Objective To investigate the effect of mycophenolate mofetil (MMF) and sildenafil on the systolic pulmonary arterial pressure (SPAP),right ventricular hypertrophy index (RVHI),pulmonary arterial and heart structural of pulmonary arterial hypertension (PAH) rat models.Methods The rat models of monocrotaline (MCT)-PAH were developed.Sprague-Dawley male rats were randomly assigned into the control group,the MCT group,the MMF (40 mg·kg-1·d-1) group,the sildenafil (20 mg·kg-1·d-1) group,and the MMF (40 mg·kg-1·d-1) + sildenafil (20 mg·kg-1·d-1) group.The SPAP and RVHI were measured,and the pulmonary arterial and heart structural changes were observed for all rats.Statistical analysis were performed by one-way ANOVA and rank-sum test.Results ① SPAP of the MMF group,the sildenafil group and the MMF + sildenafil group were (31±8),(37±8),(29±6) mmHg,while that of the MCT group was (53±7) mmHg,the difference was statistically significant (P＜0.01).The RVHIs in the MMF group,the sildenafil group and the MMF+sildenafil group were reduced [(0.365±0.038),(0.407±0.047),(0.325 ±0.459) respectively] when compared with the MCT group (0.543±0.080),the difference was statistically significant (P＜0.01).The SPAP between the MMF+sildenafil group and the sildenafil group was statistically significantly different (P＜0.05),and the RVHI difference between the MMF+ sildenafil group and the sildenafil group was statistically significant (P＜0.05).② The wall thic-kness/tubes diameter of the MMF group (0.355±0.074) and the MMF+sildenafil group (0.289±0.017) were reduced when compared with that of the MCT group [(0.466±0.006)],the difference was statistically significant (P＜0.05).The wall thickness/tubes diameter of the MMF group (0.355±0.074) were reduced compared with the sildenafil group (0.455±0.006),and the difference was statistically significant (P＜O.05).In addition,the wall thickness/tubes diameter of the MMF+ sildenafil group (0.289±0.017) was reduced when compared with that of the sildenafil group (0.455±0.006),and the difference was statistically significant (P＜ 0.05).Conclusion Both sildenafil and MMF can reduce the SPAP and RVHI of PAH rat models induced by MCT.MMF and sildenafil can reduce wall thickness as well.

Humans ; Noise, Occupational ; adverse effects ; prevention & control ; Ships

Objective To investigate the clinical features and surgical management of giant coronary artery aneurysm due to mucocutaneous lymph node syndrome(Kawasaki disease).Methods From May 2006 to Oct.2007,5 patients with giant coronary artery aneurysm were undergone surgical correction.The aneurysm mainly appeared in the left bole of coronary artery and the right coronary artery.The ST segment of electrocardiogram changed in 5 cases,cardiac ejection fraction reduced observably in 4 cases,and 1 case suffered from cardiac dysfunction.Coronary angiography showed that the right coronary artery was entirely occluded and ventricular wall motion was depressed in one case.During operation,4 cases were undergone thrombus clearing,endoarterectomy and replasty of coronary artery(with additional procedure of stent placement in one case),one case was undergone coronary artery bypass grafting(CABG) with the aneurysm sequestration.Results The surgical results were satisfactory.No operative death occurred,and all the patients recovered uneventfully and were free of symptoms.In 4 cases,the ST segment of electrocardiogram showed that the blood supply of ischemic myocardium was improved,and the cardiac ejection fraction increased obviously.With 2 to 18 months following-up,all patients were free of symptoms with no death or coronary artery aneurysm recurrence.Conclusions For stage 3 Kawasaki disease complicated with giant coronary artery aneurysm,surgical procedure is necessary.The cardiac function can be improved greatly after comprehensive treatment of thrombus clearing,endoarterectomy,replasty of coronary artery and CABG.

Objective To explore the mechanism of shengmai injection on relieving ischemia reperfusion injury and antagonizing systemic inflammatory response syndrome by regulating cytokines when it was applied at the early stage of cardiopulmonary resuscitation(CPR).Methods 40 cases suffering from cardiac arrest and had their heart beat recovered through CPR for more than 24 hours were randomly divided into SMI group and control group(20 cases for each).The patients in the two groups were treated with common therapeutics based on the CPR,but the patients in SMI group were intravenously dropped with SMI in the early period of PLS phase,then the changes of serum concentration of TNF-α and IL-81h,2h,6h,12h and24h after CPR in the two groups was compared.Results The concentrations of serum TNF-α and IL-8 stepped up gradually after resuscitation and the levels of TNF-αand IL-8 in SMI group were lower than that of the control group at 1h,2h,6h,12h and 24h after resuscitation(P＜0.05).Conclusion SMI functions to relieve ischemia reperfusion injury by regulating cytokines and antagonizing systemic inflammatory response syndrome.

Objective The expression of transforming growth factor beta receptor Ⅰ (TGF?RⅠ) and transforming growth factor beta receptor Ⅱ (TGF?RⅡ) in the synovium and the articular cartilage of patients with osteoarthritis were studied,to explore the possible relationship between the transforming growth factor beta receptor and the pathogenesis and treatment of osteoarthritis.Method The distribution and positive levels of TGF?RⅠ,TGF?RⅡ and TGF? 1 in the synovium and articular cartilage from 26 patients with osteoarthritis and 3 patients with trauma were studied,using Immunohistochemial methods.Results Immunohistochemical staining of TGF?RⅠ showed positive in all synovial samples in patients with osteoarthritis.The positive staining of TGF?RⅠ was found in most synovial lining cells,endotheliocyte and the macrophage in subsynovial layer with osteoarthritis,especially macrophage like synoviocyte.The positive particles were distributed in the cytoplasma.The distribution and staining levels of TGF?RⅡ in synovium and articular cartilage of patients with osteoarthritis were similar to those of TGF?RⅠ.Positive stainings for TGF?RⅠ, TGF?RⅡ and TGF? 1 were found in over half of chondrocytes.Conclusion It is suggested that vehicles of signal trasmission of TGF? are rich in the synovial membrane and cartilage.There is an important effect of TGF? receptor on inhibiting inflammatory process and helping to repair local tissue.

Objective To explore the effect of Shugan Lifei prescription on expression of Transforming Growth Factor-beta1(TGF-β1) and Smad3 in asthma rats under chronic stress condition. Method The 40 SD rats were randomly divided into four groups:control group, model group, dexamethasone group and Shugan Lifei group. Asthma model was established by inhaling atomized ovalbumin (OVA) passively and experiencing chronic unpredictable mild stress (CUMS). From the 15th day of modeling, the treatment groups were intervened with dexamethasone drugs and Shugan Lifei prescription. Lung pathomorphology was observed via HE staining. The expressions of TGF-β1 and Smad3 in lung tissue were measured by immunohistochemical and RT-PCR. Results Compared with control group, the wall area and the smooth muscle area in the model group significantly increased. While compared with asthmatic model group,the wall area and the smooth muscle area in the dexamethasone group and Shugan Lifei group were significantly lower. Immunohistochemistry and RT-PCR showed that in comparison with control group , the expression of TGF-β1/Smad3 protein and mRNA in lung tissues in the model group significantly increased(P<0.05), while the TGF-β1/Smad3 protein and mRNA in lung tissues in the dexamethasone group and Shugan Lifei group were detected to be significantly lower than model group (P<0.05). Conclusion Shugan Lifei method could improve airway remodeling in asthma rats under chronic stress condition , and this result is possibly achieved by reducing TGF-β1 and Smad3 expression levels.

OBJECTIVE: To study the status quo and future trend of digestive system drugs used in our hospital. METHO-DS: The digestive system drugs used in our hospital between 2001 and 2005 were analyzed retrospectively in respect to drug kinds, consumption sum, DDDs, daily costs etc. RESULTS: Drugs for peptic ulcer and hepatobiliary diseases took a big proportion and experienced a year- on- year increase. No significant change was noted for the top 10 drugs on the lists of DDDs and consumption sum before and after the medical insurance reform, but their order changed a little. The DDDs of most of the cheap and effective drugs increased after the medical insurance reform. CONCLUSION: The consumption of antiulcer drugs and drugs for hepatobiliary diseases in our hospital assume an increasing tendency.

AIM: To confirm the effects of capillary endothelium injury in the lung with ischemia reperfusion. METHODS: The rabbits pulmonary models of ischemia reperfusion (I-R)injury were established. Plasma nitric oxide and endothelin levels, arterial oxygen tension and wet/dry weight ratios were determined in different periods in control and I-R groups, and the pulmonary ultrastructure abnormities were analyzed under electromicroscope. RESULTS: The plasma levels of NO and ET-1 in I-R animals increased significantly ,compared with those in sham treated control groups. The level of ET-1 had significantly negative correlation with PaO 2 and positive correlation with the value of the wet/dry weight ratios. The swelling and karyopyknosis of capillary endothelium in the lung with I-R groups were observed in ischemia periods. The injuries of endotheliums and typeⅠandⅡ alveolar cells in 0 5 h of reperfusion were more severe than those in ischemia time, and the injuries began to repair in 2 h of reperfusion time. CONCLUSION: In the I-R group, pulmonary capillary endothelium have been injuried, which may play a prominent role in I-R injury and dysfunction of the lung.

Objective To analyze the relationship between the clinical features and the dysfunction and derangement of knee osteoarthritis(OA),in order to improve the understanding of knee OA.Methods Clinical data including symptoms,physical signs,X-ray,arthroscopical findings,pathologic changes,preopera-tive and postoperative diagnosis,treatment and curative effects from206post-arthroscopy patients with OA were analyzed retrospectively.Results The common physical signs were tenderness in knee,positive grinding test of patella,McMurray sign,fricative,muscular atrophy of quadriceps femoris,and stretch or flexion limita-tion.X-ray abnormalities were found as follows in decreasing freguency:bony hyperplasia,articular facet sclero-sis,osteoporosis,uneven articular surface,narrowing of joint space and loose bodies.Arthroscopical findings were as follows:synovial congestion and proliferation,hypertrophy or entrapment of fat pad,osteophyte,syn-ovial fold entrapment,stripping of cartilage,meniscal lesions,subchondral bone exposure,anterior cruciate lig-ament friction or obstruction,and loose bodies.The common diseases that liable to misdiagnosis preoperatively were synovial chondroma,anterior cruciate ligament impingement syndrome and meniscal lesions.The rate of excellent and good results after arthroscopic treatment was86.6%.Conclusion Hypertrophy and entrapment of fat pad,thickening and entrapment of synovial fold,stripping of cartilage,meniscal lesions,anterior cruciate ligament friction or obstruction,and loose bodies are the key factors that cause knee dysfunction in OA.The arthroscopic treatment is an effective supplement in treating knee OA.