Adult ; Haploidy ; Hematopoietic Stem Cell Transplantation ; Hemorrhage ; Humans ; Lung Diseases ; Male ; Pulmonary Alveoli

Objective To evaluate the outcomes of cardiac surgery in neonates weighing less than 2500g and premature infants. Methods From January 2000 through March 2005, 36 consecutive critically symptomatic neonates (26 males, 10 females) weighing less than 2500g underwent cardiac surgery at our center. Median gestational age was 34 weeks with 24 (70.6%) premature (≤37 weeks). Median age at operation was 15.5 days (from 4 days to 68 days). Median weight was 2120g (from 700g to 2500g). Indications for surgery were: persistent ductus arteriosus (PDA, n=15), coarctation of the aorta (CoA, n=3), transposition of great arteries with severely hypoplastic aortic arch (TGA/HAA, n=1), ventricular septal defect (VSD, n=10), pulmonary atresia with intact ventricular septum (PA/IVS, n=5), total abnormal pulmonary venous return (TAPVR, n=2). The heart functions of all patients were assessed in NYHA class IV and 7 patients (19.4%) were intubated pre-operatively. 18 cases (50%) needed extracorporeal circulation and deep hypothermia with circulatory arrest was used in 6 patients. Results The overall mortality was 11.1%. The causes of death were left heart failure in 1 patient and multiorgan failure in 2 and hypoxmia in 1. Mean extracorporeal circulation time was 92 min (from 72 min to 198 min). Mean aortic cross-clamping time was 76 min (from 46 min to 158 min). Mean deep hypothermia with circulatory arrest Peritoneum dialysis was carried out in 5 cases. Mean follow-up period was 22. 3 months (from 2 months to 46 months). 2 patients underwent reoperation and catheter intervention respectively. The heart functions of 26 patients (81.4%) were in NYHA class I at the latest clinical examination. Conclusion This study suggests that complete repair of simple and complex congenital heart diseases can be performed effectively in low birth weight neonates with acceptable mortality and morbidity. Low weight alone should not be considered as a contraindication to surgery in these patients. It is recommended that such neonates undergo early surgical correction rather than prolonged conservative palliation.

Objective To evaluate the early therapeutic effect of flail chest with pulmonary contusion by using different mode of mechanical ventilation. Methods Twenty-nine patients of flail chest with pulmonary contusion were analysed retrospectively. All the patients were treated with the ventilator Bear1000. Two groups were established: invasion group was treated with SIMV+PEEP(8 cases) and CPAP+PSV (7 cases), noninvasion group was treated with NIPPV(14 cases). Results There was no death in all the patients. CPAP+PSV was more effective than SIMV+PEEP not only in decreasing breath rate and improving hypoxemia but also in decreasing peak inspiratory pressure(P

Objective How to improve nursing students′consciousness and ability of scientific research remains a big chal-lenge to in advanced nursing education .This study aimed to investigate the mode and methods of training the scientific research ability of adult nursing students in the junior-to-regular college education program . Methods Using a new mode of scientific research train-ing, i.e.class training+tutors′guidance+individual appraisal , we trained 242 adult nursing students from grades 2009 to 2013 of the junior-to-regular college education program , along with related questionnaire investigation . Results All the students considered the mode to be effective in improving their consciousness and ability of scientific research .During their study at school , they published 115 research papers in the Source Journals for Chinese Scientific and Technical Papers and Citations , and 18 of them undertook nursing re-search projects and won various awards for science and technology achievements in nursing research . Conclusion This new mode can effectively promote the scientific research ability of adult nursing students in the junior -to-regular college education program .

Objective　To evaluate the changes and clinical s ignificances of serum growth hormore (GH) and GH binding protein (GHBP) in patie nts with obstructive jaundice (OJ). Methods　Serum levels of GH, GHBP, insulin-like growth factor-Ⅰ (IGF-Ⅰ), endotoxin, prealbumin concentr ation and liver function in 60 male in patients with OJ were detected 1 d preope ratively and 1, 3, 7 d postoperatively. And 40 male patients with simple gallbla dder stone hospitalized in the same period were served as control. Resu lts　The levels of GH, GHBP and IGF-Ⅰ were significantly lower in pati ents with obstructive jaundice than in control group(P<0.01), which was corr elated with the levels of bilirubin, endotoxin and prealbumin (P<0.01). Conclusion　The obviously downregulation of GH/GHBP axis in patients with OJ probably results from the inbibition of expression of GH receptor due t o nutritional dysfunction and endotoxemia, and further aggravate the nutritional dysfuction and endoxemia, which may be one of the important factors in the path ophysiological changes of OJ.

Objective To investigate the effects of heparin coating on intimal hyperplasia in implanted decellularized xenografts.Methods The resected canie carotid arteries were decellularized,and heparin coating was partially performed.Eighteen rabbits were divided into non-heparin-coated group(n=9)and heparin-coated group(n=9).During implantation,only the left carotid between the anastomotic stoma was ligated.Doppler ultrasonography was performed 1,3 and 12 weeks post-implantation to measure the luminal diameter,and the hemodynamic parameters such as PSV,RI and PI were calculated.All animals were sacrificed,histological observations were conducted at 12 weeks post-implantation,and I/(I+ M)was calculated.Results Except for 1 week post-implantation in the ligated side,the luminal diameters in non-heparin -coated group were significantly smaller than that of pre-implantation.Besides,those of the non-ligated side at each time points were significantly smaller than the ligated side(P

Objective To evaluate the effects of the serum in the patients with obstructive jaundice on the proliferation,migration and phenotype modulation of human pulmonary arterial smooth muscle cells (PASMCs).Methods PASMCs were isolated from the patients,underwent passage and were then subcultured.The cultured PASMCs were incubated with the serum in the patients with obstructive jaundice or with the serum in the healthy volunteers.At 24,48 and 72 h of incubation,the proliferation and migration of the cells were determined by CCK-8 assay and wound healing assay,respectively,and Western blot analysis was used for detection of smooth muscleα-actin (SM-α-actin) and calponin protein expression in human PASMCs.Results The proliferation and migration of human PASMCs were significantly enhanced,calponin protein expression was up-regulated at 24 h of incubation,and the SM-α-actin and calponin protein expression was down-regulated at 48 and 72 h of incubation when human PASMCs were incubated with the serum in the patients with obstructive jaundice as compared with those when the cells were incubated with the serum in the healthy volunteers.When human PASMCs were incubated with the serum in the patients with obstructive jaundice,the proliferation and migration of the cells were significantly enhanced,SM-α-actin expression was up-regulated and calponin protein expression was down-regulated at 48 h of incubation as compared with those at 24 h of incubation.When human PASMCs were incubated with the serum in the patients with obstructive jaundice,the migration of the cells was significantly enhanced,and no significant change was found in the proliferation and SM-α-actin and calponin protein expression at 72 h of incubation as compared with those at 48 h of incubation.Conclusion The serum in the patients with obstructive jaundice can enhance the proliferation and migration of human PASMCs and promotes synthetic PASMC phenotype.

Objective To evaluate the effect of bilirubin on proliferation of pulmonary microvascular endothelial cells (PMVECs) of rats.Methods Primary PMVECs harvested from 10 healthy male Sprague-Dawleyrats,weighing 120-150 g,aged 2-3 months,were cultured,purified and identified.PMVECs were seeded in low-glucose DMEM culture medium or 96-well culture plates,and divided into 5 groups according to the random number table:control group (group C) and different concentrations of bilirubin groups (B1-4 groups) with 30 wells or48 flasks in each group.In group C,low-glucose DMEM 1 ml was added.In B1-4 groups,5,10,20 and 50 μmol/L bilirubin 1 ml were added,respectively.At 24,48 and 72 h of incubation,proliferation of PMVECs was measured using CCK-8 assay and 3 H-TdR incorporation assay,Akt1 mRNA and Smad3 mRNA expression was measured by RT-PCR,and phosphor-Akt1 (p-Akt1) protein and Smad3 protein expression was detected using Western blot.Results Compared with group C,no significant changes were found in each parameter mentioned above at each time point in B1 and B2 groups,the proliferation of PMVECs was weakened,and Akt1 mRNA,p-Akt1 protein and Smad3 protein and mRNA expression was down-regulated at 48 h of incubation in B3 group,and the proliferation of PMVECs was weakened,and the expression of Akt1 mRNA,p-Akt1 protein and Smad3 mRNA and protein was down-regulated at 48 and 72 h of incubation in B4 group.Compared with group B3,the proliferation of PMVECs was weakened,and the expression of Akt1 mRNA,p-Akt1 protein and Smad3 mRNA and protein was down-regulated at 72 h of incubation in B4 group.Conclusion High concentration of bilirubin can inhibit proliferation of PMVECs and down-regulated expression of Akt1 and Smad3 is involved in the mechanism.

Objective To investigate the role of serine threonine protein kinase-1 (Akt1) and Smad3 in lung tissues in development of hepatopulmonary syndrome in rats.Methods Seventy-two healthy male SpragueDawley rats,aged 3-4 months,weighing 200-250 g,were randomly divided into 3 groups (n=24 each):control group (C group),sham operation group (S group) and common bile duct ligation (CBDL) group.The rats were anesthetized with 3％ pentobarbital sodium 45 mg/kg.In group CBDL,laparotomy was performed,the common bile duct was ligated and then the abdomen was closed,while the common bile duct was only exposed,but not ligated and then the abdomen was closed in group S.At 1st,3rd and 5th weeks (T1-3),8 rats were chosen randomly in each group and blood samples were obtained from the abdominal aorta for blood gas analysis.The rats were then sacrificed and lungs were isolated to detect the expression of Aktl and Smad3 mRNA and protein in lung tissues (by RT-PCR and Western blot).The lung tissues were sliced and stained with hematoxylin eosin for examination of the pathological changes of pulmonary capillaries.Results Compared with C and S groups,the expression of Akt1 and Smad3 mRNA and protein in lung tissues was significantly up-regulated at T2,3,and alveolar-arterial oxygen tension difference was increased at T3 in CBDL group (P ＜ 0.05).The pulmonary capillary was obviously dilated at T3 in CBDL group.Conclusion The expression of Akt1 and Smad3 in lung tissues is up-regulated,which may be one of the mechanisms of development of hepatopulmonary syndrome in rats.

Objective To establish a method for culture of rat pulmonary capillary pericytes.Methods Six male Sprague-Dawley rats,aged 6-7 weeks,weighing 200-220 g,were anesthetized and the chest was opened.The pulmonary capillary was isolated by type Ⅰ collagenase digestion and micropore filtration and cultured in highglucose DMEM/F12 1∶1 containing 10％ fetal bovine serum and 0.5％ mixture of penicillin and streptomycin.The morphology and growth of cells were observed with inverted phase contrast microscope.The positive cells of αsmooth muscle actin (α-SMA),desmin,neuron-glial antigen 2 (NG2),cluster of differentiation 31 (CD31) were counted by immunofluorescence.The percentage of positive cells was calculated.Results The microscopic examination showed cells of shuttle shape or star shape,mononuclear cells,binuclear cells occasionally,oval nucleus,rich cell plasma,growth in the shape of vortex or fence,and no contact inhibition.The percentage of positive cells ofα-SMA,desmin,NG2,and CD31 was (99.0± 1.2)％,(96.0±2.1)％,(99.0±0.7)％ and0,respectively.Conclusion The culture method for rat pulmonary capillary pericytes is successfully established.