Animals ; Arthritis, Rheumatoid ; Disease Models, Animal

Objective The purpose of this study was to assess the incidence,treatment and prognosis of silent pulmonary embolism (PE) after off-pump coronary artery bypass graft (CABG).Methods From December 2009 to September 2012,582 consecutive patients underwent off-pump CABG by a same surgeon.Their age ranged from 16 to 86 years with a mean age of (61.4 ± 9.3) years.Left internal mammary artery and saphenous vein were harvested routinely.A dose of 20 mg unfractionated heparin was given intravenously every 6 hours on the operative day after postoperative pleural fluid less than 50 ml per hour.All patients received aspirin 100 mg daily starting on postoperative day 1.The 64-slice coronary MDCT was performed to assess the graft patency on postoperative day 5 ～ 7.Results There were no in-hospital death.PE,which involved the lobar or more proximal arteries,was detected on the CT images of 10 patients (1.7％).In these 10 patients,there were no significant dyspnea or hypoxemia postoperatively ; echocardiography and ECG showed no specific signs of PE ; all bypass grafts were patent in CT images except a LIMA to LAD graft with LAD endarterectomy.PE involved both lungs in 6 patients,and only the right lung in 4 patients.All patients received anticoagulation with warfarin for 3 to 6 months except one.All patients were with good quality of life during 6 to 18 months of follow-up.Three to six months after discharge,8 patients received repeated MDCT,which showed diminish of PE.Conclusion Acute PE after off-pump CABG was an uncommon complication and was difficult to diagnose.MDCT played an important role in examining the patency of graft vessels and helped detect silent PE in CABG patients.The prognosis of acute PE after off-pump CABG was acceptable.PE diminished after 3 months of anticoagulation with warfarin.

Objective To investigate the galectin-3 (Gal-3) and osteopontin (OPN) expression in esophageal carcinoma and analyze its clinical significance.Methods Thirty-seven patients who suffered from esophageal carcinoma were selected from 2006 to 2008.There were 28 males and 9 females,aged from 41 to 82 vears old.The levels of Gal-3 mRNA and OPN mRNA in tissues were detected by Fluorescent PCR,and the levels of Gal-3 and OPN in blood plasma were measured by ELISA.Result The expression of Gal-3 mRNA and OPN mRNA were significantly different between the esophageal carcinoma,side of carcinoma and normal esophagus tissues (F=11.934,F=4.269,P<0.05);The expression of galectin-3 and osteopontin were correlated with pathological grading (F=3.216,P

The O152 antigens of Escherichia coli contains a Glc-β-1,3-GlcNAc linkage within the repeating unit. The wfgD gene in E. coli O152 O antigen gene cluster had been demonstrated utilizing NMR technique to encode a glucosyltransferase which is responsible for the synthesis of Glc-β-1,3-GlcNAc linkage. In this study, a synthetic substrate analog of the natural acceptor substrate undecaprenol-pyrophosphate-lipid [GlcNAc-α-PO_3-PO_3-(CH_2)_(11))-O-phenyl]) was used as an acceptor and UDP-Glc as a donor substrate, and electrospray ionization tandem mass spectrometry(ESI-MS-MS) was used for the detailed structural characte-)rization) of the enzyme product. A systematic study was conducted on product to allow rationalization of the fragmentation) processes. The major fragments observed in the ESI-MS-MS spectra result from cleavage of glycosidic) bond and diphosphate moiety. The fragment originating from the nonreducing end of the product yields information on sequence). Cross-ring cleavages, which are very informative of the linkages of the monosaccharide residues constituting) the product, and "internal" cleavage ions which are derived from elimination of substituents from around) the pyranose ring, were also observed. This extensive fragmentation was shown that the expected Glc-β-1,3-GlcNAc linkage in the product, confirming that wfgD is in the form of UDP-Glc: GlcNAc-pyrophosphate-lipid β-1,3-glucosyltransferase.)

The solvent sublation technique was applied for the separation and enrichment of L-Arg using dodecylbenzene sulfonic (DBSA) as the surfactant, di (2-ethylhexyl) phosphoric acid (P204) as the extractant and n-heptane as the organic solution. The solvent sublation was compared with the floatation complexation extraction, foam floatation and solvent extraction. The experimental results showed that enrichment ratio of 16.2 and removal rate of 97.2% to L-Arg were obtained by the solvent sublation under the conditions of room temperature, 0.09 g/L L-Arg aqueous solution 250 mL, DBSA concentration 0.15 g/L, the initial pH 7.0, volume of n-heptane 10 mL, volume of P204 4.5 mL, gas flow rate of 200 mL/min. The study of the kinetics indicated that the solvent sublation process could be divided into three stages distinctly. The processes of the first stage and the second stage followed the first order kinetics equation; the process of the third stage followed the zero order kinetics equation. The separation mechanism of solvent sublation was also discussed.

Objective To investigate the effects of continuous stellate ganglion block (SGB) on serum thyroid hormone and cortisol levels in patients with severe brain injury.Methods Eighty ASA Ⅱ or Ⅲ patients with severe brain injury aged 22-61 yr undergoing emergency craniotomy were randomly divided into 2 groups ( n = 40 each): control group (group C) received routine treatment only and continuous SGB group (group SGB) received continuous SGB with 0.2% ropivacaine besides routine treatment. SGB was performed on the operated side after induction of general anesthesia and tracheal intubation. An epidural catheter was placed. A bolus of 0.2% ropivacaine 7 ml was followed by continuous infusion of 0.2% ropivacaine at a rate of 2 ml/h. Continuous SGB was maintained for 48 h. Successful SGB was confirmed by increase in skin temperature by ≥1.5℃ behind earlobe on the operated side.Venous blood samples were obtained at 30 min before and 3 and 7 day after operation for determination of serum thyroid stimulating hormone (TSH), triiodothyronine (T3) ,thyroxine (T4) , reverse triiodothyronine(rT3) and cortisol concentrations. Glasgow prognosis score was used to evaluate the clinical results at 3 months after operation. Results Serum T4 , rT3 , TSH and cortisol concentrations were significantly lower while the serum T3 concentration was higher in the SGB group than in group C at 3 and 7 d after operation. The clinical results were significant better in SGB group than in group C according to Glasgow prognosis scores at 3 months after operation. Conclusion Continuous SGB can inhibit the stress response, and improve hypothalamus-pituitary-thyroid gland axis function and is helpful to patient's recovery from injury.

Objeetive To follow up the patients with Parkinson's disease (PD) who underwent subthalamic nucleus (STN) deep brain stimulation (DBS) therapy,and to compare the changes of cognitive function before and after this functional surgery.Methods The authors set up a series of clinical tests including unified Parkinson's disease rating scale (UPDRS) Ⅱ & Ⅲ,Hoehn & Yahr stage (H-Y stage),mini mental state examination (MMSE),Wechsler memory scale (WMS),serial reaction time task (SRTT),degraded picture naming (DPN),verbal fluency (VF),clock drawing test (CDT) to measure the performance of both clinical characteristics and cognitions 1 week before and 12 months after STN-DBS operation in 20 PD patients,matched with 20 healthy adults who just assessed by the neuropsychological tests.Results Activity of daily life (UPDRS Ⅱ),motor manifestations (UPDRS Ⅲ) and disease condition (H-Y stage) were all significantly improved whether they were on period or off period (P ＜ 0.01).In the test of WMS,the memory quotient (MQ) scores of PD patients (88.10 ± 16.70) were significantly lower (t =-3.187,P ＜0.01) than the control group (100.90 ± 6.45).By SRTT test,the mean average response time (Tavg) of the control group,pre-operation and post-operation groups was (1.09 ± 0.32) s,(1.58 ± 0.83) s and (1.62 ± 0.83) s,respectively.As to the comparison of the blocks,no changes were found within each group of PD (pro-F =0.329,P =0.964 ; post-F =0.377,P =0.945),by contrast,it had been proved to be statistically significant in the control group (F =2.316,P ＜0.05).The mean error rates of the control group,pre-operation and post-operation groups were 4.84％ ± 4.27％,9.76％ ± 1.52％ and 13.41％ ± 1.11％ respectively,and the control group was not different from pre-operation group (t =1.388,P =0.173) while significantly different compared with post-operation group (t =3.225,P ＜0.01).As for MMSE and DPN results,no significant benefits were obtained in the control,pre-operation and post-operation groups.In regard to VF,there was a statistically significant difference between control group and pre-operation group (Z =-2.927,P ＜ 0.01),and it was significantly worse after surgery (Z =-2.469,P =0.014).As for CDT,significant benefits were obtained in both preoperation (Z =-2.762,P ＜ 0.01) and post-operation groups (Z =-2.165,P =0.03) compared with control group.Conelusions To some extent,STN-DBS can affect the cognition of PD patients,such as lowing VF,improving visual-spatial function and attention,a decreasing trend of implicit memory and executive function.Explicit memory is partly dissociated with implicit memory.文章序号>=10.3760/cma.j.issn.1006-7876.2014.09.005

Objective To evaluate the CT features of primary adrenal lymphoma and its relationship with pathology.Methods Pathologically proven primary adrenal lymphoma 6 cases were reviewed.There were 4 males and 2 females.The age was 18-62 years,average age was 51 years.5 cases was single tomur in unilateral,1 case was bilateral disease.The main clinical manifestations were abdominal pain,abdominal discomfort.All patients had CT scan and were treated surgically.Results CT scan showed the characters of adrenal little low-density soft tissue mass:the maximum diameter of 3-11 cm,irregularly shaped or ovalshaped,multi-state a clear,homogeneous or slightly inhomogeneous density,CT value was 30-40 HU.Lesions could be embedded or close to blood vessels and the ipsilateral kidney.The lesions were not enhanced arterial phase enhancement,CT value was 39-50 HU.The lesions showed vein phase of mild to moderate enhancement,CT value was 47-66 HU.At the delay of continuing to strengthen phase,CT value was 60-78 HU.The pathology charaters showed that:Diffuse of tumor cells under light microscope dense,more uniform size,and a large,granular chromatin,tumor stromal components was relatively small.There was no significant bleeding,necrosis and calcification.one lesion showed sheet,tumor cell necrosis.Conclusions CT scan characteristics and pathological features of primary adrenal lymphoma might have a certain correlation.

Objective To evaluate the CT image features of urinary tract inflammatory myofibroblastic tumor (IMT) for use in clinical and differential diagnosis.Methods Eight pathologically proven IMT cases were retrospectively analyzed in this study.There were six female patients and two male patients.Patient average age was 35 (13-62) years.The main clinical manifestations were hematuria and urination pain.Tumors were found in the bladder in 5 cases,in ureter in 2 cases and in urethra in 1 case.All the 8 cases accepted CT scan five of which had contrast enhanced CT scan.The imaging features were then analyzed.Results Of the IMT in bladder,CT scan showed a cauliflower like bladder tumor or round soft tissue mass with even or uneven density of 11.5-36.0 HU.Three tunors were accompanied with necrosis.Four cases had associated adjacent bladder wall thickening and two cases were found with fuzzy surrounding fat space.Ureteral lesions in two cases showed a solid mass with smooth edges and even density of 40.3 HU compared to the surrounding muscle.The urethral lesions had clear mass realm of 17.5-22.6 HU accompanied with calcification.Enhanced CT scan showed that homogeneous or heterogeneous mild to moderate enhancement was found in the tumor.Delayed phase showed consistant enhancement of 102.7-118.6 HU.Conclusion Tumor CT imaging features,particularly the significant and consistant enhancement in delayed phase,provide important information for diagnosis and differential diagnosis of the urinary tract IMT.

Objective To explore the influence of autologous blood salvage on the gastric intramucosal pH(pHi)in operation for orthopedic patients.Methods 40 patients nnderwent orthopedic surgery were randomly divided into two groups(n=20 each).Salvage group received autologous blood transfusion.The pHi was measured by a nasogastric tube air carbon dioxide tension instrument.The blood samples were collected before operation(T0),1 h after operation(T1),2h after operation(T2)and the end of surgery(T3)for the measurement of pHi.The volume of blood recovery,erythrocyte suspension and plasma were counted.Results The volume of erythrocyte suspension and plasma were significantly higher in control group than in salvage group during operation(P＜0.05).There was no obviously different in blood gas indexes in the two groups(P＞0.05).The phi was significantly higher in salvage group[(7.381±0.023),(7.386±0.025)]than those in control group[(7.361±0.022),(7.375±0.024)]at T2 and T3(all P＜0.05).Conclusion Autologous blood salvage could recover loss blood in time,and make pHi decline,and maintain effective circulation,and significantly improved visceral microcirculatory perfusion and oxygenation in patients under went orthopedic surgery.