Objective To explore the role of process management in preventing peripheral central venous catheter (PICC)-related bloodstream infections (CRBSI). Methods A standard process management policy was established for the uniform management of PICC in our hospital. The incidences of CRBSI before and after the implementation of this policy were compared. Results The incidences of CRBSI was 6.0‰ (48/79 793 ) every 1000 catheter-days before process management and 2.9‰ (29/99643) after process management (P =0.000).Conclusion Standard process management can effectively prevent and control CRBSI caused by PICC.

Objective To determine whether specific angiotensin-conventing enzyme inhibitor with ramipril would affect ventricular arrhythmia generation in rabbits after myocardial infarction and discuss the mechanism of its antiarrhymic efficacy.MethodsTwenty-four New Zealand rabbits (Wuhan Laboratory Animal Research Center) were separated into 3 groups:sham-operated (SHAM) group (n =8 ),myocardial infraction (MI) group ( n =8) and myocardial infraction with ramipril (RAM) group ( n =8).SHAM group received a median sternotomy without left ventricular coronary artery ligation.MI and RAM groups' rabbits received a median sternotomy followed by left coronary artery ligation. The successful anterior MI was confirmed by elevation of the ST segment with more than 0.2 mV in lead Ⅱ and Ⅲ.After MI,RAM group rabbits were fed with ramipril [ 1mg/ ( kg · d) ]by intragastric administration for 12 weeks.Before and after MI 12 weeks in three groups.Ventricular tachycardia or fibrillation episodes and the monophasic actionpotential duration in epicardium,mid-myocardium and endocardium cadiocytes were recorded.The statistical technique was t-test and ANOVA.Results Ventricular tachycardia or fibrillation episodes were markedly decreased in RAM group than that in MI group after 12 weeks [ (2.6 ± 0.8) vs.(12.4 ± 2.9),P ＜0.05 ].After MI 12 weeks,the action potential duration of repolarization 90％ (APD90) of three-tier ventricular myocytes in MI group was prolonged than that before MI [ (258.2 ±21.1 ) vs.(230.1 ±23.2),( 278.0±23.8 ) vs.(245.8±25.4),(242.6±22.7) vs.(227.0±21.7),P＜0.05]; however,it was not significant difference between before and after MI 12w in RAM group (P ＞ 0.05 ).Moreover,the transmural dispersion of repolarization(TDR) was markedly increased after MI 12w in MI group than in SHAM and RAM group [ (36.2 ± 10.2 ) vs.( 18.7 ± 6.2 ),(24.9 ± 8.7 ),P ＜ 0.05 ]; but the TDR was not significant difference between RAM and SHAM group ( 18.7 ± 6.2 ) vs.( 24.9 ± 8.7 ),P ＞ 0.05].ConclusionsRamipril significantly reduced the malignant arrhythmia incidence in rabbits after MI.Mended the abnormal TDR was the mechanism for ramipril to therapy.

Objective To investigate the early development of the sinus venosus and the cardiac conduction system (CCS) of human embryonic hearts. Methods Serial transverse sections of 29 human embryonic hearts from Carnegie stage 10 to Carnegie stage 16 (C10-C16) were stained immunohistochemically with antibodies against α-smooth muscle actin(α-SMA),α-sarcomeric actin(α-SCA) and desmin ( DES ). Results During C12 and C13, the sinus venosus formed by confluence of systematic veins at the caudal end of the pericardial cavity could be recognized in the mesenchyme of primitive transverse septum. The mesenchymal cells of the sinus venosus gradually differentiated into α-SCA positive cardiocyocytes. At C14, the sinus venosus was within the pericardial cavity due to expansion of the pericardial cavity and incorporated into the right atrium. Differentiation of DES positive conductive cardiomyocyte was initiated in the right wall of atrio-ventricular canal of C10 embryonic heart and with the development, extended towards the myocardium of the interventricular sulcus to form His bundle, left and right bundle branches as well as the ventricular trabecular myocardium. In the atium, the strong expression of DES was first detected in the dorsal wall of C11 atrium. At C13, unique myocardial band showing α-SCA, α-SMA and DES expression in the left dorsal wall of the sinus venosus were found to be continuous with the basal wall of left atium and the dorsal wall of the atrio-ventricular canal, this band might be related to the development of conduction system from sinoatrial node to atrio-ventricular canal. During C14 to C16, primary conduction pathway of atria with strong DES expression was formed that extended from sinoatrial node along venous valves, DES positive myocardium in the dorsal and ventral walls of the atria to the right atrio-ventricular canal, respectively. Conclusions The mesenchyme of the primitive transverse septum is the heart forming field of human embryos responsible for formation of sinus venosus myocardium, cardiomyocytes are differentiated from mesenchymal cells in the primitive transverse septum and progressively added to the venous pole of the heart tube to form myocardial sinus venosus. The differentiation of CCS of the early human embryo initiates in the atrio-ventricular canal and develops gradually towards the arterial and venous poles of the heart tube. By C16, DES positive embryonic CCS can be clearly recognized morphologically.

Child ; Humans ; Lymphoma, T-Cell ; complications ; Panniculitis ; etiology ; Subcutaneous Tissue

Objective To investigate the spatiotemporal expression patterns and the relationship of α-sarcomeric actin(α-SCA) ,α-smooth muscle actin(α-SMA) and intermediate filament protein desmin with the maturation of the prenatal and the neonatal mouse hearts. Methods Serial sections of the embryo mouse and the neonatal mouse hearts were immunostained with antibodies against α-SCA, α-SMA and desmin. Results Ventricle and outflow tract of embryonic day(ED) 9 heart showed stronger expression of α-SCA and α-SMA, but desmin expression was lower. In the atrium, the expressions of α-SCA and α-SMA were restricted to the dorsal and ventral walls. In the sinus venosus, only a few weakly stained α-SCA positive cells were detected. No desmin expression was found in the atrium and sinus venosus. The expressions of α-SCA, α-SMA and desmin were increased to their highest level at ED 12. The higher expression of α-SCA remained to the postnatal stages. After ED 12, the expressions of α-SMA and desmin gradually decreased in different parts of the heart, but their expressions in the right ventricle persisted longer. After birth,desmin expression was mainly concentrated in the Z lines of I bands and intercalated disks. Conclusion The presence of spatiotemporal differences in the expression of α-SMA and desmin reveals regional differences in cardiomyocyte maturation in various parts of the embryonic mouse heart. The right ventricle shows a relatively slow pace of maturation. The α-SMA may contribute to a peristaltoid contraction pattern of the embryonic myocardium with a slow shortening speed, and a relatively higher level of desmin is required for the maturation of the sarcomere.

BACKGROUND:Ventricular arrhythmia (VA) is one of the most common complications of myocardial infarction (MI), and ventricular tachycardia and fibrillation are the main causes for sudden cardiac death. This study aimed to explore the effect of ramipril on the occurrence of VA and its mechanism after MI in rabbits. METHODS:Twenty-four New Zealand rabbits purchased from the Wuhan Laboratory Animal Research Center were divided into three groups:sham-operated (SHAM) group (n=8), MI group (n=8) and MI with ramipril (RAM) group (n=8). Rabbits in the SHAM group received a median sternotomy without ligation of the left ventricular coronary artery. Rabbits in the MI and RAM groups received a median sternotomy followed by ligation of the left coronary artery. The successful anterior MI was confirmed by elevation of the ST segment with more than 0.2 mV in lead II and III. After MI, rabbits in the RAM group were fed with intragastric ramipril (1 mg/kg per day ) for 12 weeks. Before and 12 weeks after MI in the three groups, ventricular tachycardia or fibrillation (VT/VF) episodes and MAP in cadiocytes of the epicardium, mid-myocardium and endocardium were recorded by a multichannel physiograph. Student'st test and ANOVA were used for statistical analysis. RESULTS:VT/VF episodes were decreased more markedly in the RAM group than in the MI group after 12 weeks (2.6±0.8 vs. 12.4±2.9,P<0.05). Twelve weeks after MI, the duration of repolarization for 90％ (APD90) of three-tier ventricular myocytes in the MI group was longer than that before MI (258.2±21.1 vs. 230.1±23.2, 278.0±23.8 vs. 245.8±25.4, 242.6±22.7 vs. 227.0±21.7,P<0.05). However, the APD90 was not significantly different at 12 weeks before and after MI in the RAM group (P>0.05). Moreover, the transmural dispersion of repolarization (TDR) was increased more markedly 12 weeks after MI in the MI group than in the SHAM and RAM groups (36.2±10.2 vs. 18.7±6.2, 24.9±8.7,P<0.05). But the TDR was not significantly different between the RAM and SHAM groups (18.7±6.2 vs. 24.9±8.7,P>0.05). CONCLUSION:Ramipril may reduce the incidence of malignant ventricular arrhythmia via improvement of transmembrance repolarization heterogeneity after MI.

Objective To investigate the prevalence and incidence of Keshan disease (KD) and the selenium concentration of food and hair in residents of Yongjin Village, Fuyu County, Heilongjiang Province, national monitoring site, in 2007. Methods According to the Standard of Keshan Disease Surveillance and the Standard of Diagnosis of Keshan Disease(GB 17021-1997), the residents living in the monitoring site were surveyed by clinical examination and electrocardiography. For individuals whose hearts showed abnormalities, a chest X-ray photograph was taken. The selenium concentrations of the residents' food (flour) and hair were assayed by flowing injection hydride generation atomic fluoremetric method(FI-HG-AFM). Results Nineteen KD patients were found from 282 residents in 2007 KD surveillance. The prevalence of KD, latent KD and chronic KD were 6.7%(19/282), 2.8%(8/282) and 3.9%(11/282), respectively. Five of the 8 latent KD cases were newly found. In addition, there were 5 the suspected KD cases, including 2 suspected chronic KD cases. No acute KD or sub-acute KD patients were found in Yongjin Village at this monitoring site this year. The average selenium concentration of children hair and residents food were (0.3197±0.0586)mg/kg and (0.0210±0.0062)mg/kg, respectively. Conclusions New cases of KD continued to emerge, indicating that etiological factors still exist. Therefore, the emphasis of monitoring KD in furore is founding the consummate report of infectious disease system and training the personnel to increase the reliability of monitoring.

OBJECTIVETo investigate the toxicity attenuation and efficacy potentiation effect of liquorice on treatment of rheumatoid arthritis (RA) with Tripterygium wilfordii (TW).

METHODSOne hundred and twenty RA patients were randomly assigned to two groups: the treated group treated with compound decoctum of TW and liquorice and the control group with TW ployglycosidium tablets both based on routine treatment. The therapeutic effect and adverse reaction were observed after 2 months of treatment.

RESULTSThe total efficacy rate was 89.8% in the treated group and 79.6% in the control group with insignificant difference between the two groups; the effect was better in the treated group than that of the control group in decreasing the swollen joint index and increasing the average grip strength of both hands (P < 0.05); the total incidence of adverse reaction was obviously lower in the treated group than that of the control (P < 0.01).

CONCLUSIONLiquorice has toxicity attenuation and efficacy potentiation effect on treatment of RA with TW.

Adult ; Aged ; Arthritis, Rheumatoid ; drug therapy ; Drug Synergism ; Drug-Related Side Effects and Adverse Reactions ; chemically induced ; prevention & control ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Female ; Glycyrrhiza ; chemistry ; Humans ; Male ; Middle Aged ; Phytotherapy ; Tablets ; Treatment Outcome ; Tripterygium ; chemistry

Objective • To investigate the mechanism of spinal chemokine C-C motif receptor 2 (CCR2)-mediated maintenance of bone cancer pain (BCP) in rats. Methods • Fifty-four SD rats were divided into BCP group, sham operation group, BCP+INCB3344 (CCR2 specific antagonist) group, and BCP+vehicle control group. Walker256 breast cancer cells were injected into the tibia medullary cavity of rats in the BCP group to establish the BCP model, while the rats in the sham operation group were injected with the same amount of saline. The rats in the BCP+INCB3344 group received intrathecal injection of INCB3344 on the 14th day after the establishment of BCP model, while the BCP+vehicle control group rats were injected with the same amount of vehicle. The mechanical pain thresholds of BCP group rats and sham operation group rats were measured to judge the success of BCP model. The expressions of CCR2 in the dorsal horn of spinal cord in the sham operation group rats and the BCP group rats were detected by Western blotting. The effects of intrathecal administration of INCB3344 on the mechanical pain threshold of BCP rats were observed by mechanical pain behavior test. Whole-cell patch-clamp recordings were used to investigate the differences of spontaneous excitatory postsynaptic currents (sEPSCs), α-amino-3-hydroxy-5-methyl-4-isoxazole-propionicacid (AMPA) and N-methyl-D-aspartic acid (NMDA)-induced currents of spinal substantia gelatinosa (SG) neurons of rats in the BCP group, the BCP+INCB3344 group and the BCP+vehicle control group. Results • Compared with the sham operation group, the mechanical pain threshold of BCP group rats reduced significantly on the 14th day after operation (P=0.000), and the expression of CCR2 in ipsilateral spinal cord of BCP group rats increased significantly (P=0.009). After intrathecal injection of INCB3344 for 4 h, the mechanical pain threshold of BCP+INCB3344 group rats was significantly increased (P=0.002). The frequency and amplitude of sEPSCs and the amplitude of AMPA and NMDA-induced currents in SG neurons of BCP group rats were significantly higher than those of the sham operation group rats (all P=0.000), while intrathecal administration of INCB3344 could significantly inhibit the above-mentioned indices in the BCP+INCB3344 group (all P<0.05). In addition, extracellular perfusion of INCB3344 could also significantly inhibit the frequency (P=0.001) and amplitude (P=0.020) of sEPSCs in SG neurons in BCP rats. Conclusion • CCR2 expressing in the spinal cord mediates the enhancement of excitatory synaptic transmission efficacy in the spinal dorsal horn of BCP rats by enhancing the functions of AMPA and NMDA receptors, which may be an important mechanism for the maintenance of BCP.

Objective To observe the seasonal changes in serum levels of interleukin-1 beta (IL-1β), interleukin-6 (IL-6) and melatonin (MT) in Bizheng rat model, and explore the relationship between MT and the pathogenesis of rheumatoid arthritis.
Methods One hundred and sixty Sprague-Dawley rats were randomly divided into four groups in summer (n=80) and winter (n=80) respectively:normal group, collagen-induced arthritis (CIA) model group, operation group, and sham-operation group (n=20 in each group). The CIA model group was injected with collagen emulsion at the base of the tail to induce arthritis. The rats in the operation group received pineal gland resection, and 7 days after the first operation, underwent testectomy or oophorectomy. The rats in the sham-operation group were operated to ligature the sagittal sinus, without extracting the pineal gland. After the operations, the operation group and the sham-operation group both were immunized as the CIA group was.The serum levels of IL-1β, IL-6 and MT in different groups were measured by radioimmunoassay.
Results Compared with the normal group, the serum levels of IL-1βand IL-6 increased in the CIA model, operation, and sham-operation groups both in summer and in winter (IL-1βin summer, P=0.008, P<0.01, P=0.012; IL-1β in winter, P=0.019, P<0.01, P=0.027; IL-6 in summer, P=0.028, P<0.01, P=0.024;IL-6 in winter, P=0.006, P<0.01, P=0.008). In the operation group, the serum levels of IL-1βand IL-6 in winter were higher than in summer, but with no statistically significant differences (P=0.844, 0.679). Compared with the normal group, the serum level of MT significantly increased in summer and winter in both the CIA model group (P=0.002, 0.008) and the sham-operation group (P=0.003, 0.007), while significantly decreased in the operation group (P=0.023, 0.003). There was no significant difference in MT level in the operation group between summer and winter (P=0.947).
Conclusions The increase of serum levels of IL-1β and IL-6 may exacerbate the inflammatory reaction and cause a more severe condition in the rheumatoid arthritis. The concentrations of IL-1β, IL-6, and MT correspond with the change of seasons, confirming that there are connections between nature and human body.