Arrhythmias, Cardiac ; diagnosis ; genetics ; pathology ; Brugada Syndrome ; diagnosis ; genetics ; pathology ; Channelopathies ; diagnosis ; genetics ; pathology ; DNA Mutational Analysis ; Electrocardiography ; Genetic Testing ; Heart Conduction System ; physiopathology ; Humans ; Infant ; Long QT Syndrome ; diagnosis ; genetics ; pathology ; Muscle Proteins ; genetics ; Mutation ; NAV1.5 Voltage-Gated Sodium Channel ; genetics ; Sodium Channels ; genetics ; Sudden Infant Death ; etiology

Objective To evaluate the effect of HTK solution on myocardial protection during valve replacement surgery.Methods 42 patients with rheumatic heart disease were randomized to receive 4∶1cold blood (control group,n =21 ) and HTK ( protective gronp,n =21 ) cardioplegic solution during valve replacement.The changes of CO and CI were collected at different time points including pre-operation,postoperative 6 hours,12 hours and 24 hours.Aortic clamping time,the ratio of spontaneous cardiac rhythm recovery and inotropic drugs application were calculated,and mechanical ventilation support time and the incidence of arrhythmia were recorded.Results The measurements of CO and CI showed that there was significant higher level in protective group at postoperative 12 hours and 24 hours [ 12 h:(4.82 ± 0.18 ) L/min vs ( 3.50 ± 0.32 ) L/min,( 3.80 ± 0.48 ) L/( min · m2 ) vs (2.79 ± 0.39) L/( min · m2 ) ;24 h:(4.97±0.45)L/min vs ( 3.81 ±0.19)L/min,(4.22±0.17)L/(min · m2) vs (2.91 ±0.21)L/(min·m2 ),P ＜ 0.05].The clinical parameters including aortic clamping time,incidence of cardiac arrhythmia,inotropic support,duration of mechanical ventilation and length was lower than in control group [ (53.6 ±24.3 ) min vs ( 68.9 ± 26.1 ) min ; ( 1.8 ± 1.3 ) min vs ( 2.3 ± 1.2 ) min ; ( 33 ± 11 ) min vs ( 42 ± 13 ) min ;(10.2±2.1) μg/(kg · min) vs (15.7 ±3.8) μg/(kg · min);(14.6 ±4.8)h vs (20.7 ±5.1)h,P ＜0.05].The auto-beating rate was higher than in control group (90％ vs 67％,P ＜0.05).Conclusions HTK solution is better than classical blood cardioplegia in myocardial protection during valve replacement.

In recent years,studies have shown that galactose - deficient IgA1(Gd - IgA1)antibodies are im-portant in the pathogenesis of IgA nephropathy(IgAN). Serum levels of Gd - IgA1 antibodies are associated with levels of proteinuria and renal histological grading. Measuring the antibodies has guidance value in the diagnosis of IgAN,for its sensitivity and specificity can be up to 88% - 89% and 89% - 92% respectively. In addition,the antibodies play an important role in clinical prognosis,and it may provide a new direction for treatment in IgAN. Now,its role in prognosis of IgAN was reviewed.

Peroxisome proliferators -activated receptors γ(PPARγ)agonist is a kind of drugs that is widely used in the treatment of type 2 diabetes,also shows effects on hypertensive disease,regulating blood lipid metabolism, anti -atherosclerosis and inhibiting inflammatory response.In recent years,good effects of PPARγagonist have been found on different animal models of asthma,and production of proinflammatory cytokines can significantly be reduced. Airway remodeling can be reduced,and airway hyper responsiveness can be inhibited by PPARγagonist that provide theoretical basis on new drugs for asthma.The mechanism of bronchial asthma cured by PPARγagonists are reviewed briefly.

Objective To evaluate the importance of serum thyroid hormonens level of patients with stable coronary heart disease(CAD)in different glucose metablic statuses.Methods 173 cases of CAD patients in different glucose metablic statuses and 58 cases of healthy people were enrolled in the study.The levels of thyroid hormonens and serum insulin was measured by electro-chemiluminescence,and the evaluation of glucose metablic statuses and insulin resistance index was by means of 75 g oral glucose tolerance test.Results There was no significant difference in the levels of systolic pressure(SBP),diastolic pressure(DBP),insulin resistence index and serum thyroid hormonens among CAD patients with different glucose metablic statuses(P >0.05).The levels of fasting plasma glucose,2 hour postprandial plasma glucose(PG2h)and glycosylated hemoglobin(HbA1c)in CAD complicated with type 2 diabetes group were significantly higher than those in CAD complicated with impaired glucose tolerance group and CAD complicated with normal glucose tolerance group (P < 0.05 ).And the PG2h level of CAD complicated with impaired glucose tolerance group was significantly higher than both of CAD complicated with normal glucose tolerance group and normal control group s(P <0.05).Conclusion It indicates that serum thyroid hormonens level may not affect glycometabolism in CAD patients.

Child, Preschool ; Coronary Aneurysm ; etiology ; therapy ; Humans ; Infant ; Male ; Mucocutaneous Lymph Node Syndrome ; complications ; therapy ; Thrombosis ; complications ; therapy ; Urokinase-Type Plasminogen Activator ; therapeutic use

Objective To investigate the effects of different concentration propofol target controlled infusion on postoperative cognitive function in patients undergoing coronary artery bypass grafting.Methods182 cases with coronary heart disease undergoing off-pump coronary artery bypass grafting were randomly divided into groupA and groupB from January 2014 to December 2016 in our hospital, 91cases in each group.GroupA were given a small dose propofol target controlled infusion anesthesia;groupB were given high dose propofol target controlled infusion anesthesia.The total dose of propofol induction and effect compartment concentration in the two groups were observed, and the Mini Mental State Examination(MMSE) in the two groups was evaluated preoperative, postoperative 24h, 48h, 72h.Concentration of S100β was determined at suture, postoperative 24h, 72h.ResultsThe total dose of propofol induction in the groupA was significantly lower than that in the groupB (P<0.05), effect compartment concentration between the two groups had no statistically significant difference.MMSE scores in the group A at postoperation 24h, 48h, were higher than those in the group B (P<0.05).Concentration of S100β in the group A was lower than those in the group B at suture, postoperative 24h, 72h.MMSE and concentration of S100β in the two groups were not statistically significant at post operation 72h.ConclusionLow dose propofol target controlled infusion can reduce postoperative cognitive dysfunction in patients undergoing coronary artery bypass grafting, which is worthy of clinical application.

Objective To evaluate the effect of sevoflurane preconditioning on brain injury induced by cardiopulmonary bypass (CPB) in rats.Methods Forty adult male Sprague-Dawley rats,aged 6-8 months,weighing 350-450 g,were randomly divided into 5 groups (n=8 each) using a random number table:sham operation group (S group),CPB group,and preconditioning with different concentrations of sevoflurane groups (SP1,SP2 and SP3 groups).In SP1,SP2 and SP3 groups,sevoflurane with the final concentrations of 1.2％,2.4％ and 3.6％,respectively,was inhaled for 1 h,and then CPB was started.After sevoflurane preconditioning and before CPB (T0),at 30 min of CPB (T1),at the end of CPB (T2),and at 1,2 and 3 h after termination of CPB (T3-5),venous blood samples were collected from the right internal jugular vein for determination of serum S100-β protein concentrations by enzyme-linked immunosorbent assay.Rats were sacrificcd at T5,and hippocampi were isolated for determination of neuronal apoptosis (by TUNEL) and NF-κB p65 expression (by immunohistochemistry).Results Compared with group S,the concentration of serum S100-β protein was significantly increased at T1-5,the number of apoptotic neurons was significantly increased,and the expression of NF-κB p65 was significantly up-regulated in CPB,SP1,SP2 and SP3 groups (P＜0.05).Compared with group CPB,the serum S100-β protein concentration was significantly decreased at T1-5,the number of apoptotic neurons was significantly decreased,and the expression of NF-κB p65 was significantly down-regulated in SP1,SP2 and SP3 groups (P＜ 0.05).Compared with group SP1,the serum S100-β protein concentration was significantly decreased at T1-5,the number of apoptotic neurons was significantly decreased,and the expression of NF-κB p65 was significantly down-regulated in SP2 and SP3 groups (P＜0.05).Compared with group SP2,the serum S100-β protein concentration was significantly decreased at T1-5,the number of apoptotic neurons was significantly decreased,and the expression of NF-κB p65 was significantly downregulated in group SP3 (P＜0.05).Conclusion Sevoflurane preconditioning can attenuate CPB-induced brain injury probably by inhibiting activation of NF-κB in hippocampal neurons of rats.

Objective To analyze the clinical features of adult patients with acute intestinal obstruction secondary to Meckel's diverticulum and the experience in management of the disease.Methods The clinical data and pathological features of 9 patients with acute intestinal obstruction secondary to Meckel' s diverticulum were retrospectively analyzed. Results All patients were diagnosed with acute intestinal obstruction secondary to Meckel's diverticulum via abdominal cavity exploration and underwent surgical treatment. Before surgical treatment, 1 out of 9 patients was correctly diagnosed as acute intestinal obstruction secondary to Meckel's diverticulum, and the other 8patients were diagnosed as acute intestinal obstruction. Diverticulum was resected in 5 cases and the rest 4 cases received partial excision of small intestine including the diverticulum. Pathological examination showed that all patients had inflammatory changes in diverticulum. Some patients were complicated with mucosal erosion, small ulcers, bleeding or perforation. Forty-four percent (4/9) of diverticula contained ectopic tissue. All patients were cured. Conclusion Meckel's diverticulum is a rare cause of acute intestinal obstruction and preoperative diagnosis is difficult. Diverticulum,howere,is likelihood to develop strangulation or contains ectopic tissue, so that the surgical treatment should be performed early.

Objective To explore the clinical features and therapeutic strategies of neuralgia after subfrontal craniotomy.Methods 132 neurosurgical patients undergoing selective subfrontal craniotomy without the pain of the incision of scalp were involved. The onset, severity, and characters of the neuralgia were recorded. The therapeutic effects of medicine and nerve block on neuralgia were observed.Results Supraorbital neuralgia (9.8%) and superficial temporal neuralgia (3%) occurred 3～4 days and aggravated 4～7 days after subfrontal craniotomy. The headache could be persistent and become more serious intermittently and irradiated to frontal, parietal, temperal, and para-orbital region. Physical examination revealed homolateral tenderness of supraorbital notch and para-arteria temporalis superficialis. Severity of headache improved dramatically after nerve block therapy.Conclusion It is important to identify whether supraorbital neuralgia and superficial temporal neuralgia are onset after subfrontal craniotomy. Nerve block therapy gets excellent clinical result in treating post-craniotomy neuralgia.