Airway problems in foetus that may cause airway obstruction can be safely managed by using an ex utero intrapartum technique(EXIT).The EXIT procedure maintains a period of uteroplacental circulation for fetal oxygenation during delivery to provide time to explore and secure the airway of the fetus or to perform fetal operations before the umbilical cord is clamped.The common indication for the EXIT procedure is the presence of foetal airway obstruction,which is usually caused by neck mass,congenital diaphragmatic hernia,congenital high way obstruction syndrome,thoracic abnormality,congenital heart and lung dysfunction,conjoined twins,and so on.It avoids the acute airway obstruction in a neonate that has disastrous consequences.

Anemia, Hypochromic ; etiology ; Humans ; Iron ; metabolism ; Protein Deficiency ; complications ; congenital ; Transferrin ; deficiency

Acupuncture Therapy ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Osteoarthritis, Knee ; therapy

Objective To study the mechanism of oxidative damage in myocardial tissue after limb ischemia reperfusion (IR), and the protective effects of heme oxygenase-1 on myocardial injury in experimental rats. Method The models of bilateral hind limbs ischemia and reperfusion in rats were established by using tourniquets applied to the roots of both hind limbs until palm blanched and pulseless for 4 hours. A total of 56 SD rats were randomly (random number) divided into 7 groups, namely one normal control group ( n = 8) and 6 ischemia-reperfusion groups as per different lengths of reperfusion time, e. g. 2 hrs, 4 hrs, 8 hrs, 16 h rs and 24 hr ( n = 8 each). The experimental rats were sacrificed after different lengths of reperfusion time. Specimens of myocardium and blood were taken for assays of malonaldehyde (MDA), superoxide dismutase (SOD) and myeloperoxidase (MPO), and pathological changes of myocardium were observed, and the expressions of HO-1 mRNA in myocardium were detected. Data were analyzed with ANOVA. Results (1) Compared with the control group, the levels of serum MDA and myocardial MDA of rats were increased in all IR groups and were higher (P < 0.05), and the levels of MDA reached the peak after reperfusion for 4 hours. The levels of serum SOD and myocardial SOD in rats of all IR groups were decreased and lower than those in rats of the control group ( P < 0.05), and the levels of serum SOD dropped away to the lowest point after reperfusion for 4 hours, and the levels of myocardial SOD fell off to the bottom after reperfusion for 8 hours. The levels of serum MPO and myocardial MPO were significantly increased in rats of all IR groups compared with the control group (P < 0.05). The levels of serum MPO reached peak after reperfusion for 4 hours, and the levels of myocardial MPO were increased to the highest spot after reperfusion for 6 hours. (2) The pathological changes in myocardium showed the most severe damage after reperfusionfor 4-6 hours.(3) After reperfusion for 2 hours, there were no significant differences in the expression of HO-1 mRNA between IR groups and control group (P >0.05), and after reperfusion for 4 hours and over, the expressions of HO-1 mRNA were markedly increased in IR groups and reached peak after reperfusion for 16 hours in comparison with the control group (P < 0.05). Conclusions The activation of neutrophils and free radicals may play a primarily adverse role in myocardial injury after limb IR, and the increase in the expression of HO-1 mRNA lessens the harm effects of IR on myocardium.

BACKGROUND:Transplantation of exogenous stem cells for functional cardiac celldeath or apoptosis easily induced complications after transplantation. Therefore, cardiac progenitor cells of heart itself have been ideal seed cells. OBJECTIVE:To establish stable celllines of cardiac progenitor cells from mouse heart, and to provide ideal cellmodels for studying proliferation and differentiation factors affecting cardiac progenitor cells during adult myocardial cells were damaged. METHODS:(1) Myocardiocytes were isolated from embryonic 15.5 days mice. (2) The cultured myocardiocytes were immortalized using retrovirus SSR69. Immortalized monoclonal myocardial cells were obtained using antibiotic selection and infinite dilution. (3) Monoclonal cellline with the property of cardiac progenitor cells was screened out. RESULTS AND CONCLUSION:(1) Myocardiocytes were successful y isolated and cultured. Partial cells showed obvious beating. (2) Myocardiocytes infected with retrovirus SSR69 were cloned and got 76 clones, then were named as CP15-#, (3) Screening the first 20 clones, the reasonable clones with the characteristics of cardiac progenitor cells were obtained according to myocardial cellmarker genes. The results suggested that immortalized cardiac progenitor cells were established mediated by reversible SV40 T antigen.

Objective By using computer tomography (CT) to evaluate the left common iliac vein (LCIV) minor diameter and stenosis in deep vein thrombosis (DVT) patients and normal population,and to explore the correlation between LCIV compression and left-sided DVT.Methods Measurement and calculation of LCIV minor diameter and stenosis were conducted in 19 right-sided DVT,60 left-sided DVT and 218 control subjects.Multiple factors regression analysis was used to study the correlation of LCIV minor diameter and stenosis with left-sided DVT.Results In control group,51.8％ had greater than 50％ compression of LCIV,and 24.3％ had greater than 70％ compression.LCIV diameter in women [(4.7 ± 2.7) mm] was significantly smaller than that of men [(6.6 ± 3.3) mm,P ＜ 0.05)].LCIV diameter in leftsided DVT [(2.4 ± 1.0) mm] was significantly smaller than that in control group [(5.4 ± 3.1) mm,P ＜0.001)] or right-sided DVT [(6.2 ± 1.8) mm,P ＜0.01].LCIV stenosis in left-sided DVT [(78 ±8) ％]was higher than that in control group [(49 ±25)％,P ＜0.01)] or right-sided DVT [(38 ±21)％,P ＜0.01)].The odds of left DVT increased by a factor of 2.69 for each millimeter decrease in LCIV diameter (P ＜ 0.001,95％ CI 1.91-3.77),and 2.78 for each ten percent increase in LCIV stenosis (P ＜ 0.001,95％ CI 1.95-3.96).With LCIV stenosis ＞75％,the risk of left DVT was associated with an 11.10-fold increase,and with LCIV diameter ＜ 2.5 mm,the risk was associated with a 13.57-fold increase.Conclusions LCIV compression was an independent risk factor for left-sided DVT.Patients with severe LCIV compression were at high risk for left-sided DVT.

Objective To investigate the application value of the Perclose Proglide vascular devices in the thoracic endovascular aortic repair (TEVAR) of aortic dissection.Methods Retrospective analysis of 106 patients who underwent TEVAR for Standford B type aortic dissection were performed.The femoral lumen was measured by CTA be fore,1 month and 1 year after TEVAR.Results A total of 223 Perclose Proglide vascular closure devices were used in the 106 patients,including 97 patients with 2 devices,7 patients with 3 devices,2 patients with 4 devices.The puncture femoral artery diameters had no significant differences between before and 1 month,1 year after TEVAR (all P ＞0.05).Conclusion Per close Proglide vascular closure devices can be effectively and safely used in the TEVAR,which has little influence on the femoral artery diameter,and is worth to be applied in the clinics extensively.

Objective To evaluate the feasibility,efficacy,and short to mid-term results of endovascular management of acute type B aortic dissection complicating visceral or lower limb malperfusion.Methods A retrospective study was conducted in 23 consecutive patients with acute type B dissection complicating visceral or lower limb malperfusion treated endovascularly at a single center between July 2001 to December 2012.Of the 23 patients identified [20 men,3 women; mean age (52 ±9) ranging 42-75]presented with clinical and imaging evidence of end-organ malperfusion:renal artary in 5 (21.7％),superior mesenteric artery in 9 (39.1％),celiac trunk in 3 (13％) and lower limb in 6 (20.1％),artary renal and lower limb in 2.Results All patients had stent-graft coverage of the proximal entry tear.11 (47.8％) patients needed additional branch vessel stenting.Successful correction of malperfusion was achieved in all the patients and the successful rate of operation and technology was 100％.In 1 patient,ischemia in the lower limb was resolved after a stent was implanted to the right iliac artery.In another patient,complicated with lower limb ischemic necrosis,amputation was performed after one stage stent-graft placement.The duration of follow-up was 6 months to 72 months,mean (21 ± 11)months.There was no migration of stent-graft and end-organ ischemia.No patients suffered from paraplegia in this group.Conclusions Endovascular coverage of the proximal entry tear in acute type B aortic dissections complicating end-organ malperfusion is a reasonable first line treatment.But some cases may need a combination branch vessel stenting.

Aiming at building research disciplines,Xijing hospital has initially achieved a strategic transformation into a hospital with research disciplines,with such measures as scientific layout of disciplines,making of advantageous disciplines with overseas benchmarks,encouragement of potential disciplines with advantageous disciplines,promotion of medical innovation with innovative ideas,and upgrading clinical service quality with technical innovation.

A strain with 2 g/L yield of poly-?-lysine was firstly screened from soil on an agar plate containing methylene blue and then further selected by a flask experiment. The strain was preliminarily identified as Streptomyces albulus. The experiment about medium optimization showed that glucose was the best carbon sources and yeast extract and (NH_4)_2SO_4 were the best compound nitrogen sources. The yield of ?-PL reached 3.9 g/L with optimal medium.