BACKGROUND: The restenosis occurs up to 20%-30% following metal coronary stent implantation. Under the support of the 863 program, the feasibility to treat coronary artery stenosis using a novel drug-eluting stent (DES) has been investigated to reduce restenosis. OBJECTIVE: A drug-eluting stent (rapamycin as drug mode) was implanted into porcine models of coronary stenosis. The safety and efficacy of the drug-eluting stent were observed and compared with bare-metal stent. DESIGN, TIME AND SETTING: A randomized controlled animal experiment was performed in the Fu Wai Hospital for Cardiovascular Disease between November 2003 and April 2004. MATERIALS: A novel bioinspired phospholipid copolymer was synthesized by free radical polymerization of stearyl methacrylate, β-hydroxypropyl methacrylateand 3-(trimethoxysilyl) propylmethacrylate. METHODS: Twenty-one pigs were randomly divided into 3 groups: bare-mental stent, drug-eluting stent, and polymer-coated stent. The treated stents pre-loaded onto a delivery system through the use of crimping instrument were implanted into pig's coronary artery, with 2 stents per pig. MAIN OUTCOME MEASURES: Determination of luminal diameter, luminal area, mean intimal thickness on and between the stents, neointimal area, percentage of luminal area restenosis, and damage index using an image analysis instrument. RESULTS: At 28 days after implantation, there was significant difference in mean intimal thickness on and between the stents, as well as neointimal area, between the DES and bare-metal stent groups (P < 0.05). The neointimal area was reduced by 44.87% in the DES group compared with the bare-metal stent group. No significant difference in percentage of luminal area restenosis was found between the DES and bare-metal stent groups, but P value equaled to 0.053, which was close to 0.05. In addition, no restenosis was found in the DES group. CONCLUSION: Rapamycin DES can markedly resist intravascular intimal hyperplasia and restenosis following stenting.

A novel bioinspired phospholipid copolymer has been synthesized by the radical polymerization of poly2-Methacryloyloxyethylphosphorylcholine (MPC), stearyl methacrylate (SMA), hydroxypropyl methacrylate (HPMA) and trimethoxysilylpropyl methacrylate (TSMA). Contact angle results indicated that the coating surface rearranged to get a more hydrophilic surface at the polymer/water interface. The membrane mimic phosphorylcholine coating surface could resist the platelet adhesion and prolong plasma recalcification time significantly. Rapamycin was used as model drugs to prepare drug-eluting coating. The animal experiments showed that this novel drug-eluting stent could effectively prevent the phenomena of restenosis.
Angioplasty, Balloon, Coronary ; instrumentation ; Animals ; Coated Materials, Biocompatible ; Coronary Restenosis ; prevention & control ; Drug-Eluting Stents ; Female ; Humans ; Male ; Materials Testing ; Methacrylates ; chemistry ; Phosphorylcholine ; analogs & derivatives ; chemistry ; Pilot Projects ; Polymers ; chemistry ; Prosthesis Design ; Random Allocation ; Sirolimus ; chemistry ; Swine ; Swine, Miniature

Objective:To evaluate the clinical effect of applying the programmed management procedure in the prenatal diagnosis of pyriform sinus fistula(PSF).Methods:This study retrospectively enrolled eight fetuses with PSF who were managed according to the programmed management procedure for prenatal diagnosis of PSF, which was established in January 2016, in Guangzhou Women's and Children's Medical Center from January 2016 to October 2020. The procedure consisted of the detection of fetal neck cysts by prenatal ultrasound followed by further confirmation by MRI, evaluation of the degree of airway compression, indwelling gastric tube after birth, no oral feeding, complement of CT/MRI, and surgical treatment within a limited time after necessary preoperative examination. The prenatal diagnosis, postnatal treatment, and follow-up were summarized using descriptive analysis.Results:(1) Prenatal: The gestational age at the first detection of cervical cysts by prenatal ultrasound was (27.1±4.1) weeks and all the cysts were located on the left side. Prenatal MRI indicated that the largest cysts was (32.0±12.2) mm in diameter, and the tracheal transit index was (10.9±2.8) mm. (2) After birth: Among the eight children, five were males and three were females, with the gestational age of (38.0±0.9) weeks and birth weight of (3 020±459) g. One case was intubated during labor due to a intrauterine tracheal transposition index of 17.4 mm. All infants were not allowed for oral feeding. The median age at CT/MRI examination was 2.5 d (1-8 d), which revealed that the maximum diameter of the cysts was (40.6±6.9) mm and visible air bubbles in all cysts. The infection index before operation was not high and the age at operation was (8.6±2.3) d. All cysts were completely removed and the PSFs were ligated at a higher position, with the average operative duration of (95.0±19.6) min, and the postoperative duration of mechanical ventilation and hospitalization of 5 h (3-71 h) and (8.8±1.0) d, respectively. No complications such as hoarseness were reported. During the follow-up of 4 to 58 months through outpatient clinic and telephone, no recurrence were observed.Conclusions:The programmed management procedure can provide guidance for postnatal treatment of patients with a prenatal diagnosis of PSF, and help to achieve a successful treatment result.

Immunoparalysis is the main cause of death in patients with intermediate and terminal sepsis. The correction of immunoparalysis is an important direction of sepsis treatment. In the pathological process of sepsis, a variety of factors contribute to the imbalanced secretion of cytokines, weakened function of antigen-presenting cells, apoptosis and depletion of lymphocytes, and ultimately lead to immunoparalysis, secondary infection, and even patient deaths. Cytokines such as GM-CSF, IFN-γ, IL-7, and IL-15, immune checkpoint-related therapies such as PD-1/PD-L1 antibodies, CTLA-4 antibodies, TIM-3 antibodies, and LAG-3 antibodies, and immunoreactive substances such as thymosin α1 and immunoglobulin might be beneficial to correct the immune paralysis of patients. the progress of immunotherapy to correct immune paralysis in sepsis were reviewed in this article.

Sepsis is life-threatening with complex pathogenesis. It is a big problem in the medical field. Clinically, antibiotics, hormones and mechanical ventilation are the main treatments. There is a lack of specific therapeutic drugs. The treatment effect is not good. In recent years, more and more progress has been made in the treatment of sepsis with traditional Chinese medicine. This article reviews the etiology, pathogenesis and treatment strategies of sepsis. It focuses on four therapies, including clearing away heat and detoxification, clearing the interior, activating blood circulation and removing blood stasis, and strengthening the foundation. We further discuss the advantages and disadvantages of traditional Chinese medicine in the treatment of sepsis, in order to provide reference for the clinical treatment of sepsis.

Motion sickness is a series of physiological responses in human being caused by abnormal movement stimulation. With the development of science and technology, a growing number of people choose to travel by high speed vehicles. Motion sickness happens more frequently. A large number of non-drug and drug intervention methods have been reported in the treatment of motion sickness. This article provides an overview on the research developments in the prevention and treatment of motion sickness in order to provide new ideas for drug research.

Objective To establish an assay method for diphenhydramine hydrochloride and caffeine in rat plasma by UPLC-MS/MS for pharmacokinetic study. Methods The chromatographic separation was performed on an ACE 3 C₁₈-PFP (3.0 mm×150 mm, 3 μm) by isocratic elution with the mobile phase of water containing 0.1% formic acid and acetonitrile (62:38, V/V). MS condition was optimized in the positive ion detection mode by multiple reaction monitoring (MRM), along with the Agilent JetStream electrospray source interface (AJS-ESI). The precursors to the product ion transitions were 256.2→167.0 (m/z) for diphenhydramine hydrochloride, 262.0→167.0 (m/z) for the internal standard (IS) diphenhydramine-D6, 195.0→138.0 (m/z) for caffeine and 204.0→116.2 (m/z) for the IS caffeine-D9. Results The calibration curve was linear in the range of 1-1×10³ ng/ml for diphenhydramine hydrochloride in rat plasma (r=0.999 6), and in the range of 15-1.5×10⁵ ng/ml for caffeine in rat plasma, (r=0.999 9). The intra-day and inter-day precision and accuracy were good (RSD<10%, RE<±10%). Pharmacokinetic studies showed that metabolic characteristics of diphenhydramine hydrochloride 10-30 mg/kg and caffeine 24-72 mg/kg were linear after intragastric administration. The two components were metabolized in rats with gender difference, the c_max and the AUC of diphenhydramine hydrochloride and caffeine were greater in female than those in males. Conclusion This method is accurate, rapid and sensitive. It can be used for the determination of diphenhydramine hydrochloride and caffeine in rat plasma collected for pharmacokinetic study. The results of pharmacokinetic studies in rats provide reliable data support for the clinical application of the compound preparation.