OBJECTIVE:To prepare an intramyocardial bilayered porous biodegradable drug delivery stent and to evaluate its effects on myocardial channel after transmyocardial revascularization (TMR).METHODS:A biodegradable drug delivery stent was prepared by using poly (ε-caprolactone) (PCL),bovine serum albumin (BSA)and poly (D,L-lactide-co-glycolide) (PLGA).The levels of BSA in stent and released in vitro were determined by the Coomassie brilliant blue assay.The mechanical strength of stent was tested by universal material testing machines.Porcine models of chronic myocardial ischemia were created to evaluate the effects of this stent on myocardial channel after TMR,RESULTS:Each bilayered porous stent could carry 10 mg BSA and release about 80% of BSA after 30 days.The stent diminished 80% of initial scale under the stress of 1.2 MPa.It could keep myocardial channel patency after TMR.CONCLUSION:An intramyocardial bilayered porous biodegradable drug delivery stent was successfully prepared.It could sustain the pressure from the heart and maintain myocardial channel patency after TMR.

BACKGROUND: Studies have shown that basic fibroblast growth factor has effects on stimulating vessel regeneration and collateral reconstruction. However, administration was performed mostly by peripheral vein, left atrium or percutaneous coronary intervention, and it is difficult to achieve an effective therapeutic concentration in the local myocardium. OBJECTIVE: Based on the property of poly(D, I-lactic-coglycolic acid) (PLGA), to investigate outcomes of inducing neovascularization in the myocardium in combination of basic fibroblast growth factor (bFGF) by ensuring target release of protein growth factor in local tissue. METHODS: PLGA and bFGF were dissolved in dichloromethane. This liquid mixture was rolled into the form of a hollow tube (3.0 mm outer diameter, 2.8 mm inner diameter, 0.1 mm thick, 10 mm length) for further use. The middle third of the left anterior descending coronary artery of mini-swines was ligated, and the local myocardium became dark purple. After the successful establishment by abnormal regional wall motion in the cardiac apex at anterior wall using ultrasound, the mini-swines were assigned to channels and bare scaffolds (BS) group and channels and bFGF-incorporating scaffolds (FS) group. The scaffold was implanted in the myocardium using self-made hollow bit. At 6 weeks, the number of proliferative cells was quantified by immunohistochemical staining. New vessels were quantified utilizing Image-Pro Plus software package in both groups. Quantitative analysis of changes in mass defect percentage was performed by Emory Cardiac Toolbox software combined with single-photon-emission computed tomography. RESULTS AND CONCLUSION: At 6 weeks, number of proliferative cells and the density of new vessels were significantly increased in the FS group compared with BS group(P<0.001). Single-photon-emission computed tomography illustrates that MDP was significantly lower in the FS group compared with the BS group (P < 0.001). Results have suggested that PLGA scaffolds that incorporate bFGF were able to induce angiogenesis and enhance blood-flow perfusion.

Objective: To investigate the clinical efficacy of acupuncture combined with tuina in treating patients with cervical vertigo. ＜br> Methods: According to the principle of randomization, 258 cases with cervical vertigo who met the inclusion criteria for the study were randomly divided into an observation group and a control group, with 129 cases in each. The patients in the observation group received acupuncture combined with tuina therapy, while those in the control group were just treated by the same acupuncture therapy as in the observation group. After 10-day continuous treatments, the clinical efficacies of the two groups were analyzed and compared. ＜br> Results: The total effective rate of the observation group was 100%, versus 86.0% of the control group, and the difference was significant (P＜0.05). After treatment, cervical range of motion (ROM) scores in both groups were statistically significantly different from those before treatment (allP＜0.05); in addition, there was a statistically significant difference in inter-group comparison of ROM score (P＜0.05). ＜br> Conclusion: Compared with simple acupuncture treatment, acupuncture combined with tuina therapy has a better effect in improving the ROM of cervical vertigo patients, with higher clinical efficacy.

BACKGROUND: A new method, i.e., heparin slow-release stent implantation combined with myocardium drilling, is discovered for myocardial revasculadzation, which remarkably improves myocardial perfusion. OBJECTIVE: To investigate the effect of heparin slow-release stent implantation combined with myocardium drilling on myocardial regeneration of pigs with acute myocardial infarction.METHODS: Anterior descending coronary of pig was ligated to induce myocardial infarction model, which was randomly divided into control and implantation groups, with 6 pigs for each group. Self-made borer was used in the implantation group to drill two transmural channels (3.5 mm diameter) on epicardium. A heparin slow-release stent was fixed in the transmural channel. Following intravenous injection, BrdU was used to label DNA duplication so as to observe stromal cell-derived factor-1 (SDF-1) mRNA expression, myocardial perfusion, newborn yocardium, and heart function prior to and following implantation. RESULTS AND CONCLUSION: As compared with control group, SDF-1 expression was enhanced in the implantation group at 6 weeks after stent implantation (P < 0.001), perfusion mass defect percentage was significantly decreased (P < 0.001), ejection fraction of left ventricle was increased (P < 0.05), newborn myocardium was increased (P< 0.001), and survival myocardium in the ischemic region was increased (P < 0.001). The results demonstrated that heparin slow-release stent implantation combined with myocardium drilling could repair damaged myocardial cells and improve heart function through increasing SDF-1 expression and myocardial perfusion.

Objective To investigate the impact of glucose metabolism-related protein 1 (GMRP1) on the regulation of c-Myc gene transcription, to establish GMRP1 gene knockout mouse model, and to study the influence of GMRP1 on glucose metabolism. Methods Chromatin immunoprecipitation-PCR (ChIP-PCR) was utilized to screen out the genes transcriptionally regulated by GMRP1. Luciferase reporter system was applied to assay the regulation of c-Myc promoter activity by GMRP1. GMRP1 knockout mice were constructed and validated by PCR and western blotting. Body weight and random blood glucose were measured in both knockout and wild type mice fed with either chow diet or high-fat diet. The levels of glucose metabolism in mice of 20 or 28 weeks old were evaluated by intraperitoneal glucose tolerance test. Results GMRP1 was capable of binding to the promoter of c-Myc gene and activating the expression of c-Myc gene. There were no significant differences in body weight, random blood glucose or glucose tolerance between GMRP1-deficient and wild type mice fed with either chow diet or high-fat diet (all P > 0.05). Conclusion GMRP1 may activate the transcription of c-Myc gene. GMRP1 deficiency exerted no significant effects on mouse glucose metabolism.

Objective Biodegradable polycaprolactone (PCL)/poly D,L-lactic/glycolic acid (PLGA) scaffold is a promising modality for diffuse coronary atherosclerosis diseases unavailable to bypass graft.The purpose of this study was to evaluate the long-term performance of PCL/PLGA scaffold in vivo following polymer degradation.Methods Two scaffolds with and without heparin modification [Heparinized Scaffold (HS) and Blank Scaffold (BS)] were implanted.Except for control group,bone marrow mesenchymal stem cells (MSCs) were also transplanted around the scaffold.Animals were grouped into control BS group,BS-MSCs group and HS-MSCs group (each n =6) and survived 6 months.Patency and integrity of scaffold were evaluated by echocardiography and 3D-DOCTOR software.Endothelium coverage of the lumen was evaluated by scanning electron microscopy.Neovessles and collagen fiber within the scaffold were identified by histological staining.Prostacyclin (PGI2) and thromboxane (TXA2) production in the plasma were measured by ELISA.The expression of cyclooxygenase (COX-1,COX-2) and prostacyclin synthase PGIS was detected by Western blot.Results The heparinized scaffold kept patent up to 6 months and the lumen was covered by confluent endothelial cells.Histological staining revealed remodeling of collagen fiber and reconstruction of neovascular network immediately around the lumen.PGI2 production and PGIS expression in BSMSCs group and HS-MSCs group significantly increased compared with BS group (P ＜ 0.05 and P ＜ 0.01,respectively).Nonetheless,TXA2 production and COX-1 expression in BS-MSCs group was more pronounced than HS-MSCs group (P ＜ 0.01),showing no difference between BS-MSCs and BS group (P ＞ 0.05).Conclusion Despite polymer degradation and entire heparin release,the scaffold could continuously keep the structual integrity and lumen patency until 6 months by reinforcement of host collagen fiber and PGI2 expression.

Objective To study the efficacy of combining Entecavir with TACE to treat patients with primary hepatocellular carcinoma with undetectable levels of HBV-DNA.Methods From Aug 2011 to Sep 2013, patients with HBV-related hepatocellular carcinoma but with undetectable levels of HBV DNA who underwent TACE were divided into the treatment group (treated with Entecavir antiviral therapy) and the control group.The endpoints of the study were HBV reactivation rates, liver function, and survival rates.Results Using our predefined inclusion and exclusion criteria, 64 patients with primary liver cancer were divided into the treatment group (n =32) and the control group (n =32).The transaminase and bilirubin levels were raised and the albumin level was reduced at 5 days after TACE.However, there were no significant differences between the 2 groups (P ＞0.05).At 12-month follow-up after TACE, 8 (25.0％) patients developed HBV reactivation in the control group and 2 (6.3％) in the treatment group, the difference was significant (P ＜ 0.05).The level of transaminase was significantly higher in the HBV reactivation group when compared with the no HBV reactivation group (P ＜ 0.05).The overall 6-and 12-month survival rates in the treatment group and the control group were 93.8％ and 84.4％ vs 90.6％ and 59.4％ respectively.There were significant differences in the 12-month survival rates (P ＜ 0.05).Conclusion Entecavir combined with TACE to treat patients with HBV-related primary liver cancer with undetectable HBV-DNA effectively reduced HBV reactivation and improved survival at 12 months.

Objective To investigate the therapeutic effect of hydrogen-rich saline on the rheological behavior of leukocytes in mesentery capillary of rats with high-voltage electrical burn .Methods 180 rats were randomly divided into four groups :burn injury plus normal saline group ,burn injury plus hydrogen-rich saline group ,sham plus normal saline group ,and burn injury plus papaver-ine group .The rats were received saline ,hydrogen-rich saline ,saline ,papaverine at different time points after scald respectively .The changes of rheological behavior of leukocytes in mesentery capillary of rats before and after the injury were investigated .Results The rheological behavior of leukocytes in mesentery capillary of the control group were observed no significant change (P>0 .05) . In experimental group the rolling white blood cell count ,the number of leukocyte adhesion ,the length of contact of leukocyte-endo-thelial cell at each phase after injury were higher than those at 15 min before injury (P<0 .05);leukocyte rolling speed after injury is lower than that before injury (P<0 .05) .In treatment group and positive control group ,the rolling white blood cell count ,the number of leukocyte adhesion ,the length of contact of leukocyte-endothelial cell at each phase after injury were higher than those at 15 min before injury (P<0 .05) ,but compared with the experimental group ,the increase range was lower (P<0 .05) .leukocyte rolling speed after injury is lower than that before injury (P<0 .05) ,and compared with the experimental group ,the reduction was lower (P<0 .05) .Conclusion The hydrogen-rich brine can effectively reduce the changes of rheological behavior of leukocytes in mesentery capillary of rats caused by high-voltage electrical burn ,and have a protective effect on rat mesenteric .

This paper reported a rare case of hypercalcemic crisis caused by a parathyroid adenoma with hemorrhage and cystic degeneration. Preoperative imaging examination of the patient was unable to determine the histological origin of the cervical cystic lesion. Despite aggressive medical treatment and hemodialysis, hypercalcemic crisis could not be relieved. Therefore, surgical exploration and excision of the cervical lesion were performed, and final diagnosis of parathyroid adenoma with hemorrhage and cystic degeneration was confirmed by pathology. Blood calcium level and renal function returned to normal after the surgery.

Gallbladder-duodenal fistula is a rare disease in clinical practice, and difficult to diagnosis. One patient with high suspicion of gallbladder-duodenal fistula in preoperative examination was performed with percutaneous transhepatic gallbladder drainage due to could not tolerate surgical operation, and gallbladder-duodenal fistula was diagnosed with the gastric and intestinal fluids extracted from the drainage tube. In the later of fistula repair and the patient′s nutritional support management, the jejunal nutrition tube is inserted through the bile duct, and then the nutrition support was performed through this jejunal nutrition tube. This patients was recovered well.