 ±0.91) μmol/L and the hydroxyl free radical levels (0.74 ± 0.06) U/L in the lutein intervention group were significantly lower as compared with the HHcy model group.RT-PCR and Western blot results also showed decreased expression of SOD2 and GPxl mRNA in aorta epithelial tissues of HHcy model rats.With lutein intervention,the expressions ofSOD2 and GPx1mRNA were significantly increased and the gene expression of Nrf2 also up-regulated.Conclusions The Hhcy model rats were under the status of augmented oxidative stress,and carotenoid lutein could attenuate the Hcy-mediated oxidative stress,and its mechanism might be potentially associated with up-regulating the expression of Nrf2,thereby inducing the expression of its downstream antioxidant proteins.

Objective To investigate the abnormal characteristics of electrocardiogram and its early diagnostic value in acute pulmonary embolism (PE) of different positions.Methods A total of 147 hospitalized patients of acute PE diagnosed by the pulmonary artery CT angiography (CTA) were enrolled in this study and divided into the following two groups:pulmonary trunk or main pulmonary artery (MPA) embolism (group A) and lobar artery or remote branch embolism (group B).ECG,D-dimer,BNP,cTnT were collected and determined,the varieties of abnormal ECG were counted.Then,the relationships between the severities of the PEs at different positions and the corresponding ECG abnormalities as well as the degree of right ventricular hypertrophy (RVH) were analyzed.Results There were significant differences in dyspnea,syncope,in-hospital mortality and the level of cTnT,BNP between the two groups (P ＜ 0.05).There were significant differences in the occurrence of SIQ Ⅲ T Ⅲ,right bundle branch block (RBBB),ST segment depression (STD) in leads Ⅲ and aVF,ST segment elevation (STE) in lead aVR,negative T waves (NTWs) in leads Ⅲ and aVF,STD in leads V1-V3/V6,and STE in leads V1-V3 in combination with STD in leads V4-V6 between the two groups (P ＜ 0.05).The proportion of RVH diagnosed via ECG has significantly different between the two groups.The result of correlation analysis showed that the incidence of pulmonary trunk or MPA embolism was significantly related to the number of ECG abnormalities (r =0.782,t =-7.086,P ＜ 0.05).Conclusions The number of abnormal ECGs increase and the RVH is more serious when PE occurring in pulmonary trunk as well as in the MPA,early recognition of electrocardiographic abnormalities is of greater value in the diagnosis of acute pulmonary trunk and MPA embolism.

Objective: To evaluate the anal sphincter function of congenital anorectal malforotation retrospectively.Methods: With continuous pull through technique, the manometry of 22 congenital anorectal malforotation patients and 24 controls were studied and the results were analysed with their clinical scores. Results: Anal resting pressure in the children with neurogenic anorectum induced by myelodysplasia(21.3?3.4) mmHg was lower than that in normal children(66.7?24.0) mmHg.The maximum contractive pressure of anus in the patients(22.4?3.3) mmHg was lower than that in normal children(129.0?18.8) mmHg. The length of high pressure zone in the patients(12.3?4.6 mm) was lower than that in normal children(23.6?4.6 mm). Rectoanal inhibitory reflex was identified in both patients and normal children. Conclusion:Anorectal manometry might be an effective parameter to evaluate the anal sphincter function of congenital anorectal malformation.

Objective Objective The present study was to increase the awareness of nonalcoholic Wernicke's encephalopathy ( WE) to reduce its misdiagnosis.Methods The clinical features and MR imaging findings in 6 patients with nonalcoholic WE were retrospectively analyzed.Results All patients exhibited different degrees of unconsciousness.Only two patients presented with the typical triad of neuro-ophthalmologic manifestations, ataxia, and global confusion.All patients presented with typical MR features characterized by bilaterally altered signal of the medial thalamus, periventricular region of the third ventricle and periaqueductal area. In addition, two patients developed symmetric cortical and facial nerve nucleus involvements with deep coma, which was clinically rare.The average clinical recovery and MRI imaging recovery times were 7.5 months and 2.8 months, respectively,.Two patients with deep coma showed a poor prognosis:1 patient died, and the other had a sever spastic paralysis of her extremities and mental retardation during a follow -up of 2 years.Two patients with deep coma showed symmetric hyperintensities on diffusion -weighted imaging ( DWI) .Conclusions MRI images are useful in the early diagnosis of nonalcoholic WE.Cortical and cranial nerve nucleus involve-ment in nonalcoholic WE patients may be an indication of irreversible damage and a poor prognosis.In addition, hyperintensities on DWI may also indicate an unfavorable prognosis.

Objective Brain natriuretic peptide(BNP) is released from the cardiac ventricles in response to increased wall tension. The prognostic significance of blood brain natriuretic peptide in Chinese patients with cardiovascular disease has not been established. The purpose of this study was to investigate the value of brain natriuretic peptide for predictin g cardiac death within 1 month in Chinese patients with cardiovascular disease. Methods One hundred and seven inpatients with cardiovascular disease, whose blood brain natriuretic peptide concentration were measured within 1 - 3 days of admission, using triage BNP test, were divided into 2 groups: the survival and the non-survival, according to the results of 1was positively correlated with heart rate, left ventricular end-diastolic dimension, history of heart failure and old myocardial infarction (r=0.28, P=0. 000 4; r=0.49, P＜0. 000 5; r=0.39, P＜0. 000 5; r=Area under the curve of the receiver-operating-characteristic(ROC) of brain natriuretic peptide to predict cardiac death at 1 month in patients with cardiovascular disease was 0.89%, 95% confidence interval 0.79-0. 98, P＜0. 000 5; stepwise logistic regression analysis indicated that brain natriuretic peptide (≥755pg/mL) was the only independent predictor of cardiac death at 1 month in patients with cardiovascular disease (OR= 17.6, 95 % confidence interval, 8.7- 66.5, P＜0. 000 5 ). Conclusion Brain natriuretic peptide might predict cardiac death at 1 month in patients with cardiovascular disease.

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Objective To approach the significance of procalcitonin(PCT)in judgment of the degree of severity in patients with acute pancreatitis(AP). Methods A prospective method was conducted in the study. Ninety-eight patients with AP admitted from April 2013 to December 2013 in the First Affiliated Hospital of Zhengzhou University were enrolled. They were divided into mild AP(MAP,48 cases)and severe AP(SAP,50 cases)groups, biliary AP(58 cases)and non biliary AP(40 cases)groups,and biliary SAP and biliary MAP groups,non biliary SAP and non biliary MAP groups. The venous blood levels of PCT on the first day and second day after admission were assayed for all the patients,and the correlations between PCT levels on the two time points respectively and each of the following items were calculated:Ranson score,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,CT grade,number of organ dysfunction,intensive care unit(ICU)time of stay and total time of hospitalization. Results On the second day after admission,the PCT levels in groups different in etiology and groups different in severity were all elevated and higher than those on the first day,the level in SAP group being significantly higher than that of MAP group〔3.723(2.538,9.023)vs. 0.282(0.166,1.348),P<0.01〕,the level in biliary AP group being higher than that in non biliary AP group〔2.567(1.483,8.412)vs. 2.391(1.262,7.453),P>0.05〕,the level in biliary SAP group being higher than that in biliary MAP group〔4.023(3.273,10.015)vs. 0.305 (0.244,1.413),P<0.01〕,and the level in non biliary SAP group being higher than that in non biliary MAP group〔3.624(2.454,8.993)vs. 0.256(0.144,1.137),P<0.01〕. The correlations between PCT levels on the first day and second day after admission and each of the following items were respectively as follows:the correlations with Ranson score〔relative risk (RR1)=0.643,P1=0.001,95% confidence interval(95%CI1):0.435-1.596;RR2=0.762, P2=0.001,95%CI2:0.692-1.541〕,APACHE Ⅱ score(RR1=0.543,P1=0.009,95%CI1:0.842-1.512;RR2=0.672,P2=0.001,95%CI2:0.747-1.234)and CT grade(RR1=0.231,P1=0.048,95%CI1:0.596-1.412;RR2=0.256,P2=0.032,95%CI2:0.702-1.324)were all positive;the higher the number of organ dysfunction,the higher the level of PCT(RR1=0.321,P1=0.023,95%CI1:0.763-2.588;RR2=0.389,P1=0.020,95%CI2:0.683-1.742);the level of PCT had relatively favorable correlation with ICU time of stay(RR1=0.423,P1=0.019,95%CI1:0.779-1.459;RR2=0.453,P2=0.010,95%CI2:0.684-1.853),but there was no correlation between the level and the total time of hospitalization(RR1=0.004,P1=0.067,95%CI1:0.864-2.071;RR2=0.009,P2=0.078,95%CI2:0.645-1.376). Conclusion The level of PCT can be used in judgment of the degree of severity of the patients with AP,not only it can be applied in patients biliary in origin,but also can be used in patients non biliary in origin.