Congenital heart disease often lost the opportunity of radical sureryfor secondary pulmonary hypertension.pulmonary hypertension is pathologicallycharacterizzed by pulmonary vascular remodeling,including the vascular smooth musclecell' s proliferation,migration and extracelluar matrix deposition,Recently,someresearchers have found that connective tissue growth factor can bind with somesurface receptors of vascular smooth muscle cells,causing some biological behaviorchanges such as proliferation,migration and extracellular matrix abnormaldeposition,and activating crresponding gene expression through this signaltransduction pathway.Pulmonary vascular remodeling may be one of the molecularpathogenesis in pulmonary hypertension.

The treatment of myopic amblyopia and myopic anisometropic amblyopia is difficult and usually resultless and it has been the obstacle of amblyopic treatment. Corneal contact lens, corneal refractive surgery and phakic intraocular lens as new methods can significantly improve visual acuity of patients with high myopic amblopia and myopic anisometorpic ambyopia. For correcting myopia and myopic anisometropic amblyopia it provides a new method. This paper discusses the availibility and safty of above methods for the treatment of myopic amblyopia and myopic anisometropic amblyopia.

Objective To evaluate the risk of cardiovascular adverse events using nonsteroidal anti-inflammatory drugs during the perioperative period.Methods A systematic review of formally published in English and Chinese literature was conducted by using computerized database on PubMed, Web of Science, Medline, Cochrane Library, CNKI and Wanfang database.The literature about controlled clinical study of nonsteroidal anti-inflammatory drugs in perioperative use, a prospective cohort study and a retrospective review were collected.The cardiovascular risk was evaluated by the number of adverse cardiovascular events cases (myocardial infarction, angina, myocardial ischemia, arrhythmia) occurred during the period of drug use.The relevant data was extracted and their heterogeneity was tested.Results A total of 8 articles including 15 623 patients met the inclusion criteria, including 5 articles (n=13 019) on non-selective nonsteroidal anti-inflammatory drugs, and 3 articles (n=2 604) about selective (cyclooxygenase 2) COX-2 inhibitors.Nonsteroidal anti-inflammatory drugs used in the perioperative or a short term would reduce the risk of adverse cardiovascular events (OR=0.59, 95%CI 0.45-0.77, P=0.000 1), non-selective nonsteroidal anti-inflammatory drugs using in the perioperative or a short term would reduce the risk of adverse cardiovascular events, the difference being statistically significant (OR=0.42, 95%CI 0.31-0.58, P＜0.001).A selective COX-2 inhibitor using in the perioperative or short-term might increase cardiovascular adverse events (OR=2.53, 95%CI 1.26-5.09, P=0.009).Conclusion Non-selective nonsteroidal anti-inflammatory drugs should be chosen for patients at high risk of adverse cardiovascular events during the perioperative period.

Objective:To investigate the protective effect of intratracheal transplantation of different dose of human umbilical cord mesenchymal stem cells (MSCs) in rats with acute lung injury induced by severe burns.Methods:Seventy-five male Wistar rats were randomly divided into five groups:Sham(group A),Saline group(group B) and different doses of hUMSCs transplantation groups(C,D and E).The dosage ofhUMSCs was 1 × 105,5 × 105 and 1 × 106 respectively.Rats inflicted by 50 ％TBSA Ⅲ degree scalding employed as the model.After modeling,rats in group B and transplantation groups were immediately fluid resuscitated.Transplantation groups were intratracheally administered different dose hUCMSCs (0.2 mL),and group B were given normal saline in the same dose intratracheally.The lung tissue samples were collected on day 1,day 3 and day 7 after administration.HE staining was used to observe the pathological changes of lung tissue.MPO and CD68 immunohistochemical staining were used to observe the positive expression of neutrophils and macrophages in lung tissue.Results:Lung pathology showed that alveolar cavity was clear,alveolar structure integrity,occasionally a small amount of inflammatory cells of group A at each time point.At 1 day after scald,group B and the transplantation group (group C,D,E)the alveolar septum was thickened,and there was visible pulmonary capillary hyperemia,as well as a large amount of inflammatory cell infiltrations in the pulmonary capillaries and alveolar space.At 3 day,group B and the transplantation group alveolar structural damage,pulmonary hemorrhage and inflammatory cell infiltrations were better than those in 1 day.Compared with group B,the alveolar structure was clear and the septum was thinner,but there was no significant difference between the transplantation groups.On the 7 day after scald,the lung injury in the transplanted group was significantly less than group B,and the recovery of the injured lung tissue in E group was the most obvious.The number of the MPO positive cells increased significantly on the first day after scald (P ＜0.05) compared with group A,but there was no significant difference between the two groups.Compared with B group,the number of positive cells in transplantation group was significantly reduced at 3 and 7 day after scald,(P＜0.05),and the number of positive cells in group E was significantly lower than other groups (P＜0.05).CD68 staining showed a significant increase in positive cells in each group on day 1 (P＞ 0.05).The number of positive cells decreased in 3 day after transplantation (P＜0.05),but there was no significant difference between the transplantation groups.The number of positive cells in transplantation group was significantly lower than group B (P＜0.05) after 7 day.Compared with group C and D,there was significant difference in group E (P＜0.05).Conclusions:Intratracheal transplantation of different dose hUCMSCs have protective on severe burns induced acute lung injury models;the protection mechanisms may be that the hUCMSCs transplantation can inhibit the invasion of the inflammatory cells in lung tissues,and the optimal dosage is 1 × 106.

Objective To carry out a pharmacokinetic evaluation of oral FK506 in 13 patients after renal transplant. Methods 13 patients after renal transplantation were given prograf based immunosupressive regimen 24 hours after surgery.Blood samples to determine FK506 levels were drawn in heparinized tube at 0、20、40、60、90 min and 2、3、6、8、10 hours after the first oral dosing.The whole blood concentrations were measured by MEIA and the pharmacokinetic parameters were calculated by 3P87 program.The FK506 doses were recorded in detail for the first month. Results Cmax was (13.6259?4.1117)ng/ml;T(peak) was (1.4866?1.0725)h;t1/2 ? was (0.7749?0.7791)h,t1/2 ? was (10.7267?10.4926)h;AUC was (91.0415?40.7694)ng?ml -1 ?h -1 ,CL was (0.046?0.0036)ng?ml -1 ?h -1 and MRT was (8.1540?4.2937)h.AUC was negative correlateld with prograf dose in the first month posttransplant (r=-0.53, P =0.038). Conclusions The absorption of oral administration of FK506 was rapid in patients after renal transplantation,and can achieve Cmax in (1.5?1.1)h,the mean half life time being 10.7 h.The pharmacokinetic parameters can be the guideline for FK506 application.

Objective To explore the diagnostic value of Holter monitoring for coronary heart disease (CHD) in diabetic and non-diabetic patients. Methods 188 patients with coronary heart disease were divided into diabetic group(n=65)and non-diabetic group(n=123). The diagnostic sensitivity, specificity, accuracy and other indices of Holter monitoring for CHD were compared between the two groups according to the results of angiography and Holter monitoring. Logistic regression analysis was applied to analyze the factors affecting holter ST-segment change. Results The sensitivity of Holter monitoring for diagnosing CHD in diabetic group was higher than that in non-diabetic group(P=0.046). There was an association between the positive ST-segment change and number of stenosal arteries, diffuse arterial lesion and complete vessel occlusion respectively (OR=2.36, 4.91, 3.90). Conclusion Although the sensitivity and specificity of Holter monitoring for diagnosing coronary heart disease were low, it remains some diagnostic value for coronary heart disease in diabetic patients.

AIM: To analyze and screen humoral bioactive factors associated with accelerated fracture healing after traumatic brain injury. METHODS: A computer-based online search of Chinese Journal Full-text Database and Pubmed database was undertaken to identify related articles. After the first trial, only articles about the effect of humor changes after brain trauma or humoral factors on fracture healing were selected, and those published in recent five years and published in a authoritative journal were preferred. Repetitive research was excluded. RESULTS: Fracture healing can be accelerated, especially for people with traumatic brain injury. Brain injury, spinal cord injury, different parts of the spinal cord injury, and nerve injury have different influences on fracture healing. There are cell active factors in humour of patients after traumatic brain injury, which can induce karyogenetic division and proliferation of bone marrow-derived stroma cells. Bone morphogenetic protein (BMP) is a very important factor in fracture healing, but it seems not one of factors that are associated with accelerated healing mechanism. Transforming growth factor-? (TGF-?) is correlated with brain injury and bone healing. It is likely to be one of cell factors that can promote fracture healing. Basic fibroblast growth factor (bFGF) has an early expression in traumatic brain injury patients, which can promote osteoblast by stimulating vascular endothelial growth factor (VEGF) and TGF-? expressions. VEGF is only a member of various factors in the network in fracture healing. The action mechanism of single factor needs further exploration. Growth hormone has a high concentration in patients with traumatic brain injury, and can promote fracture healing through interaction with insulin-like growth factor. However, the mechanism is still uncertain. Nerve growth factor, prolactin and melantonin concentration significantly change after traumatic brain injury. They may be the humoral factors that influence bone healing, but the mechanism has not yet been identified. CONCLUSION: Accelerated fracture healing associated with traumatic brain injury is influenced by systemic and local bioactive factors. Currently, the researches about the association of some humoral factors such as BMP, TGF-? and bFGF with fracture healing have been conducted, but others need to further study.

Given the limited sources of autogenic tendon and the difficulties of the tissue engineering tendon to clinical application, the allograft tendon transplantation was a good way for tendon repairing defects. The domestic and foreign scholars have done a lot of studies on the acquisition, preservation, immunological characteristics, clinical application and prognosis of allograft tendon transplantation technology. The allograft tendon transplantation has been more and more used to repair the tendon tissue defects, but there still were some problems to be solved, such as the preservation, immunological characteristics, mechanical strength and postoperative adhesions.

Objective To analyze drug resistance of pathogenic bacteria from the blood culture and distribution in clinical departments,and to guide the rational clinical drug use.Methods We retrospectively analyzed 11 275 samples of blood cultures in The Central Hospital of Wuhan from 2012 to 2014.The blood specimens were cultured by VersaTREK(USA).The pathogenic bacteria were identified and their drug resistance was analyzed by BD-PHOENIX 100 automicrobiological identification systems(USA).Results Among the 11 275 blood cultures,636 bacterial strains were detected.The top four bacterial strains were Escherichia coli,Staphylococcus aureus,Klebsiella pneumonia and Enterococcus f aecium.A vancomycin-resistant Enterococcus faecium strain and a pandrug-resistant Klebsiella pneumoniae strain were detected.The top three clinical departments with distribution of pathogens were Gastroenterology Department,Nephrology Department and Intensive Care Unit (ICU).Pathogens isolated from ICU were evenly distributed.Conclusion Distributions of pathogenic bacteria in the blood culture are different in clinical departments.Identification of pathogenic bacteria and result of drug susceptibility can reduce use of broadspectrum antimicrobials and enhance antimicrobial de-escalation.

Objective To explore the pathogenesis of ischemic preconditioning to warm ischemia reperfusion injury of hepatocytes in rats. Methods Ninety SD rats were randomly divided into three experimental groups:sham operation group (group A), warm hepatic ischemia/reperfusion group(group B and group C). Group C was given ischemic preconditioning treatment. Serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were detected 0 h, 2 h, 6 h, 12 h and 24 h after ischemia reperfusion injury. Levels of TNF-α and IL-1β were tested detected by ELISA. Levels of malondialdehyde (MDA) and superoxide dismutase (SOD) of hepatocytes were detected at the same time points. Mitochondrial membrane potential was examined to assess ischemia reperfusion injury of hepatocytes in rats using chart of intensity of JC-1 in mitochondria. Results The serum levels of ALT, TNF-α, IL-1β, and MDA were significantly higher in hepatic warm ischemia reperfusion group and ischemic preconditioning group than those in sham operation group (P<0.05). Values of prothrombin activity and cholinesterase were significantly lower in liver warm ischemia reperfusion group and ischemic preconditioning group than those of sham operation group (P<0.05). The SOD level of liver was significantly lower in warm ischemia reperfusion group and ischemic preconditioning group than that in sham operation group. The indexes were better in ischemic preconditioning group than those of warm ischemia reperfusion group (P<0.05). The mitochondrial membrane potential level of liver cells reached the lowest value 0 hours after ischemia and reperfusion, and then increased gradually within 24 hours (P<0.05). And the level of mitochondrial membrane potential of liver cells was significantly higher in ischemic preconditioning group than that in warm ischemia reperfusion group (P<0.05). Conclusion Ischemic preconditioning may play a protective role in warm ischemia-reperfusion injury in rats. Ischemic preconditioning may significantly decrease the levels of ALT, AST, TNF-α, IL-1βand MDA, and increase the SOD activity in hepatocytes. Thedamage of mitochondrial membrane potential is decreased after ischemic preconditioning, which might be the pathogenesis of ischemic preconditioning to warm ischemia reperfusion injury of hepatocytes in rats.