BACKGROUND:The implantable artificial pacemaker that needs long-term wear is in direct contact with human body tissue, and thus, biocompatibility of the materials is very important. OBJECTIVE:To investigate the material progress and material-related complications of implantable artificial pacemakers. METHODS:Articles related to implantable artificial pacemaker materials and related complications were searched in Wanfang database and PubMed database from 2000 to 2015. The keywords were pacemaker; materials; pacemaker leads; pacemaker electrode; complication in Chinese and English, respectively. Finaly, 27 articles were included and summarized. RESULTS AND CONCLUSION: The implantable artificial pacemakers are in direct contact with the body tissues through the titanium alloy shell covering the pulser, the electrode wire covering the silicone, polyurethane, epoxy resin, and the electrode materials (including carbon, platinum-iridium alloy, Elgilog alloy). These materials have good physical and chemical properties as well as good cytocompatibility, electrophysiological compatibility and blood compatibility with the human body that have been confirmed in the past decades. However, material-related complications often occur, such as contact dermatitis, wire breakage, dislocation, cardiac perforation, venous thrombosis and tricuspid regurgitation along the wire, capsular infection and hematoma when placing the pulser. With the rapid development of today's microelectronic technology, research on the modification of pacemaker materials and the pacing system has been ongoing and has made considerable progress. Moreover, wireless pacemaker development and clinical application may be the future direction of development.

Objective:To explore efficacy of the rehabilitative strategy in hospitalized schizophrenics.Method:Sixty-four schizophrenic patients were randomly divided into the intervention group and the control group.Both groups received the anti-psychotics therapy, but the teamwork education,medication management skills training module, symptom management skills training module were only given to the intervention group for ten weeks. And a one-year follow-up was carried out after their discharge from hospital. All subjects were evaluated with the Positive and Negative Syndrome Scale (PANSS), Nurses` Observation Scale for Inpatient Evaluation-30 (NOSIE-30), Insight and the Attitude to Treatment Scale, Social Disability Screening Schedule (SDSS), Morning Side Scale. We also recorded the relapse rate, reemployment rate, and re-hospitalization rate. Result:The clinical outcome of the intervention group was significantly superior to the control group on overall improvement according to PANSS (31.17?3.13 vs 52.34?13.02,7.34?1.08 vs 12.36?4.28,7.76?2.13 vs 13.26?4.50,16.13?1.82 vs 32.17?9.82 ),increase of active factor score of NOSIE-30 (-18.3?3.2 vs 14.4?6.7),and the reduction of inactive factor score of NOSIE-30(9.4?6.2 vs -22.3?7.4).The relapse rate(9.4% vs 54.8%),re-hospitalization rate(3.2% vs 42%),reemployment rate(37.5% vs 9.6%)were also better in the intervention group.Conclusion:The effect of rehabilitative strategy for schizophrenic patients not only improves the symptom, but also their social function.

Objective To investigate the effects of propofol on neuronal apoptosis in anterior horn of spinal cord in rabbits with spinal cord ischemia-reperfusion (IR) injury. Methods Sixty New Zealand white rabbits aged 4-6 months weighing 2.0-2.5 kg were randomized to receive normal saline (group C), 10% intralipid (group F) and propofol 30 mg/kg (group P1 ), 40 mg/kg (group P2), 50 mg/kg (group P3) and60 mg/kg (group P4 ). 10% intralipid was added to propofol solution to make the fluid infused equal in volume between the 6 groups ( n = 10 each). Spinal cord ischemia was induced by occlusion of abdominal aorta distal to the left renal arteries combined with simultaneous occlusion of bilateral common iliac arteries for 30 min. A catheter was inserted into abdominal aorta close to the site of occlusion via left femoral artery. Normal saline, 10% intralipid or different doses of propofol was infused through the catheter as soon as aorta was clamped at the rate of 12 ml·kg-1·h-1 for 30 min. The aorta and bilateral iliac arteries were then declamped. The L4-6 of spinal cord was removed at 48 h of reperfusion for microscopic examination and the total number of normal motor neurons in the anterior horn of spinal cord was counted. The total number of neurons and apoptosis neurons in the anterior horn of spinal cord was counted by TUNEL and the apoptosis index of neurons was calculated. The expression of caspase-3 in the anterior horn of spinal cord was determined by immunohistochemical technique. Results The number of normal motor neurons was significantly higher, and the apoptosis index and expression of caspase-3 were significantly lower in group P1-4 than in group C and F ( P < 0.05). Compared with group P1, the number of normal motor neurons was significantly increased and the apoptosis index was significantly decreased in group P2-4 and the expression of caspase-3 was down-regulated in group P3 and P4 ( P < 0.05). Compared with group P2, the number of normal motor neurons was significantly increased in group P3 while decreased in group P4, and the apoptosis index was significantly decreased and the expression of caspase-3 was down-regulated in group P3 and P4 ( P < 0.05). Compared with group P3, the number of normal motor neurons was significantly decreased and the apoptosis index was significantly increased and the expression of easpnse-3 was up-regulated in group P4 ( P < 0.05) . Conclusion Propofol 30-60 mg/kg infused through aorta during occlusion can inhibit the neuronal apoptosis and attenuate IR injury to spinal cord dose-dependently in rabbits. The underlying mechanism may be related to the down-regulation of caspase-3 expression.

Objective To investigate the relation between serum adiponectin and coronary artery calcification score (CACS), and find the risk factors for CACS in patients with chronic kidney disease (CKD). Methods Twenty-nine patients with 3-5 stage CKD were selected. The serum adiponectin was measured by enzyme linked immunosorbent assay. The heart was scanned by 64-row spiral CT, and the CACS was calculated. The blood calcium, phosphorus, intact parathyroid hormone, total cholesterol, low density lipoprotein cholesterol, albumin, urea nitrogen, creatinine, uric acid and high sensitive C reactive protein levels were measured, and the calcium-phosphorus product and estimation glomerular filtration rate were calculated. Results In 29 patients with CKD, 24 cases (83%) had coronary artery calcification with different degree (CACS>0 score), and the average CACS was 508 (0-3 363) scores. There were statistical differences in systolic blood pressure, urea nitrogen and estimation glomerular filtration rate between CKD patients with CACS≥100 scores (15 cases) and CKD patients with CACS<100 scores (14 cases):(146.00± 13.00) mmHg (1 mmHg=0.133 kPa) vs. (123.00±9.00) mmHg, (15.44±8.36) mmol/L vs. (9.71±2.52) mmol/L and (21.77 ±11.81) ml/ (min·1.73 m2) vs. (38.71 ±11.56) ml/ (min·1.73 m2), P<0.01 or <0.05. Pearson correlation analysis results showed that CACS had positive correlation with systolic blood pressure, creatinine and uric acid, and negative correlation with albumin and estimation glomerular filtration rate. Mult-stepwise regression analysis results showed that systolic blood pressure and estimation glomerular filtration rate were the independent risk factors of CACS. Conclusions The patients with 3-5 stage CKD have severe coronary artery calcification. The systolic blood pressure and estimation glomerular filtration rate are the independent risk factors of coronary artery calcification.

OBJECTIVE To investigate the epidemic situation of Acinetobacter in lower respiratory tract infection and their drug resistance,in order to provide evidence for clinical anti-infection therapy. METHODS The data of Acinetobacter from the sputum specimens of inpatients in our hospital with lower respiratory tract infection during 2006-2007 were collected and analyzed with the software the software WHONET5.4. RESULTS Among all pathogens in lower respiratory tract infection,Acinetobacter accounted for 9.2% in 2006 and 7.4% in 2007,the rate in deparment of neurosurgery,surgical ICU and respiratory ICU was higher. Acinetobacter had the highest susceptible rate to imipenem and were also susceptible to meropenem and cefoperazone/sulbactam. However,Acinetobacter had higher resistant rate to imipenem and meropenem while higher susceptible rate to cefoperazone/sulbactam in 2007 than in 2006. The susceptible rate of Acinetobacter to the third and forth generation cephalosporins,amikacin,levofloxacin and aztreonam was lower than 50%. CONCLUSIONS The drug resistance mechanism of Acinetobacter is so complicated that many kinds of drugs prove poorly effective. Carbopenems are recommended when single drug is utilized and drug combination based on the clinical and laboratory information can be tried.

Objective: To prepare ibuprofen sustained-release dropping pills, to evaluate the accumulative release percentage in vitro and to study the drug state in the base.Methods: With the drug content, mass ratio of water-soluble base to insoluble base and mass ratio of stearic acid to glyceryl monostearate as the investigation factors, and the comprehensive score of 2-hour and 10-hour cumulative dissolution rate as the evaluation index, a Box-Behnken response-surface method was used to screen the optimal formula of ibuprofen sustained-release dropping pills.The drug state in the matrix was examined by differential scanning calorimetry (DSC).Results: The optimal formula of ibuprofen sustained-release dropping pills was as follows: the drug content of 10%, water-soluble and insoluble matrix ratio of 4∶1, and stearic acid and glyceryl monostearate ratio of 3∶1.The maximum cumulative dissolution rate of ibuprofen sustained-release dropping pills was 78.85%.The DSC analysis showed that the drug crystallization peak disappeared in the sustained-release dropping pills, and formed a solid dispersion.Conclusion: The preparation has good sustained-release effect, and the preparation process is simple.

Objective To observe the relationship between the skin incision of anterior cruciate ligament(ACL) reconstruction and the sensory disturbance around the surgical incision of the leg.Methods From Oct 2007 to Jun 2008,223 patients underwent arthroscopy ACL reconstruction,among them 50 patients were followed-up and defined as four groups according to different types of skin incision.The area of skin sensory disturbance around the incision were measured and compared.Results Compared with transversal incision group(transversal incision for double bundle ACL reconstruction),vertical incision group(using hamstring or Bone-Patella-Bone autografl for ACL reconstruction) and posteromedial incision group(medial meniscus repair group),the length of incision in small incision group(using allograft for ACL reconstruction)was significant shorter(P<0.001).For the area of sensory disturbance,there were no statistics differences between small incision group and transversal incision group(P=0.800),and no statistics differences between vertical incision group and posteromedial incision group(P=0.316).But both small incision group and transversal incision group showed significantly smaller(P<0.05)area of sensory disturbance than vertical incision group and posteromedial incision group.Conclusion For ACL reconstruction,using small incision(allograft)and transversal incision could decrease the area of sensory disturbance of anterior tibial skin.

Objective:To compare the pharmacokinetics and relative bioavailability between matrine sustained release tablet,matrine conventional capsule and matrine injection. Methods: Dogs were given single oral dose and multiple doses of matrine sustained release tablet, capsule or injection in a randomized crossover way. Matrine concentrations in dog plasma were determined by RP-HPLC method. Results: The results showed that the t max and c max were 300 min and (5.088?0.490) ?g/ml for matrine sustained release tablet, (85?12) min and (6.360?0.215) ?g/ml for the conventional capsule, and 10 min and (6.500?0.404) ?g/ml for the injection. The relative bioavailability of the sustained release tablet was (153.7?9.4)% compared with that of the conventional capsule; the absolute bioavailability of the sustained release tablet was (73.5?14.2)% compared with that of the injecetion. The in vivo absorption rate of the sustained release tablet was significantly correlated with the in vitro release rate(r=0.981 2,P

Objective To find the key miRNA that relative to peritoneal fibrosis associated with peritoneal dialysis (PD) by microarray technology,and verify its expression in vitro and in vivo.Methods The peritoneal fibrosis mouse model associated with PD were established by intraperitoneal injection of lipopolysaccharide (LPS)+ 4.25％ peritoneal dialysate.The expression of miRNA was detected by microarray in peritoneal tissues.The expression of miRNA profiles between fibrotic and normal peritoneal tissues was compared.The differentially expressed miRNA (miR-200a) was validated by real-time PCR in lager sample size cohorts.The expressions of miR-200a were also detected in the epithelial-mesenchymal transition (EMT) process of human peritoneal mesothelium cells.Results In mice model of PD,peritoneal tissue was markedly thickened and with a massive extracellular matrix accumulation.In contrast with control,the expression level of epithelial marker E-cadherin was significantly decreased,α-SMA,Col-Ⅰ and FN were remarkably increased (P ＜ 0.05).By miRNA microarray analysis,miR-200a was significantly down-regulated (3.31 folds change,P ＜ 0.05) in fibrotic peritoneal tissues.The down-regulated expression level of miR-200a was also validated by realtime PCR in larger cohorts (P ＜ 0.05).Then,the expression level of miR-200a was detected in the EMT process of human peritoneal mesothelium cells.During the process of TGF-β1 induced EMT,miR -200a was significantly down-regulated compared with the control (P ＜ 0.05).Conclusions Downregulated expression of miR-200a was observed both during peritoneal fibrosis and TGF-β 1 induced EMT in vivo and in vitro,suggesting that miR-200a may be involved in the peritoneum fibrosis by regulating the target genes of EMT.

Objective To observe the effects of high mechanical index ultrasound contrast on hepatic metastasis of colorectal cancer. Methods Hepatic metastasis models were established by injecting Lovo cells into the spleen of SD rats.This study was divided into control group, microbubble plus ultrasound radiation group simple contrast agent group and simple ultrasound radiation group.Ultrasound contrast agent SonoVue(1 ml/kg) was injected via tail vein, high mechanical index ultrasound contrast (frequency 1.5 MHz,MI 1.7) was performed intermittently for 2 min.After 10 d,the animals were killed and the size and number of hepatic metastasis were compared.Histological pathology and its ultrastructure were observed.Results There were no significant differences between contral group,simple ultrasound radiation group and simple contrast agent group in metastatic rate ( P＞0.05).There were no obvious differences between contral group, simple ultrasound radiation group and simple contrast agent group in cells'ultrastructure by transmission electron microscopy (TEM).The number and size of hepatic metastasis decreased obviously in microbabble plus ultrasound radiation group ( P＜0.01 ), the mitochondrion was swelling and the gaps of endothelial cells were loose. Conclusions High mechanical index ultrasound contrast can inhibit the hepatic metastasis of colorectal cancer.