Animals ; Carotid Arteries ; surgery ; Carotid Artery Injuries ; etiology ; Disease Models, Animal ; Female ; Mice ; Mice, Inbred C57BL ; Microsurgery ; Random Allocation

Objective Through the correlation study of fibroblast growth factor 23 (FGF-23) and chronic heart failure to investigate the pathogenesis of chronic heart failure and provide a new method for chronic heart failure diagnosis.Methods One hundred and twenty-eight chronic heart failure patients (chronic heart failure group) were involved in this study.According to the level of left ventricular ejection fraction (LVEF),they were divided into LVEF slightly lowing group (LVEF 40％-50％,50 patients),LVEF moderately lowing group (LVEF 30％-39％,35 patients),LVEF severely lowing group (LVEF ＜30％,43 patients).Fifty healthy people was as control group.The level of FGF-23,parathyroid hormone (PTH),creatinine (Cr),urea nitrogen (BUN),blood calcium,blood phosphorus,N-terminal pro-B-type natriuretic peptide (NT-proBNP) were detected.The patients in two groups were performed color Doppler ultrasonography.Results The level of FGF-23,blood phosphorus,PTH,left ventricular mass index (LVMI),NT-proBNP in chronic heart failure group were significantly higher than those in control group [68.44(55.85-94.73) ng/L,34.18(30.57-38.87) ng/L,(1.13 ± 0.13) mmol/L vs.(1.02± 0.12) mmol/L,(15.51 ± 3.99) ng/L vs.(9.97 ± 0.89) ng/L,(112.27 ± 52.02) g/m2 vs.(71.37 ± 12.95) g/m2,(6 265.3 ± 15 991.6) ng/L vs.(76.12 ± 51.80) ng/L](P ＜ 0.01).The level of blood calcium,glomerular filtration rate (GFR) in chronic heart failure group were significantly lower than those in control group [(2.28 ±0.16) mmol/L vs.(2.48 ±0.13) mmol/L,(78.28 ± 14.20) ml/ (min ·1.73 m2) vs.(85.03 ± 14.44)ml/ (min·1.73 m2)] (P ＜ 0.01).Spearman correlation analysis showed that FGF-23 had positive correlation with age (r =0.256,P ＜0.01),blood phosphorus (r =0.326,P ＜0.01),PTH (r =0.584,P ＜0.01),NT-proBNP (r =0.799,P ＜ 0.01),LVMI (r =0.540,P ＜ 0.01),and had negative correlation with blood calcium (r =-0.308,P ＜ 0.01),GFR(r =-0.527,P ＜ 0.01).The level of FGF-23 was increased when LVEF reduced.Conclusions It has significant correlation between the level of FGF-23 and the degree of chronic heart failure.It suggests that the level of FGF-23 can evaluate the myocardial systolic function and ventricular remodeling.

Objective To discuss the safety and effectiveness of heat-sensitive moxibustion for bladder dysfunction after poisonous snakebite. Method Twenty-six patients with bladder dysfunction due to poisonous snakebite were intervened by heat-sensitive moxibustion, and the changes of residual urine volume and uroflowmetry parameters were analyzed by using type-B ultrasonic scanning and uroflowmetry. Result According to the ultrasonic scanning and uroflowmetry, the residual urine volume was significantly changed after treatment in the 26 subjects (P<0.05), and the maximum urine flow rate (Qmax) was also significantly different from that before treatment (P<0.05). Conclusion Heat-sensitive moxibustion can improve the residual urine volume and Qmax in bladder dysfunction after poisonous snakebite, and it’s a safe and reliable method.

A simple and efficient method for the determination of organotin compounds ( OTCs) in biota by GC-MS coupling with sodium tetraethylborate ( NaBEt4 ) derivatization was established. The results showed that recoveries for each OTCs spiked in blank freeze-dryed biological samples ( 0 . 1 g ) following extraction (15 mL 0. 035 mol/L methanolic HCl solution for 1 h ) and derivatization (2 mL contained internal standard n-hexane and 0. 5 mL of 2% (m/V) NaBEt4 solution for 30 min) were above 80%. The method is fast and easy to operate for the determination of OTCs in complex biological samples. The minimum limit of detection was about 0. 01 μg/L, and relative standard deviation values were within 10% for three parallel samples.

Objective To analyze the correlation of visual acuity and metamorphopsia with foveal morphology before and after vitrectomy with internal limiting membrane peeling (ILMP) in idiopathic macular epiretinal membrane (IMEM) eyes.Methods This is a retrospective case series of 47 IMEM patients (49 eyes).All the patients underwent 25G pars plana vitrectomy with IMEM removal and ILMP.The best corrected visual acuity (BCVA) was measured using the international standard visual acuity chart,and the results were converted to the logarithm of the minimum angle of resolution (logMAR) visual acuity.The severity of metamorphopsia was measured using M-charts.The central macular thickness (CMT),inner nuclear layer thickness (INT),inner retinal layer thickness (IRT),outer retinal layer thickness (ORT),the status of ellipsoid zone (EZ) were assessed with spectral-domain optical coherence tomography at baseline and each month postoperatively.The differences in BCVA,CMT,INT,IRT,ORT and status of EZ before and after surgery were analyzed,so did the correlations between these indexes at the same time.Results Compared with baseline,the postoperative BCVA was significantly increased (F=6.133,P＜0.001),but the M value,CMT,INT,IRT,ORT were significantly decreased (F=12.481,10.565,15.739,6.046,10.569;P＜0.001);the integrity of EZ was improved significantly (x2=12.309,P＜0.001).Preoperative BCVA was positively related to the CMT (r=0.720) and ORT (r=0.720,0.887;P＜0.05),while negatively related to preoperative integrity of EZ (r=-0.295,P＜0.05).The postoperative BCVA was positively related to the preoperative BCVA and postoperative CMT,ORT (r=0.774,0.754,0.842;P＜0.05),while negatively related to postoperative integrity of EZ (r=-0.676,P＜0.05).The preoperative M value was positively related to the preoperative CMT,INT,IRT,and ORT (r=0.931,0.668,0.840,0.637;P＜ 0.05).The postoperative M value was positively related to the preoperative M value and postoperative CMT,INT,IRT,and ORT (r=0.723,0.722,0.767,0.825,0.387;P＜0.05).Conclusions Vitrectomy with ILMP for IMEM can improve the visual acuity,metamorphopsia and foveal morphology.Both visual acuity and metamorphopsia correlate with foveal morphology.

OBJECTIVE:To observe clinical efficacy and safety of Xuebijing injection combined with imipenem and cilasta-tion in the treatment of severe abdominal infection,and its effects on plasma endotoxin and inflammatory factors. METHODS:Dur-ing Apr. 2013-Apr. 2016,100 patients with severe abdominal infection in our hospital were divided into observation group and control group according to random number table,with 50 cases in each group. Both groups were given Imipenem and cilastation sodium for injection 0.5 g added into 0.9% Sodium chloride injection 500 mL,ivgtt(≥40 min),q12 h. Eight hours later,ob-servation group was additionally given Xuebijing injection 100 mL added into 0.9% Sodium chloride injection 500 mL,ivgtt, bid;Both groups were treated for 5-7 d. The levels of plasma endotoxin and inflammatory factors(TNF-α,IL-6,IL-6/IL-10) were compared in 2 groups before after treatment,and clinical efficacies and the occurrence of ADR was recorded. RESULTS:Before treatment,there was no statistical significance in plasma endotoxin or inflammatory factor levels between 2 groups(P>0.05). After treatment,plasma endotoxin and inflammatory factor levels of 2 groups were decreased significantly,and the obser-vation group was significantly lower than the control group,with statistical significance(P<0.05). The excellent and good rate of observation group was 98.00%,which was significantly higher than 78.00%,with statistical significance(P<0.05). No obvi-ous ADR was found in 2 groups. CONCLUSIONS:Xuebijing injection combined with imipenem and cilastation show significant therapeutic efficacy for severe abdominal infection,can effectively control the release of endotoxin and inflammatory factors with good safety.

Objective To compare the prognosis of sentinel node-positive breast cancer patients forgoing axillary lymph node dissection.Methods A systematic literature search (Medline,Embase,Cochrane Library)ended in April 2014 was performed to identify all eligible articles.Two reviewers independently screened and extracted data.RevMan5 was used for statistical analysis.Results A total of 1026 abstracts were retrieved and 18 clinical controlled studies finally included,the total number of patients were 47 894,7389 had micrometastases in sentinel lymph node,35 217 had macrometastases in sentinel lymph node and 5288 had positive sentinel lymph node regardless of micrometastases or macrometastases.For patients with MIC,the 5-year axillary recurrence rate,5-year disease free survival and 5-year overall survival had no significant difference between patients who only received sentinel lymph node biopsy and patients who received further axillary lymph node dissection,(OR =1.78;95％ CI:0.72-4.39,P=0.21),(OR =0.76,95％CI:0.56-1.04,P=0.08),(OR=0.77,95％CI:0.43-1.40,P=0.39).For patients with MAC,the 5-year axillary recurrence rate had no significant difference between patients who only received sentinel lymph node biopsy and patients who received further axillary lymph node dissection,(OR =1.21;95％ CI:O.76-1.91,P =0.42).For patients with positive sentinel lymph node regardless of micrometastases or macrometastases,the 5-year axillary recurrence rate and 5-year overall survival had no significant difference between patients who only received sentinel lymph node biopsy and patients who received further axillary lymph node dissection,(OR =1.29;95％ CI:0.92-1.80,P =0.14),(OR =0.96,95％ CI:0.64-1.45,P =0.84).Conclusions Among patients with limited positive SLN of breast cancer,patients forgoing ALND compared with ALND did not have obvious affect on long-term survival.

ObjectiveTo investigate the therapeutic effectiveness of defibrase in treating penumbra and reperfusion.MethodsIntraluminal suture method was used to develope reversible middle cerebral artery occlusion(MCAO). Rats were subjected to MCAO 3 hours followed by reperfusion for 3, 6, 24, 72 hours, and to MCAO 6 hours followed by reperfusion for 3, 6, 24 hours. The treatment groups rats were injected intravenously defibrase at 0.5 hour before reperfusion. Meanwhile, the control group received normal saline. Clinically Neurological Deficits Scale were evaluated every day. Infarction volume was measured by using 2,3,5-triphenyltetrazolium chloride staining. Pathologic change were examined microscopically in HE stained sections.ResultsThere were significant difference at treatment groups of reperfusion 3 hours after MCAO.Infarction volume and Clinically Neurological Deficits Scale was significant reduced as control group (P<0.05). There were no significant differences at treatment groups of reperfusion 6 hours after MCAO (P>0.05). Cerebral hemorrhage wasn't increased in defibrase treatment group.ConclusionsDefibrase was effective on Clinically Neurological Deficits of rats in reperfusion 3 hours after MCAO.

AIM:To study the effect of posterior sub - Tenon's capsule injection of triamcinolone acetonide ( TA ) in treatment of patients with diffuse diabetic macular edema ( DME) before panretinal photocoagulation ( PRP) .
METHODS:Retrospective analysis of the clinical data of 96 cases (96 eyes) with DME treated in our hospital from October 2008 to May 2012, and the patients were divided into the study group and control group, each group with 48 cases ( 48 eyes ) , the control group were only treated with PRP, and for the study group, TA was injected one week before PRP. At 6mo after treatment, best-corrected visual acuity ( BCVA) and retinal thickness changes of two groups were compared, the changes of intraocular pressure in two groups was analyzed.
RESULTS:After treatment, two groups were followed up for 6mo, compared with before treatment, the expression of BCVA in control group was reduced, and rise in the study group, with significant difference between the two groups (P<0. 05), and during the follow-up period, IOP change was in the normal range for the two groups, with no the difference (P>0. 05), the study group had foveal thickness reduction of 9. 6μm, the control group was increased by 31. 9μm, with significant difference (P<0. 05), parafoveal thickness in the study group decreased 5μm, significantly increased 22. 1μm in the study group, centre concave surrounding thickness increased 0. 4μm in study group and 19. 4μm for the control group, with no significant difference (P>0. 05).CONCLUSION:TA injection in patients with diffuse DME before PRP is safe and effective, and it is superior to simple PRP therapy, and it can be applied in primary hospital.

Objective To research the efficacy and safety of sequential rivaroxaban use in reducing blood loss after applying tranexamic acid(TXA)in total hip arthroplasty(THA).Methods According to the design by the random control principle,150 pa tients undergoing unilateral primary THA from September 2012 to June 2015 were selected and randomly divided into the group A,B,C,D and E (n=30).The group A did not use TXA,the group B received intravenous drip of 10 mg/kg TXA at 10 min before skin incision,the group Creceived intravenous drip of 15 mg/kg TXA at 10 min before skin incision,the group D respectively received intravenous drip of 15mL/kg TXA at 10 min before skin incision and after 3 h,the group E received intravenous drip of 15 mL/kg TXA at 10 min before skin incision and articular cavity use of 1 g TXA before closing the incision.Oral 10 mg rivaroxaban was given at postoperative 6-12 h when the drainage volume was less than 30 mL/h and then the conventional dose was used until postoperative 35 d.The intraoperative blood loss,postoperative drainage volume,hidden blood loss,blood transfusion rate,postoperative anticoagulation time,time of removing drainage tube,postoperative prothrombin time on postoperative 1 d,activated partial thromboplastin time,descend value of hemoglobin,and occurrence rates of postoperative deep vein thrombosis (DVT) and pulmonary embolism (PE) were observed in the group A,B,C,D and E.Results The intraoperative blood loss,postoperative drainage volume,hidden blood loss,blood transfusion rate and descend value of hemoglobin on postoperative 1 d had statistical differences among 5 groups(P＜0.05).The are significant differences between the group D and A in the intraoperative blood loss,postoperative drainage volume,hidden blood loss,blood transfusion rate,descend value of hemoglobin on postoperative 1 d,postoperative anticoagulation time and removal drainage tube time(P＜0.05).All cases had no symptomatic DVT and PE during the perioperative period and postoperative 3-month outpatient or telephone follow-up.Conclusion Sequential rivaroxaban use after applying TXA during THA perioperative period is safe and effective.Moreover intravenous drip of 15 mL/kg TXA at 10 min before skin incision and after 3 h has most significant effect in reducing bleeding volume during THA perioperative period.