Aortic Coarctation ; complications ; Ductus Arteriosus, Patent ; complications ; Humans ; Infant ; Pulmonary Artery ; abnormalities

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Eye ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Paralysis ; physiopathology ; therapy ; Trochlear Nerve Diseases ; physiopathology ; therapy ; Young Adult

Objective To investigate the effect of circadian rhythm on the duration of neuromuscular blockade (NMB) elicited by atracurium. Methods Sixty-one ASA Ⅰ or Ⅱ patients aged 18-55 yr with body mass index of 18-24 kg/m2 undergoing general anesthesia were enrolled in this study. Anesthesia was induced with fentanyl 2 μg/kg and propofol 2 mg/kg. Atracurium 0.75 mg/kg was injected iv as soon as the patients lost consciousness . NMB was assessed by TOF-stimulation of ulnar nerve using TOF-Watch(R) SX. Tracheal intubation was performed as soon as the first twitch (T1) disappeared. The patients were mechanically ventilation (VT 6-8 ml/kg, RR 12 bpm, I ∶ E 1.0 ∶1.5). PETCO2 was maintained at 35-45 mm Hg. Anesthesia was maintained with continuous infusion of propofol 6-8 mg·kg-1·-1·-1and remifentanil 0.25-0.50 μg·kg-1·min-1 . Anesthesia was performed at 5 time periods: (1) 8:00-11:00, (2) 11:00-14:00, (3) 14:00-17:00, (4) 17:00-20:00 and (5) 20:00-23:00. The duration of NMB produced by atracurium was defined as the interval between the end of atracurium injection and 3% recovery of T2 . The data were analysed using generalised linear models (GLMs) and cosinor method. Results Fifty-three cases completed the study. GLM analysis showed that the duration of NMB was longest at 20:00-23:00 (53 min (95% confidence interval 50-56 min)) and shortest at 11:00-14:00 (43 min (95% confidence interval 39-46 min)), suggesting that there is a significant diurnal variation in the duration of NMB elicited by atracurium. Cosinor method analysis showed that equation of the duration of NMB and time point of atracurium administration was y = 48.05 + 15cos( 15t + 52.66). Conclusion Circadian rhythm can affect the duration of NMB elicited by atracurium, which shows that the duration of NMB is longest at 20:00-23:00 and shortest at 11:00-14:00.

Objective To observe the effect of kallikrein and ozagrel on hemorheology in the treatment of patients with acute cerebral infarction,provide a theoretical basis for clinical treatment.Methods 100 patients with acute cerebral infarction met the inclusion criteria were randomly divided into 50 cases of observation group and 50 cases of control group,the control group were received conventional drug therapy,the observation group were given kallikrein and ozagrel on the basis of the control group,kallikrein 0.15PNA /times,ozagrel 80mg one time,bid,14d for a course of treatment.The symptoms improvement were observed,the NIHSS score and ADL score were calculated after treatment,then the blood were extraced for detecting high shear viscosity of whole blood,red blood cell aggrega-tion index,hematocrit,fibrinogen,erythrocyte sedimentation rate,and the clinical efficacy were judged.Results The total effective rate of the observation group were 96% (48 /50),which of the control group were 66% (33 /50),the total effective of the observation group was significantly higher than the control group (χ2 =16.105,P <0.01);The high shear viscosity of whole blood,red blood cell aggregation index,hematocrit,fibrinogen,erythrocyte sedimentation rate,NHISS of the observation group and the control group after treatment were lower than before treatment (t =6.589 and 3.762,6.204 and 3.661,8.112 and 5.774,5.542 and 3.529,9.429 and 3.962,9.621 and 6.586,all P <0.05),the ADL score was significantly higher than before treatment(t =7.673 and 5.446,all P <0.05),the high shear viscosity of whole blood,red blood cell aggregation index,hematocrit,fibrinogen,erythrocyte sedimentation rate, NHISS of the observation group after treatment were lower than those of the control group (t =3.387,3.545,3.525, 3.288,3.302,4.988,all P <0.05),the ADL score was significantly higher than the control group (t =3.446,P <0.05).Conclusion The method containing kallikrein and ozagrel has exact clinical efficacy,can effectively improve blood rheology and cerebral blood perfusion ischemic area,promote neurological deficits and recover the ability of daily life,and its security is good,which is worthy of promotion.

Objective To discuss the mode of onset,clinical characteristics,treatment and prognosis of children with granulocyte sarcoma (GS),in order to provide guidance for early diagnosis and effective treatment of GS.Methods Six cases of children with GS diagnosed at the Department of Hematology,Children's Hospital Affiliated to Soochow University between June 2009 and June 2014 were analyzed,the data including the mode of onset,clinical manifestation,diagnosis,treatment and outcome.Results There were 2 cases with a painless mass onset (1 case was 2 years old,characterized by right waist mass,about 10 cm × 5 cm;the other case was 6 years old,characterized by axillary lump,about 2 cm × 3 cm),and both of them received surgical removal of the tumor,then the postoperative tumor was examined by pathologic and immunohistochemical method,and at last the primary granulocyte sarcoma was diagnosed.The third case was a 7 years old girl,she was onset characterized by scalp lump,about 2 cm × 3 cm,and was diagnosed by the pathologic and immunohistochemical method,and changes in hematological system appeared a month later and acute myeloid leukemia(AML) was confirmed by bone marrow examination.The onset ages of other 3 cases were in 10 months,1 year and 7 months,13 years and 3 months old respectively,characterized by scalp lump (about 2 cm × 3 cm),spinal canal tumor (about 1.0 cm × 1.5 cm),intracranial tumors (6.0 cm × 4.9 cm),with AML occurring at the same time,which was confirmed by surgical pathology,immunohistochemistry and bone marrow cell morphology,immune classification,chromosome,and fusion gene diagnosis.Four cases were hematopoietic malignancies by pathology,2 cases of then belonging to small round cell tumor.The immune pathology showed 5 cases of myeloperoxidase positive,CD68-positive,3 cases of CD43-positive,CD123-positive.All children CD3,CD20 levels in all children were negative.Four cases underwent surgery combined with chemotherapy,other 2 cases received surgery and then gave up treatment,1 case discontinued follow-up 3 months later,and the other case died of intracranial hemorrhage after 3 months,which induced by thrombocytopenia.The treated 4 cases were followed up 3 to 58 months,and all had disease-free survival.Conclusions Children with GS have low incidence and non-specific diagnostic criteria,its diagnosis depends on immune pathology,and the treatment is mainly in accordance with AML program for high-dose chemotherapy.The systematic chemotherapy helps to prolong overall survival;at the same time,the hematopoietic stem cell transplantation with bone marrow may help to improve the prognosis.

Objective To explore the differences of patient comfort and nursing workload between ultrasound guidance on upper arm placement of PICC and traditional placement of PICC, and to provide a reference for correct selection of catheter way. Methods Using a nonrandomized controlled study, a total of 1 116 patients were divided into the control group and the observation group, patients with traditional placement of PICC were set as the control group, and the patients with upper arm placement of PICC were named as the observation group. The patient comfort and workload of use and maintenance of PICC by nurses were compared between two groups. Results The incidence of catheter sliding out of PICC in the observation group was 1.9%(7/365), obviously higher than that of the control group, which was 0.3%(2/751), the difference was significant (χ2=8.37,P=0.007). The patient comfort had no statistical significance between two groups (t=2.13,P=0.082). The workload of use and maintenance of PICC in the observation group were (1.87±0.31) min and (9.16±1.07) min ,which were obviously higher than that of the control group [(0.85±0.16) min and(7.22±2.13) min] in winter (t=4.39, P=0.022;t=3.44, P=0.041), but there was no statistical significance between two groups in summer (P>0.05). Conclusions The workload of use and maintenance of PICC on upper arm placement was higher than traditional placement of PICC in winter, but the obvious differences of patient comfort and nursing workload in summer between the two PICC groups were not been found.

Objective To assess the value of diffusion tensor imaging(DTI)and susceptibility weighted imaging(SWI)in diagno-sis of acute diffuse axonal injury.Methods The imaging data of 45 cases with acute DAI diagnosed by clinical symptoms were ana-lyzed retrospectively.In all the images of T2 WI,FLAIR ,DTI and SWI we analyzed the characteristic of signal and distribution of all the lesions.The numbers of lesions found in each sequence group were statistically analyzed by chi-square test.Results 497 lesions of DAI we all found.265 lesions were found in FLAIR,the detection rate was 53.3%.313 lesions in DTI,the rate was 62.9%.448 lesions in SWI,the rate was 90.1%.The detection rate of DTI and SWI were significantly higher than FLAIR,they had significant difference(P <0.05).Conclusion DTI combined with SWI,we can find DAI lesions in acute phase more comprehensively.DTI di-mensional diffusion tensor imaging technique can help us visualize discontinuous fibers intuitively in DAI and confirm objectively the existence of DAI lesions.

AIM:To investigate the effect of cigarette smoking condensate on histone deacetylase 2 (HDAC2) and inflammatory mediators in mouse myoblast C 2C12 cells.METHODS:C2C12 cells were treated with cigarette smoke extract (CSE).HDAC2 siRNA was transfected into the cells using Lipofectamine TM 2000.The levels of interleukin-8 (IL-8) and tumor necrosis factor-α( TNF-α) in the culture supernatants were measured by ELISA , and the expression of HDAC2 at mRNA and protein levels was determined by real-time PCR and Western blotting .RESULTS:The expression of HDAC2 at mRNA and protein levels in CSE group was lower than that in control group (P<0.05).The supernatant levels of IL-8 and TNF-αin CSE group were significantly higher than those in control group ( P<0.05 ) .When the cells were transfected with HDAC2 siRNA followed by CSE stimulation , the expression of HDAC2 at mRNA and protein levels was de-creased , and the supernatant levels of IL-8 and TNF-αwere significantly increased as compared with CSE group and control group (P<0.05).CONCLUSION: Under the oxidative stress condition , C2C12 cells generate high levels of IL-8 and TNF-αby down-regulating the expression of HDAC2.

BACKGROUND: Study on bone tissue-engineered material is one of the most successful fields in tissue engineering, but the mechanism on synthesis of artificial bone has not been known in many aspects.OBJECTIVE: To explore the mechanism of collagen and calcium phosphate (CP) in artificial bone synthesis.DESIGN: Single sample experiment was designed.SETTING: Material Research Room of Honghe University.MATERIALS: The experiment was performed in Material Research Room of Honghe University from July to August 2003. The materials included collagen (10 g/L acetic acid solution), calcium chloride, sodium dihydrogen phosphate (SDP), sodium hydroxide (NaOH), Tris, hydrochloric acid and deionized water (DI water).METHODS: Liquid nitrogen freezing and freeze-drying were used to prepare collagen-CP complexes A and B and the samples at different times during mineralization. UV spectrophotometer was used to determine the biomineralized dynamic curve of collagen-CP. Based on law of curve, the different times of sample collection were determined in preparation of electronic microscopic samples. According to electronic microscopic pictures and spectral data, mechanism analysis was carried on.MAIN OUTCOME MEASURES: Morphology of collagen-CP complex and law of its structure with time changeRESULTS: ①Under agitation, collagen-CP complex A was sheaf-like or needle-like in structure manufactured with retarded neutralization. ②Under static state, with biomineralization, collagen-CP complex B was in layered structure at initial phase of mineralization, which was similar to the self-assembled structure of pure collagen and the molarratio of C, O, P and Ca was 7.26: 20: 0: 2. At the end of mineralization, the structure was strip-like in high density with a certain grains and very fine rills and the molar ratio of C, O, P and Ca was 11.02: 22.5:1.06: 2.CONCLUSION: At the early phase of biomineralization, collagen iscoordinated initially with calcium ion, calcium-carrier layered collagen template is formed with the self-assembling of collagen, and then phosphates is combined with calcium ion to manufacture calcium phosphate in the formed template. By controlling agitation and acting time, collagen complex material of reticular and spinal structure is obtained.

Objective To evaluate the expression of Tc17 in a cigarette smoke-induced mice model of emphysema.To explore the probable mechanisms about how Tc17 cells to elevate in lungs of mice.Methods Forty male Balb/c mice were randomly divided into four groups,including control group ( 12 weeks,C12),control group (24 weeks,C24),smoke-exposure group (12 weeks,S12) and smoke-exposure group (24 weeks,S24 ),10 mice each group,Emphysema of mice was observed by HE pigmentation.Morphological changes were evaluated by mean linear intercepts (Lm) and destructive index (DI).The proportion of CD8+ IL-17 + Tc17,CD8+ IL-17 + CC chemokine receptor type 6 ( CCR6 ) + and 6CCR6 + Tc17 cells in lungs of mice was determined by flow cytometry.The mRNA expressions of retinoidrelated orphan nuclear receptor(RORγt) and IL-17 were evaluated by real-time PCR.The levels of IL-1 β,IL-6,IL-23,transforming growth factor β (TGFβ) and CC chemokine ligand 20 (CCL20) were tested by ELISA.Correlations among these indexes were analyzed.Results Lm and DI were significantly higher in S12 and S24 than in C12 and C24,S24 in particular (t value 4.378-15.188,all P ＜ 0.05).The percentages of Tc17 in S12 and S24[(9.28 ± 1.12)%,( 13.13 ±3.56)%]was significantly increased as compared with that in C12 and C24[(2.40 ±0.60 )%,(2.64 ±0.96 )%],S24 in particular.The mRNA levels of RORγt and IL-17 in S12 and S24 were higher than in C12 and C24,S12 and S24 in particular.There was significant difference (all P ＜0.05 ).The frequency of Tc17 cells had a positive correlation with Lm and DI ( r value were 0.734 and 0.884 respectively,P ＜ 0.01 ).The percentages of CD8+ IL-17 + CCR6 +T cells and CCR6 + Tc17 were significantly elevated in S12 and S24 compared to C12 and C24,S24 in particular (all P ＜ 0.05 ).There was positive correlation between Tc17 cell ratio and CCL20 levels( r =0.899,P ＜0.01 ).The levels of IL-1 β,IL-6,IL-23 and TGFβ in S12 and S24 were significantly increased as compared with that in C12 and C24.There was significant difference (all P ＜0.05).Meanwhile,the frequency of Tc17 cells had a positive correlation with IL-1β,IL-6,IL-23,and TGFβ.Conclusions An up-regulation of proportions Tc17 in lungs of cigarette smoke-induced emphysema mice were detected.The CCR6/CCL20 axis and the increased IL-1β,IL-6,IL-23 and TGFβ probably contributed to this up-regulation.