Coronary Restenosis ; Drug-Eluting Stents ; Humans

Arterial Occlusive Diseases ; diagnosis ; etiology ; Coronary Disease ; complications ; diagnosis ; Humans ; Lower Extremity ; blood supply ; Male ; Middle Aged

Objective To study the feasibility and efficacy of minimally invasive repair for pectus excavatum in adult patients. Methods A total of 23 patients with pectus excavatum aged 18-38 years(mean 24.1?6.6) were treated in our hospital from June 2006 to June 2008.On admission,21 of patients had never been treated,and 2 patients were recurrent cases after Ravitch surgery;the Haller index of the cases ranged from 3.2 to 7.5(mean 4.38?1.16);type I pectus excavatum was diagnosed in 14 of the patients(60.9%) and type II in the other 9(39.1%).Under general anaesthesia with the patients at supine position,two 3-cm incisions were made along the bilateral mid-axillary line at the level of the most pronounced sternal depression.Then,a conductor was penetrated into the mediastinum from the right to the left at almost the same level.After establishing artificial pneumothorax by CO2 gas,a pectus bar(Lorenz) was placed through the mediastinum under the guidance of thoracoscopy.Afterwards,a stabilizer was used to fix the bar at the right side.Both the stabilizer and the bar were fixed to the muscle layer.Chest X-ray was performed to observe the stabilizer and the bar after the operation. Results Among the cases,the procedure was successfully completed in 22 patients.In the other patient,the pericardium and the right atrial appendage were injured,and we had to enlarge the incision for haemostasis.All of the patients were uneventful after the operation.No incisional infection or bar displacement occurred during the perioperative period.During a mean of 16-month follow-up(range 3-24 months),the symptom of chest distress was significant improved,and the cosmetic results were satisfying in 87% of the patients(20/23).Conclusions Minimally invasive repair is feasible and effective for adult patients with pectus excavatum.

Adult ; Coronary Artery Disease ; complications ; etiology ; Female ; Heart Valve Prosthesis ; adverse effects ; Humans ; Mitral Valve ; surgery ; Myocardial Infarction ; etiology ; Postoperative Complications ; Thromboembolism ; complications ; etiology

BACKGROUND: Preliminary experimental study found that the human amniotic mesenchymal stem cells (hAMSCs)transplantation can improve nerve injury symptoms of rats with cerebral infarction.OBJECTIVE: To observe the survival, colonization and differentiation of hAMSCs in the infarct area of cerebralinfarction rats.METHODS: Sixty Sprague-Dawley rats were randomly assigned into hAMSCs transplantation, model or shamoperation groups (n=20/group). Animal models of middle cerebral artery occlusion were produced in the model andtransplantation groups by Zea-Longa method. One day after modeling, rats in the hAMSCs transplantation groupwere given in situ transplantation of 10 μL of hAMSCs (2×106) into the damaged striatum and cortex, while those inthe model and sham operation group were given the same volume of PBS. Within 1 week after transplantation, ratneurological defects were assessed and changes in their body mass were continuously monitored. Two weeks aftertransplantation, TTC staining was used to observe cerebral infarct size, hematoxylin-eosin staining was used forpathological observation of brain tissues, and immunofluorescent staining was used to detect expression ofneuron-specific nuclear protein.RESULTS AND CONCLUSION: With time, weight loss was increased while neurologic deficit scores were graduallyreduced in the hAMSCs and model groups. Compared with the model group, the weight loss and neurologic deficitscores were lower in the hAMSCs group,; however, there was a significant difference in the neurologic deficit scoresbut not in the weight loss between the two groups. Additionally, the hAMSCs significantly reduced infarct size,attenuated pathologic injury, and decreased the number of inflammatory cells. Immunofluorescence stainingshowed that the hAMSCs were observed at 1 week after transplantation under inverted luorescence microscope,and gradually differentiated into nerve cells at 2 weeks after transplantation. In conclusion, transplanted hAMSCsmay migrate to and survive in the cerebral infarct region, and differentiate into nerve cells in situ in rats with cerebralinfarction.

Coronary Restenosis ; etiology ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; therapy ; Stents ; Thrombosis ; etiology

ObjectiveTo investigate the relationship between the oxidative injury induced by low glucose and mitochondrial membrane potential in HUVEC-12 cells. Methods Human umbilicalvein endothelial cells HUVEC-12 were cultured in low concentration glucose for 4 h.Cell viability of HUVEC-12 cell was assessed with MTT assay.Dihydroethidium (DHE) was used as a reactive oxygen species (ROS)capture, which was detected the mean fluorescence intensity of samples and Rhodamine 123 as a fluorescence detector was to measure the level of mitochondrial membrane potential (MMP) in cells.Results Comparing to HUVEC-12 cells viability in 5.5 mmol/L glucose group (96.80 ±3.20)％, cells exposed to 2.8 mmol/L glucose group (66.40 ± 1.60) ％ and 0 mmol/L glucose group (58.93 ± 1.67) ％ were decreased by 32％ and 40％ respectively (P ＜ 0.01).ROS level of 5.5 mmoL/L glucose group, 2.8 mmol/L glucose group and 0 mmol/L glucose group were 0.59 ± 0.02, 0.74 ± 0.04 and 0.88 ± 0.05,respectivdy, increased by 25％ in cells exposed to 2.8 mmol/L glucose and by 48％ in cells without glucose exposure comparing to 5.5 mmol/L glucose group (P ＜0.01) ; MMP levels of 5.5 mmol/L glucose group,2.8 mmoL/L glucose group and 0 mmoL/L glucose group were 148.83 ± 3.51, 271.07 ± 19.54 and357.74 ±51.32 respectively, increased to 1.8 times in cells exposed to 2.8 mmol/L glucose and to 2.4times in cells without glucose exposure comparing to 5.5 mmoL/L glucose group (P ＜ 0.01).Conclusion Low glucose leads to injury in HUVEC-12 cells, which is probably induced by the oxidative stress via the increasing MMP.

Objective To explore the inhibiting effects of arsenic trioxide and cisplatin on MG-63 cells. Methods Using MTT assay,flowcytometry,phase contrast microscopy and electron microscopy methods,the therapeutic effect of arsenic trioxide was studied for the osteosarcoma in the cultured MG-63 cells in vitro,and compared these effects with cisplatin. The inhibitory rotes of cell growth and the effect of apoptosis and cell cycle were compared between arsenic trioxide and cisplatin on MG-63 cells. Results The contrast phase microscope revealed the adhesion ability of normal groups was good and cellular morphology showed epithelium cells. But the celhdar morphology showed irregular arrangement in arsenic trioxide groups and cytoplasmic vacuoles in cisplatin group. Electron microscope revealed the globular plasmalemma ecphymas in cell surface of control groups,the enlarged crista mitochondriales and the double-deck membrane structure appeared clearly. But electron microscope revealed globular plasmalemma processes in cell surface of arsenic trioxide groups,thinned crista mitochondriales and clearly seen karyopycnosis and nuclear membrane of apoptotic cells. The globular plasmalemma processes in cell surface of cisplatin groups were separated,nuclear membrane thickened and chromatin were in sandy shape. Both arsenic trioxide and cisplatin inhibited effectively MG-63 cells growth. There was a significant difference in different groups of inhibition ratios to the growth of cells(all P < 0.05). In 2,4,8,16,32,64,128 hours,the inhibition ratios(%) of arsenic trioxide(56.31±0.03,70.00±0.06,79.84±0.03,87.31±0.13,84.70±0.09,90.68±0.06,91.18±0.05) and cisplatin groups(7.55±0.15,15.70±0.17,30.72±0.07,49.80±0.05,45.11± 0.13,61.62±0.08,93.80±0.12) were obviously increased as compared with those in the control group(2.03± 0.07,2.78±0.08,3.11±0.01,5.67±0.04,12.23±0.04,18.65±0.04,24.45±0.04,all P < 0.05). Moreover the inhibition ratio of arsenic trioxide group in 2 to 32 hour was significantly higher than that of cisplatin group and the effect was more faster(all P < 0.05). Both arsenic trioxide and cisplatin could induce apoptosis MG-63 cells. There was a significant difference in different groups of the inhibition ratio to the growth of cells(F = 13.317,P < 0.05). The inhibition ratios(%) of arsenic trioxide on 24,36,48 hour(20.50±3.78,45.76±9.90,25.16±15.41),and cisplatin groups on 24,36,48 hour(12.55±1.51,18.85±3.40,12.37±5.43),were obviously increased as compared with those in the control group at the same time(6.57±1.48,8.03±2.08,6.54±1.30,P< 0.05 or<0.01). Both arsenic trioxide and cisplatin inhibited MG-63 cells cycle. There was a significant difference in different groups of the inhibition ratio to the growth of cells(F = 54.579,43.429,21.795,P < 0.05 or < 0.01). And the total inhibition ratios(%) in G1 cycle of arsenic trioxide(78.26±5.24) and cisplatin groups(80.48±2.81) were obviously increased as compared with those in the control group(57.49±6.65,all P < 0.05 or < 0.01). Conclusions Arsenic trioxide and cisplatin can effectively inhibit the proliferation of MG-63 cell line and induce the apoptosis of MG-63 cell line. And the effects induced by arsenic trioxide group were faster than that of cisplatin groups. Moreover arsenic trioxide can arrest the cell cycle of MG-63 cell line at G1 phase.

Problem-based learning(PBL)teaching mode was applied in general surgery practice of the seven-year system externs.The externs were organized to analyze and discuss a real case,having grasped enough knowledge of relative diseases,and try to provide their advice about the diagnosis and treatment,and then their conclusions were verified by post-operational follow-up.PBL teaching mode can increase the students'study motivations and interests and the ability to resolve practical problems,master medical knowledge,train their clinical thinking and eventually pave a way to become qualified clinicians.

In order to solve the problems of erratic drug absorption and low bioavailability after oral administration for poorly-water soluble drugs due to low solubility, a series of novel pharmaceutical dosage forms as solid dispersion, liposome, microemulsion, vesicle, cyclodextrin inclusion complexes and drug nanocrystal have been developed in recent years. Among which drug nanocrystal attracts more attentions for its simpler preparation method, higher drug loading and easier manufacturing technology in the design of dosage forms suitable for different administration routes. In this paper, the nanocrystals of the poorly-water soluble drugs prepared based on bottom-up and top-down technologies were introduced. The characteristics and applications of the nanocrystal-based dosage forms as suspension, tablet and capsule were also introduced and carefully evaluated with the focus on their pharmacokinetics, pharmacodynamics and tissue targeted drug distribution after delivery by oral administration, intravenous injection and pulmonary inhalation. The advantages of drug nanocrystals in their therapeutics effects over the bulk drugs were discussed together with the inherent mechanism. Finally, the problems existing in basic research and scaled-up manufacture of drug nanocrystal as well as the possible ways of solution were listed out so as to make the nanocrystal-based preparations exert their maximum therapeutic effect after clinical application.