Objective To observe the therapeutic effect and adverse effect for chemthrombocytopenic of rhIL-11 in chemotherapy for acute myeloid leukemia. Methods We adopted a randomized, blank-control, crossover trial of rhIL-11 in 16 newly diagnosed patients with acute myeloid leukemia. The treatment group were accepted chemotherapy by DA or TA. rhIL-11 (25μg·kg-1·d-1, subcutaneously) was administered from 24 h after chemotherapy and continued for seven to fourteen days. The changes of platelet counts were observed. Results The group by chemotherapy had higher platelet counts than control after rhIL-11 treatment and platelet transfusion frequency was reduced. The adverse effect of rhIL-11 was light, including fatigue, muscular soreness and low-grade fever. Conclusion rhIL-11 is safe and effective in reducing chemotherapy thrombocytopenia.

Objective To evaluate the role of intercellular gap junction in lung injury induced by hemorrhagic shock and resuscitation in rabbits. Methods Twenty-four healthy rabbits of both sexes weighing 1.5-2.2 kg were used in this study. The animals were anesthetized with iv 3% pentobarbital 30 mg/kg,tracheostomized and mechanically ventilated. Femoral artery was cannulated for MAP monitoring, blood-letting.Right external jugular vein was cannulated for fluid infusion. Hemorrhagic shock was induced according to the method described by Wiggers. MAP was maintained at 35-40 mm Hg for 60 min. The animals were then randomly divided into 2 groups (n = 12 each):traditional treatment group (group A) and octanol group (group B). Both groups received rapid iv infusion of lactated Ringer's solution (LR solution) 1.5 ml·kg-1 ·min-1 for 30 min (T3 ).In group B 99.5% octanol (a specific gap junction inhibitor) 5 mmol/kg was injected intraperitoneally (IP) in addition to iv LR solution infusion. Thirty minutes later the animals were resuscitated with infusion of the blood withdrawn and LR solution (the volume was equal to the volume of blood loss). Then LR solution was infused iv at 2.5 ml· kg-1 · h-1 for 150 min ( T4 ). Left ventricular systolic pressure (LVSP) and HR were recorded before blood letting (T1), immediately after successful establishment of the model (T2), and at T3 and T4. The mortality during resuscitation was calculated. The animals were killed at T4. Blood samples were taken from femoral artery for determination of the serum protein concentration. The lungs were removed. The left lower lobe was lavnged. The protein concentration in broncho-alveolar lavage fluid (BALF) was measured. Lung permeability index (LPI) was calculated (LPI = protein concentration in BALF protein concentration in serum). Na+-K+-ATPase and Ca2+-ATPase activities and W/D lung weight ratio were determined and microscopic examination was performed. Results HR was significantly lower at T3 and T4 and LVSP higher at T4 in group B than in group A. The pulmonary permeability index, W/D lung weight ratio and mortality were significantly lower and the activities of Ns+-K+-ATPase and Ca2+ -ATPase were significantly higher in group B than in group A. The lung tissue danage was significantly ameliorated in group B. Conclusion Intercellular gap junction is involved in the development of lung injury induced by hemorrhagic shock and resuscitation in rabbits.

Objective To explore the effect of glial cell line-derived neurotrophic factor(GDNF) on the expressing of calbindin D28K(CB) in substantia nigra(SN) of rat model of Parkinson's disease(PD) and the possible role of neural cell adhesion molecule(NCAM) in this course.Methods 36 rat models of PD were made,and divided into GDNF group,NCAM blocked group and control group(each group had 12 rats).Immunohistochemistry and Western blot method were used to detect the number of CB-positive cells and the expressed level of CB protein in SN of rats.Results The number of CB-positive cells(46.50?6.28) and the expressed level of CB protein(33770.60?6929.76) in SN of GDNF group were significantly higher than control group [(27.00?8.60),(18281.00?5266.78) respectively](all P0.05).Conclusions GDNF may protect the injured dopaminergic neurons through up regulating the expressing of CB,but NCAM is not involved in this mechanism.

Objective To introduce the strategy of perioperative blood glucose control and the early outcome in diabetic and non-diabetic patients undergone coronary artery bypass grafting (CABG). Methods A total of 1019 CABG were performed and the patients were divided into diabetic and non-diabetic groups (n=211, 808, respectively). The demography was comparable between the two groups with the exception that the percentage of preoperative myocardial infarction was significantly higher in diabetic group than that in non-diabetic group. Off-pump and conventional CABG were routinely performed and the left internal mammary artery (IMA) and great saphenous vein (GSV) were used as conduit. Perioperative blood glucose was controlled according to the close supervision. The aim of preoperative 6mmol/L and postoperative 8mmol/L was achieved by means of oral medication or subcutaneous injection of insulin, which was complimented by continuous pump infusion of regular insulin to optimize the glucose level. Results 99.2% patients were discharged. The overall perioperative mortality was 0.8% and the percentage was 1.4% and 0.6% respectively in diabetic and non-diabetic group with significant difference(P0.05), respectively. Cerebral infarction occurred in 1.4% diabetic patients and in 0.5% non-diabetic patients(P

0.05). But there have extremely significant between the normal and abnormal groups.(P0.05) , but the stunting group was extremely significant with the other three groups (P

Humans ; Stress, Physiological ; Takotsubo Cardiomyopathy ; diagnosis ; therapy

Objective To investigate the protective effect of allicin on intestinal mucosal barrier of septic rats so as to explore the possible mechanism.Methods Twenty-four male SD rats were randomly (random number) divided into sham,septic model and allicin treatment group.Septic model was established by cecal ligation and puncture (CLP) in rats.Rats in the treatment group were administered with allicin (30 mg/kg,ip)at 6 h and 12 h after modeling,while those in the model and sham groups were treated with equal amount of saline instead.Rats were sacrificed at 24 h and the serum D-lactic acid,diamine oxidase (DAO) and fluorescence isothiocyanate-dextran (FITC-Dextran,FD-40) were determined to evaluate the intestinal mucosal barrier function.The levels of tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6),malondialdehyde (MDA),and the activity of superoxide dismutase (SOD) in intestinal tissue were measured.Histopathological changes of intestinal mucosa injury were assessed by Hematoxylin-eosin staining.Results Compared with the sham group,levels of serum D-lactic acid,DAO and FD-40 increased significantly in the CLP group (D-lactic acid:599.4±101.1 vs.149.2±20.63 nmoL/mL,t=11.84,P＜0.01;DAO:302.1 ±64.5 vs.76.57±14.76 ng/mL,t=9.433,P＜0.01;FD-40:6664.0±1437.0vs.1446.0±205.0 ng/mL,t =9.704,P ＜0.01);intestinal morphology damage occurred in the CLP group;intestinal levels of TNF-α,IL-6 and MDA increased greatly (TNF-αt:186.35 ±20.43 vs.58.76 ±8.94 pg/mL,t=17.23,P＜0.01;IL-6:763.25±85.23vs.125.36±14.37 pg/mL,t=22.54,P＜0.01;MDA:29.36±3.27vs.7.24±0.85 nmol/mg prot,t=16.61,P＜0.01),while SOD activity reduced (35.75±6.53 vs.73.26 ±8.35 U/rmg prot,t =10.57,P ＜0.01) in the CLP group.Allicin treatment greatly inhibited the increase of D-lactic acid,DAO and FD-40 levels in rat plasma caused by CLP (D-lactic acid:330.1 ±81.77 vs.599.4±101.1 nmol/mL,t=7.086,P＜0.01;DAO:171.8±49.70vs.302.1±64.56ng/mL,t=5.45,P＜0.01;FD-40:3349.0±1167.0 vs.6664.0±1437.0 ng/mL,t=6.165,P＜0.01);intestinal morphology damage was improved in the allicin treatment group;allicin treatment greatly inhibited the intestinal levels of TNF-o,IL-6 and MDA and preserved the intestinal SOD activity compared with the CLP group (TNF-α:95.37 ±12.68 vs.186.35 ±20.43 pg/mL,t =12.29,P＜0.01;IL-6:354.27±46.27vs.763.25±85.23pg/mL,t=14.45,P＜0.01;MDA:16.27±3.14vs.29.36±3.27 nmol/mgprot,t=9.831,P＜0.01;SOD:55.35 ±6.23vs.35.75±6.53 U/mgprot,t=5.522,P ＜0.01).Conclusions Allicin could inhibit local inflammation and oxidative stress in the intestine and exerts protective effect on intestinal mucosal barrier of septic rats.

Objective The aim of this study is to address learning curve and clinical outcomes of totally robotic atrial septal defect repair on the basis of a single - center experience.Methods 54 cases of atrial septal defect (ASD) were repaired using “da Vinic S surgical system on arrested ( group Ⅰ,54 cases) or beating heart ( group Ⅱ,40 cases) from January 2007 to December 2010.Learning curves were assessed by means of regression analysis with logarithmic curve fit.The effect of operative variables on clinical outcome was analyzed by linear by regression using the Spearman's rho coefficient.Results All cases were accomplished successfully without complications.No residual shunt was detected at intraoperative or postoperative echocardiography.Significant learning curves were noted for corss clamp time in group Ⅰ:y (min) =68.741 -8.283 (n) (x)( r2 =0.489 ; P ＜ 0.01 ) ; the operation time in group Ⅱ:y (min) =355.51 - 56.29 (n) (x) ( r2 =0.581 ; P ＜ 0.01 ).No correlation was detected between operation time,cardiopulmonary bypass time,or cross clamp time and intubation time,intensive care unit stay,or total length of stay.Conclusion The robotic atrial septal defect repair can be performed safely.The learning curves is steep and the longer cardiopulmonary bypass times,operation time or cross clamp time had no negative impact on intraoperative and postoperative outcome.

Objective To Summary the first 40 cases underwent robotic atrial septal defect (ASD) closure or atrial septal defect closure combined bicuspid valve plasty (TVP) using da Vinci S surgical System on beating heart. Methods 40 cases of atrial septal defect or combined sever tricuspid valve regurgitation were repaired using da Vinic S surgical system on beating heart from March 2009 to December 2010 in cardiovascular department of PLA general hospital. The average age was (38 ± 13) yeas old. 23 cases were female and 17 cases were male. All patients were ostium atrial septal defect with or without pulmonary hypertension. The atrial defect diameter was 1.5 -3.5 cm, and the mean diameter was(2. 8 ±1.3)cm. 9 patients had sever tricuspid valve regurgitation. Without sternotomy, the extracorporeal circulation was established through groin artery,groin vein and internal jugular vein cannulation with the guidance of transeophageal echocardiography. 3 ports of 8 mm and 1 working port of 2 cm were made in the right chest wall. After da Vinci S syetem was set up, with the assistant of bed-side surgeon, the surgeon completed the atrial septal defect closure or combined tricuspid valve plasty in the surgeon console with three dimensions visualization. During the operation, without cardioplegia administrated and aortic occlusion, the procedure was completed through right atriotomy. The pleural space was insufflated with carbon dioxide to avoid the air embolism. The direct suturing was used in 22 cases and pericardial patch were used in 18 cases. 9 patients accepted concurrent De Vega tricuspid valve plasty. The transesophageal echocardiography were used to evaluate the result of atrial defect closure or tricuspid valve repair. The operation time, robotic using time and cardiopulmonary time were compared with totally robotic atrial defect repair in arrested heart. Results All cases were accomplished successfully without complication. There was no residual shunt and air embolism. The operation time, robotic using time and cardiopulmonary time were less than the arrested group. Conclusion Robotic atrial septal defect closure or combined tricuspid valve repair on beating heart can avoid aortic ocllusion and can be utilized effectively and safely.

BACKGROUND:On-pump coronary artery bypass grafting(CABG)is replaced by off-pump coronary artery bypass grafting step by step.Effects of the two operations on liver and renal function deserve further studies.OBJECTIVE:To analyze the postoperative changes in liver and renal function between off-pump and on-pump CABG.DESIGN.TIME AND SETTING:Controlled study.The experiment was conducted at the Department of Cardiovascular Surgery.General Hospital of Chinese PLA.Beijing between June and November 2005.PARTICIPANTS:Fifty patients undergoing elective CABG at General hospital of PLA from June to November 2005 were enrolled in the study.All patients had normal liver and renal function before surgery.None of them developed severe acute liver and renal function.METHODS:All patients were allocated to either off-pump coronary bypass(OPCAB)(n=30)or on-pump conventional CABG (CCABG)(n=20)group according to patient's intention and condition.No significant difference was detected in age,gender,body mass index,preoperative ejection fraction,preoperative liver and renal function and operation risk factors between both groups(P>0.05).MAIN OUTCOME MEASURES:Alanine aminotransferase(ALT),aspartate aminotransferase(AST),blood urea nitrogen (BUN)and creatinine(Cr)were respectively measured in patients of both groups before surgery,1 day,1 week and 2 weeks after surgery.RESULTS:A total of 50 patients were involved in the final analysis.Changes in liver function:Serum ALT and AST Ievels in the OPCAB group were significantly lower than those in the CCABG group at 1 day after surgery(P<0.05).The level of two parameters recovered to the baseline at 2 week after surgery in both group.Changes in renal function:Serum BUN and Cr levels in the OPCAB group were significantly lower compared to the CCABG group at the first postoperative day(P<0.05).BUN and Cr levels recovered to the preoperative levels at 2 weeks after surgery in bOth group.CONCLUSl0N:CABG has an adverse effect on liver and renal function.which can recover in the early postoperative period.OPCAB has the less adverse effect on liver and renal function and offers a better liver and renal protection compared to CCABG.