Objective:To observe the therapeutic effect and timing of reteplase in patients with ST-segment elevation myocardial infarction (STEMI) .Methods:A total of 106 STEMI patients were selected from Central Hospital of Wafangdian City of Liaoning Province , from Jan 2013 to Apr 2014 ,and all patients received thrombolytic treat-ment .According to the duration from onset to thrombolysis ,patients were divided into :group 1 with duration <3h (<3h group ,n=28) ,group 2 with duration 3~6h (3~6h group ,n=47) ,group 3 with duration 6~12h (6~12h group ,n=22) and group 4 with duration 12~24h combined sustained chest pain (12~24h group ,n=9) .Thrombo-lytic recanalization rate ,30d all-cause mortality and incidence rate of adverse reactions were observed in all groups . Results:Compared with group 1 , 2 , the thrombolytic recanalization rate significantly reduced (82.14% vs . 76.60% vs .50.00% vs .44.44% ) in group 3 ,4 (P<0.05 all) ,but there was no significant difference between group 3 and group 4 ;Compared with group 1 , the 30d all-cause mortality (3.57% vs .6.38% vs .9.09% vs . 11.11% ) and incidence rate of adverse reactions (3.57% vs .10.64% vs .13.64% vs .22.22% ) in group 2~4 (P<0.05 all) ,but there were no significant difference among group 2~4 (P>0.05 all) .Conclusion:The thrombolytic recanalization rate is highest ,and the 30d all-cause mortality and incidence rate of adverse reactions are lowest for thrombolysis within 3 h from onset .

Objective [WT5”BZ] To evaluate the surgical treatment of insulinomas in the head and neck of the pancreas. [WT5”HZ]Methods [WT5”BZ] Data of 43 patients with insulinomas located in the head and neck of the pancreas during the past 16 years in PUMC Hospital were analyzed retrospectively.[WT5”HZ] Results [WT5”BZ] The average age of patients was 37 years old with an average preoperative history of 2 7 years. The preoperative accuracy of PTPC, DSA, B ultrasound, CT and MRI were 89 5%,72 5%,22 4%,25 3% and 66 7% respectively. The accuracy of intraoperative palpation was 97 8%. Enucleation of tumors was usually applied, and distal pancreatectomy or Roux en Y pancreaticojejunostomy were performed in 7 cases. The incidence of postoperative pancreatic leakage was 32 6%.[WT5”HZ] Conclusions [WT5”BZ] Selection of operation methods depends on the relationship of tumor with pancreatic duct and bile duct. Intraoperative monitoring of blood glucose is an essential mean to verify the complete resection of tumors. [WT5”HZ]

Objective To analyze the clinical characterist ic s and treatment of chronic idiopathic intestinal pseudo-obstruction(CIIP). Methods We retrospectively reviewed 8 C IIP patients admitted to our hospital from 1980 to 1999. There were 4 males and 4 females, with an average age of 29 years. Results The earliest onset of symptom was at an age of 2 years old. Re current abdominal distention is the most common symptom. Gastrointestinal imagin g and colonoscopy showed dilated loops of bowels with no evidence of mechanical obstruction. Delayed gastric emptying was presented by radionucleotide(~99m Tc-Sc) gastric emptying test. Gastrointestinal manometry showed low pressure in esophagus and colon. Biopsy taken in 2 patients showed chronic inflammation. On e patient underwent total colectomy for the treatment of lesions confined within the colon. Prokinetic agents have limited efficacy. Conclusions CIIP is a rare disease. Operation is not a prima ry method for treatment. The patients usually have poor prognosis.

Objective To investigate the effect of aprotinin on the inflammation response to reinfusion of shed blood during operation after being aspirated, filtered and washed using cell saver.Methods Twenty-four ASA I - II patients undergoing elective spinal surgery under general anesthesia were randomly divided into 2 groups: aprotinin group ( n = 12) and control group ( n = 12) .The patients were premedicated with intramuscular pentobarbital 0.1 g and atropine 0.5 mg. Anesthesia was induced with propofol 2 mg ? kg -1 , fentanyl 2-4 ?g ? kg-1 and vecuronium 0.1-0.3 mg ? kg-1 and maintained with isoflurane, propofol infusion and intermittent i. v. boluses of fentanyl and vecuronium. The patients were mechanically ventilated after tracheal intubation. In aprotinin group aprotinin 10 ? 105 IU was given before skin incision and another dose of aprotinin 10 ? 105 IU was continuously infused during operation. The blood shed during operation was collected, anticoagulated with heparin, filtered, washed and reinfused using AutoLog cell saver. Blood samples were taken from CVP line before skin incision (T1 , baseline), 30 min after reinfusion of salvaged bloods (T2) and at the end of operation (T3 ) for WBC and neutrophil granulocyte counts and determination of expression of CD11b and CD18 on the surface of neutrophil granulocytes using flow cytometry. Results The two groups were similar with respect to the general condition of the patients, duration of operation and account of shed blood reinfused. (676? 353) ml was reinfused in control group. The expression of CD11b and CD18 on the surface of neutrophil granulocytes increased significantly at T2 and T3 as compared to the baseline at T1 in control group ( P

Objective To investigate the effect of high glucose on proliferation of rat mesangial cells and reactive oxygen species (ROS) in culture and the intervention of polysaccharides-2b from Mudan Cortex (PSM2b). Methods Cell proliferation was assessed by MTT colorimetric assay. Colorimetric assay was used to detect SOD and MDA in the supernatant of high glucose culture of rat mesangial cells. Results PSM2b could significantly inhibit the proliferation of mesangial cells, the inhibiting effect showed a dose-dependent manner. And SOD increased with PSM2b compared with that only with high glucose, while MDA decreased. Conclusion High glucose contributes to an increase in rat mesangial cells and ROS produced by rat mesangial cells and PSM2b can better control high glucose-induced proliferation of rat mesangial cells and oxidative stress.

Objective To investigate the effects of traditional transmyocardial laser revascularization (T-TMLR) and non-transmural myocardial laser revascularization (N-TMLR) on myocardial ischemic and necrotic areas and angiogenesis. Methods In rabbit models, using Evans′ blue -TTC stain and HE stain technique for measuring ischemic and necrotic areas and observing angiogenesis. Results After T-TMLR and N-TMLR,compared with the control group, the ischemic areas significantly decreased and significant elevation of angiogenesis was observed. But no difference in necrotic areas was observed among the three groups. Conclusion N-TMLR can achieve the same effects with T-TMLR. Inducing angiogenesis via laser channels and decreasing ischemic area may be one of the predominant mechanisms of TMLR whereas laser channels themselves open or not has no relation to the effects of TMLR.

Regeneration of axon was play an important role in the functional repair after spinal cord injury,and it was affected by vascular damage,absent availability nutrition transportation,urged to be solved.Inducing angiogenesis by electrical fields might be benefit to enhance anatomical plasticity and recovery of function after spinal cord injury.

Objective:To investigate the effect and mechanism of donor-Ag specific T cell vaccination on inducing specific immune tolerance of allogenic liver transplantation and the mechanism of immune privilege of liver transplantation .Methods:CBA mice were recipients,B6 mice were donors,T cell vaccination (TCV) were made from the attenuated spleen cells of CBA mice ,which were stimulated by Con A and were challenged with the spleen cells of B 6 mice.There are 3 groups in this experiment:Transplant control group:Orthotopic liver transplantation ( OLT) were performed with the recipients of CBA mice and donors of B 6 mice;Flt3-L treating group:OLT were performed with the recipients of CBA mice and donors of B 6 mice treated with Flt3-L;TCV group:OLT were performed with the recipients of CBA mice inoculated with TCV and donors of B 6 mice treated with Flt3-L.Median survival time (MST) of liver grafts was recorded, IL-4, IL-10 and IFN-γin peripheral blood were tested after transplantation in each group .One-way mixed lymphocyte reaction ( MLR) were carried out with effectors of spleen cells from CBA mice and stimulator of spleen cells from B 6 mice at the 5th day after transplantation.The apoptosis of liver graft infiltrating cells (GICs) were analyzed by flow cytometric analysis at the 5th day after transplantation.Results: Flt3-L treating donor activated allogenic acute rejecting reaction , TCV vaccinating recipient before and after transplantation significantly depressed the acute immune rejecting reaction mediated by Flt 3-L.The liver grafts were accepted by recipient without the presence of Flt 3-L.The cytokines test show that the serum value of IL-4 and IL-10 were increased in Transplant control group and TCV group ,but decreased in Flt3-L treating group.The value of IFN-γwas increased in Flt3-L treating.

BACKGROUND:Drug eluting stents and endothelium stents for clinical treatment of vascular stenosis can lead to delayed endothelialization and restenosis. A rapamycin eluting stent combined with CD34 antibody can play a synergistic role to offset delayed endothelialization and intimal hyperplasia due to antiproliferative drugs, but it is stil in the pilot phase. OBJECTIVE:To observe the ability of rapamycin eluting stent combined with CD34 antibody to capture endothelial progenitor cels, and to observe the differentiation characteristics of the captured cels. METHODS:Scanning electron microscope and indirect immunofluorescence were used to observe the morphology and differentiation characteristics of captured endothelial progenitor cels. Under a fluorescence microscope, we observed the captured endothelial progenitor cels and the degree of endothelialization after implantation of the rapamycin eluting stent combined with CD34 antibody into rabbit ear vein. RESULTS AND CONCLUSION:Under the scanning electron microscope, fusiform-like cels with a diameter of 6-8 μm were captured by the composite stent, and 24 hours later, the cels became ful-shaped. The captured cels had the appearance characteristics of endothelial progenitor cels. Results from indirect immunofluorescence observation showed that there were a lot of red fluorescent spots on the coating which represented adherent cels positive for vascular endothelial growth factor receptor-2; the composite stent was largely covered with vascular endothelial cels at 24 hours after stent implantation, and fuly covered at 48 hours, but there was no abnormal cel cluster. These findings indicate that the rapamycin eluting stent combined with CD34 antibody can be specific to rapidly capture endothelial progenitor cels in the peripheral blood, and the stent can be completely covered with vascular endothelial cels at 48 hours after stent implantation, thereby achieving rapid endothelialization and promoting the repair of endothelial cels.

Objective To investigate the analgesic efficacy and spinal neurotoxicity of intrathecal (IT) different doses of dexmedetomidine in rats. Methods Sixty male SD rats weighing 180-220 g were randomly divided into 5 groups ( n = 12 each): groupnormal control (group C); group IT normal saline (group N); different doses of dexmedetomidine groups received IT dexmedetomidine 0.75, 1.50 and 3.00 μg/kg respectively (groups D1.3). Paw withdrawal threshold to mechanical stimulation (PWMT)with yon Frey filaments and tail flick latency (TFL) to a thermal nociceptive stimulus were measured before (To, baseline) and at 30 or60 rin after IT dexmedetomidine or normal saline administration (T1, T2 ) and the percentage of the maximum possible effect ( MPE ) was calculated. Lumbar segment of the spinal cord ( L4-6 ) was removed for microscopic examination and determination of c-Fos expression (by immuno-histochemistry) at 7, 24 and 48 h after IT dexmedetomidine or normal saline administration. Results PWMT, TFL and the percentage of MPE were significantly increased after IT dexmedetomidine as compared with the baseline values at T0 in groups D1-3 ( P ＜ 0.05). PWMT was significantly higher at T1 and TFL and the percentage of MPE were higher at T2 in groups D1-3 than in groups C and N,and in group D3 than in groups D1,2 ( P ＜ 0.05). At 7,24 h after IT dexmedetomidine c-Fos protein expression was significantly higher in group D3 than in groups C and N( P ＜ 0.05). There was no significant difference in c-Fos expression at 48 h after IT dexmedetomidine between group D3 and groups C and N ( P ＞ 0.05 ). At 24 h after IT dexmedetomidine c-Fos protein expression was significantly higher in group D3 than in other 4 groups( P ＜ 0.05). Slight spinal cord injury was observed at 24 h after IT dexmedetomidine in group D3. Conclusion IT dexmedetomidine has antinociceptive effect. High dose dexmedetomidine IT can produce transient reversible toxicity to the spinal cord.