ObjectiveTo observe the dynamic change of mtDNA in rats with lung ischemiareperfusion (IR) injury and the implications.MethodsThe rat model of lung IR injury was made.Thirty-two male SD rats were divided into IR group and control group.Each group was sub-divided into two subgroups.Thirty and 60 min after reperfusion,8 rats of each group were sacrificed; left lungs and whole blood were collected.Histopathological study of lung tissues were performed; wet weight/dry (W/D) weight ratio of the lung was detected; DNA was extracted from whole blood,and mtDNA level in circulation was detected by using real-time PCR; the protein levels of MMP-9 and MCP-1were examined by ELISA.Results(1) As compared with control group,the edema and PMN emigration were more serious in IR group; besides,the W/D ratio was increased progressively in IR groups as compared with control groups respectively (P＜0.01); (2) As compared with control group,the mtDNA in circulation was significantly increased 30 min after reperfusion (P＜0.01),and the same trend was detected 60 min after reperfusion (P＜0.01):(3) There was no significant difference between the two groups in the content of MMP-9 and MCP-1in the lungs 30 min after reperfusion (P＞0.05),but the MMP-9 and MCP-1expression levels were increased 60 min after reperfusion (P＜0.01).ConclusionThe mtDNA expression in circulation was increased in the early stage of lung IR,and the increased expression of mtDNA was earlier than the up-regulation of MMP-9 and MCP-1.Our results indicated that mtDNA may aggravate lung injury through increasing MMP-9 and MCP-1in the lung IR.

Objective To evaluate the value of low concentration of isotonic contrast agent combined with 80 kV and adaptive statistical itera-tive reconstruction (ASiR)technique for bronchial artery with CT angiography (CTA).Methods 40 patients (18.5 kg/m2 ≤ body mass index(BMI)≤25 kg/m2 )with lung cancer were randomly divided into two groups and performed enhanced chest CT examina-tion.20 patients (low concentration group)were scanned with Visipaque 270mg I/mL,scanning protocol of (80 kV,260 mA)and other 20 patients (high concentration group)were scanned with Ultravist 370 mg I/mL,scanning protocol of (120 kV,1 50 mA). The CT value,signal noise (SD),signal-to-noise ratio (SNR),contrast-to-noise ratio (CNR)and effective dose (ED)of the two groups were compared and analyzed statistically.Differences between the two groups were determined with t test(P <0.05).Results The mean CT value of the low concentration group (31 7.33 HU±70.44 HU)was higher than that of the high concentration group (256.39 HU±37.38 HU)(P <0.05).SD,ED and dose length product (DLP)of the low concentration group (SD:7.55 ±1.51 HU;ED:1.74±0.14 mSv;DLP:124.94±9.9 mGy/cm)were lower than those of the high concentration group (SD:9.36±1.26 HU;ED:3.20±0.35 mSv;DLP:228.82±25.13 mGy/cm)(P <0.05).CNR and SNR of the low concentration group (CNR:59.71± 17.36;SNR:44.01±14.71)were higher than those of the high concentration group (CNR:37.61±6.16;SNR:27.75±4.72)(P <0.05).The subjective scores of the two groups were (3.73±0.66)and (3.81±0.59),respectively,with no statistical difference.Conclusion For the patients with normal body mass index ,it can reduce 47% radiation dose and 27% iodine dosage using low concentration of isotonic contrast agent combined with 80kV and ASiR technique for bronchial artery CTA,while maintaining similar excellent image quality.

Objective To established cardiac-specific transgenic mice of the cTnC D145E and cTnCG159D and compare the HCM and the DCM.Methods The cTnCD145E and cTnCG159D were generated by site-directed mutagenesis and the transgenic plasmids were constructed by insertion of the mutant genes under the control of α-MHC, which is a myocardium specific promoter.The transgenic mice were generated by microinjection and were all maintained on a C57BL/6J genetic backgroud .The cardiac structure and function of the transgenic mice were compared and analysized by echocardiographic and pathological observation at different ages .Results The cTnCD145E and cTnCG159D transgenic mice were established and developed to HCM and DCM, respectively, with aging.The left ventricular end-systolic volume (ESV) and left ventricular end-diastolic volume ( EDV) decreased and ejection fraction ( EF) and left ventricular end-systolic posterior wall thickness (ESPWT) increased in the cTnCD145E transgenic mice, while EDV and ESV increased and EF and ESPWT decreased in the cTnCG159D transgenic mice at 12 months of age.Conclusions Cardiac-specific human cTnCD145E transgenic mice showed HCM phenotypes , and cardiac-specific human cTnC G159D transgenic mice showed DCM phenotypes , which can be used as different models for comparative study of the pathogenesis of cardiomyopathy .

Objective To evaluate the method and outcome of surgical treatment for refractory slow-transit constipation (STC). Methods Clinicopathologic data of 24 patients with severe STC which underwent (colectomy) in recent years were retrospectively analyzed. Results 18 of the patients underwent pancolectomy,and 6 underwent subtotal colectomy. All of the 14 STC patients complicated with outlet obstructive (constipation)(OOC) were corrected preoperatively by related surgery. The curative rate of surgical (treatment) was 95.8%,with an average of(3?1.9) times of bowel motion per day. The incidence of (abdominal) distention decreased from 75% to 12.5%. One patient who underwent ileorectal anastomosis (developed) recurrent constipation. Conclusions Colectomy produces satisfactory results in the majority of (patients) with refractory slow-transit constipation.Patients complicated with OOC should undergo energetic (preoperative) correction therapy,in order to ensure a satisfactory surgical outcome.

Disease Outbreaks ; prevention & control ; Humans ; Influenza A Virus, H5N1 Subtype ; Influenza Vaccines ; Influenza, Human ; prevention & control

Objective To compare the clinical efficacy of postoperative analgesia between intercostal nerve freezing and con‐trolled intravenous analgesia in patients of thoracic surgery .Methods 80 patients of thoracic surgery from January 2012 to June 2013 were randomly divided into two groups :Intercostal nerve cryotherapy group (frozen group n=40) and intravenous analgesia group(control group n=40) .Frozen group :the intercostal incision and down each one intercostal and chest tube placement of inter‐costal nerve roots were frozen before sternal closure ;control group :intravenous analgesia pump were used postoperative .According to VAS method to evaluate pain level and observe adverse reactions ,complications and analgesic drug usage of postoperative pa‐tients .Results The analgesic effect of frozen group was better than that of control group within five days after thoracotomy .Com‐pared with the control group ,the incidence of adverse reactions ,postoperative complications ,and analgesic drug usage was signifi‐cantly reduced in frozen group ,there was a significant difference between the two groups (P<0 .05) .Postoperative follow‐up dis‐play :intercostal nerve area in some patients may appear numbness ,dysesthesia ,etc .,but the above situation can return to normal gradually .Conclusion The analgesic effect of intercostal nerve cryotherapy for thoracotomy patients is excellent ,and with few side effects and good safety ,and it is worthy of promotion .

Objective To analyze and evaluate the efficay of split liver transplantation in children.Method From September 2006 to December 2014,210 children were treated with liver transplantation in Tianjin First Central Hospital.The clinical data were retrospectively analyzed and the difference in postoperative survival was compared between the groups.The 210 childrens were categorized into living donor liver transplantation group (183 cases) and split liver transplantation group (27 cases) based on their operation styles.In living group,all donors to recipients were immediate relatives within three generations.In split group,all donors were men,and livers were obtained from no heartbeat donors.Postoperatively,tacrolimus combined a duplex of prednisolone served as immunosuppression scheme.The survival and incidence of complications were observed.Result There was significant difference in the sex ratio between two groups (P＜0.05).The donor liver cold ischemia time was significantly longer in split group than in living group (P＜0.05).The 1-month,6-month,1-year and 2-year overall survival rate in 210 recipients was 99.5％,98.1％,96.2％ and 94.2％ respectively.The median follow-up time in living group and split group was 15.2months and 26.1 months,respectively.The 1-mont,6-month,1-year and 2-year survival rate was 99.5％,96.7％,92.6％ and 74.1 ％ in living group,and 97.8％,96.2％,77.8％ and 74.0％ in split group,respectively (P＜0.05).During the follow-up period,8 cases died (29.6％) in split group (5deaths due to infection and sepsis,and 3 deaths due to multiple organ failure),and 10 cases died (5.5％) in living group (6 deaths due to infection and sepsis,and 4 deaths due to multiple organ failure).Conclusion In the case of strict selection of donors,split liver transplantation can obtain good effect,but the incidence of complications is higher than living donor liver transplantation.Especially,the biliary complications should be prevented and managed actively.

Objective To explore the efficacy and safety of conversion from calcineurin inhibitor (CNI) to sirolimus (SRL) as major immunosuppressive therapy in lung transplant recipients.Method Retrospective analyses were conducted for the clinical data of all the patients undergoing lung transplantation in Wuxi People's Hospital between January 2011 and December 2014.Sixteen were given conversion treatment with Sirolimus in the postoperative irnmunosuppressive therapy.We analyzed the opportunity and reasons in the conversion treatment,and the safety,effectiveness and complications of the conversion treatment.Result The follow-up period was 8 to 25 months,and the median time of conversion was 6 months after operation (2-18 months).The indications of conversion concluded:malignant tumor (n =8),renal dysfunction (n =5),lymphangioleiomyomatosis (n =1) and intractable diarrhea caused by CNIs (n =2).Four cases suffered from interstitial pneumonitis associated with Sirolimus and one case suffered from spontaneous pneumothorax,and they all conversed back to CNIs.In those patients,cancer recurrence occurred in 4 cases (of them,there were 3 deaths),and 3 patients developed chronic rejection.Those recipients receiving the conversion treatment due to renal dysfunction showed recovery of renal function to some extent.Conclusion It's effective and safe to converse the immunosuppressive therapy based on Sirolimus.Sirolimus should be reduced or withdrawn when interstitial pneumonitis associated with Sirolimus occurred.

@@

Objective To investigate clinical service delivered at the Polyclinic of Beijing 2008 Olympic and Paralympic Village and outcomes of the medical patients visited there.to provide experiences in medical care service for other mass-gatherings in the future.Methads Clinical data of all the medical patients evaluated at the Polyclinic during July 27 to August 27 and during August 29 to September 19,2008 were reviewed retrospectively.with univariate and multivariate analyses.Results In total.1537 and 1206 medical patients visited the Polyclinic at the Olympic and Paralympic Village,respectively.Proportion of athletes visited was hisher during the Paralympic Games than that during the Olympic Games(14.2% vs.9.8%,P<0.01).We reeeived 775 patients(50.4%)with acute respiratory tract disorders,including 16 cases(1.0%)with asthma,during the Olympic Games,and 686(56.9%),including eight cases (0.7%)with asthma,during the Paralympic Games,and antibiotics were prescribed for 149(9.7%)and162(13.4%)of them,respectively.Twelve(0.8%)patients were hospitalized during the Olympic Games and four(0.3%)during the Paralyrnpie Games,and age equal to or nlore than 55 years and digestive disease were independent risk factors for hospitalization,with odds ratios(ORs) of 5.3 and 9.5 and their 95% confidence intervals(Cls)of 1.4-19.6 and 2.5-36.4,respectively.Conclusions Acute respiratory disorder was the most connnon cause for medical visits in the Polyclinic.Asthma did not play a significant role to iniluence athletes'performance in the Beijing 2008 Olympic and Paralympic Games.Antibiotic prescription in the Polyclinic had been controled to an acceptable level.Conditions in elder patients and those with digestive disorder tended to be severe.deserving more attention infuture's mass gathering.