BACKGROUND:Airway epithelial regeneration can effectively inhibit submucosal hyperblastosis and the occurrence of obliteration. Studies demonstrated that ventilation could accelerate the regeneration of airway epithelium. OBJECTIVE:To establish and improve an orthotopic tracheal transplantation model and to further observe the effects of ventilation on trachea in alogeneic mice. METHODS:C57BL/6 mouse's tracheal served as donor, and BALB/c mouse's tracheal as recipient. This experiment contained two groups. In the experimental group, the membranous part of trachea was longitudinaly dissected in two donors and sutured into an enlarged trachea, which was implanted in the recipient. In the control group, donor's trachea was implanted into the recipient in situ. Samples were obtained and detected at 28 days after surgery. RESULTS AND CONCLUSION: Hematoxylin-eosin staining results demonstrated that compared with the control group, wel-differentiated ciliated epithelium was visible in the epithelial lamina of tracheal lumen, accompanying a few non-ciliated single or stratified squamous epithelium, mild submucosal fibrosis and inflammatory cel infiltration. Morphological analysis revealed that ciliated epithelial proportion in the experimental group was higher than in the control group (P < 0.05). The ratio of lamina propria to the tracheal cartilage, submucous fibrous tissuearea and the degree of lymphocyte infiltration were lower in the experimental group than in the control group (P < 0.05). Immunohistochemical staining demonstrated that the transplanted tracheal epithelium in both groups was recipient epithelial phenotype. Results verified that a modified orthotopic tracheal transplantation model was successfuly established. The increased ventilation of the tracheal alografts can accelerate the differentiation of tracheal epithelium. The wel-differentiated airway epithelium inhibited the proliferation of fibroblast.

Objective To analyze and compare the capacity and efficiency of county-level hospitals′medical service by using the diagnosis related groups ( DRGs ) method. Methods The homepage data of discharged inpatients from seven county-level hospitals in Wenzhou region in 2013 - 2015 period were analyzed, for measurement of the medical service capacity changes of such hospitals using the number of DRGs, total multiplicity of weight, and CMI value, and that of their medical service efficiency changes using expense consumption index and time consumption index. Results The study found in the seven hospitals 8. 49% increase of the total number of DRGs, 17. 34% increase of total multiplicity of weight, and 5. 06%increase of CMI value, with unchanged expense consumption index and 9. 82% decrease of the time consumption index. These facts evidenced enhancements of these hospitals in both service capacity and service efficiency in general. Conclusions DRGs as tools prove useful objectively and scientifically. Policies of Two emphases at primary ends and two enhancements have been implemented desirably.

Objective: To observe the changes of circulating fractalkine and its receptor CX3CR1 level in patients with chronic congestive heart failure (CHF).
Methods: Our work included 2 group, CHF group, n=55 patients and Control group, n=25 healthy subjects. Plasma level of soluble fractalkine (sFKN) was measured by ELISA, CX3CR1 in peripheral blood mononuclear cell was examined by lfow cytometry method. The relationship between sFKN and NT-proBNP was studied.
Results: Compared with Control group, CHF group had increased sFKN level, P=0.004, and the patients with NYHY III, IV were more than NYHY II, and CHF group also had the higher CX3CR1 expression (14.7 ± 8.1), P<0.05. The CX3CR1 level increased accordingly with NYHY classiifcation, as the patients with NYHY II, CX3CR1 was at (25.1 ± 12.4), P=0.03 compare with Control group;with NYHY III, CX3CR1 was at (37.3 ± 11.0) , P=0.04 compared with NYHY II;with NYHY IV, CX3CR1 was at (41.7 ± 11.1), P=0.009 compared with NYHY II. The circulating sFKN level was positively related to pro-BNP level (r=0.364, P<0.01).
Conclusion: The circulating FKN l and its receptor CX3CR1 might be involved in pathogenesis of immune-inlfammatory pathogenesis in CHF patients.

Objective To investigate whether timing of image acquisition influenced infarct size estimation using delayed CeMRI,and the association of left ventricular ejection fraction between magnetic resol3anee imaging and left ventrieulography Was also studied.Method From Junary 2005 to April 2006,27 first,onset AMI patients [23 male,mean age(54.3±10.5)years]were enrolledinthistudr.Allpatients receivedleft ventrictdographyas well as coronary angiography.The average checking time was(13.2±5.2)clays after the onset of AMI.MR imaging was performed with a 1.5-T magnet(SIMENS).After breath-hold eine images were acquired,patients re.ceived afI intravenous bolus of 0.05 mmol/kg Gd-DTPA at a rate of 5 ml/8.A first-pass perfusion scan was ac.qllired.Then a second bolus of 0.15 mmoVkg Gd-DTPA was give.at a rate of 2 mE/Is.After the hyperenhancement localized,the typical short axis slice with hyperenhancement WaS chosen to repeat imaging for IlleasuriIin.farct size every5minutesfrom5minutes after secondinjection ofcontrast until 20minutes.Results Twexty-seren patients showed hyperenhancement at the delayed CeMRI and hypoenhancement at the first pass enhancement(FPE).The average infarct size estimated by CeMRI WaS(17.9士9.8)%of LV nlass.Myocardial enhancement at a repesentative short-axis slice WIllS(7.2±6.2)%of LV Imss at 5 minutes,(8.5±7.4)%at 10 minutes,(7.3±6.3)%at 15 minutes and(6.9-t-6.4)%at 20 minutes respectively.There WltlS significant difference be-tween lmfninmes and 20-minutes enhancement size(P<0.05).Correlations of EF obtained by cineventriculo-grapIIy and MR irr,lg were significant(r=0.867,P<0.01).There were also correlations between infarction size and pe.k CK(r:O.819,P

Objective To detect the feasibility of magnetically labeled swine bone marrow mesenehymal stem cells(MSCs)with SHU 555A combined with poly-L-arginine(PLL),under MR imaging in vitro and in vivo.Methods Swine mesenehymal stem cells were isolated and culture-expanded 3 passages in vitro,then magnetically labeled by incubation with SHU 555A(25?g Fe/ml,Resovist,Schering)for 24 hours with 750 ng/mL poly-L-lysine(PLL;average MW_275 kDa)added 1 hour before incubation.Cellular iron incorporation and detention at 0 d,4 d,8 d,12 d,16 d,20 d after labeling was qualitatively assessed using Prussian blue and quantified at atomic absorption spectrometry.Cell viability was assessed by trypan-blue exclusion test.Cell suspensions underwent MR imaging with T_1-and T_2-weighted spin-echo and fast field-echo sequences on a clinical 1.5 T MR system.At last,1?10~6 SHU 555A labeled and unlabeled MSCs were transextracardially implanted into the infracted and normal myocardium approximately 2 week following the ligation of left anterior descending coronary artery in 1 swine respectively,and finally performed 1.5-T MRI within 1 week after infarction.Results①Intracytoplasmic particles stained with Prussian blue stain were detected for all cells with mean cellular iron content of(13.13?2.30)pg per cell.With division of stem cells, the stained particles decreased gradually with iron content(0.68?0.20)pg per cell.at 16 days after labeling, approximately to the prelabeled baseline values.(0.21?0.06)pg per cell(P＞0.05).The viability of the labeled cells at various time points were not significantly different with that of nonlabeled cells(P＞0.05).②MR images showed signal intensity changed most obviouly in T2*WI in vitro.The percentage change of signal intensity increased with increasing cell numbers,and decreased with the time.As few as 5?10~4-1?10~5 cells could be detected by using this approach.③Two injected sites containing MR-MSCs were detected in vivo,presentingas low signal intensity areas with the T_2*WI scanning sequence.Conclusion Swine bone marrow MSCs can be labeled with SHU555A-PLL and depicted with a standard 1.5-T MR imager in vitro and in vivo.(J lntervent Radiol,2007,16:115-121)

AIM:We investigated how AT 1-R stimulated by mechanical stresses induces cardiac fibrosis .METHODS:We produced in vivo cardiac pressure overload model in angiotensinogen knockout ( ATG-/-) mice and in vitro mechanically-stretched cell model in cultured neonatal cardiac cells of ATG-/-mice both lack the participation of Ang II .RESULTS: Pressure overload for 4 weeks in ATG-/-mice induced myocardial hypertrophy accompanied by the significant interstitial fibrosis , however , the TGF-β, a key regulatory factor of fibrosis, was not significantly increased in these ATG-/-mice.Meanwhile, the inhibitor for AT1-R significantly inhibited mechani-cal stress-induced cardiac fibrosis in these ATG-/-models whereas inhibition of TGF-βdid not.CONCLUSION:The results showed that mechanical stress-induced fibrotic responses through AT 1-R required the phosphorylation of Smad 2 but not the involvement of TGF-β.

β2 microglobulin (β2-MG) is a key component I molecule of the major histocompatibility complex class that assists in the cytotoxic T lymphocyte (CTL) immune response. Serum β2-MG content is dynamically correlated with many diseases. Most studies on β2-MG mainly focus on the pathogenesis of kidney disease, tumor and amyloid fibrils. In recent years, some studies have found that β2-MG is also involved in the adverse prognosis of cardiovascular system, cognitive impairment of aging and antibacterial effects. This paper summarized the domestic and foreign studies on β2-MG in recent years, and proposed the possible role of β2-MG in multi-system human body and its potential application prospect of drug molecular targeting.

Angiotensin receptor/neprilysin inhibitor (ARNI) is a novel combination drug that is a dual inhibitor of angiotensin receptor and neprilysin. In June 2021, the National Medical Products Administration approved ARNI for hypertension indications. This review provides an update of current literature on ARNI in elderly hypertension.

OBJECTIVETo study the experiences and operative procedure choice for surgical management of chronic tuberculous empyema.

METHODSTotally 461 patients of chronic tuberculous empyema were treated surgically in Shandong Provincial Chest Hospital between January 2006 and December 2011. There were 317 male and 144 female patients, aging from 6 to 79 years with a mean age of 32 years. Preoperative duration lasted from 3 months to 50 years, including 347 cases within 1 year, 61 cases 1 to 2 years, and 53 cases above 2 years. Chest tube drainage or pleuracentesis was performed in 395 patients, decortication in 287 patients, thoracoplasty in 13 patients, pleuropneumonectomy and resection of remaining lung in 11 patients, complex operation in 150 patients.

RESULTSThere was no death perioperatively. Four hundred and forty-five patients were cured at once, 6 patients were cured by stages. One patient with empyema and bronchial fistula relapsed bronchial fistula after pulmonary lobectomy and pleural decortication, whom was cured by the combination operation which including fistula repair, muscle flap tamponing and local thoracoplasty according to the closed drainage of thoracic cavity after 6 months. Three cases were suffered incision delayed healing and were cured by dressing change. Five cases were suffered abscess of chest wall within 3 months and were cured by local thoracoplasty. One patient died due to respiratory failure in one year which resulted in tuberculosis spreading because of bronchial fistula after pleuropneumonectomy.

CONCLUSIONSSurgical management of chronic tuberculous empyema still have irreplaceable roles. Selecting appropriate operations according to different cases will achieve good results.

Abscess ; Adolescent ; Adult ; Aged ; Bronchial Fistula ; Chest Tubes ; Child ; Chronic Disease ; Drainage ; Empyema, Tuberculous ; surgery ; Female ; Humans ; Male ; Middle Aged ; Pneumonectomy ; Respiratory Insufficiency ; Surgical Wound Infection ; Thoracic Wall ; Thoracoplasty ; Young Adult