Acetylcholine ; metabolism ; Acetylcholinesterase ; metabolism ; Animals ; Brain ; enzymology ; metabolism ; Female ; Hypoxia, Brain ; physiopathology ; Ischemic Preconditioning ; methods ; Male ; Memory ; physiology ; Mice ; Random Allocation ; Reperfusion Injury ; prevention & control

Objective To prepare a 10-hydroxycamptothecin (10-HCPT) loaded folate-receptor targeted phase-change contrast agent (FR-HCPT-PNPCA),and to study the general characteristics including drug loading,phase changing and targeting capability in vitro.Methods Using a method of two-step emulsification,the phase-change nanoparticles loading anticancer drug (10-HCPT) with lipids shell and liquid pefluorocarbon core were prepared.The entrapment efficiency and the drug-loading amounts were studied by high performance liquid chromatography,and the phase transition of the nanoparticles after heating was observed.The targeting ability was evaluated on liver cancer cell line 7721 in vitro.Results The FR-HCPT-PNPCA,with a drug encapsulation rate of about 70.42 ％ and drug loading amounts of about 20.05 ％,was prepared successfully.When being heated to 70℃,obvious phase changing and microbubbles generating could be observed under microscope.In addition,a large amount of FR-HCPT-PNPCA particles could adhere specifically around the 7721 cells.Conclusion The prepared FR-HCPT-PNPCA,which has a stable characteristic and high performance of drug loading and tumor targeting,is expected to become a promising multifunctional molecular ultrasound probe for diagnosis and treatment of tumor.

Objective To investigate the protective effects of Ginkgo Biloba leaves(EGb) preconditioning on liver graft in rat liver transplantation.Methods Male Sprague-Dawley rats were used as donors and(recipients) of orthotopic liver transplantation(OLT).The rats were randomly divided into EGb group,normal saline(NS) control group and sham operation(SO) group.The animals were killed at 2h,6h,24h after graft reperfusion.Plasma samples were collected for ALT and AST test.Liver tissues were collected to detect the expression of TNF-?mRNA and Bcl-2mRNA by RT-PCR.Also,liver tissues were used to detect rat(liver) histological change and apoptosis by TUNEL.Results The serum levels of ALT in EGb group were(significantly) lower than the NS group(P

OBJECTIVE To investigate the clinical distribution and antibiotics resistance of Pseudomonas aeruginosa nosocomial infection after open-heart operation.METHODS The clinical data of 393 patients with nosocomial infection from Jan 2004 to Dec 2007 were analyzed retrospectively.RESULTS There were 57 infected cases caused by P.aeruginosa,and accounted for 14.5% of all infections during period.All infected patients had serious original heart diseases,and received broad-spectrum antibiotic therapy previously.Forty-two patients developed postoperative cardiorespiratory function failure,and 28 patients needed circulatory support.Thirty-six patients prolonged mechanical ventilation time for over 1 week.Results of susceptibility test showed that ciprofloxacin,levofloxacin and piperacillin/tazobactam were the most active antibiotics,followed by tobramycin,netilmicin,gentamicin,meropenem and imipenem/cilastatin.P.aeruginosa presented high resistance to ceftazidime and cefoperazone/sulbactam.CONCLUSIONS P.aeruginosa is one of the most common pathogenic bacteria after open-heart operations in our hospital and presented multidrug resistance.Rational use of antibiotics is important to reduce drug resistant strains.

Objective: To explore the characteristics of external iliac artery vascular complications atfer renal transplantation and the diagnosis and treatment. Methods: We reviewed the clinical data of 6 patients with of external iliac artery vascular complications atfer renal transplantation from more than 2000 renal transplantation patients in the Transplantation Center of the Third Xiangya Hospital of Central South University from 2001 to 2013, and analyzed the clinical characteristics, diagnosis and treatment. Results: hTe renal allogratf was removed in 5 of the 6 patients due to repeated external iliac arteryhemorrhage: 2 patients were replaced the external iliac artery with reversed autogenous great saphenous vein, 2 patients underwent the bilateral femoral artery bypass surgery, and 1 was repaired the external iliac artery directly. The other 1 was resected the renal allograft and the involved external iliac arteries due to fungal mass in the external iliac artery. Among the 6 patients, except 1 patient died atfer the surgery of the repair of the external iliac artery, the other 5 are all alive. Conclusion: Vascular replacement and artery bypass are effective methods for patients with external iliac artery vascular complications atfer kidney transplantation.

OBJECTIVE To investigate the risk factors and treatment of nosocomial pulmonary fungal infection after open heart surgery.METHODS A total of 11040 consecutive patients who underwent open heart surgery were retrospectively studied from Jan 2004 to Dec 2006.And the clinical data of 324 patients with microbiologically documented nosocomial infection were analyzed.RESULTS There were 61 infected cases caused by fungi,accounted for 18.8% of all infections during the same period.Sixteen patients died.All infected patients had serious original heart diseases,and received previously glucocorticoids and broad-spectrum antibiotic therapy.The number of senile and pediatric patients was 28.Forty three patients developed postcardiotomy cardiorespiratory and renal function failures,and circulatory assist was established in 22 patients.Thirty six patients prolonged mechanical ventilation time for over one weeks.Thirty four patients developed hyperglycosemia.Candida albicans was the predominant pathogen(39 strains,63.9%),followed by C.glabrata(15 strains,24.6%).Results of susceptibility test showed that fluconazole,itraconazole and flucytosine presented highly antimicrobial activity.CONCLUSIONS Developments of nosocomial pulmonary fungal infection is closely associated with the severity of preoperative underlying heart diseases,prolonged mechanical ventilation and longer period of broad-spectrum antibiotic therapy.

Objetctive To summarize the associated complications with circulatory support device,and provide reference for chnical practice.Method A total of 8306 consecutive patients who underwent open heart surgery,in Department of Post-operation Intensive Care Unit of the Cardiac Surgery,Anzhen Hospital,Capital Medical University,was retrospectively studied from January 2005 to February 2007.And the clinical data of 246 patients including 63 female and 183 male patients with mean age 56.7±14.2 years supported with various circulatory support devices for perioperative cardiorespiratory function failure in ICU were analyzed.Left ventricular assist device (LVAD) was used in 3 patients by the cannulation of the left alritan and ascending aorta.The extracorporeal membrane oxygenation(ECMO) was established in 48 patients for postoperative cardiorespiratory function failure.The vencarterial bypass was established by cannulation of the right atrium in 41 patients and femoral artery and of venovenons in 2 patients,and of the right atrium and ascending aorta in 5 cases,lntra-aortic balloon pumping(I-ABP)was performed via the femoral artery either percutaneonsly by the Seldinger technique in 195 patients.The cardiac operations included coronary artery bypass grafting (n=170),coronary artery bypass grafting with romoldingof left ventricle (n = 22),coronary artery bypass grafting with valvular operation (n=10),valvular operation (n=27),heart transplantation(n=8),correction of congenital heart defects(n=6),aortic operations(n=2).The duration of circulatory support ranged from 4 to 451 hours.Correlative complications of 3 kinds of circulatory support device were compared and repair of ventricular septal perforation in the wake of acute myocardial infarction (n=1).Results Seventy-eight (31.7%) patients died.Seventy-one(28.9% ) patients devdoped various complications including infection(n=27),renal failure required renal rephcement therapy (n=27),re-exploration for bleeding(n=24),haemolysis(n=6),limb ischemia(n=15),neurological complications(n=6),oxygenator failure(n=7) Conchusions The improvement of management to reduce complications may result in improved outcomes of patients supported with circulatory support devices.

OBJECTIVETo explore the immunological pathogenesis of multiple sclerosis (MS) patients of different TCM syndrome types.

METHODSFifty-nine MS patients were assigned to two types by syndrome typing according to their clinical manifestations, the Gan-Shen yin-deficiency (GSYD, 40 cases) type and the both yin-yang deficiency (YYD, 19 cases) type. Difference of patients' age of first attack, times of relapsing, duration of disease, MRI finding and evoked potential between the two groups were compared. The immunology indexes were also compared in part of the patients (26 cases in GSYD type and 12 cases in YYD type).

RESULTSThe age of first attack was later (P < 0.01), level of myelin basic protein in cerebrospinal fluid was higher (P < 0.05), in the YYD type than those in the GSYD type. Besides, the relapsing time in GSYD type, and the blood-brain barrier index and level of myelin basic protein in YYD type showed an ascending trend (P = 0.056, 0.074, 0.093, respectively).

CONCLUSIONImmunological difference exists between the MS patients of GSYD type and those of YYD type.

Adolescent ; Adult ; Child ; Diagnosis, Differential ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Multiple Sclerosis ; drug therapy ; immunology ; pathology ; Myelin Basic Protein ; Nerve Tissue Proteins ; cerebrospinal fluid ; immunology ; Phytotherapy ; Syndrome ; Transcription Factors ; cerebrospinal fluid ; immunology ; Yang Deficiency ; drug therapy ; immunology ; pathology ; Yin Deficiency ; drug therapy ; immunology ; pathology ; Young Adult

Objective To report the experience of the arterial switch operation(ASO) for Taussig-Bing anomaly and late outcomes.Methods From January 2001 to December 2015,57 patients were underwent arterial switch operation for Taussig-Bing anomaly in Fudan university affiliated children's hospital cardiac center,Median age and weight at operation was 63(37.5-88.5)days, 4.1(3.4-5.0)kg, respectively.29 patients with Arch anomalies(50.9%), 23 patients with unusual coronaries(40.3%),according to have arch anomaly or not and surgery time, dividing the patients into two groups, group A(have, n=29)and group B(not have, n=28), earlier experience into group 1(2001-2008, n=27), later experience into group 2(2009-2015, n=30), respectively.Results The Mortality was12.3%, the mortality of group A and group B was 13.8%, 10.7%(P>0.05),group 1 and group 2 was 22.2%, 3.3%(P<0.05) respectively, follow up was complete in 47 patients with a mean follow-up of(6.2±3.5) years , three patients lost, there was no late mortality, the actual survival at 1, 5year was 87%, 87%, respectively.Reintervention was required in 10 patients(21.3%), the aorta-PA valve diameter ratio was a risk factor for reintervention(group A P=0.02, group B P=0.04) ,and 1,2,5year free of reintervention was 95.6%, 86.6%, 77.2%, respectively.Conclusion The ASO approach can be applied to Taussig-Bing anomaly with acceptable mortality , and it is the procedure of choice at our institution.One stage to repair TBA with aortic arch abnormalities did not influence outcomes.The aorta-PA valve diameter ratio<0.5 was a risk factor for reintervention.

Objective The rate of post -operative complications has been increased with the changes in patients' age,prolonged duration, more severe and diffused lesions, and more patients with complications in recent years. We try to identify the risk factors associated with prolonged stay in the intensive care unit ( ICU ) after coronary artery bypass graft surgery (CABG). Methods 1623 patients who received CABG surgery in Beijing Anzhen Hospital Between June 1, 2006 and December 31,2007 were divided into two groups based on their stay duration in the ICU. Prolonged stay in ICU was defined as 5days or more. Univariate and multivariate analysis ( logistic regression) were used to identify the risk factors. The discrimination and calibration of the result were tested after the risk factors were determined. Results Fifty one patients had prolonged ICU stay, accounting for 3.14% of total cases. Multivariate logistic analysis showed that the age of patients, peripheral vascular diseases, critical status before operation, LVEF, operative status, mitral regurgitation, postoperative respiratory failure,postoperative renal failure, secondary thoracotomy for postoperative bleeding were associated risk factors. Conclusion Prolonged ICU stay after CABG surgery can be predicted based on the above factors. For patients with these risk factors, more pre-and postoperative care strategies are needed.