Objective To explore the effects of aging on ventricular remodeling and cardiac rupture after acute myocardial infarction in mice. Methods　Male C57BL/6 mice of 3 months and 12 months old were randomly divided into sham operation group and myocardial infarction(MI)group.Following acute myocardial infarction(AMI)modeling induced by open-chest surgery,the events of cardiac rupture were monitored and the echocardiography and hemodynamics were performed on the 7th day after surgery.Zymography,immunohistochemical method and pathological staining were used to measure the activity of matrix metalloproteinases(MMPs),the content of collagen and the degree of inflammatory cell infiltration on the 3rd and 7th days after surgery,respectively. Results　The incidence of cardiac rupture was higher in elderly group than that in young group(38.0% vs.16.0%,X2=6.139,P＜0.05).Compared with young group,significant infarct expansion,left ventricular (LV)remodeling and hemodynamic deterioration were showed in elderly group on the 7th day after surgery(t=5.754,P＜0.05).The degree of inflammatory cell infiltration and the expression of MMP-9 were significantly increased in elderly group on the 3rd day following AMI modeling(P＜0.05),and the collagen content and the expression of type Ⅲ collagen were significantly increased (P＜0.05)compared with young group. Conclusions　Aging is a risk factor for post-infarct cardiac rupture in the mice model.The mechanisms which are responsible for this age-related difference of cardiac rupture are related to increasing degree of inflammatory cell infiltration, overexpression of MMP-9 and type Ⅲ collagen and aggravated early LV remodeling.

Objective To explore the association between ratio index of gamma glutamyl transpeptidase/platelet (GPRI) and the prognosis of patients with hepatitis B virus (HBV) related hepatocellular carcinoma (HCC) before liver resection. Methods A total of 368 patients underwent liver resection for HBV-related HCC were retrospectively analyzed in this study. Patients were divided into high GPRI group (n=184, GPRI≥0.38) and low GPRI group (n=184, GPRI<0.38). Clinicopathologic characteristics including overall survival (OS) and disease-free survival (DFS) were compared between the two groups. Independent risk factors influencing DFS and OS were determined by Cox multivariate analysis. Results Compared to low GPRI group, there were higher levels of serum total bilirubin and alanine aminotransferase, higher proportions of tumor diameter larger than 10 cm, amount of tumou more than 3, and patients with macrovascular invasion and intermediate or advanced HCC in high GPRI group (all P<0.05). Values of DFS at 1, 3, and 5 years were significantly lower in high GPRI group (50.8%, 16.9%and 5.7%) than those in low GPRI group (69.0%, 33.3%, 10.7%;P=0.001). Values of OS at 1, 3, and 5 years were also significantly lower in high GPRI group (75.0%, 51.8%and 36.0%) than those in low GPRI group (89.8%, 72.8%and 63.2%;P<0.05). Cox multivariate analysis also demonstrated that GPRI ≥0.38 was an independent risk factor for DFS and OS in patients with HBV-related HCC after liver resection. Conclusion Preoperative GPRI can predict tumor recurrence and long-term survival in patients with HBV-related HCC after liver resection.

Objective To construct transgenic mice tissue-specifically co-expressing human DAF/CD59 in the vascular endothelia and to investigate the ability to protect against human comple- ment-mediated attack.Methods Transgenic mice were generated by co-microinjection of hDAF/CD59 expression constructs driven by the human intercellular adhesion molecule-2(ICAM-2)promoter.PCR and Southern blot of genomic DNA were used to assess the presence of hDAF/CD59 in the genome of the founders,and the expression at protein level was measured by flow cytometry.Immunohistochemis- try was used to detect the distribution of hDAF/CD59.An ex vivo perfusion model was used to com- pare hearts from these hDAF/CD59 transgenic mice with hDAF hearts.Results After microinjection of genes,11 of 135 mice born were shown to be double-transgenic,and human DAF/CD59 were ex- pressed on the surface of leucocytes in 6 of the 11 DAF/CD59-integrated mice.Expression levels of 6 founders ranged from 80% to 95% of that in human leucocytes.Human DAF/CD59 were strongly expressed in the vascular endothelia of heart,kidney,with little or no positive staining observed in non- endothelial cells.Compared to hDAF hearts that maintained approximately 20% maximum work during perfusion with 20% human plasma,these endothelial-specific hDAF/CD59 hearts were further protected with work maintained at 40% of the maximum level during 60 min.Conclusion The intro- duced hDAF/CD59 genes have been integrated and specifically expressed in the vascular endothelia. The endothelial co-expression of hDAF/CD59 can provide greater protection against human complement-mediated attack than the expression of hDAF alone.

BACKGROUND:Dexmedetomidine has already been used in septic patients as a new sedative agent, few studies have examined its effects on immunomodulation. Therefore, the authors have designed a control ed experimental study to characterize the immunomodulation effects of dexmedetomidine in the cecal ligation and puncture (CLP) model in rats. METHODS:After CLP, 48 Wistar rats were randomly allocated into four groups:(1) CLP group;(2) small-dose treatment group (2.5 μg·kg-1·h-1); (3) medium-dose treatment group (5.0 μg·kg-1· h-1);and (4) large-dose treatment group (10.0 μg·kg-1·h-1). HLA-DR and plasma cytokine (IL-4, IL-6, IL-10 and TNF-α) levels were measured, and the mean arterial blood pressure (MAP), heart rate (HR), arterial blood gases, lactate concentrations and mortality were also documented. RESULTS:The HLA-DR level, inflammatory mediator levels, MAP and HR had no obvious changes among Dexmedetomidine treatment groups (DEX groups). Compared with the CLP group, the DEX groups exhibited decreased HLA-DR levels (Pgroup=0.0202) and increased IL-6 production, which was increased at 3 h (P= 0.0113) and was then attenuated at 5 h; additionally, the DEX groups exhibited decreased HR (P<0.001) while maintaining MAP (Pgroup=0.1238), and remarkably improving lactate (P<0.0001). All of these factors led to a significant decrease in the mortality, with observed rates of 91.7％, 66.7％, 25％ and 18％ for the CLP, DEX2.5, DEX5.0, DEX10.0 groups, respectively. CONCLUSION:Dexmedetomidine treatment in the setting of a CLP sepsis rat model has partially induced immunomodulation that was initiated within 5 h, causing a decreased HR while maintaining MAP, remarkably improving metabolic acidosis and improving mortality dose-dependently.

Objective: To study the predictive value of combination scores of leukocyte and platelet counts (COL-P) for in-hospital mortality in patients with acute ST segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI) treatment. Methods: A total of 660 STEMI patients with emergent PCI in our hospital from 2009-11 to 2013-08 were retrospectively studied. The patients were divided into 3 groups according to COL-P scores: COL-P0 group,n=283, COL-P1 group,n=319 and COL-P3 group,n=58. The relationship between the in-hospital mortality and COL-P scores was analyzed among different groups. Results: There were 88/660 in-hospital death. The patients in death group had the higher white blood cell count and lower platelet count than those in survival group, bothP<0.01. Logistic regression analysis indicated that compared with COL-P0 group, the COL-P scores at COL-P1 level (OR 4.346, 95% CI 2.134-8.850,P<0.001) and COL-P2 level (OR 10.126, 95% CI 4.061-25.250,P<0.001) were the independent risk factors for in-hospital death in STEMI patients after emergent PCI. The in-hospital mortality in COL-P0, COL-P1 and COL-P2 groups were at 4.9%, 15.4% and 43.1% respectively, allP<0.001. Conclusion: COL-P score was useful for predicting the in-hospital mortality in STEMI patients after emergent PCI, while the long term mortality estimation should be further studied.

OBJECTIVETo study therapeutic effects of retrograde locked intramedullary nail for the treatment of middle or distal fractures of humeral shaft.

METHODSFrom October 2002 to February 2005, 21 patients with middle or distal fractures of humeral shaft were treated with AO retrograde locked intramedullary nail. Among the patients, 13 patients were male and 8 patients were female, ranging in age from 23 to 56 years, with an average of 34.5 years. Nineteen patients were fresh fractures, and 2 patients were old fractures. Eleven patients had middle fractures of humeral shaft, and other 10 patients had distal fractures of humeral shaft. Two patients with old fractures were non-union and treated with autoallergic bone grafting; 5 patients combined with radial nerve injury underwent exploration. The therapeutic effects were evaluated according to Constant-Murley shoulder score and Mayo elbow score.

RESULTSAll the patients were followed up, ranging from 18 to 24 months, with an average of 20.8 months. The fractures were healed except 1 patient with old fracture and 1 patient with extremely distal acute fracture. The shoulders and elbows had satisfactory recovery except 1 patient with old fracture. The mean Constant-Murley score was (83.6 +/- 13.4) points (50-97), 12 patients got an excellent result, 5 good, 4 fair and no bad; the mean Mayo elbow score was (88.6 +/- 9.8) points (65-95), 13 patients got an excellent result, 5 good, 3 fair and no bad.

CONCLUSIONThe retrograde locked intramedullary nail offers an ideal treatment method for middle and distal fractures of humeral shaft. Strict operative indication, precise surgical techniques and stable locking are the keys to a successful treatment results.

Adult ; Bone Nails ; Elbow Joint ; physiopathology ; Female ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; methods ; Humans ; Humeral Fractures ; physiopathology ; surgery ; Male ; Middle Aged

Objective To determine whether recombinant adeno-associated virus serotyoe 9 with CaMEK gene transfected on myocardial cells leads to reduce I/R-induced apoptosis.Methods Establish an ischemic/reperfusion(I/R) model of myocardial cells in vitro and the cells were divided into four experimental groups:(1) control group;(2) I/R group;(3) I/R+rAAV9-CBA-CaMEK group;(4) I/R+rAAV9-CBACaMEK+PD98059 group,respectively.The P-ERK1/2 and the Caspase-3,Bax were quqntitated by Western blot.Results These data clearly demonstrate that AAV9-mediated CaMEK gene transfected lead to active ERK1/2 and reduce I/R-induced apoptosis notablely.Conclusion rAAV9-mediated CaMEK gene transfected on myocardial cells can reduce I/R-induced apoptosis.

OBJECTIVETo investigate the presenting symptoms and signs, endoscopic findings, imaging changes and the clinical outcomes of endoscopic surgery in 23 patients with sphenoid mycetoma.

METHODSThe clinical data and the follow-up results of endoscopic surgery in 23 patients with sphenoid mycetoma, between April 2001 and January 2006, were retrospectively analysed.

RESULTSThe study population included 15 women and 8 men with a median age of 52.7 years. Presenting symptoms included headache (13 cases, 57%) and bloody discharge (9 cases, 48%). The computed tomography scans showed high density shadow in all 23 cases, with 17 cases (74%) had plaque or cord shaped calcification. All patients were treated by endoscopic transnasal approach. No surgical complications were found. Follow-up ranged 3-18 months, all symptoms disappeared, except strabismus in one case after 7 months of operation. The mucosa in surgical cavity is good.

CONCLUSIONSThe most common clinical symptoms of sphenoid mycetoma are headache and bloody discharge. Computed tomography scan has great value for the diagnosis of sphenoid mycetoma. The minimal invasion and the good outcome are the main advantages of the endoscopic surgery.

Adult ; Aged ; Endoscopy ; Female ; Headache ; Humans ; Male ; Middle Aged ; Mycetoma ; surgery ; Retrospective Studies ; Sphenoid Sinus ; pathology ; Sphenoid Sinusitis ; diagnosis ; surgery

Objective To evaluate the prognostic significance of preoperative serum gamma glutamyl transpeptidase (GGT) level in patients with hepatocellular carcinoma (HCC) after liver resection.Methods A total of 432 patients undergoing hepatectomy for HCC were divided into normal GGT group (175 patients with GGT ≤ 50 U/L) and high GGT group (257 patients with GGT ＞ 50 U/L).After balancing baseline characteristics by propensity score analysis,disease-free survival (DFS) and overall survival (OS) were compared between the two groups.Independent risk factors influencing DFS and OS were identified by Cox multivariate analyses.Results Propensity score analysis identified 124 matched pairs of patients from each group.In the propensity-matched cohort,DFS at 1,3,and 5 years in normal GGT group (69.3％,36.1％,12.8％) was significantly higher than that in high GGT group (60.6％,18.7％,7.5％;P=0.039).OSat1,3,and5 years innommlGGTgroup (90.7％,73.7％,66.1％) was also significantly higher than that in high GGT group (89.2％,63.6％,43.3％;P =0.024).COX multivariate analyses revealed that alpha-fetoprotein ≥400 ng/ml,GGT ＞ 50 U/L,macrovascular invasion,tumor size ≥ 10 cm,and tumor number ≥3 were independent risk factors for DFS in patients with HCC after liver resection.Albumin ＜ 35 g/L,GGT ＞ 50 U/L,macrovascular invasion,tumor size ≥ 10 cm,and tumor number ≥ 3 were identified as independent risk factors for OS.Conclusions Preoperative serum GGT level is an independent factor predicting tumor recurrence and long-term survival in HCC patients after liver resection.

Objective To study the risk factors of hyperthyroid heart diseases(HHD) by analyzing clinical features of patients in order to provide a scientific basis for prevention and treatment of HHD. Methods Nine hundred and eighty two cases were selected as objective from in-patient data of Thyroid Disease Treatment Centre of Shandong Province. The cases were divided into hyperthyroidism group and HHD group. The variables of etiology,sex, age, duration of disease, TSH, FT3, FT4 and TRAb were analyzed by comparative analysis. The risk factors were analyzed by logistic regression. Results The prevalence of hyperthyroidism complicated hyperthyroid heart disease was 7.7%(76/982), age, duration of diseases, FT3, TRAb in the HHD group were [(51.4 ± 11.5), (6.3 ±2.1) years, 21.6 pmol/L, 71.6 U/L], in hyperthyroidism group were [(37.9 ± 9.8), (2.6 ± 1.3) years, 14.9pmol/L, 49.6 U/L]. The differences were statistically significant(u = 9.93,15.23, T = 44954,48792.5, P ＜ 0.05)between the two groups. The factors of the older, higher FT3 and TRAb, longer duration, Graves disease (OR =1.751,1.470,1.483,1.445,1.234) increased the risk of HHD. Conclusions Graves disease, longer duration, old age, higher FT3 and TRAb are the risk factors of HHD. Timely prevention and control of risk factors is necessary to reduce the incidence of HHD.