Objective To explore the mechanism of Fuke Zhixuexiaotong Keli in rats model of incomplete puerperal involution of uterus by detecting the expression of metalloproteinases-9(MMP-9) and tissue inhibitor of metalloproteinase-1(TIMP-1) in the uterine redintegration incomplete model.Methods Seventy-two SD female rats were randomly divided into 6 groups:blank group,model group,Chanfukang group,and high-,middle-,low-dose of Fuke Zhixuexiaotong Keli group.The model of incomplete puerperal involution of uterus was established,and MMP-9,TIMP-1 gene expression level in each group were detected by in situ hybridization detection of uterine tissue.Results The expression of MMP-9 and TIMP-1 could be successfully detected in each group.The expression of MMP-9 in model group was significantly higher than the control group,and the expression of TIMP-1 was lower.The mRNA of MMP-9 gene was significantly decreased in both high-,middle-and low-dose of Fuke Zhixuexiaotong Keli group and Chanfukang group(P

Objective To explore the quality of life(QOL) of stroke patients and the influence factors.Methods The QOL of stroke patients was measured with Shot Form 36 Health Survey Questionnaire(SF-36) and questionnaire survey before discharge and six months after discharge;the patients' state of life was analyzed with the ordinal Logistic regression method to find out influence factors.Results The QOL of the stroke patients decreased obviously with an average sphere score between 38.18～67.57.Sphere scores increased during the six months of post-discharge,but only those of physical functioning(PF),role limitations due to physical health(RP),bodily pain(BP),general health perceptions(GH) and vitality(VT) rose significantly.Some common factors that would affect physical and mental health of the patients included: marriage state,economic conditions,medical care assurance,health care,psychological obstacles,rehabilitation and viability.Besides,age,the features of pathological changes and the complication had significant effect on the physical health of the patients,while children and aphasia affected mental health.Conclusion Early and canonical rehabilitation physical care,language and psychological training and so on,as well as family caring and nursing all are contributive to improve the QOL of the stroke patients.

Objective To investigate the inhibitory effect of dauricine on the growth of human bladder cancer T-24 cell and its mechanism.Methods The T-24 cells were treated with dauricine(Dau) at different concentrations.The proliferation of T-24 cells was assayed with MTT colorimetric method.The apoptosis of T-24 cells induced by Dau was studied by fluorescent staining,flow cytometry(FCM) and DNA agarose gel electrophoresis.Results Dau effectively inhibited the proliferation of T-24 cells in a concentration dependent manner.A characteristic DNA ladder was observed in Dau treated groups.Dau at the concentration of 5-30 ?g/ml induced the apoptosis of T-24 cells and the apoptosis rate increased in a time-dependeut manner.Cell cycle was arrested at G_0/G_1 phase.The expression of bcl-2 was inhibited and the expression of bax was up-regulated.Conclusion Dauricine significantly inhibits the growth of bladder cancer cells.Cell cycle arrest and apoptosis might be the functional mechanisms.

Objective To investigate the effects of stellate ganglion block (SGB) on brain injury in patients undergoing cardiac valve replacement under cardiopulmonary bypass (CPB). Methods Forty ASA Ⅱ or Ⅲ patients of both sexes aged 22-50 yr weighing 40-64 kg undergoing elective cardiac valve replacement were randomly divided into 2 groups (n = 20 each): control group (group C) and SGB group. Radial artery and right internal jugular vein were cannulated for BP and CVP monitoring. A catheter was inserted into left internal jugular vein under local anesthesia and advanced cephalad until resistance was met for blood sampling. Right SGB was performed with 0.25% ropivacaine 10 ml. Successful block was confirmed by ipsilateral Homer's syndrome.ECG, BP, CVP and SpO2 were monitored. Anesthesia was induced with midazolam 0.2 mg/kg, fentanyl 5-8 μg/kg and vecuronium 0.12 mg/kg and maintained with fentanyl infusion at 8-10 μg· kg- 1· h- 1 and intermittent iv boluses of midazolam and vecuronium. Blood samples were collected for determination of plasma NO, ET-1, S100β protein and NSE concentrations and NOS activity immediately after left internal jugular vein was retrogradely catheterized (T0 ), at 30 min of CPB (T1), 10 min after release of aortic cross clamp (T2 ), 6 and 24 h after operation (T3 ,T4 ). The patients' cognitive function was assessed by using mini-mental state examination (MMSE) the day before operation and on 1st and 7th day after operation. Results The plasma ET-1, S100β protein and NSE concentrations were significantly increased during and after operation at T1-3 as compared with baseline values at T0 in both groups and were significantly lower in group SGB than in group C. Plasma NO concentration was significantly increased during CPB at T1 as compared with the baseline at T0 in both groups but was significant higher after CPB at T2 but lower after operation at T3,4 in gToup SGB than in group C. The NOS activity was significantly higher during operation at T1,2 in group SGB than in group C. The cognitive function was significantly better at 1st postoperative day in group SGB than in group C. Compared with the baseline value,NO/ET-1 ratio was significantly decreased during and after operation in group C,but no significant change in NO/ET-1 ratio was found in group SGB. Conclusion SGB can attenuate brain injury induced by CPB by improving cerebral perfusion through maintenance of relative balance of NO/ET-1.

Objective To conclude the results of electrophysiological (EP) mapping and ganglianated plexis (GPs) ablation during the minimally invasive atrial fibrillation (AF) surgery.Methods During the period of Sep 2007 to May 2010 to-tally 185 paroxysmal atrial fibrillation cases were recruited receiving the minimally invasive AF surgery with video assistance.The EP mapping was used to test the dual direction block after ablation and the distribution of GPs was recorded.The sinus rhythm rate was followed up after surgery.Results All the minimally invasive surgery were performed successfully withoutdeath in the hospital.There was no permanent pacemaker implant and other serious complications.EP mapping results showed92％ pulmonary vein (PV) potential to the left atrium (LA) could be isolated with the dual direction block for the paroxysmal atrial fibrillation cases.And there were 89％ GPs positive,higher rate than the persistent AF.There were more GPs positive in the right PV area than the left and 86％ GPs lied at the LA domain,not the PV orifice.At least 5 or 6 ablation lesions were needed to get the dual direction block and denervation of the GPs.The sinus rhythm rate after surgery after 3,6,12 and 24months is 83.7％,82.4％,85.4％ and 83.9％.The 12 months follow up data showed the cases with more GPs positive (＞6) had 81.3％ sinus rate and the less GPs positive (≤2) group with 52.6％.Conclusion The EP mapping and GPsablation techniques during the minimally invasive AF ablation surgery could get good sinus rhythm rate during the long term follow up.

Objective To evaluate the effects of inhaled aerosolized different doses of lidocaine on lung injury in patients undergoing cardiac valve replacement under cardiopulmonary bypass (CPB).Methods Thirty ASA physical status Ⅱ or Ⅲ patients of both sexes,aged 18-58 yr,weighing 35-70 kg,undergoing elective cardiac valve replacement with CPB,were randomly divided into 3 groups (n =10 each) using a random number table:control group (group C),lidocaine 100 mg group (group L1) and lidocaine 200 mg group (group L2).Anesthesia was induced with iv injection of midazolam,etomidate,fentanyl and vecuronium.The patients were endotracheally intubated and mechanically ventilated.The aemsolized normal saline 10 ml,2％ lidocaine 5 ml + saline 5 ml and 2％ lidocaine 10 ml were inhaled in C,L1 and L2 groups,respectively,starting from 10 min after induction.At 10 min after induction (T0),1 and 10 min after opening of vena cava (T1,2),and the end of CPB (T3),blood samples were collected from the left radial artery (LRA) and right atrium (RA) for determination of plasma interleukin8 (IL-8),tumor necrosis factor-α (TNF-α) and malondialdehyde (MDA) concentrations (using ELISA) and the expression of CD11 b on polymorphonuclear leukocytes (by flow cytometry).Blood samples were collected from the left radial artery at T0,immediately after beginning of CPB,at T3 and at 2 and 6 h after termination of CPB for blood gas analysis.The oxygenation index (OI),respiratory index (RI) and dynamic lung compliance (Cdyn) were calculated.Results Compared with group C,the ratio between IL-8 concentration in LRA and in RA (concentration of IL-8LRA/RA) was significantly decreased at T2,3,the concentration of MDALRA/RA was decreased at T3 (P ＜ 0.05),no significant change was found in the expression of CD11bLRA/RA at each time point (P ＞ 0.05),and RI was decreased at T3 in L1 and L2 groups (P ＜ 0.05).There were no significant differences in the concentration of IL-8LRA/RA,TNF-αLRA/RA and MDALRA/RA,expression of CD11bLR A/RA,RI,OI and Cdyn at each time point between group L2 and group L1 (P ＞ 0.05).Conclusion Aerosolized lidocaine inhalation can attenuate lung injury and improve lung function in patients undergoing cardiac valve replacement under CPB by reducing inflammatory responses and lipid peroxidation in lung tissues.

Objective The cardiac synchronization therapy (CRT) was proven to have good treatment for the cardiac conduction disorders patients with serious heart failure. But many disadvantages were gradually be noticed, such as difficulty of sinus electrode implantation, coronary sinus injury and bleeding, still one third CRT cases remain unchanged cardiac function.Recently the epicardial lead CRT therapy by the cardiac surgeons appears promising to provide better clinic resynchronization.The aim of this research is to explore the clinical value of surgical epicardial lead CRT for the cardiomyopathy heart failure with micro-invasive thoracoscopy techniques. Methods During April 2007 to Sep 2009 eleven patients were diagnosed as advanced heart failure with cardiac dysynchronization proven by the ECG and tissue Doppler echo examination. The dysynchronization parameters of tissue Doppler echo includes left ventricle maximize delay time , the left dysynchronization index (Ts-SD), the inter-ventricle mechanical delay time (IVMD), left ventricle end-dilation diameters (LVEDD) and the left ventricle ejection fraction (LVEF). All the patients got the consent agreement before the surgery. In the hybrid operation room the right atrial and ventricle endocardial electrodes were placed firs guided by X ray under the general anesthesia and double lumnen incubation. Then the thoracoscope techniques were used to explore the left ventricle lateral wall. The right atrial and ventricle electrodes were connected into the three chamber pacemaker. The Tissue Doppler Echo TEE technique was used to check which part of the left ventricle lateral wall is suitable for the idea CRT therapy. Usually the latest activated part of the left ventricle wall is the goal place. Then the epicardial electrode was fixed with 4-0 prolene suture at the idea place. All the cases were performed by the same surgeons group in the same medical center. The resynchronization features were examined after surgery and during the follow up. Results The endocardial and epicardial electrodes were implanted successfully without any serious complication. All patients were weaned and discharged without any adverse cardiac episodes. There is no mortality during the follow up period. All the patients received the β-blokers, diuretics, ACEI/ARB and other traditional medicine for the heart failure.The Tissue Doppler showed the E peak wave separated form the A peak which means the good resynchronization between the atrium and the ventricle. After surgery during the follow up the left ventricle maximize delay time decreased from (393.4 ±40.2 ) ms to ( 102.1 ± 34.6) ms, the left dysynchronization index (Ts-SD) decreased from (145.2±29.3)ms to(51.0±21.4) ms, the inter-ventricle mechanical delay time (IVMD) decreased from (59.1 ±23.4) ms to (31.2 ± 11.5 ) ms, left ventricle end-dilation diameters increased from (73.1 ± 13.4) mm to (63.2 ± 6.7) mn and the left ventricle ejection fraction increased from 0.32 ±0.04 to 0.41 ±0.07. Conclusion The micro-invasive surgical synchronization therapy could get good CRT result for the cardiomyopathy heart failure patients. Some patients traditionally in the waiting list for the heart transplant could be considered for the CRT therapy candidates.

Objective:To explore the clinical characteristics, possible causes and treatment methods of anaphylactoid reactions related to PICC catheterization.Methods:A retrospective analysis of the data of 27 patients with anaphylactoid reactions in 3 933 PICC catheters from October 2018 to February 2020.Results:The incidence of anaphylactoid reactions was 0.69%(27/3 933), its clinical symptoms were mainly skin reactions, some of which were complicated with respiratory, digestive, cardiovascular system and other symptoms. There was no difference in the incidence of different genders, diagnosis, and history of allergy ( χ2 value was 2.233, 0.839, 0.027, P>0.05). The incidence of patients younger than 60 years old was higher than that of patients older than 60 ( χ2 value was 12.821, P<0.01); the incidence of two catheters with different coatings was higher than that of uncoated catheters ( χ2 value was 27.195, 84.203, P<0.01). Twenty six patients continued the catheterization after the symptoms relieved, and one patient stopped the catheterization. Conclusion:The incidence of anaphylactoid reactions related to PICC, which is more common in catheters or the stylet wire is coated. It is recommended to use a large amount of saline to flush the catheter to reduce or avoid coating materials into the blood, so as to effectively control the occurrence and severity of such complications.

Objective To analyze the clinical features of recurrent acute pancreatitis (RAP).Methods The clinical data of patients diagnosed as RAP were collected in Changhai Hospital, the Second Military Medical University between January 2016 to July 2016, and chronic pancreatitis(CP) patients and RAP patients to matching, as control group.A prospective cohort study about the clinical features of RAP and CP was set.The survival analysis model was established by Kaplan-Meier′s method, to calculate the cumulative rate of RAP which progressed into CP.Results The morbidity of male patients was 69.0% in the RAP group(n=100) and 60% in the CP group(n=100).The average first onset age of RAP and CP was 38 and 21 years old, respectively;and the teenagers accounted for 12% and 38.6%.The incidence of diabetes was 49.5% and 9%;and the incidence of fatty diarrhea was 46.6% and 19% of the two groups.The cumulative incidence of CP was 2% within 1 year, 4.6% in 3 years, and 12.4% in 5 years.Conclusions Men has higher morbidity in both RAP group and CP group.RAP patients′ first onset age was older than that of CP.Teenagers had a low incidence in RAP group.The risk of diabetes and fatty diarrhea was lower in RAP group than CP group.A certain proportion of RAP patients can progress to CP.

Objective:To investigate associations of interleukin-31 (IL-31) and pruritus in atopic dermatitis (AD) with Meta-analysis.Methods:Materials were extracted from the citations listed in the following databases:PubMed,Science Direct,Web of Science and Cochrane.Key search terms included:atopic dermatitis,pruritus,and IL-31.The Meta-analysis was used to analyze the correlation between pruritws in AD and IL-31 expression level.Results:The Meta-analysis showed that serum IL-31 levels were higher in AD patients than those in the healthy controls.The levels of IL-31 were higher in severe AD patients than those in the mild and moderate AD patients.Moreover,a positive correlation between serum IL-31 levels and severity of pruritus was identified.Conclusion:Increased serum levels of IL-31 generally exist in the AD patients,and it may accelerate the pruritus in the AD patients.