OBJECTIVE To evaluate the cardiotoxicity of a widen-spectrum antineoplastic drug, gambogic acid, through quantitative multiple cellular phenotypic characterization. METHODS H9c2 cell line was used as a model with doxorubicin (Dox) and amiodarone (Ami) as positive controls, hypaconi?tine as negative control and 0.1% DMSO as normal control. An optimized protocol was established to identify the morphology and function of cell nuclei. The effect of drugs on cell viability, nuclear area (Hoechst33342), mitochondria mass (MitoTracker Deep Red) and cytoplasmic calcium ion mobilization (Rhod2 AM)was studied. EC50 and Z′values were calculated to evaluate the degree of toxicology and to estimate the precision and false-positive rate, respectively. RESULTS Dose-response analysis indicated that EC50 of Dox on cell viability, nuclear area, mitochondrial mass was 0.72, 0.014 and 1.21μmol · L-1, respectively. On the other hand, EC50 of Ami on the parameters of cell viability, nuclear area and mitochon?drial mass was 14.83, 6.72 and 4.54μmol·L-1, respectively with Z′value above 0.5. Hypaconitine decreased the SER ridge of mitochondria. Gambogic acid caused significant mortality of H9c2 cells and induced nuclear shrinkage as Ami did. The EC50 values of cell viability and nuclear area were 0.24 and 1.16 μmol · L- 1. Meanwhile,gambogic acid disturbed the mitochondrial function as indicated by the increased mitochondrial area (EC50=0.44 μmol · L-1), abnormal SER Ridge(EC50=0.99 μmol · L-1) and decreased mitochondrial mass(EC50=1.21 μmol · L- 1). Cellular calcium mobilization was lower than normal (EC50=0.41 μmol · L-1). CONCLUSION The EC50 values of positive controls calculated from our assessment are similar those reported in literature. A multi-parameter and simultaneous evaluation enables a comprehensive analysis of the morphology of nuclei and mitochondria of cardiomyocytes and a preliminary assessment of the mechanisms of toxicity.

Objective To assess and compare the the results of tricuspid annuloplasty performed with the Edwards MC3 and Kay methode.Methods From January 2010 to May 2014, 759 patients with function tricuspid regurgitation(FTR) secondary to left-sided valve disease received tricuspid annuloplasty.Cardiac ultrasound Heartbeat diagram were made to confirm the degree of tricuspid regurgitation, the diameter of tricuspid annulus, the pressure of pulmonary artery and the heart function both in the left and the right, and so on.Of them, 355 cases of male, female 404 cases, at the mean age of(54.1 ± 8.3) years old, with the heart function classical(NYHA) : Ⅰ 13, Ⅱ 177, Ⅲ 400, Ⅳ 169, the mean left ventricles ejection fraction(LVEF) was 0.53 ±0.04, the mean pulmonary artery pressure was(62.5 ± 17.6) mmHg(1 mmHg =0.133 kPa).The diagnosis include rheumatic heart disease 517 cases, degenerative disease 209 cases and infective endocarditis 33 cases.The operation include mitral annuloplasty 132 case, mitral replacement 295 cases, mitral annuloplasty and aortic replacement 20 cases, mitral and aortic replacement 388 cases, CABG 86 cases and Maze Ⅲ methode 23 cases.The degree of tricuspid regurgitation before the operation were class Ⅰ 88, Ⅱ 189, Ⅲ 352 and V 130.From January 2010 to May 2012, 447 cases received Kay' s methods and 312 cases received MC3 annuloplasty ring during May 2012 to May 2014.In the MC3, We use the rings in 28mm size were 79 cases, 30 mm 155 cases, 32 mm 66 cases and 34 mm 12 cases.Results There were no death, reoperation and adverse events in both groups.There were no diffent in the aorta block time, the circulation bypass time, the time of mechanical ventilation, stay in ICU and in the hospital(P ＞ 0.05).All the patient were followed up regularity.The rat of follow up was 90.4％ (686/759), and the mean time of follow up was(39.9 ± 7.7) month.The patients' s EF increased, inner diameter of the right ventricle decreased in both group.There were no severe TR in the patients in the Kay group within 3 months, and 1 case of severe TR 1 year later, as 5 cases at 2 years and 12 cases after 2 years.The regurgitation volume of tricuspid was (3.4 ± 1.4) ml at the moment of 3 month, (6.5 ± 2.1) ml at 1 year, (7.9 ± 2.5) ml at 2 years and (12.4 ± 4.7)ml 2 years later.In the MC3 group, there were no severe TR in the patients during all the stage of fellow-up.There were on regurgitation in the patient within 3 months, 1 case of Class Ⅲ of TR at 1 year and 3 cases of Class Ⅲ at 2 years, without worse TR happen.At the same stage as in MC3 group, the regurgitation volume was(2.9 ±0.9) ml,(3.5 ±1.3) ml and(3.4 ±2.1) ml.The result in MC3 group was similar with Kay group(P ＞0.05) in short term, but much better in the long-term(P ＜ 0.05).Conclusion The Kay methode has good early result, but not the same good in the long-term, which can be applied in the elder persons or the patient without long Life expectancy.And the MC3 ring can correct the FTR enduringly and effectually, specifically the size in small one which behaves perfectly.The MC3 ring should be used in the young patient or the patient wants more.

Objective To observe changes of venous blood gas when applying tourniquets to arterial bleeding dog models and compare the injury of the bundled tissues caused by three different tourniquets. Methods A total of 18 dogs were randomly divided to three groups and made into femoral artery bleeding model of the hind limbs. Then, rubber tubing, half-hitch tourniquet and multi-function pressure-control bandage (hemostatic bandage group) were employed respectively for femoral artery hemostasis in three groups. The pressure produced by the bandage and femoral vein blood gas indices were measured at 0.5, 1, 3 and 6 hours respectively after tourniquet application. Results The pressure produced by the hemostatic bandage group was 0.74 kg, which was obviously lower than 1.46 kg in the rubber tubing group and 2.09 kg in the half-hitch tourniquet group ( P ＜ 0.05 ). At one hour after hemostasis, PvO2 was (36.45 ± 10.45 )mm Hg in the hemostatic bandage group and (28.73 ± 9.07 )mm Hg in the rubber tubing group, which was significantly higher than (21.87 ±4.30) mm Hg in the half-hitch tourniquet group ( P ＜ 0.05 ). At 3 and 6 hours after hemostasis, PvCO2 was (50.67 ± 9.31 ) mm Hg and (60.02 ± 10.85)mm Hg respectively in the hemostatic bandage group, while (16.85 ± 16.51 )mm Hg and ( 60.02 ± 10.85) mm Hg respectively in the rubber tubing group, which were lower than that in the half-hitch tourniquet group ( P ＜ 0.05 or 0.01 ) . Conclusion Compared with rubber tubing and Halfhitch tourniquet, the hemostatic bandage can efficiently stop bleeding under slight pressure, with the least injury to the bundled tissues.

Objective:This article has summarized the second generation cognitive screening exam(NCSE) about it's subtests,methods of use,applicability,characteristics and flaws.

OBJECTIVE:To prepare shenmai injection and establish its fingerprints,and to categorize the peaks in the fingerprints.METHODS:Shenmai injection was prepared from ophiopogonis tuber extracted by water and precipitated by ethanol and red ginseng extracted by ethanol and precipitated by water.The fingerprints of Shenmai injection was established by HPLC,and the relative retention time and peak area ratio of each common peak was determined.RESULTS:11peaks in fingerprints of Shenmai injection were noted.CONCLUSION:The method is suitable for the preparation and quality control of Shenmai injection.

Objective To evaluate the causes,treatment,and prevention of left ventricular rupture after mitral valvereplacement.Methods From May 1981 to November 2010,11 cases occurred in 4 male and 7 female patients aged 28 - 71 years old.There were 2 cases of New York Heart Association (NYHA) functional class Ⅱ and 9 cases of class Ⅲ.Echocardiography showed that the left ventricular end diastolic internal diameter (LVEDI) was 32 -62 mm.Results Rupture probably occurs after endocardial damage to a thin myocardium that has lost the internal buttress of the subvalvar apparatus.With the rise in intraventricular pressure at the end of bypass blood dissects into the myocardium,resulting in a large haematoma and eventual rupture.According to the onset of ruptures,there were 4 cases of delayed rupture which occured at several hours till days post operation after the patients had been back in the ICU,and 7 cases of early ruptur,which occured at the early stage of surgery,while the patient was still in the operation room.There were no cases of ruptures.The types of the ruptures were identified by operation or necropsy as 5 cases of type Ⅰ,4 cases of type Ⅱ,and 2 cases of type Ⅲ.Four patients were saved after emergency treatment,and 7 died.Conclusion It is difficult to repair left ventricle rupture,but effective prevention for onset can decrease its occurrence.The risk factors for left ventricular ruptures are female,advanced age,pathological changes characterized by mitral stenosis,small left ventricle (LVEDD ＜ 35 mm),and low weight( ＜50 kg ).The following actions raise the risk of let ventricular rupture.Isolated replacement of the mitral valve than after double valve replacement or mitral valve replacement and coronary artery bypass graft; aggressive removal of calcification at the mitral valve; undue selection and replacement of mitral valve prostheses; large size of prosthetic valve with a high bioprosthetic angle in particular; deep sutures at the valve ring; aggressive traction or removal of papillary muscle,hematoma,and heart move.Also we should continue correcting unstable hemodynamic especially with very high blood pressure.Once left ventricular rupture occurs,extracorporeal circulation should be established as soon as possible,and direet suture or intracardiac and extracardiac repair suited to actual conditions are reliable ways to save the patient's life.

Objective To explore the prognostic factors of endometrial carcinoma.Methods 166 patients with endometrial carcinoma in Cancer Hospital of Shantou University Medical College from May 1996 to June 2009 were analyzed retrospectively.Prognostic factors were analyzed by univariate analysis.Results The total 5-year survival rate of 166 cases was 86.7 ％.The univariate analysis showed that the age,deep myometrial invasion,lymph-node metastasis and operative-pathological staging were significantly associated with the prognosis (P ＜ 0.05).As well as,according to muhivariate Cox proportional-hazard model,3 independent factors as the age,deep myometrial invasion and lymph-node metastasis were related significantly to overall survival (P ＜ 0.05).Conclusions The 5-year survival rate of endometrial carcinoma is high.The age,deep myometrial invasion and lymph-node metastasis are independent prognostic factors of endometrial carcinoma.

Objective To observe the influence of exercise intensity on cardiorespiratory function in the elderly with coronary heart disease using simplified 24-action Taijiquan and jogging. Methods A total of 115 sedentary elderly patients with heart disease were randomly divided into a control group ( no exercise), a low-intensity exercise group, a medium-intensity exercise group (whose exercise was simplified 24-action Taijiquan at 40-60% of their individual maximum oxygen consumption (VO2max) for 90 to 200 minutes per week) and a high-intensity exercise group ( whose exercise was jogging on a treadmill at ＞ 70% of their maximum oxygen consumption for 200 minutes per week). The regime was maintained for 6 months. All patients accepted a treadmill exercise test before and after the 6 months of exercise to evaluate the changes in VO2max, maximum heart rate ( HRmax), VO2max/HRmax and exercise time (t). Results ( 1 ) After 6 months of exercise, VO2max, HRmax, VO2/HRmax and t had increased sisnificantly in all three exercise groups. Work capacity had increased 18.6% , 33% and 34.4% and HRmax had increased 9.3% , 13.8%, 19.1%. There was no difference between before and after in the control group. (2) Compared with the control group the average VO2max, HRmax and t of all three exercise groups had increased significantly. VO2 max was 9.4% , 26% and 23. 1% better; HRmax was 6.7% , 8.8% and 12% better; t was 3.5,4 and 4.9 minutes longer. (3) Compared with the low-intensity exercise group, VO2max, HRmax and t in the medium- and high-intensity groups increased significantly more. VO2max increased 16.6% and 13.7% more; HRmax increased 2.1% and 3.2% more and average t was 0.5 and 1.4 minutes longer. (4) There was no significant difference between the medium- and high-intensity exercise groups in terms of VO2max. (5) The incidence of self-reported adverse responses to exercise such as dizziness, chest stuffiness and fatigue in the high-intensity exercise group increased significantly compared with the other 3 groups. Conclusions Exercise can gradually improve cardiorespiratory function in the sedentary elderly with heart disease. The effects of medium-intensity exercise are similar to those of high-intensity exercise, but medium intensity is safer.

ObjectiveTo investigate the effects of the asphyxia as a Second Hit on renal function during early stage after birth in small for gestational age (SGA) infants.MethodsThe infants who were hospitalized within 24 hours after birth in Peking University Third Hospital between January 2013 and March 2015 were retrospectively enrolled, and divided into different groups depending on gestational age and asphyxia history. There were 40 preterm non-asphyxia SGA infants and 80 controls who were preterm non-asphyxia appropriate for gestational age (AGA) infants; 11 preterm asphyxia SGA infants and an equal number of preterm asphyxia AGA infants as controls; 33 term non-asphyxia SGA infants and 33 term non-asphyxia AGA infants as controls; and four term asphyxia SGA infants and 13 term asphyxia AGA infants as controls. Blood urea nitrogen (BUN), serum creatinine (SCr), and estimate glomerular filtration rate (eGFR) were tested within 48 h after admission and the incidence of abnormal indexes was compared between groups byt-test and Fisher exact test.Results(1) Compared with preterm non-asphyxia AGA group, BUN level significantly decreased in preterm non-asphyxia SGA group [(3.99±1.69) vs (5.11±2.08) mmol/L,t=2.948, P=0.004]. Compared with term non-asphyxia AGA group, term non-asphyxia SGA group had higher SCr level [(72.03±10.29) vs (62.58±12.27)μmol/L,t=3.390,P=0.001] and lower eGFR level [(25.19±4.07) vs (33.99±8.75) ml/(min·1.73 m2),t=5.238,P=0.000]. (2) Compared with preterm non-asphyxia AGA infants, preterm asphyxia AGA infants had higher BUN [(6.96±3.09) vs (5.11±2.08) mmol/L,t=2.602,P=0.011] and SCr [(76.45±10.11) vs (66.70±13.18)μmol/L,t=2.357,P=0.021] and lower eGFR level [(15.86±2.31) vs (19.54±5.08) ml/(min·1.73 m2),t=2.361,P=0.020]. Compared with preterm non-asphyxia SGA group, there was a significant increase in BUN level [(6.70±3.37) vs (3.99±1.69) mmol/L,t=2.581,P=0.025] and decrease in eGFR level [(14.80±4.67) vs (18.66±5.03) ml/(min·1.73 m2),t=2.285,P=0.027] in preterm asphyxia SGA group. Changes in term infants were similar to preterm infants. (3) Compared with asphyxia AGA group, asphyxia SGA group showed a higher frequency of abnormal eGFR in term infants (4/4 vs 4/13, Fisher exact test,P=0.029). ConclusionsAsphyxia as a probable Second Hit can influence the renal function during early stage in both preterm and term infants, especially in SGA infants.

Objective To explore the effect of cluster needling of scalp acupuncture combined with treadmill training on axonal regener-ation and expression of S-100 protein in rats with sciatic nerve injury. Methods Ninety male Sprague-Dawley rats were randomly divided in-to blank group, sham group, model group, treadmill group and cluster needling of scalp point combined with treadmill group (combination group), each group was further divided into 7, 14 and 21 days subgroups, with 6 rats in each subgroup. The sciatic nerve of rats was clamped in the model group, the treadmill group and the combination group. The sham group was subjected to the same surgical procedure with sciat-ic nerve exposure but without crush injury. Three days after modeling, the treadmill group was treated with treadmill training, and the combi-nation group was treated with cluster needling of scalp acupuncture and treadmill training, while the other groups were grabbed regularly, with no other intervention. The sciatic functional index (SFI) was tested, the condition of axon growth was observed with HE staining, and the expression of S-100 protein was examined with immunohistochemistry at each time point. Results At each time point, SFI was higher, the axon grew better, and the S-100 protein was higher expressed in the treadmill group and the combination group than in the model group (P<0.05), especially in the combination group (P<0.05). Conclusion Cluster needling of scalp acupuncture combined with treadmill training can accelerate the regeneration of axons and increase the expression of S-100 protein and improve sciatic function after sciatic nerve injury.