Objective To discuss the utility of MRI in evaluating arrhythmogenic right ventricular cardiomyopathy(ARVC).Methods Nine patients of ARVC who received treatment in our hospital from January 2005 to May 2008,were retrospectively analyzed.They all underwent MRI by using GE signa 1.5 Tesla CV/I MR system.White blood technique(Fast cine sequence) were performed in short axis view,four-chamber view,and long axis view of two ventricles.Black blood techniques(Double IRFSE and Triple IRFSE) were performed in short axis view and long axis view of the right ventricle.Results MRI displayed thinning of the right ventricular(RV) wall(9 cases),dilatation of the RV(8 cases),fat signal intensity of the RV wall in DIRFS and irregular insula or continuity breaking in TIRFSE(3 cases),dilatation of the left ventricle(LV)(2 cases),a bit thickening of ventricular septum(1 case),enlargement of the outflow of the RV(2 cases),and ventricular wall aneurysm formation(2 cases).Their positions involved apex of the right ventricle(6 cases),facies diaphragmatica(4 cases),anterior ventricle(4 cases),infundibulum(4 cases) and the papillary muscle of the RV(1 case).Conclusion Cardiac MRI is the most specific and sensitive examination technique in diagnosing of ARVC,which can present structural and functional changes and the quality,degree,range of the disease.We recommend cardiac MRI if ARVC is suspected.

Objective To investigate the effects of ulinastatin on pro- and anti-inflammatory cytokines and respiratory index during open heart surgery under CPB. Methods Twenty ASA Ⅱ- Ⅲ patients of either sex (9 males, 11 females) scheduled for elective valve replacement under CPB were randomly divided into two groups of 10 each : control group (C) and ulinastatin group (W) . Patients with hepato-renal dysfunction or taking glucocorticoid were excluded. The patients were premedicated with intramuscular phenobarbital 0.1 g and scopolamine 0.3 mg. Anesthesia was induced with midazolam 0.1 mg?kg-1 , fentanyl 10?g?kg-1 and vecuronium 0.1mg?kg-1 . After tracheal intubation anesthesia was maintained with midazolam and fentanyl. The patients were mechanically ventilated. VT was set at 8-12 ml?kg-1 , RR 10-12 bpm and I: E 1:2. PETCO2 was maintained at 35-45 mg. In ulinastatin group, the patients received ulinastatin 12 000 U?kg-1 of which half was given i.v. before CPB and half was added to the priming fluid, while group C received normal saline instead of ulinastatin. Blood samples were taken from radial artery for determination of plasma TNF-?, IL-6, and IL-10 concentrations and blood gas analysis before operation (T1 ) , 30 min after initiation of CPB (T2), 1 h (T3 ) , 4 h (T4 ) and 24 h (T5 ) after CPB. Respiratouy index (PA-aDO2/ PaO2) was calculated at T1-5 .Results There were no significant differences in sex, age, weight, height, duration of CPB, and aortic cross-clamping time between the two groups. In group C the plasma levels of TNF-?, IL-6 and IL-10 were significantly higher than the baseline values (T1 ) during and after CPB (P

The concentration of cytosol receptors for estrogen(ERc).progestin(PRc).and androgen(ARc)were deterimined in the tissue specimens of uterine myoma,uterine myoadenopa-thy,and postmenopausal uterus and of normal endometrium and myometrium as well.It was found that the concentration of ERc.PRc and ARc was significantly higher in myomatous tissue than in normal myometrium.Remarkable difference existed of the concentration of sex steroid receptors between normal endometrium and adenomyosis tissue.Postmenopausal uterine tissue still retained high concentration of ERc.PRc and ARc.In addition,the regulation of sex steroids in these pathological conditions was discussed.

The paper analyzes the status of hospital websites construction in Jiangau province, which would provide useful evidence for further development. Surfing on the hospital wehaites covering both third and second class hospital in Jiangsu province, it reveals that the websites of third-class hospital are much better than the second-class ones. However, both of them have problems on contents, domain names and interactive parts. The paper suggests that we should constantly explore the methods and ways to solve those existing prob-lems, focus on strengthening informafization construction in hospital and play its advantages.

Objective To observe-the different effects of 2 doses recombinant human granulocyte colony-stimulating factors (rhG-CSF) on Nogo receptor(NgR) expression in the brain tissue of neonatal rats after hypoxic-ischemic brain damage(HIBD) at different times in order to reveal the neuroprotective effects of rhG-CSF.Methods Seven-day neonatal Sprague-Dawley(SD) rats were randomly divided into 4 groups by drawing method:sham operation group,model group,low-dose rhG-CSF group and high-dose rhG-CSF group,24 rats in each group.Then each group was divided into 4 subgroups (6 rats in each subgroup)and all rats were exterminated at different times after HIBD(1 d,3 d,7 d and 14 d).In the low-dose rhG-CSF group and high-dose rhG-CSF group,the rats were given daily doses of rhG-CSF 50 μg/kg,100 μg/kg respectively for 7 days by subcutaneous injection immediately after the molding(total 7 injections).In model group,rats received an injection of same amount of 9 g/L saline.In sham operation group,rats received no special treatment.Brain tissues of rats from each group were collected at different time points.The expressions of NgR protein and NgR mRNA in the left brain tissue were detected by immunohistochemistry and real-time fluorescent quantitative polymerase chain reaction (PCR).Results Immunohistochemistry:NgR proteins were constitutively expressed in the cerebral cortex in sham operation group at each time point;compared with sham operation group,the expressions of NgR in model group were increased markedly at each time point (135.67 ± 16.63,173.98 ± 17.82,234.00 ± 14.70,319.59 ± 25.22),and the differences were statistically significant(all P ＜ 0.01);compared with model group,the expressions of NgR in the cerebral cortex in low-dose rhG-CSF group (134.35 ± 8.89,109.04 ± 12.62,75.99 ± 13.39) and high-dose rhG-CSF group (81.38 ± 12.25,80.14 ± 10.50,72.58 ± 13.66) on the 3rd,7th,14th day were reduced significantly (all P ＜ 0.01).Compared with low-dose rhG-CSF group,the protein expressions of NgR in the high-does rhG-CSF group were decreased faster,and had the marked difference on the 3rd,7th day (P ＜ 0.05).Real-time fluorescent quantitative PCR:compared with the sham operation group,the expressions of NgR mRNA increased gradually in the cerebral cortex in the model group (1.34 ± 0.24,1.88 ± 0.27,2.88 ± 0.84,4.26 ± 0.86),the differences in NgR mRNA expression were statistically significant at different times(all P ＜ 0.05) ; compared with model group,the expressions of NgR mRNA in low-dose rhG-CSF group on the 7th (1.08 ± 0.30),14th day (0.93 ± O.26) and high-dose rhG-CSF group on the 3rd (0.61 ± 0.10),7th (0.56 ± 0.28),14th day (0.47 ± 0.12) were significantly different (all P ＜ 0.05).The expressions of low-dose group and high-dose group were reduced gradually.The NgR mRNA expression reduced more quickly in the high-dose group than in the low-dose rhG-CSF group and had substantial difference between two groups in 3 days (P ＜ 0.05).Conclusions The findings suggest that rhG-CSF intervention can reduce the expressions of NgR in the brain tissues of neonatal rats after HIBD,and low-dose rhG-CSF also has neuroprotective effect,but it could be weaker than high-dose rhG-CSF.

Objective To establish a method for the determination of complanatuside in Semen Astragali Complanati, and study the content change of complanatuside processed. Method HPLC was used with Apollo-C18 column (4.6 mm?250 mm, 5 ?m), acetonitrile-0.1%phosphoric acid (21∶79) as mobile phase, the flow rate at 1.0 mL/min, and detected wavelength was set at 266 nm. Result Complanatuside showed a good linearity relationship in the range of 0.041 6～0.665 6 ?g, r =0.999 9. The average recovery was 100.6%, RSD was 0.73%. Conclusion The method is simple, accurate, reproducibility and strong specificity. It can be used for the quality control of Semen Astragali Complanati. Processing with salt can lead to content decrease of complanatuside in Semen Astragali Complanati.

Objective To investigate the effect of ulinastin on the gastro-intestinal circulation and systemic inflammatory response during open heart surgery with cardiopulmonary bypass( CPB) .Methods Thirty adult patients undergoing valve replacement with mild hypothermic CPB were randomly divided into two groups: ulinastin group (U ,n = 15) and control group (C , n = 15). In ulinastin group patients received ulinastin 6000 IU?kg-1iv after induction of anesthesia and another 6000 IU?kg-1 was added into the priming solution. In control group patients received equal volume of normal saline, instead of ulinastin. The patients were premedicated with morphine 0.2 mg?kg-1 and scopolamine 0.06 mg?kg-1 .Ranitidine 1 mg?kg-1 was given iv before induction of anesthesia. Anesthesia was induced with midazolam 0.1 mg?kg-1 , fentanyl 10?g?kg-1 and vecuronium 0.1 mg?kg-1 and maintained with fentanyl 50-60?g?kg-1, midazolam, isoflurane and vecuroinum. The patients were intubated and mechanically ventilated. PET CO2 was maintained at 35-45 mm Hg during operation. Gastric intramucosal PCO2 (PiCO2 ) was measured (pHi was calculated) and blood concentrations of TNF-?and IL-6 were determined before CPB (T0), 30 min after aorta was cross-clamped (T1), 60 min after termination of CPB(T2 ) and 6 h after operation (T3 ) .Results The two groups were comparable with regard to age, sex, body weight, ejection fraction, duration of CPB and cross-clamping time. (1) pHi decreased significantly at T1-2 as compared with the baseline value at T0 (P

Objective To compare the effects of snfentanil and fentanyl combined anesthesia on stress responses in pediatric patients undergoing surgical repair of congenital heart defect with cardiopulmonary bypass (CPB) .Methods Twenty-four pediatric patients aged 2-6 yr undergoing surgical repair of congenital heart defect were randomized into 2 groups (n=12 each): sufentanil combined anesthesia group (group S) and fetanyl combined anesthesia group (group F). The patients were premedicated with intramuscular morphine 0.2 mg/kg, scopolamine 0.01 mg/kg and ketamine 5 mg/kg. Anesthesia was induced with midazolam 0.1 mg/kg and snfentanil 0.7 μg/kg (in group S) or fentanyl 5 μg/kg (in group F). Tracheal intubation was facilitated with vecuronium 0.15 mg/kg. The patients were mechanically ventilated. PCO_2 was maintained at 35-45 mm Hg. Anesthesia was maintained with propofol infusion at 6-9 mg·kg~(-1)·h~(-1) and intermittent in boluses of midazolam,vecuronium and 3 doses of sufentanil (0.7, 1.5, 1.5 μg/kg) or fentanyl (5, 10, 10 μg/kg). Arterial blood samples were taken after entering the operation room, at 1 min after tracheal intubation, 1 min after splitting of sternum, immediately after rewarming, 10 min after termination of CPB and 24 h after operation for determination of plasma ACTH, cortisol, glucagon, lactic acid and blood glucose. Results The MAP and HR were maintained in the normal range during operation in both groups. The plasma concentrations of ACTH, cortisol, glucaon and lactic acid were significantly lower in group S than in group F. Plasma ACTH cortisol, glucagon, lactic acid and blood glucose increased significantly during operation as compared with the baseline before anesthesia in both groups. Conclusion Sufentanil combined anesthesia can inhibit stress response in pediatric patients more effectively during surgical repair of congenital cardiac defect performed under CPB.

Purpose To explore the value of ultrasound contrast time-intensity curves in hepatic tumor qualitative diagnosis and evaluation of tumor ablation effect. Materials and Methods Forty-two patients who were clinically diagnosed as hepatic cancer or cirrhosis underwent contrast enhanced ultrasound for the tumor lesions within the liver, dynamic analysis of the lesions were executed with software SonoLiver CAP, the nature of the tumors were determined and the results were compared with those of the enhanced MRI. Ultrasound guided biopsy was followed with radiofrequency ablation treatment, two-dimensional and contrast enhanced ultrasound were executed two weeks after the ablation, and the results were compared with enhanced MRI findings during corresponding period. Results 52 tumor nodules were found with two-dimensional and color Doppler ultrasound, 65 (33 hyperplastic nodules, 32 malignant lesions) with CEUS, 65 (21 hyperplastic nodules, 44 malignant lesions) with ultrasound contrast time-intensity curves, and 61 (20 hyperplastic nodules, 41malignant lesions) with contrast enhanced MRI; pathological examination revealed that 26 of the lesions were benign and 39 were malignant;there was statistically significant difference (χ2=4.561, P<0.05) between the results of ultrasound contrast time-intensity curves and simple contrast enhanced ultrasound for the assessment of the nature of tumor;no statistically significant difference (χ2=0.003, P>0.05) was found between ultrasound contrast time-intensity curves and enhanced MRI for the assessment of the nature of tumor;there was statistically significant difference (χ2=5.298, P<0.05) between ultrasound contrast time-intensity curves and simple contrast enhanced ultrasound for the assessment of whether the tumor was malignant or benign, when taking biopsy results as the reference standard. Conclusion With ultrasound contrast time-intensity curves, dynamical, intuitive, and quantitative evaluation can be obtained for the perfusion differences between the lesion and the surrounding liver parenchyma, which provides more accurate information for qualitative diagnosis of hepatic tumors thus contains great application value in the evaluation of the effects of radiofrequency ablation for hepatic tumors.

This article discussed characteristics of current off-label drug use in China and other countries,and analyzed the current administration and future development,making valuable reference for off-label drug use.