OBJECTIVE:To prepare adriamycin-loaded PLGA-PLL-PEG nanoparticles,and study its antitumor activity. METH-ODS:PLGA-PLL-PEG with the polymerization of PLGA-PLL and activated polyethylene glycol was used as carrier for adriamy-cin,and adriamycin-loaded PLGA-PLL-PEG nanoparticles were prepared. The shape size,particle size distribution,adriamycin con-tent of nanoparticles were detected,drug loading and encapsulation efficiency were calculated. Cumulative release rate (Q) of nanoparticles and adriamycin within 144 h and its proliferation inhibition rate on breast cancer HeLa cells were compared,and half inhibitory rate (IC50) was calculated. RESULTS:Prepared adriamycin-loaded PLGA-PLL-PEG nanoparticles were regular circular with good dispersion and no adhesion. The average particle size was (136.7 ± 9.3) nm (n=5),average encapsulation efficiency was(76.67±8.63)%,average drug loading was(3.86±0.55)%(n=3). Q12 h of adriamycin had reached 100%;Q12 h of adriamy-cin-loaded PLGA-PLL-PEG nanoparticles was 52.9%,Q144 h was 81.2%. The inhibitory rate of adriamycin-loaded PLGA-PLL-PEG nanoparticles on HeLa cells increased slowly than adriamycin;IC50 were 1.844,0.345 μg/mL,respectively. CONCLUSIONS:Adri-amycin-loaded PLGA-PLL-PEG nanoparticles are prepared successfully,showing good sustained-release effect and more significant inhibitory effect than adriamycin.

Objective To analyze the independent risk factors associated with acute kidney injury(AKI)after Sun’s pro-cedure in the patients with acute aortic dissection .Methods Clinical data of 400 patients who underwent Sun ’ s procedure from February 2009 to August 2013 were collected.Data included preoperative GFR, Cleveland values, CPB time and fluid balance of 24 h intra and after operation were gathered .The patients were divided into the group of AKI and the group of non-AKI accounting to the changing of serum creatinine.Results AKI was occurred in 150(37.5%) patients.Hospital mortality in AKI group was significant higher than that in the non-AKI group(11.3% vs.2.4%, P<0.05).Univariable analysis re-vealed male, BWI, hypertension, preoperative MAP,WBC, eGFR, Cleveland value, cardiopulmonary bypass time, intra and postoperative fluid balance for 24 h have significant difference between 2 groups.Multivariate logistic regression analysis showed hypertension, Cleveland value, cardiopulmonary bypass time and fluid balance were independent risk factors for AKI .Conclu-sion AKI after acute aortic dissection was a severe complication .Hypertension, Cleveland value, cardiopulmonary time and fluid balance were associated with AKI.

Viral myocarditis (VM) refers to human infections thermophilic myocardium virus that causes the circumscribed or diffuse myocardium-inflammatory lesion.Myocarditis can be caused by a variety of microbial infections,and VM is the most common one.In order to make the medical staff in clinical work have a more in-depth understanding of VM,this paper describes the common rviruses related,VM and its pathogenesis,process.At present,there is no effective drug and treatment method for VM.It is particularly important to further study the pathogenesis of VM on the role of the virus in,and inhibit its role in the further exploration of clinical therapeutic targets,to improve the quality of life of patients with VM and prolong the survival time is of great significance.Studying in-depth virus in the pathogenesis of VM and restraining its function are particularly important for the further exploration of clinical therapeutic targets.It is significant to improve the life quality and prolong the survival time for VM patients.

Objective To evaluate the impact of cerebrospinal fluid drain(CSFD) on the incidence of acute spinal cord injury(SCI) following extensive TAAA repair.Methods From February 2009 to July 2016,153 patients underwent extensive TAAA repairs with a consistent strategy of normal thermia,non-circulatory bypass,sequential aortic cross clamping,aortic-lilac bypass,and intercostal artery reconstruction.The repairs were performed with preoperative CSFD (n =78) or without CSFD (n =75).In the former group,CSFD was inserted after the patient has been anaesthetized and continued for 72 hours after surgery.The target CSF pressure was 10 mmHg or less.Results The mean age of patients was (38 ± 10) years and 108 (70.6％) were male.There were 87 (53.8％) patients with previous aortic surgeries and 33 (22％) with Marfan syndrome.The two groups had similar risk factors for paraplegia.Aortic clamp time,operation time and number of reattached intercostal arteries were similar in both groups.In-hospital mortality rates were 1.3％ (one patient) and 6.7％ (five patients) for CSFD and the group without CSFD,respectively (P =0.086).Ten patients (13.3 ％) in the group without CSFD had paraplegia develop.In contrast,only two patients in the CSFD group(2.6％) had postoperative paraplegia(P =0.013).Stepwise logistic regression analysis identified CSFD had spinal cord protection,P =0.026;OR =0.171;95％ CI:0.036-0.809).No patients occurred CSF catheter related complications.Conclusion This randomized clinical trial showed that preoperative CSFD placement could be an effective strategy in preventing SCI following extensive aortic aneurysm repair.Care should be taken to prevent complications related to overdrainage.

Objective This study aims to analyze if high sensitivity C Reactive Protein (hs-CRP) was a independent risk factor of acute kidney injury(AKI) after A type aortic dissection surgery.Methods Clinical data of the 169 patients who underwent A type acute aortic dissection surgery from February 2009 to October 2010 were collected.Patients without preoperative detection of hs-CRP,patients with preoperative infection and patients diagnosed infection before AKI were excluded.Enrolled patients were divided into AKI group and non-AKI group,and according to using RRT or not,the patients were divided into RRT group and non-RRT group.All the factors were evaluated by means of univariate and multivariate logistic regression analysis to identify relative risk factors of AKI.Results AKI occurred in 95 cases(56.2％),Using RRT in 8 cases (4.7％).hsCRP is an independent risk factor of AKI(OR =0.975,95％ CI 0.952-0.999,P =0.041).hs-CRP and aortic cross clamping time were the independent risk factors of using RRT,The in-hospital mortality was significant difference between RRT group and non-RRT group (P ＜ 0.05).The area under the ROC curve of hs-CRP on RRT diagnosis was 0.733,95％ CI 0.570-0.896,P =0.026.The sensitivity of CRP ＞ 30.42 mg/L warning AKI need RRT was 87.5％,the specificity was 53.4％.Conclusion AKI after A type aortic dissection surgery was a severe complication and RRT associated with in-hospital mortality,hs-CRP was higher in acute aortic dissection patients.The level of hs-CRP and aortic cross clamping time were independent risk factors of AKI and RRT.

Objective This study aims to analyze midterm survival and to assess the midterm mortality following acute kidney failure (AKF) of patients undergoing surgical treatment of acute type A aortic dissection.Methods Clinical data of the patients who underwent Sun's procedure from February 2009 to March 2015 were collected.Patients with preoperative dialysis were excluded.Data including preoperative cardiovascular diseases,serum creatinine leve1 and CPB time were gathered.The patients were divided into the group of AKF and the group of non-AKF accounting to require dialysis.The group of AKF was follow-up by phone.Midterm mortality was studied with Cox analysis and midterm survival was estimated by Kaplan-Meier analysis.Results 524 patients underwent aortic surgeries which AKF was occurred in 51 (51/524,9.7％) patients.Hospital mortality was 23.5％ (12/51) in AKF group which seven death were strokes,three death were lower-extremity ischemia and two death were low cardio output.There were 2 patients dead with multi organ failure and paraplegia in first year.One reoperation patient because of anastomotic fistula was dead in fifth year.Only diabetes was independently associated with midterm mortality.Midterm survival for patients with AKF was 56％ during a median follow-up of 30.5 months.Survival was equal between the subgroups of Cr ＞ 200 mol/L and Cr ＜ 200 mol/L(P =0.741).Conclusion AKF after acute aortic dissection was a severe complication and the incidence was 9.7％.In patients with AKF,diabetes was associated with increased mortality across follow-up.Five years survival was 56％ not effected by preoperative Cr.

AIM: To investigate the effects of caveolin-1 (Cav-1) scaffolding domain peptide, cavtratin, on lipopolysaccharide (LPS)-induced mouse acute lung injury and heme oxygenase-1 (HO-1) activity.METHODS: Adult male BALB/c mice were randomly divided into 6 groups (n=8 to 10): control, Antennapedia internalization sequence (AP), LPS, LPS+hemin, LPS+ hemin+cavtratin and LPS+hemin+cavtratin+zinc protoporphyrin IX (ZnPP) groups.After LPS administration for 24 h, the lung pathological changes, the wet/dry weight (W/D) ratio of lung tissues, total cell number in bronchoalveolar lavage fluid and serum lactate dehydrogenase activity were measured.The co-localization of HO-1 and Cav-1 was displayed by immunofluorescence, and the HO-1 activity were detected.The mRNA expression of pro-inflammatory cytokines IL-1β, IL-6, TNF-α, MCP-1 and iNOS was detected by real-time PCR.RESULTS: The mice in LPS+hemin+cavtratin group had the decreased interaction between HO-1 and Cav-1, and the increased HO-1 activity compare with LPS group (P<0.05).Compared with LPS group, the pulmonary damage was attenuated in LPS+hemin+cavtratin group, and the injury indexes, including W/D ratio, total cell number in bronchoalveolar lavage fluid and lactate dehydrogenase activity in the serum, and the mRNA expression of inflammatory cytokines all decreased (P<0.05).HO-1 activity inhibitor ZnPP abolished the above protective effect of cavtratin on the lung tissues with LPS-induced acute lung injury.CONCLUSION: Cavtratin has beneficial effects on the lung with LPS-induced acute injury by restoring the HO-1 activity.

OBJECTIVE: To explore the clinical treatment effects of sea buckthorn oil for in different size traumatic perforation of tympanic membrane in different size. METHOD: Prospective, randomized study of 199 outpatients with traumatic perforation of tympanic membrane who were enrolled between December 2012 and December 2014 after informed consent. The patients were divided into treatment group (101 cases) and control group (98 cases). According to the size of the perforations, patients in each group were divided into large perforation group, middle perforation groups and small perforation group. The cases in large perforation group, middle perforation groups and small perforation group were 36, 34, 31 in treatment group and 35, 33, 30 in control group. The patients in treatment group were treated with sea buckthorn oil once a week, while the patient in control group were self-healing and checked once a week. All the patients were followed-up in two months. The healing rate of two groups was applied for the evaluation indicator of clinical effect. We compared the healing rate, average healing time and phological change of tympanic membrane of patients at the first and second month. RESULT: The total healing ratio of patients in treatment group is 62.4% and 79.2% compared with 29.6% and 57.1% in control group at the first and second month (P < 0.05). There is statistical significance between the healing ratios of middle, large perforation groups in treatment group and control group (P < 0.05). There is no statistical significance between the healing ratios of small perforation group in treatment group and control group (P > 0.05). The average healing time of large, middle and small perforation group at the second month are significantly shorter than the control group. CONCLUSION It is better to apply observation method and let it self-healed for small traumatic tympanic membrane perforation according to its higher healing ratio. While, it is better to apply sea buckthorn oil method for middle and large traumatic tympanic membrane perforation according to its lower healing ratios. Sea buckthorn oil treatment is benefitial for increasing the ratio of perforation healing, shorten the healing time, resumpting of the middle ear function earlier, helping most of the patients to avoid operation and the reduce medical expense. Therefore, it is valuable to promote the method in clinical treatment.
Drugs, Chinese Herbal ; therapeutic use ; Hippophae ; Humans ; Plant Oils ; therapeutic use ; Prospective Studies ; Tympanic Membrane ; injuries ; Tympanic Membrane Perforation ; drug therapy ; Wound Healing ; drug effects

Objective To assess the outcome of pemetrexed as monotherapy for Chinese patients with advanced non-small cell lung cancer ( NSCLC) at the Peking Union Medical College Hospital.Methods From February 2006 to August 2009, 69 patients with advanced NSCLC, including 36 (52.2% ) men and 33 (47.8%) women, received pemetrexed monotherapy.Six patients had squamous cell carcinoma, 57 adenocarcinoma, 6 unspecified.Median survival (MS) and progress-free survival (PFS) were calculated using the Kaplan-Meier method.Results Adverse events (AEs) were generally mild (grade 1 and 2) and reversible. The most frequent AEs were gastrointestinal adverse events, skin rash, fever and fatigue. Total 5 cases with 3/4 grade AEs were reported, including fever, fatigue, rash, decreased platelets and elevated ALT/AST. The objective tumour response rate and stable disease rate were 10.1% (7/69) and 47.8% (33/69) respectively. Median PFS of all patients was 4.7 months (95% CI 3.0 -6.4) and mean overall survival was 14.7 months (95% CI 11.5 - 17.9).Conclusions Our study suggests that treatment with pemetrexed may be well-tolerated and beneficial for some Chinese patients after failure of prior chemotherapy. The rate of disease control is high and the frequency of 3/4 grade AEs is very low.

Objective To quantitatively analyze the correlation between stenosis ratio and cerebral perfusion in patients with solely symptomatic M1 stenosis of middle cerebral artery.Methods All the patients with solely symptomatic M1 stenosis of middle cerebral artery were selected to this study from consecutive 203 patients with elective stenting of symptomatic intracranial artery stenosis.Brain CT, CT perfusion (CTP) and DSA examinations were performed in all cases.The CTP parameters of mean transit time (MTT), cerebral blood flow (CBF) and cerebral blood volume (CBV) were measured in regions of interest (ROIs) including bilateral frontal lobe, anterior watershed, opercula of the insula (including parsopercluaris and part of insula), temporal lobe, posterior watershed and occipital lobe.Compared with the unaffected side as control, the change of CTP and their relative CTP parameters in these ROIs at affected side were analyzed.Based on DSA data, the ratio of M1 stenosis was measured manually and blindly, the source of collateral branch of compensative artery was estimated and the blood flow was graded.Correlation between the ratio of M1 stenosis and the CTP parameters including the absolute and the relative values was investigated.Results Twenty patients were selected into this study; their average M1 stenosis ration of the affected side was 70.5% ± 10.6% (53% to 91%).Compared with the unaffected side, MTT and CBF were no significant change but CBV increased in the affected frontal lobe; MTT prolonged, CBF was normal and CBV increased in the affected anterior watershed and opercula of the insula; MTT prolonged, CBF and CBV had no significant difference in the affected temporal lobe; MTT prolonged, CBF decreased and CBV had no significant difference in the affected posterior watershed; MTT, CBF and CBV were normal in occipital lobe.Tissue perfusion gradually decreased from the front to the backward in all the M1 stenosis affected cerebral regions and the posterior watershed area was the only region at hemodynamic failure stage.Leptomeningeal vessels of the anterior cerebral artery were the major sources of compensative arteries shown in the DSA in all cases.The ratio of M1 stenosis was positively correlated (r =0.66, P =0.002) with the rCBV in posterior watershed and there is no significant correlation between the ratio and any other CTP parameters in any regions.Conclusions Associated with distribution of collateral compensative artery,tissue perfusion showed obvious spatial distribution at different level in different cerebral region.M1 stenosis ratio is positively correlated with rCBV in hemodynamic failure regions, and there is no correlation with tissue perfusion in hemodynamic compromise regions.