Objective:To investigate the incidence rate of carditis secondary to Kawasaki disease(KD)and its prognosis.Methods:Clinical data including serum myocardial enzymes such as CK-MB and cTnI,Holter and 12-lead and high frequency electrocardiograms and echocardiography test results,clinical manifestation,therapeutic methods and prognosis were analyzed retrospectively in 182 patients with KD.Results:About 35%patients had abnormal CK-MB,cTnI,ECG or UCG in acute phase,but they had no typical carditis clinical manifestation besides 2 cases with heart failure.90.66% cases were given intravenous immune globulin(IVIG)within ten days from the onset and within one to nine months of follow-up,CK-MB,cTnI,ECG or UCG had improved or returned to normal.Valvular inadequacy,hypokinetic left ventricle,ventricle amplification and pericardial effusion disappeared gradually in three to ten weeks,.Valvular lesion,heart amplification,constrictive pericarditis and serious arrhythmia were not found.Conclusion:This study showea about 35% patients with KD might develop low-grade transient myocarditis,pericarditis or endocarditis.An early diagnosis and therapy could lead for the patients to have good course and no sequelae.

Objective:To estimate the prevalence,impact,prevention and cure of diarrhea of inhabitants in Chongqing urban areas within two weeks before the interview.Methods:A population-based telephone survey about diarrhea of inhabitants in Chongqing urban areas was conducted.Results:A total of 1114 subjects completed interviews (83.51% response rate).Among respondents,95 reported diarrhea,and the two-week morbidity was 8.5%. Men were more likely than women to report diarrhea(9.51% vs 7.80%).The morbidity of those

Objective:To assess the preoperative management strategy for patients with transposition of the great arteries and intact ventricular septum(TGA-IVS). Methods:Twenty eight patients with TGA-IVS were reviewed. We analyzed their clinical characteristics, method of diagnosis,preoperative management and outcome,mortality rate and the complication incidence before surgery. Results:There were 19 boys and 9 girls in this group,with the mean gestational age of 38+4 weeks and birth weight of 3.244 kg. 7 cases (25%)were prenatal diagnosis,while the remaining 21 cases were postnatal diagnosis at the mean age of 45 hours. The karyotype was normal in those tested and no extracardiac anomalies were found. Cyanosis was the most common and critical characterization been noticed. Diagnosis generally could be confirmed by echocardiography. All patients received prostaglandin E2 (PGE2)infusion once highly suspected of or confirmed with TGA-IVS,25 of whom(89%)effectively maintained the patency of the ductus arteriosus preoperatively and was stopped PGE2 after Balloon atrial septostomy(BAS). BAS was performed successfully in all cases at the mean age of 21 hours,as judged by oxygen saturation increased from(56?26)% before BAS to(82?19)% after BAS(P

Objective To evaluate the influence of epidural block on blood coagulation and rhedogy in patients undergoing esophagectomy or lobectomy. Methods Twenty-two ASA Ⅰ-Ⅱ patients (14 male, 8 female) aged 40-65 yr undergoing esophagectomy or lobectomy were randomized to receive either combined general-epidural anesthesia (GEA group , n = 11) or general anesthesia (GA group, n = 11). The patients were premedicated with intramuscular pethidine 50 mg, promethazine 25 mg and scopolamine 0.3 mg. In GEA group epidural catheter was placed at T9-10 interspace before general anesthesia. A test dose of 4 ml 2% lidocaine was given. When correct positioning of the epidural catheter was confirmed, general anesthesia was induced with propofol 1.5-2.0 mg? kg-1 , fentanyl 2?g?kg-1 and rocuronium 0.6 mg? kg-1 , after placement of double- lumen endobronchial tube the patients were mechanically ventilated (VT 10 ml?kg-1 , RR 12 bpm, I: E = 1:2). Anesthesia was maintained with isoflurane inhalation and intermittent i. v. boluses of vecuronium. A mixture of 2 % lidocaine and 0.33% dicaine (1:1) was continuously infused at a rate of 4-6 ml?h-1 during operation. After operation PCEA was commenced with 0.12% ropivacaine and morphine 80 ?g?ml-1 (background infusion 4 ml?h-1 , bolus dose 2 ml, lockout interval 6 min) . In GA group the patients received the same general anesthesia technique. Postoperatively the patients were placed on PCIA with morphine 0.5 mg?ml-1 (background infusion 1 ml?h-1 , bolus dose 2 ml, lockout interval 6 min) Pain intensity was measured using VAS (0-10). Blood samples were taken before induction of anesthesia (T0, baseline), 1 and 3 h after skin incision (T1 , T2 ) and on the morning of 1st and 3rd postoperative day (T3 , T4 ) . Blood samples were tested immediately in a thromboelastograph (TEG) coagulation analyzer. Usual clotting tests (PT, APTT, platelet count, Hb, Hct), fibrinolysis tests (t-PA, PAI-A) and rheology tests were performed at the same time. Results PT and APTT were significantly prolonged during and after operation (T2,T3 ) as compared with the baseline values in both groups (P

BACKGROUND:Mesenchymal stem cells have been an important source of seed cells for tissue engineering, regenerative medicine and immunosuppressive therapy areas. The large expansion is the key to the clinical application of mesenchymal stem cells. OBJECTIVE:To summarize the research progress in the in vitro expansion of human mesenchymal stem cells in animal serum-free media. METHODS:A computer-based online retrieval of CNKI and PubMed databases was performed to search papers published between 2004 and 2014 using the key words of“mesenchymal (stromal) stem cells, animal serum-free media, humanized media, human serum, umbilical cord blood serum, platelet rich plasma, platelet lysate, defined medium”in English and Chinese, respectively. Final y, 41 articles were retained. RESULTS AND CONCLUSION:Human serum, umbilical cord blood serum, platelet rich plasma, platelet lysate and defined medium can replace fetal bovine serum for large-scale expansion of mesenchymal stem cells in vitro. These media or additives have their advantages and disadvantages;therefore, it is urgent to guarantee the functional effectiveness and transplantation safety before large-scale, systematic clinical application of mesenchymal stem cells.

BACKGROUND:Platelet lysate has been known as a kind of lysate of autologous or alogeneic platelet-rich products. It not only removes the residual cel structure, reduces immunogenicity, but also retains many growth factors. Platelet lysate has been suggested as a substitute for fetal bovine serum to expand mesenchymal stem cels in vitro. OBJECTIVE:To observe the effects of platelet lysate on biological characteristics of human bone marrow mesenchymal stem cels and adipose mesenchymal stem cels, and provide some experimental data for clinical cel therapy and regenerative medicine. METHODS:Platelet lysate was prepared by repeated freezing and thawing from fresh blood. Healthy adult bone marrow and adipose tissue were colected. Human bone marrow mesenchymal stem cels and adipose mesenchymal stem cels were obtained by density gradient centrifugation and type I colagenase digestion. We tested the morphology, cel phenotype, differentiation characteristics, proliferation capacity, colony forming ability and the level of cytokine secretion of bone marrow mesenchymal stem cels and adipose mesenchymal stem cels after cultured with platelet lysis. RESULTS AND CONCLUSION:Bone marrow mesenchymal stem cels and adipose mesenchymal stem cels were successfuly cultured in vitro using platelet lysate. There were no significant differences in morphology, cel phenotype, colony forming ability and the level of cytokine secretion, and chondrogenic, osteogenic and adipogenic capacities between bone marrow mesenchymal stem cels and adipose mesenchymal stem cels. Adipose mesenchymal stem cels had a high cumulative population doublings than bone marrow mesenchymal stem cels (P < 0.05). These findings suggest adipose mesenchymal stem cels had a stronger proliferative ability, and are more suitable for large-scale expansionin vitro cultivation system of platelet lysate compared with bone marrow mesenchymal stem cels.

BACKGROUND:Classic media and fetal bovine serum are commonly used in the culture of umbilical cord mesenchymal stem cells, but the potential risk of serum culture limits its clinical application. OBJECTIVE:To use human platelet lysate alternative to fetal bovine serum for large-scale production of mesenchymal stem cells for therapeutic applications. METHODS:Human platelet lysate was prepared by repeated freezing and thawing, centrifugation, filtration, and concentration. Human umbilical cord mesenchymal stem cells were cultured in Iscove’s Modified Dulbecco’s Medium containing 5%concentrated platelet lysate (experimental group) or 10%fetal bovine serum (control group). After separation and enzymatic digestion, human umbilical cord mesenchymal stem cells were subcultured at a concentration of 3 000/cm2 up to the fifth generation. Then, cellmorphology and diameter, immune phenotype, osteogenic and adipogenic differentiation, and cloning efficiency were detected and compared between two groups. RESULTS AND CONCLUSION:Human umbilical cord mesenchymal stem cells cultivated in human platelet lysate-supplemented media showed a smal er size and more elongated morphology than those in fetal bovine serum-supplemented media. Colony forming unit-fibroblast analyses further showed no significant differences in colony efficiency. Human umbilical cord mesenchymal stem cells cultivated in human platelet lysate-supplemented media showed an increase of proliferation capacity;whereas, similar immunophenotypes remained in the two groups. In vitro assays revealed intact differentiation potential. Moreover, human umbilical cord mesenchymal stem cells cultivated in human platelet lysate-supplemented media showed a significantly higher capacity to differentiate towards osteocytes, indicating human platelet lysate is an alternative to fetal bovine serum for low-density production of mesenchymal stem cells for therapeutic applications.

Objective To explore the expression and significance of nestin in renal tubular epithelial cells in hypercholesterolemic rats. Methods Dietary-induced hyperlipidemia were induced in female SD rats by given 4% cholesterol and 1% cholic acid diet for 16 weeks. Changes of serum lipid, urinary albumin, serum creatinine and renal interstitial pathological changes were assessed. The expression of nestin and a-smooth muscle actin (α-SMA) were detected by immunohistochemical stain. Results The serum levels of total cholesterol, low density lipoprotein, urinary albumin and serum creatinine were significantly increased in hyperlipidemia group, accompanied with renal interstitial injury and fibrosis. As time extended, the expression of nestin and a-SMA in renal tubular epithelial cells were increased significantly. There was positive correlation among the expression of nestin and total cholesterol, low density lipoprotein, urinary albumin and serum creatinine( r =0.963,0.830,0.944,0.706, P <0.01). Nestin also had a positive correlation with tubular-interstitial index ( r = 0. 974, P < 0. 01) and α-SMA ( r = 0. 804, P < 0. 01). Conclusion The increased expression of nestin may be associated with renal tubular-interstitial fibrosis and tubular epithelial myofibroblast transdifferentiation in hypercholesterolemic rats.

Objective To explore the risk factors of ventilator-associated pneumonia(VAP)in neonatal patients.Methods A retrospective study was conducted on the 82 neonates who had ever received mechanical ventilation for more than 48 hours,non-conditional logistic regression analysis was performed to determine independent predictors for VAP.Results By logistic regression analysis,the following risk factors independently predicted VAP:gestational age(OR = 6.209,95%CI =2.112～16.835),duration of mechanical ventilation(OR =5.842,95%CI = 1.366～14.936),times of endotracheal suctioning(OR =4.764,95%CI = 1.416～14.736),re-intubation(OR = 6.190,95%CI = 1.669～16.019),gastric tubes retention(OR =6.794,95%CI = 1.928～19.160),treatment with CNS suppressant(OR = 4.297,95%CI = 1.002～15.216).Conclusion The neonatal VAP occoured for multiple facors,the rsik factors include gestational age,duration of mechanical ventilation,endotracheal suctioning,re-intubadon,gastric tubes retention and treatment with CNS suppressant.

Objective To evaluate parathyroidectomy combined with parathyroid tissue transplantation in forearm in the treatment of severe secondary hyperparathyroidism (SHP). Methods 9 cases treated with the procedure were reviewed.The diagnosis,operation indication and peri operative management were discussed. Results Thirty five hypertrophic parathyroids were resected from the 9 cases with SHP,and a left thyroidectomy was carried out for one case.Some parathyroid tissue has been grafted into the forearm for every patient.All of those grafts have survived.The symptoms va nished in all and the relevent laboratory tests recovered to normal after the surgery. Conclusions This surgical strategy is safe and effective for SHP not benefited from medical therapy.