Objective To evaluate left atrial (LA) function by real-time three-dimensional echocardiography (RT-3D) and speckle tracking imaging (STI) after circumferential ablation of pulmonay vein ostia for atrial fibrillation guided by carto mapping system. Methods Thirty patients who had ablation procedure for paroxysmal atrial fibillation were accepted echocardiography to estimate the LA function at pre-operation,3 days and 3 months of post-operation. The LA maximal, minimal and pre-systolic volume (LAVmax, LAVmin and LAVp), LA passive ejection fraction (LAPEF), LA active ejection fraction (LAAEF) were measured by RT-3DE respectively. The strain rate curve was acquired in each LA segment (anterior, posterior, lateral, inferior and septal) by STI. Systolic strain rate (SRs), early diastolic strain (SRe) and late diastolic strain rate(SRa) of each left atrial segments were measured. Results Comparing with preoperative,3 days post-ablation SRs,SRe and SRa decreased significantly in each wall of LA. After 3 months,SRa and SRe in anterior, inferior and septal were significantly improved, however, SRs showed no significant difference. LAVmax and LAVpre were significantly decreased. LAPEF and LAAEF were significantly improved. Conclusions The patients with circumferential pulmonary vein ablation were in a deterioration after three days. The pump function and conduit functions of left atrial were increased after 3 months.

Objective:To study the inhibitory effect of deoxyschizandrin on the growth of brain glioma C6 cells, and to explore its mechanism.Methods:The rat glioma C6 cells were cultured and divided into control group,50, 100,and 200 mg·L-1 deoxyschizandrin groups.The proliferation rates of C6 cells were examined by MTT assay;the changes of cell cycles were examined by flow cytometry;the expression levels of CyclinD1,Bax,Bcl-2 and Caspase-3 proteins in supernant were detected by ELISA assay. Results:Compared with control group, the proliferation rates at 24 and 48 h in 50,100,and 200 mg·L-1 deoxyschizandrin groups were significantly decreased (P <0.01),and the proliferation rates at 72 h in 100 and 200 mg·L-1 deoxyschizandrin groups were significantly decreased (P < 0.05 or P < 0.01 ). Compared with control group, the percentage of cells at SubG1 phase in 200 mg·L-1 deoxyschizandrin group was increased (P < 0.05 ), and the percentage of cells at S phase was decreased (P <0.05).Compared with control group,the expression levels of CyclinD1 in 100 and 200 mg· L-1 deoxyschizandrin groups were decreased (P < 0.01 );the expression levels of Bax protein in deoxyschizandrin groups were increased (P < 0.05 or P < 0.01 ), and the expression level of Bcl-2 protein in 200 mg · L-1 deoxyschizandrin group was decreased (P < 0.01 ), and the Bax/Bcl-2 value in deoxyschizandrin groups were increased (P < 0.01 ); the expression level of Caspase-3 protein in 200 mg · L-1 deoxyschizandrin group was increased (P < 0.01 ).Conclusion:Deoxyschizandrin could inhibit the growth of glioma cells through down-regulating the expression levels of CyclinD1 protein and up-regulating the expression levels apoptotic factors Bax and Bcl-2.

AIM:To study alterations of cardiac sarcoplasmic reticulum (SR) function in vitamin D 3-induced calcium overload rats. METHODS: The Ca-overload rat models were prepared by vitamin D 3 plus nicotine. Cardiac SR was seperated by centrifuging. The measurement of SR Ca 2+ uptake and Ca 2+ release activities were preformed by the Millimore filtration technique. Specific SR [ 3H]-ryanodine binding capacity was measured by radioligand method. RESULTS: Compared with control,myocardial calcium content in calcium overload rats increased by 78%( P

Objective To discuss the application of prospective risk nursing measures in reducing the occurrence of postoperative local hematoma at femoral artery puncture site. Methods A total of 605 patients receiving femoral artery puncture for interventional management were collected as the control group , and 322 patients were used as the intervention group. The risk factors causing postoperative local hematoma at femoral artery puncture site in the control group were recorded, and based on which risk estimation survey table was designed. According to risk estimation survey, the prospective intervention measures, including risk assessment, standardization of professional training, individual health education, the improvement of care appliance, etc. were carried out for the patients of the intervention group. The occurrences of postoperative local hematoma at femoral artery puncture site were recorded and the results were compared between the two groups. Results No statistically significant differences in demographic and clinical data existed between the two groups. However, the incidence of hematoma in the intervention group was significantly lower than that in the control group (χ2 = 4.652, P < 0.05), although the difference in the severity of hematoma was not significant between the two groups. Conclusion The use of prospective risk nursing measures can effectively reduce the incidence of postoperative hematoma at femoral artery puncture site.

Aim To investigate the immunomodulatory effects of sea cucumber fucoidan ( SC-FUC) on macro-phage and the signaling pathways. Methods Cell via-bilities in response to different concentrations of SC-FUC were analyzed by MTT, phagocytosis ability was detected by neutral red,and nitric oxide ( NO) produc-tion was examined by Griess reaction kit. The mRNA expression levels of IL-6 , IL-10 , Toll-like receptors (TLRs) and related signal molecules MyD88, TRIF, NF-κB were assayed by real-time PCR. All the experi-ments were based on murine RAW264. 7 cell line. Re-sults SC-FUC could promote RAW264 . 7 cell prolif-eration, phagocytosis as evidenced by uptake of neutral red and release of NO. The effects were significant at the early stage (6 h and 12 h) . SC-FUC could up-reg-ulate the expression of IL-6 , IL-10 , TLR4 , TLR5 , TLR9. Moreover, mRNA expressions of TLRs signaling molecules were increased, as well as MyD88, TRIF, NF-κB. Conclusions SC-FUC could activate macro-phage, and then promote the immune function by pro-moting production or expression of NO, IL-6, IL-10. It is speculated to be relevant to activated cell surface re-ceptors in macrophage, including TLR4, TLR5, TLR9, and NF-κB signaling pathways.

Objective To explore the clinical value and typing characteristic of prenatal ultrasonography for fetal cystic adenomatoid malformation of the lung(CAML).Methods Ultrasonographic features and typing of fetal CAML in 41 cases detected by prenatal ultrasonography were analyzed retrospectively.All cases were followed up until to the induction of labor or birth.Results (1)Site of tumor: in the 41 cases,there were 22 cases on the left side,15 on the right side and 4 on bilateral.(2)Typing diagnosis of prenatal ultrasonography: three cases were CAML type Ⅰ,14 were type Ⅱ,and 24 cases were type Ⅲ.(3)Pathology diagnosis: thirty two cases were induced abortion.CAML was confirmed in 29 cases by autopsy and the classifications were consistent with the prenatal diagnosis of ultrasonography.Three pulmonary sequestration cases were prenatally misdiagnosed as CAML type Ⅲ by ultrasonography.(4)The other nine cases were followed up to birth.Three masses decreased gradually and then disappeared.Six newborns were confirmed as CAML by CT.Their typings were consistent with the postnatal diagnosis.(5)The diagnostic accuracy rate of prenatal ultrasonography for CAML was 92.7%(38/41).Its misdiagnostic rate was 7.3%(3/41).Conclusions Prenatal ultrasonography has a high accuracy rate for the diagnosis and classification of CAML and is the first choice to detect CAML early in pregnancy.It has an important clinical value.Pulmonary sequestration should be distinguished from CAML type Ⅲ because they tend to be confused.

Objective To evaluate a relationship between the nutritional risk and nutritional support in elderly hospitalized patients (aged ≥ 65 years) with gastrointestinal cancer,and to analyze the relationship between nutrition support and clinical outcomes.Methods Elderly hospitalized patients with gastrointestinal cancer were recruited from September 2009 to November 2011.Patients were screened using Nutritional Risk Screening 2002 (NRS 2002) on admission.Data were collected on the application of nutrition support,including complication rate,length of hospital stay and medical care costs.Results In 592 recruited patients,the malnutrition rate was 14.0％ (83/592) and the rate of a validated nutrition risk was 43.7％ (259/592).79.2％ of patients with nutritional risk received nutritional support while 62.2％of non-risk patients received nutritional support.The case numbers of paraenteral nutrition (PN),enteral nutrition(EN) and paraenteral nutrition + enteral nutrition(PN + EN) were 141,64 and 49 respectively,with the PN:EN ratio of 2.2 ∶ 1.The rate of postoperative complications,lengths of hospital stay and medical care cost were higher in patients with nutritional risk than without nutritional risk[complications 39.8 ％ (103/259) vs.20.4 ％ (68/333),lengths of hospital stay (17.1±4.8) d vs.(12.6±3.6) d,medical care cost(62 191.5 ±4 251.2) RMB vs.(46 792.3±3 115.4) RMB,x2 =26.55 or t=13.03,50.84 respectively,all P＜ 0.01].The average of the rate of postoperative complication [36.8 ％ (75/205) vs.45.9％ (20/44),x2 =19.38,P＜0.01],length of hospital stay [(15.6±3.5) d vs.(18.1±5.4) d,(12.1±4.8) d vs.(15.6±3.5) d,P＜0.05 or 0.01] and medical care cost[62843.3±3491.7) RMB vs.(68925.1± 4633.2) RMB,(53410.5±1954.3) RMBvs.(59857.3±3221.6) RMB,allP＜0.05 or0.01] were lower or shorter in elderly gastric cancer or colorectal cancer patients with nutritional support than in patients without nutritional support.Conclusions A considerable numbers of elderly hospitalized patients with gastrointestinal cancer are at nutritional risk.There is significant relationship between the nutritional risk and clinical outcome.Nutritional support for elderly hospitalized patients with nutritional risk may improve the clinical outcome.

AIM: To observe the effect of adrenomedullin(ADM)on proliferation of vascular smooth muscle cells(VSMC) induced by urotensin Ⅱ(UⅡ). METHODS: DNA synthesis of cultured rat aortic VSMC was measured by -TdR incorporation. The activities of mitogen activated protein kinase(MAPK) were determined by isotope tagged with [?- 32 P]-ATP. RESULTS: UⅡ(10 -8 mol/L) significantly increased -TdR incorporation of VSMC and MAPK activities by 38%( P0.05 ), 32%( P0.05 ), 32%( P

ObjectiveTo evaluate the potential value of acoustic radiation force impulse (ARFI)elastography in the characterization of solid liver tumors.MethodsForty-three patients with 56 liver tumors were evaluated with ARFI,which included 21 patients with hepatocellular carcinoma (HCC),8 patients with metastase,5 patients with cholangiocarcinoma(CCC),and 9 patients with hemangioma.The shear wave velocity of the tumor and background liver parenchyma were calculated,and results were compared with 30 healthy subjects.Statistical analysis was performed on the shear wave velocity for differentiation of normal liver,background liver parenchyma,and tumors.ResultsHCC and CCC had greater stiffness than metastase (P ＜0.05),there were no statistical differences between HCC and CCC (P = 0.179).Malignant liver tumors had significantly greater stiffness than hemangioma and normal liver (P = 0.000).34.5% (9/26) HCC and 33.3% (4/12) hemangioma appeared softer than the background liver.With a cut-off value of 1.5 m/s for the shear wave velocity,the sensitivity,specificity,positive predictive value and negative predictive value for malignancies were 79.5%,83.3%,94.5% and 52.6%,respectively.ConclusionsARFI elastography quantification is a promising noninvasive technique for assessing solid liver tumors.Use of ARFI elastography quantification may lead to new quantitative tissue characterization parameters for differentiating hemangioma and malignant liver tumors.

BACKGROUNDAspirin and clopidogrel resistance plays a significant role in the development of cardiovascular ischemic events for ninety patients undergoing percutaneous coronary intervention. Recent studies have indicated that increasing the dose of antiplatelet drugs maybe a potent method to improve the inhibition of platelet aggregation.

METHODSThrombelastograph (TEG) determinations were used to evaluate the effect of antiplatelet therapy. According to the results, 90 patients were divided into three groups and given different doses of aspirin and clopidogrel. Thirty patients with both an inhibition rate of aspirin > 50% and an inhibition rate of clopidogrel > 50% were defined as the control group. Sixty patients with an inhibition rate for aspirin < 50% and an inhibition rate for clopidogrel < 50% were defined as the resistance group. Patients in resistance group were randomly assigned to be given a routine dose (100 mg aspirin plus 75 mg clopidogrel per day, which we called a resistance plus routine dose group, R + R) and a loading dose (200 mg aspirin and 150 mg clopidogrel per day, which we called resistance plus loading dose group, R + L) of antiplatelet therapy. A 12-month follow-up was observed to examine the change of inhibition rate of antiplatelet therapy and to estimate the relationship between inhibition rate and the occurrence of cardiovascular ischemic events.

RESULTSAfter 6 months of antiplatelet therapy, the inhibition rate of aspirin in the R + L group increased from (31.4 ± 3.7)% to (68.6 ± 7.1)%, which was significantly higher than that in R + R group, (51.9 ± 8.2)% (P < 0.01). The inhibition rate of clopidogrel in the R + L group increased from (22.1 ± 3.8)% to (60.2 ± 7.4)%, which was significantly higher than in the R + R group, (45.9 ± 4.3)% (P < 0.01). The occurrence rates of cardiovascular ischemic events, stent thrombosis, recurrent unstable angina and myocardial infarction in the R + R group were 20%, 36% and 17%, respectively. Occurrence was significantly increased compared with that in the control group, 3%, 10% and 1%, respectively (P < 0.01). In contrast, the occurrence rates in the R + L group (10%, 23% and 6%, respectively) were attenuated compared with those in the R + R group (P < 0.01), although still higher than in the control group (P < 0.01).

CONCLUSIONSAlmost all of the cardiovascular ischemic events occurred in the first six months after percutaneous coronary intervention. According to the result of TEG determinations, earlier application of a loading dose of aspirin and clopidogrel can decrease the rate of recurrent cardiovascular ischemic events.

Adult ; Aged ; Angioplasty, Balloon, Coronary ; adverse effects ; Aspirin ; administration & dosage ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Myocardial Ischemia ; prevention & control ; Platelet Aggregation ; drug effects ; Platelet Aggregation Inhibitors ; administration & dosage ; therapeutic use ; Prospective Studies ; Thrombelastography ; Thrombosis ; prevention & control ; Ticlopidine ; analogs & derivatives ; therapeutic use