Adolescent ; Capillary Leak Syndrome ; chemically induced ; Female ; Granulocyte Colony-Stimulating Factor ; adverse effects ; Humans ; Male ; Middle Aged

Structural heart disease includes congenital cardiovascular structural abnormalities, valvular heart disease and cardiomyopathy, which shows the common features of cardiac anatomical structure and hemodynamic abnormalities, especially anatomical abnormalities. Echocardiography, especially three-dimensional (3D) ultrasound, is good at displaying anatomical structure and blood flow abnormalities. As a non-invasive method of examination, it has advantage in the evaluation of such heart diseases. In recent years, the gradual rise of 3D printing technology can make physical printing, and the printed heart model can stereoscopically display abnormal state of heart diseases. Ultrasound combined with 3D printing technology may provide more intuitive and accurate information for the assessment of structural heart disease.

Objective To investigate the diagnostic value of preoperative real-time three-dimensional color Doppler transthoracic echocardiography on assessment of patients with structural heart disease (SHD). Methods A total of 111 pa?tients were assessed preoperatively using real-time three-dimensional color Doppler transthoracic echocardiography (RT-3D-CDTTE), which include 31 SHD patients and 80 patients without SHD that were designed as negative control. Conven?tional two-dimensional color Doppler transthoracic echocardiography (2D-CDTTE) were used to compared with RT-3D-CDTTE while cardiovascular angiography and intraoperative findings were used as“Golden Standard”simultaneously. First of all, preoperative echocardiographic examination were performed and diagnosis was given. Angiography and intraoperative findings were hired to verify the accuracy of echocardiographic diagnosis before operation. Results (1) The preoperative RT-3D-CDTTE displayed three-dimensional structure and hemodynamic status of SHD cardiac lesions clearly, which were consistent with cardiovascular angiography and intraoperative findings. (2) P value of McNemar test between 2D-CDTTE and“Golden Standard”was greater than 0.05, Kappa=0.654 (P<0.001). P value of McNemar test between RT-3D-CDTTE and“Golden Standard”was greater than 0.05, Kappa=0.932 (P<0.001). Conclusion RT-3D-CDTTE can provides essen?tial information for preoperative evaluation which is important for decision of SHD management.

ObjectiveTo explore the damage of blood vessels in carbon monoxide poisoning patients by hyperbaric oxygen, especially for damage of vein, to understand the factors aggravating inflammatory response, thus work out the homologous protective measures.MethodsFrom January 2006 to January 2008, 80 patients of carbon monoxide poisoning were selected as the observation group. Another 80 patients with other diseases were set as the control group. Two groups both accepted hyperbaric oxygen treatment. The time of angioplerosis was compared between the two groups, besides, pain reaction of the observation group was also observed.ResultsThe time of angioplerosis was significantly different between the two groups, pain sensibility intensified in the observation group compared with that before treatment.ConclusionsHyperbaric therapy is closely related with vascular inflammatory reaction of carbon monoxide poisoning patients. Protective measures should be established in order to prevent further damage of vessel, relieve pain of patients and ensure smooth progress of the treatment.

Shanghai East Hospital has built a general practice residency training information system based on "Internet +" technology since 2017. This training system effectively promoted the training quality, improved the clinical and research ability of general practitioners, and strengthened the supervision of the training. It has improved the training satisfaction, increased passing rate of national medical licensing examination and graduation comprehensive examination of trainees. This training system can largely break the time and space limitations, and has strong replicability. It may provide reference to optimize the general practice standardized residency training for other institutions.

Objective To observe the clinical effects of lesionectomy combined with bipolar coagulation on the cortexes with epileptogenic foci in symptomatic epilepsy. Methods Twenty-three cases of space-occupying lesion complicated by secondary epilepsy were treated by lesionectomy combined with bipolar coagulation under cortical EEG monitoring, and the control rate of epilepsy after operation was studied during the follow-up. Results All cases were followed up for 20 months on average. The clinical success of the treatment was assessed according to the criteria of the International Epilepsy Institute:level Ⅰ 14 cases,levelⅡ5 cases,levelⅢ2 cases,levelⅣ2 cases.The success rates (level Ⅰ,ⅡandⅢ)amounted to 91.3%(21/23). Conclusions Lesionectomy combined with cortex thermocoagulation is safe and effective in the treatment of symptomatic epilepsy.

OBJECTIVETo study the mechanism of spontaneous rupture of hepatocellular carcinoma (HCC).

METHODSThe specimens of 30 patients with ruptured HCC and 30 patients with non-ruptured HCC were collected. Immunofluorescence, immunohistochemical and flow cytometry techniques were used to detect the phagocytosis of macrophages and the deposition of immune complex (IC) on vascular wall.

RESULTSIn this study, the poor function of macrophage phagocytosis was found in patients with ruptured HCC, which could results in the cumulating of IC and deposition on vascular wall. The IC, which composed of hepatitis B virus e1 antigen (HBeAg/1), complement C1q and immunoglobulins, was found deposited in the elastic membrane of arteries. Likely as a result of IC deposition, vascular injury occurs mainly in the small arteries where the deposition of IC was present. As the small arteries were the blood vessels with predominant injury, they would likely to be the ones to split and cause hemorrhage and rupture of HCC during vascular load increase.

CONCLUSIONSWe would conclude that the poor function of macrophage phagocytosis, which lead to the IC deposition and vascular injury may be the factors involved in the pathogenesis of ruptured HCC.

Adult ; Antigen-Antibody Complex ; metabolism ; Carcinoma, Hepatocellular ; immunology ; pathology ; Complement C1q ; metabolism ; Female ; Flow Cytometry ; Hepatitis B e Antigens ; metabolism ; Humans ; Immunoglobulins ; metabolism ; Immunohistochemistry ; Liver Neoplasms ; immunology ; pathology ; Macrophages ; immunology ; Male ; Middle Aged ; Rupture, Spontaneous ; immunology

Objective To study the mediating effect of psychological defense mechanism between personality and depression or anxiety in postgraduate entrance re-examinee. Methods 496 examinee in entrance re-examination of medical postgraduate were investigated by applying Minnesota Multiphasic Personality Inventory(MMsion and anxiety(r=0. 107 ～0. 668, P＜0.05). Psychological defense mechanism was remarkably correlated with depression and anxiety(r= -0. 090 ～ -0.666, P＜0.05;r=0. 131 ～0. 663, P＜0.01). Personality was significantly correlated with psychological defense mechanism (r = - 0. 158 ～ - 0. 586, P ＜ 0.01;r = 0.125 ～ 0.532, Psion, anxiety factor, explicit anxiety, and fear (21.6%, 43.8%, 35.7%, 65.7%). Conclusion Personality is a remarkable predictor of depression and anxiety,and has indirect and direct influence on depression and anxiety through psychological defense mechanism.

OBJECTIVETo explore the effect of combined therapy of shenmai and compound danshen injection (SM-DS) on myocardial reperfusion injury after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI).

METHODSThirty-eight AMI patients who received PCI were randomly divided into two groups, the 19 patients in the treated group were treated with SM-DS before and after PCI. Serum levels of malondialdehyde (MDA), superoxide dismutase (SOD), interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-alpha) in patients' venous blood were measured at different time-points, and the integrated left ventricular ejection isometric index (Tei) was determined by echocardiogram.

RESULTSAs compared with before operation in the treated group, MDA was higher and SOD was lower at 2 hrs, 24 hrs after operation (P < 0.05); IL-6 and TNF-alpha were significantly lower at 24 hrs, 48 hrs and 1 week (P < 0.05, P < 0.01) and the Tei began to be improved at 24 hrs (P < 0.05) and significantly improved at 1 week after operation (P < 0.01). While in the control group, MDA was higher and SOD was obviously lower at 2 hrs and 24 hrs (P < 0.01); lowering of IL-6 and TNF-alpha appeared at 1 week (P < 0.05) and improving of Tei index revealed 1 week after operation respectively (P < 0.05). Comparison between the two groups showed significant difference in levels of MDA and SOD at 2 hrs and 24 hrs (P < 0.01); significant difference in levels of IL-6, TNF-alpha at 24 hrs, 48 hrs and 1 week; and in Tei index at 24 hrs and 1 week after operation (P <0.05).

CONCLUSIONSM-DS could reduce the myocardial reperfusion injury in patients with AMI after PCI.

Adult ; Aged ; Angioplasty, Balloon, Coronary ; Drug Combinations ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; drug therapy ; therapy ; Myocardial Reperfusion Injury ; prevention & control ; Phytotherapy ; Plant Extracts ; therapeutic use ; Salvia miltiorrhiza

Objective:To study the influence of different culture conditions on charcic and inhibition activity of nature killer cells ( NK) ,whether to join the modified K562 cells with IL-6 cytokine.Methods:According to the 5′end of the human IL-6 cDNA sequence,PCR primers designed to amplificate,express and transfect K562 cells cDNA library as a template for DNA.Genetic modified K562 cells as stimulating cells were prepared by expressing IL-6.To extract peripheral blood mononuclear cells( PBMC) from human peripheral blood.PBMC were explanted by genetic modified K562 stimulated.The expansion was initiated by CO-culture of PBMC and irradiate genetic modified K562 cell.The number of NK cell increased by directed induced generation of genetic modified K562 cell.Immunophenotypic analysis of NK cell surface markers was performed by flow cytometry (FCM).51Cr release assay was employed to measure the specific lysis skilling of NK cell target K562 cells.Results:We have constracted genetic modified K562 cells by genetic engineering.As stimulated cell added into the PBMC,an average of 760 ±18 fold expansion of CD56+CD16+CD3-cells was observed after 3 weeks of co-culture system.The NK cells population could proliferated more 91%±2% after expansion comparing with 6%± 0.4%in PBMC before expansion by FCM.The cytotoxical activity of NK cells which was induced by genetic modified K562 cell was the strongest than induced by IL-6 cytokine alone.The expanded NK cells lysed 92%±2% of K562 targets in a 5∶1 effector to target ratio.In this case,the NK cells induced by genetic modified K562 cells against tumor cells was more lethal.Conclusion:PBMC based in vitro expansion of natural killer cells was set up by genetic modified K562 cells.The cytotoxicity of NK cells was the strongest induced by genetic modified K562 cell treated.These results had important guiding significance for the the NK large number of amplification and used in clinical.