Ohjective To study the effects of emphysema on peripheral skeletal muscle biomechanics,pathomorphology and oxidative metabolism in rats.Methods Twenty Sprague-Dawley rats were used and randomized equally into a control group and an emphysema group.A dose of 40 U/100 g body weight of porcine pancreatic elastase was instilled into the trachea of the animals of the emphysema group to model emphysema,while the same volume of saline was instilled into those of the control group.Twenty weeks after instillation,in situ mechanical properties of gastrocnemius were evaluated.Gastrocnemius fiber type composition and capillary density (CD) were assessed by using ATPase staining.Lipofuscin accumulation (LI/F) was determined with the ferric-ferricyanide reduction test technique.Immunohistochemistry was used for the detection of nitric oxide synthases (NOS) in gastrocnemius.The muscle biopsy homogenate was used to measure the activity of superoxide dismutase (SOD),catalase (CAT),NOS,total antioxidant capacity (T-AOC) and the content of nitric oxide (NO).Results Emphysema increased fatigability and decreased the recovery rate of gastrocnemius muscle [(145.0 ± 55.4) s vs (55.2 ± 29.3)s,P ＜ 0.05].Compared to control,the gastrocnemius muscle in rats with emphysema had a lower CD [(513.9±71.1)n/mm2 vs (578.6 ±59.9)n/mm2,P ＜0.05] and a decreased proportion of type I fibers [(16.0 ±5.0)％ vs (30.7 ±4.1) ％,P ＜0.05],with a reciprocal increase in type II b/x fibers [(27.3 ±4.8)％vs (11.0±3.2)％,P＜0.05].LI/F was higher (3.3±0.5 vsl.7±0.4,P＜0.05) and the activity of SOD,CAT and T-AOC was increased in emphysema group.Compared with control,rats with emphysema demonstrated a lower expression of endothelial NOS (eNOS) (1.9 ± 0.5 vs 3.4 ± 0.6,P ＜ 0.05),and an equivalent expression of neuronal NOS (nNOS) (4.7 ± 1.0 vs 5.1 ± 0.8,P ＞ 0.05) in the gastrocnemius muscle.The inducible NOS (iNOS) was not found in both groups.Conclusions Emphysema could induce biomechanical,pathomorphological and oxidative metabolic changes in peripheral skeletal muscle.

Objective To investigate the expressions of peripheral type benzodiazepine receptor (PBR) and steroidogenic acute regulatory protein (StAR) of testis in rats with chronic ethanol feeding.Methods Forty rats were treated with different ethanol dosages for twenty weeks, the morphology of testis and protein expressions of PBR and StAR were observed.Results In the ethanol-feeding rats, seminiferous tubular wall of testes became thin and the layer of germ cells was significantly reduced, moreover, the broken spermatozoon′s flagella were frequently observed and few integrated spermatozoa were produced.Compared with control group, the protein expressions of PBR and StAR protein were reduced by 13.8%, 20.9%, 50.4% and 34.5%, 37.7%, 95.2% in low-, middle- and high-dose ethanol feeding group respectively by immunoprecipitation.Similarly, both locating at interstitial cells in testes were also decreased by 33.27 %, 37.71 %, 63.59 % and 27.12 %, 51.84 %, 58.41% in the same ethanol feeding groups respectively by immunohistochemistry.Conclusion Both PBR and StAR protein expressions are decreased in interstitial cells of testes in chronic ethanol-feeding rats, which shows positive correlation with ethanol dosage.

Objective The aim of this study was to evaluate of adilty of two acute renal failure-specific scoring systenms (the classification by Bellome et al and the AKIN criteria) for predicting hospital mortality after cardiac surgery in adult patients. Methods Between October 1 st 2006 to Decemjber 31 st 2006, 509 adult patients who ungerwent coronary artery bypass grafting (CABG) and/ or valve operation were enrolled in this study. The medical data collection included gender, age, types of operation, perioperative he- modynamic parameters, urine output, biochemical parameters and outcome. Renal function was assessed daily according to the classi- ficatinn by Bellomo and the AKIN criteria, respectively. As references, Acure Physiology and Chronic Health Evaluation(APACHE) Ⅱ and Sepsis-related Organ Failure Assessment (SOFA) score were also calculated. Resuits Three hundred and forty-one patients were male (67.0%), and 168 were female (33.0%), mean age was (56.2±12.0) years old. Tnree hundred and nine patieats un- derwent CABG, 182 underwent valve operation and 18 underwent CABG plus valve operation, Mean duration of ventilation support was (20.4±17.7) houra, and the ICU stay was (1.4±1.0) days. Postoperative hospital stay was (13.8±9.1) days. According to the classification by Bellomo., the highest in-hospital mortality was 52.9% in ARFS group. Mahiplicatinn of in-hospital morality rate was abserved (X2 for trend, P<0.01) in 0.4% (non-ARF), 1.2% (stage 1), 12.0% (stal～ 2) and 32.4% (stage 3) of pa- tients based on the AKIN criteria. By applying the area under the receiver operating characteristic ourve, the classification by Bellomo and the AKIN criteria had good discriminative power. Furthering, multivariate logistic regression analysis verified that the Odds Ratio of the AKIN criteria was 5.478 (P =0.028, 95% Confidence Interval 1.027- 24.856), after adjusting for gender and age. Con- clusion Analytical data confinned good discriminative power of both the AKIN criteria and the classification by Bellomo for predicting hospital mortality of adult postoperative patient with ARF.

Aim To investigate the effect of progester-one ( PROG) in protecting the neurons against impair-ment induced by the Aβ1-42 activated astrocytes, and the underlying molecular mechanism. Methods The astrocytes were divided into 5 groups: control, Aβ, and Aβplus PROG groups treated with 3 different con-centrations of progesterone for 24h. Then, Aβand pro-gesterone were removed, and neurons were co-cultured with the treated astrocytes. MTT assay was used to e-valuate the viability of cultured neurons; ELISA was used to detect the levels of IL-1βand TNF-αin culture media of astrocytes; immunofluorescence and Western blot were performed to detect the activation of NF-κB in astrocytes. Results PROG dose dependently pro-tected against Aβ1-42 activated astrocytes induced via-bility decrease in co-cultured neurons. Aβ induced release of IL-1β and TNF-α from astrocytes, and in-crease of NF-κB activity was abolished by progesterone treatment. Conclusion PROG protects the neurons through inhibiting the reactivity of astrocytes, and the underlying mechanism involves the NF-κB signal trans-duction.

Objective To evaluate the value of acute kidney injury network (AKIN) criteria for predicting hospital mortality in post-cardiosurgery elderly patients. Methods From October 2006 to January 2007, the elderly patients who underwent coronary artery bypass grafting or valve replacement operation were enrolled in this study. The medical data included gender, age, operation type, perioperative hemodynamic parameters, urine output, biochemical parameters and outcome. Renal function was assessed according to the AKIN criteria, and severity of illness was determined after surgery by calculating Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ ) score. Results A total of 225 patients underwent cardiac surgery during this period, 169 patients were male (75. 1%), while 56 were female (24. 9%), mean age was (66. 7±5. 0) years old. The overall hospital mortality rate was 5.8% (13/225). According to AKIN criteria, there were 125 patients with acute kidney injury (55.6%), and the hospital mortality of stage 1, 2 and 3 patients were 2. l%(2/96), 9. 1% (1/11) and 50. 0% (9/18) respectively. A significant increase was observed in mortality based on AKIN criteria (P<0. 01). By applying the area under the receiver operating characteristic curve, the AKIN criteria had a good discriminative power. Conclusions Both the incidence and mortality rate of acute kidney injury in the post-cardiosurgery elderly patients are high, the AKIN criteria is a simple and valuable method with a good prognostic capability for evaluating acute kidney injury.

Objective The incidence of post-operative hyperbilimbinemia, which is associated with poor outcomes in patients, was reported to be increased in recent years though it has been a rare complication for cardiac operations. Post-opera-tive impairment of liver function is highlighted. We evaluated the incidence and prognosis of post-operative hyperbiliruhinemia in adult patients who underwent cardiotomy with extracorporeal membrane oxygenation (ECMO) support. Methods Sixty-five adult patients who had received ECMO support after cardiac surgery from 2004 to 2008 were enrolled and evaluated retrospec-tively. Post-oporative hypethilirubinemia was defined as the serum level of the total bilirubin more than 51.3 μmol/L during postoperative period. Demographic and clinical data included gender, age, types of surgery, perioperative hemodynamic param-eters, biochemical variables, duration of the ventilation support, ICU stay and outcomes. Results The mean age of the pa-tients was (50.1 ± 13.9) years, forty-six patients(70.8%) were male. The main cardiac procedures were heart transplanta-tion for 9 patients, coronary artery bypass grafting and/or valve operations for 47 patients, congenital heart disease correction for 4 patients and other operations for 5 patients. Among all patients, fifty-one patients(78.5%) were weaned from ECMO succeas-fully and thirty-thrce patients were discharged from hospital. The overall mortality rate was 49.2%. Overall incidence of post-operative hyperbilirubinemia was 55.4%. In patients with postoperative hyperbilirubinemia, the mean peak value for serum to-tal bilirubin was 104.8 (68.5-156.7) μmol/l. The hospital mortality in the hyperbilirubinemia group was significantly higher than that in the non-hyperbilirubinemia group(66.7% vs. 27.6%, P <0.01). Moreover, postoperative hypethilirubinemia (adds ratio = 3. 895, 95% confidence interval, 1.088 - 13.947 ; P = 0.037) and SOFA score (odds ratio = 1.214, 95% confidence interval, 0.987 - 1.494, P = 0.047) and APACHE Ⅲ score (odds ratio = 1.096, 95% confidence interval, 1.028 - 1.169 ; P = 0.004) were associated with hospital mortality after adjusting for preoperative levels of the total bilirubin, direct bilirubin, gender and age. Conclusion Postoperative hyperbilirubinemia is one of the complications in adult patients who undergo cardiotomy with ECMO support, and is associated with increased hospital mortality.

Objective Extracorporeal membrane oxygenation (ECMO) provides a treatment for patients with acute heart-lung failure. However, as an invasive procedure, it associated with high incidence of complications. It is important to a-vert and reduce the complications for improving the success rate in critically ill patients. We investigate the complications associated with ECMO after cardiac surgery and their management. Methods Clinical data from 117 postoperative patients[32 male, mean age (48.7 ± 16.5) years]supported with ECMO in the cardiovascular intensive care unit( ICU) from March 2005 to June 2008 were analyzed retrospectively. The cardiac operations they had undergone included coronary artery bypass grafting (n = 20), coronary artery bypass grafting and remodeling of left ventricle(n =9), coronary artery bypass grafting and valvular operation(n =5), repair of ventricular septal perforation following acute myocardial infarction(n =2), valvular operation( n = 46), heart/lung transplantation (n = 20/1), correction of congenital heart defects ( n = 10), and aortic operations ( n = 4). Venoarterial bypass was established in 110 patients by cannulation of the right atrium and femoral artery, and that of the right atrium and ascending aorta in 5 cases. Left atrial drainage to ECMO was added in 2 cases. Venovenous bypass was established in 2 patients with hypoxemia following cardiac surgery. Heparin was infused for maintaining the activated coagulation time (ACT) at 160 to 200 seconds for centrifugal pump(114 cases),and 200 to 250 seconds for roller pump(3 cases) to avoid thrombotic events until decannulation was achieved. Results The mean ECMO duration was 61 hours (range 3 to 225 hours). 48(41.0% ) patients died, 18 of them died of complications after weaning from circulatory assistant successfully. Complications occurred in 74 (63.2% ) patients included reoperation for hemostasis (n = 24), renal failure requiring renal replacement therapy (n =29), nosocomial infections ( n = 32) , ischemia in the extremities(n = 5), plasma leakage of oxygenators ( n = 29), gastroenteral hemorrhage ( n = 14), hemolysis ( n = 7 ), neurological complications ( n = 4) and centrifugal pump failure (n =1). Conclusion Bleeding is an early complication associated with ECMO support. The risk of nosocomial infection, renal failure and plasma leakage of oxygenators increases with the duration of ECMO support.

This article was aimed to study the effect of polyphenols fromRubus suavissirnusS. Lee (RSLP) on spontaneous hypertensive rats (SHR) and to explore its mechanism of anti-hypertensive. The water extraction of RSLP was prepared. And the polyphenols was extracted with macroporous resin. The non-invasive blood pressure analysis system was used to detect the blood pressure. SHR model was selected to study the anti-hypertensive effect. The 16 normal Wistar rats were randomly divided into the control group and the normal RSLP high-dose group (RSLP-NH). The 40 SHR were randomly divided into the model group, Captopril group, RSLP-L group, RSLP-M group and RSLP-H group. SBP, DBP, HR, body weight and organ index were observed after the drug administration for 8 weeks and drug withdrawal for 2 weeks. The contents of SOD, MDA, GSH-Px, NO, NOS and ANP in serum were measured. The results showed that the blood pressure of SHR was significantly higher than that of the control group, which can be used for anti-hypertensive studies. Each RSLP group can obviously reduce the SBP and DBP of SHR (P < 0.05), but it had no effect on HR (P > 0.05). RSLP can elevate GSH-Px, SOD levels and reduce the activity of MDA (P < 0.05). RSLP can reduce NO, NOS and ANP contents in serum (P < 0.05). It was concluded that RSLP can significantly reduce the SBP and DBP of SHR, but it had no significant effect on HR. It can increase the activity of GSH-Px, SOD, NO, NOS levels, and reduce the contents of MDA, ANP in serum. It had certain inhibitory effect on the left ventricular hypertrophy.

Objective To investigate the effect of ERK1/2 phosphorylation on the proliferation of human aorta vascular smooth muscle cells (HAVSMCs) stimulated by advanced glycation end products (AGEs) Methods CCK8 was used to test the effect of AGEs with different concentration on the proliferation of HAVSMCs, and the effect of PD98059, a specific inhibitor of ERK1/2, on HAVSMCs proliferation stimulated by AGEs was also detected. Flow Cytometer (FCM) was used to detect the cell cycle transformation induced by AGEs. Western Blot was used to detect the expression of relative proteins. Results 10 mg/L AGEs observably facilitated the proliferation and the DNA synthesis of HAVSMCs and PD98059 (40 umol/L) markedly inhibited the proliferation and cell cycle evolution of HAVSMCs induced by AGEs. Furthermore, ERK1/2 phosphorylation, and PCNA were regulated by AGEs and thus it showed time and dose dependent. Conclusion AGEs participates in the proliferation of HAVSMCs by activating ERK1/2 signal path.

OBJECTIVE: To observe the effects of Xuefu Zhuyu Capsule (XFZYC), a compound traditional Chinese herbal medicine, on endothelin-1 (ET-1) release in myocardium and vascular endothelium and nitric oxide (NO)/nitric oxide synthase (NOS) system of swines after acute myocardial infarction (AMI) and reperfusion, and to explore the action mechanisms of XFZYC in improving the endothelium function. METHODS: Forty-five Yorkshire swines were randomized into 3 groups: sham-operated group, untreated group and XFZYC-treated group. A Yorkshire swine model of reperfusion in AMI was established by ligation of left anterior descending coronary artery for 90 min followed by 2 h relaxation. The content of serum ET-1 and NO was measured by radioimmunoassay before and after AMI and after reperfusion, respectively. Twenty-four hours after operation, all Yorkshire swines underwent diagnostic coronary angiography to delineate coronary arteries. The expressions of ET-1 and endothelial nitric oxide synthase (eNOS) in myocardial tissue of ischemic area were quantified with Western blotting. Microvessel density of the implanting sites was assessed by using HE staining. RESULTS: Compared with the untreated group, the levels of serum ET-1 after AMI and reperfusion were significantly decreased in XFZYC-treated group (P<0.01), while the NO levels after AMI and reperfusion in XFZYC-treated group were significantly increased (P<0.01). There was no significant difference in diagnostic coronary angiography between XFZYC-treated group and untreated group (P=0.253). Western blotting showed that the level of ET-1 in ischemic area in XFZYC-treated group was lower than that in the untreated group (P<0.01), while the eNOS protein expression in XFZYC-treated group was higher than that in the untreated group (P<0.01). The results of HE staining and microvessel density analysis of the implanting sites all showed that the degree of telangiectasis was reduced, the cardiac muscle damage was improved, and the density of capillaries was increased obviously in XFZYC-treated group as compared with the untreated group. CONCLUSION: The endothelium injury may be one of the important mechanisms for no-reflow phenomenon. XFZYC may reduce the no-reflow by protecting endothelium cells.