Cardiac Resynchronization Therapy ; China ; Chronic Disease ; Heart Failure ; therapy ; Humans ; Practice Guidelines as Topic

Hepatic fibrosis is a wound healing response to liver injury. Activated hepatic cell is thekey evidence in the pathological fibrosis,which results in synthesis of large quantities of extracellular matrix components. Cytokines secreted mostly by activated Kupffer cell were remarkabe factors which have been proposed to stimulate and inhibit the fibrosis process.The close relationship between hepatic fibrosis and cytokines has been investigated. The article summarizes some important cytokines and the cytokines which can be used as target of antifibrotic therapy.

BackgroundAllogenic immunological rejection is still the common cause of keratoplasty failure.Organ culture is a good choice for gradually attenuating corneal antigeniciy.However,the complicated regulatory mechanism of such allogenic rejection with organ culture gratts is unclear until now.ObjectiveTo investigate the changes of several Thl/Th2 cytokines and T lymphocyte subsets in the rat corneal allogenic transplantation rejection with organ culture grafts.MethodsThirty-six SPF Wistar rats served as donors,and 72 SPF SD rats served as recipients in this study.Seventy-two SD rats were divided into two groups randomly.Organ culture and fresh grafts from Wistar rats were performed on 36 recipients SD rats,respectively.Six normal SD rats were served as the normal control.After transplantation,graft survival time was observed ; Aqueous humor levels of IL-2,IFN-γ,IL-4 and TNF-α were measured by enzyme linked immunosorbent assay.Immunohistochemistry was performed to examine CD25 expressions in grafts.Levels of TNF-αmRNA,IFN-γmRNA,IL-4mRNA and CD25mRNA in grafts were detected by using reverse transcription polymerase chain reagction.The levels of CD28subsets in peripheralblood were determined by Flow Cytometry.The use of experimental animals followed the Statement of ARVO.Results The mean rat graft survival time was longer in the organ culture grafts group( 13.78 d) than that with fresh gratts( 10.56 d)(t=14.945,P =0.000 ).The aqueous humor levels of IL-2,IFN-γ,IL-4 and TNF-α were higher in two allograft groups at day 6,day 13 and day 24 after transplantation than that in the normal control,which peaked at day 13,and the fresh grafts group had the highest level( F=324.891,416.416,240.661,364.533,P=0.000).At day 13,CD25 was weakly expressed in frozen section of two operation groups.The expression of TNF-α and IFN-γmRNA in organ culture grafts group was markedly less than in fresh grafts group at day 13 after surgeries (t =2.464,P =0.039;t=5.438,P=0.001 ),whereas there was no significient difference in IL-4 and CD25 mRNA levels between them (t=-0.782,P =0.457,t =0.712,P =0.497).The percentages of CD28 of the fresh graft group increased significantly and more weakly expressed in organ culture grafts group (P =0.016 ). Conclusions Th1/Th2 cytokines and CD28 lymphocyte subsets may play important roles during corneal allograft rejection with organ culture grafts.

This paper focus on conductive education approach during exercise therapy of cerbral palsy childrens, which emphasis the children active participation in the exercises and their phsycological reactions. Its main feature is using the rythmicl intention, task analysis and task series as the tools to perform the goal - directed activities in group setting and carry it out in the children' s daily life. The current studies on the motor control and motor learning are reviwed in this paper as well.

Objective To investigate precaution effect of ephedrine on protamine's untoward reaction. Meth-ods Forty patients, who were scheduled to have mitml valve replacement operation were randomly divided into two groups: ephedrine group(group A, n = 20) and control group (group B, n = 20). 50ml solution, mixed with protamine and 5% glucose,was injected through internal jugular vein in five minutes to neutralize the effect of heparin. In group A,3mg ephedrine was added into neutralization solution while in group B nothing was added. Arterial pressure(AP) , heart rate(HB) peripheral hemoglobin oxygen saturation(SpO2) and airway resistance(AR) were measured before injection and 1,3,5,10 minutes after injection in both groups. Results In group A, the AP, HR, SpO2 and AR had no significant difference before and after injection (P >0.05) ;while in 6 eases of group B, the AP, HR, SpO2 and AR have significant difference before and after injection. Conclusion Ephedrine can significantly improve protamine's untoward reaction, and neutralize the effect of heparin.

Cationic polymer, a kind of nonviral nanometric gene vector,have attracted more and more attention because they have many advantages in terms of low toxicity,lack of specific immune response,ease of large-scale production and big load.There are also many advance in how to increase the efficience of transduction.The anthor reviewed the advance of PLL and PEI as the nonviral nanometric gene vectors.

The involvement of oxidization of peroxid in the antigen-antibody reaction makes the cell membrane permeability enhanced, so the fluorescence-labeled antibody stain can infiltrate into the cell easily and contact the antigen rapidly and diffusely, and then the antigen-antibody crosslinking can be formed efficiently. With the enhanced staining efficiency, shortened test duration, simplified operation, increased positive detection rate and accuracy, the new technology lays a foundation of clinical definite, curative effect view and prognosis.

Objective To evaluate the clinical efficacy of tigecycline combinated with isepamicin for treatment of pneumonia caused by multidrug-resistant Acinetobacter baumannii.Methods A retrospective analysis was performed in adult patients with multidrug-resistant Acinetobacter baumannii pneumonia in two general hospitals from January 2012 to January 2014.Total eighty-four patients with MDR-Acinetobacter baumannii pneumonia were randomly divided into two groups(n=42).One group was treated with tigecycline combinated with isepamicin(termed combination therapy group),and another group was administrated with cefoperazone sulbactam (termed control group ).The clinical cure rates,microbiological eradication rates and adverse events were collected and compared. Results There was no difference in APACHEⅡ score between two groups.The clinical cure rates in combination therapy group was significantly higher than that in control group(88% vs 61%,P<0.05),and with a higher rate of microbiological eradication(59.5% vs 35.7%,P <0.05 ).However,the occurence rate of adverse events was similar in the two groups (7.1% vs 1 1.9%). Conclusion With a higher rate of clinical efficacy and a lower rate of adverse events,the combination therapy with tigecycline and isepamicin would be a promising alternative for treatment with MDR-Acinetobacter baumannii pneumonia.

Objective To compare the efficacy of the streamlined liner of the pharynx airway (SLIPA) and the proseal laryngeal mask airway (PLMA) in airway management in elderly patients undergoing laparoscopic cholecystectomy.Methods One hundred and twenty patients aged 60-75 years with American Society of Anesthesiologists (ASA) grade] or Ⅱ undergoing laparoscopic cholecystectomy were randomly divided into three groups:the endotracheal intubation group (Group T,n=40),the SLIPAgroup (GroupS,n=40) and the PLMA group (GroupP,n=40).Endotracheal intubation and laryngeal mask airway insertion were conducted after induction of anesthesia.All the patients were ventilated with intermittent positive pressure ventilation.Mean arterial pressure and heart rate were recorded at before induction (T0),successful insertion (T1),ten minutes after pneumoperitoneum (T2),successful extubation (T3),and ten minutes after extubation (T4).The rate of successful placement at first attempt,time taken for placement,airway sealing pressure,and side effects were recorded.The incidences of post-extubation cough,backflow,aspiration,larynogospasm,bleeding,gastric distension and sore throat within 2 days after intubation were also recorded.Results The successful rates of insertion were 92.5 ％,92.5 ％,95.0 ％,respectively,at first attempt and 100.0％ at second attempt in the three groups (x2 =0.268,P＜0.05).Changes in hemodynamic parameters were significantly different between Group T and Group S or P after induction (t=4.076,P＜0.05).Time taken for placement was shorter in Group S than in Groups T and P,meaning that the placement of SLIPA was easier than that of endotracheal intubation or PLMA (t=43.561,P＜0.05).The airway sealing pressure was higher in Group P than in Group S,but had no statistically significant difference between the two groups (t=0.363,P＞0.05).There was no significant difference in post extubation complications,including backflow,aspiration,laryngospasm and gastric distension (t=0.321,P＞0.05),among the three groups,but incidences of postextubation cough and pharyngalgia were higher in Group T than in Group S and Group P (x2 =26.674,10.568,P＜0.05).Conclusions SLIPA and PLMA can both provide adequate ventilation during operation,with few complications.SLIPA placement is the easiest,while PLMA has good airway sealing and thus is more suitable for elderly patients undergoing laparoscopic cholecystectomy.