Objective To evaluate the methods and consequences of surgical technique in the treatment of Stanford A aortic dissection.Methods 108 patients with type Standford A aortic dissection underwent surgery in our study,including urgent surgery in 53 and selective surgery in 55.The operation was performed under deep hypothennic circulatory arrest (DHCA) in 85 cases.Surgical procedures included ascending and semi arch replacement or total arch replacement (some cases combined with stented graft implanted into the descending aorta),"elephant trunk" procedure.Concomitant procedures included repair of intimal tear in arch or descending aorta,Bentall procedure,aortic valve replacement,Cabrol or modified Cabrol procedure,aortic valvuloplasty,mitral valvuloplasty or mitral valve replacement,tricuspid valvuloplasty and CABG.Results In-hospital mortality was 6.5% (7 of 108 patients).The mor- tality was 7.5% (4 of 53 patients) in urgent surgery group and in elective surgery group was 5.4% (3 of 55 patients).Ninety six percent survived patients were followed up for 1 month to 13.3 years [mean (3.2?1.3) years] and 2 deaths occurred during the fel- low-up period.3 patients underwent re-operatian.Conclusion The choice of surgical procedures depend on the location of intimal tear for Stanford A aortic dissection.The better operative effects can be expected with proper surgical indication,perfecting surgical technique,and enhancing postoperative treatment.

Cardiovascular Diseases ; Cell Proliferation ; Humans ; MicroRNAs ; Muscle, Smooth, Vascular

AIMTo study the relationship between resonance Rayleigh scattering(RRS) and the formation of association nanoparticle, and to develop a new and sensitive RRS method for the determination of trace berberine (BB).

METHODSThe association nanoparticle between BB and tetraphenylboron (TPB) was investigated by means of RRS, absorption spectral method and transmission electron microscope (TEM).

RESULTSIn pH 5.0 NaAc-HAc buffer solution, BB and TPB combine to BB-TPB association complex. The association complexes aggregate to (BB-TPB)n association nanoparticles, due to the strong hydrophobic force and Van der Waals force. It exhibits a resonance Rayleigh scattering peak at 470 nm, a maximum absorption peak at 368 nm. A new RRS method was proposed for the determination of 0.06 to 5.28 mg.L-1 BB in real samples with satisfactory results. The detection limit is 26 micrograms.L-1.

CONCLUSIONThe TEM of (BBjAgp-TPBj + p)h composite association nanoparticles was observed by means of composite association nanoreaction both TPB- and BB+ or Ag+. The results indicated that the formation of (BB-TPB)n association nanoparticles and interface of solid-liquid results in the enhanced resonance light-scattering. This new RRS method showed high sensitivity, and had been successfully applied to the determination of BB in real samples.

Berberine ; administration & dosage ; analysis ; Drug Carriers ; Drugs, Chinese Herbal ; administration & dosage ; analysis ; Nanotechnology ; Scattering, Radiation ; Spectrum Analysis ; Tablets ; Technology, Pharmaceutical ; methods ; Tetraphenylborate ; chemistry

The purpose of this research was to monitor quantitatively and study the dynamic changes and development rules of engraftment, chimera types, as well as relative amount of donor cells after allogeneic transplantation of mixed umbilical-cord blood from two units. An adult patient with acute myeloid leukemia received two units HLA one locus mismatched unrelated umbilical cord blood transplantation (2.5 x 10(7)/kg karyocytes in umbilical cord blood unit 1, and 1.53 x 10(7)/kg karyocytes in umbilical cord blood unit 2). Nine STR loci of the blood sample before and after transplantation were determined by quantitative detecting technique with fluorescence labeling polymerase chain reaction, while the engraftment and chimera types were qualitatively evaluated by comparing differential loci between the recipient and the donors. Then the relative proportion of chimera from two units of umbilical-cord blood in the patient after transplantation was calculated according to the differential gene peak areas of two donors on 377XL DNA sequencer after fluorescence scanning, and the engraftment level and the development rules of donor cells were analyzed. In addition, the results were also compared with that of HLA loci distinct analysis for engraftment. The results showed that two umbilical cord blood units at 15 days after transplantation were engrafted simultaneously and revealed a complete chimerism of the two. The relative amounts of chimera from unit 1 vs that of unit 2 were 51.3% vs 48.7%; subsequently relative amounts of chimera from unit 1 went up to 70.0% at 30 days, and that from unit 2 declined to 30.0%. However, at 52 days, only the genotype of umbilical cord blood unit 1 was detected, so that the engraftment turned to a complete chimerism of a single donor type. The one with fewer karyocytes was rejected and the one with more karyocytes finally engrafted in long-term. It is concluded that quantitatively detecting STR chimera with fluorescence labeling polymerase chain reaction can depict precisely the engraftment level and the change course of two umbilical cord blood units. It provides an accurate and reliable experimental basis for clinical umbilical cord blood application and donor selection, and is proved to be feasible for adult transplantation by using dual unit of umbilical-cord blood with HLA one locus mismatched at the same time.
Adult ; Cord Blood Stem Cell Transplantation ; HLA-B Antigens ; genetics ; Humans ; Male ; Polymerase Chain Reaction ; Tandem Repeat Sequences ; Transplantation Chimera

OBJECTIVETo evaluate the early and mid-term outcome of surgical repair for post-ductal coarctation of the aorta (CoA) under normothermia without cardiopulmonary bypass.

METHODSClinical data from 15 patients (11 males, 4 females, mean age 18 +/- 10 years) undergoing surgical repair for post-ductal CoA under normothermia without cardiopulmonary bypass between January 1999 and December 2004 were analyzed retrospectively. There were 7 isolated cases, 7 cases associated with patent ductus arterious (PDA), 1 case with PDA and ventricular septal defects. Operation was performed under normothermia with partial cross-clamping of descending aorta in 8 cases, compete cross-clamping in 6 cases and temporary shunt in 1 case. Operative techniques adopted prosthetic bypass graft in 9 cases, Gore-Tex patch graft aortoplasty in 4 cases and stenosis resection with end-to-end anastomosis in 2 cases. PDA was ligated at single-stage in 8 cases. Ventricular septal defect was repaired at second stage in 1 case.

RESULTSNo early and late death. Hypertension occurred in 9 cases during early postoperative period but was normalized gradually in 5 cases without medication during follow-up period, from 6 months to 5 years. The arterial blood pressure of lower extremities increased significantly and no hoarseness, paraplegia occurred after operation. No recoarctation and aneurysm formation were found during follow-up.

CONCLUSIONSurgical repair of post-ductal CoA under normothermia without cardiopulmonary bypass is safe and effective, which is a procedure of choice for patients with isolated CoA, CoA associated with PDA, or with other intracardiac anomalies that are ready to be repaired at second-stage.

Adolescent ; Adult ; Aortic Coarctation ; surgery ; Cardiovascular Surgical Procedures ; methods ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Male ; Retrospective Studies ; Temperature ; Treatment Outcome

OBJECTIVETo detect the expression of human telomerase reverse transcriptase (hTERT) protein and mRNA in bile duct carcinomas and the adjacent tissues and to elucidate its role in bile duct carcinogenesis.

METHODSThe expression of hTERT protein and hTERT mRNA in the formalin-fixed paraffin-embedded specimens of 71 cases of bile duct cancers and 39 cases of adjacent tissues was detected by streptavidin-peroxidase immunostaining and in situ hybridization. The correlation was analysed statistically between the expression of hTERT protein and mRNA and clinicopathological parameters bile duct carcinomas.

RESULTSThe positive rate of hTERT protein expression and mRNA expression in malignant specimens was 78.9% (56/71) and 67.6% (48/71), while that in the adjacent tissues was 35.9% (14/39) and 23.1% (9/39), respectively. All the positive signals were found in the hyperplastic biliary epithelia. No significant correlation was established between hTERT expression and clinicopathological parameters.

CONCLUSIONhTERT gene transcription and protein expression is most likely involved in the proliferation and malignant transformation of bile epithelia and the malignant progression of bile duct carcinomas. The detection of hTERT expression may serve elucidating the carcinogenesis of bile duct.

Adult ; Aged ; Aged, 80 and over ; Bile Duct Neoplasms ; enzymology ; pathology ; DNA-Binding Proteins ; Female ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; RNA, Messenger ; analysis ; Telomerase ; analysis ; genetics

OBJECTIVETo explore the preventive effect of etomidate-induced myoclonus by different concentrations of target-controlled infusion of remifentanil.

METHODSA total of 120 cases undergoing general anesthesia were randomly divided into 4 groups according to different concentrations of target controlled infusion of remifentanil using plasma target controlled infusion ( Minto model) , in which the target concentration was set as 1 f.Lg/L ( group A) , 2 f.Lg/L ( group B) , 3 f.Lg/L ( group C) , and 4 f.Lg/L ( group D) . Five minutes after the balance of effect compartment, induction with etomidate 0. 3 mglkg was conducted intravenously. The intensity and duration of myoclonus was recorded.

RESULTSThe incidence of etomidate-induced myoclonus was 70.9%, 33.3%, 26.7%, and 0 in groups A, B, C, and D, respectively. Along with the increase of the remifentanil concentration, the incidence of severe myoclonus gradually reduced, which was significantly lower in group B and C than in group A ( P < 0. 05). When the concentration reached 4 f.Lg/L, bradycardia and apnea appeared.

CONCLUSIONMyoclonus induced by etomidate under general anesthesia can be prevented by target controlled infusion of remifentanil, with 2-3 f.Lg/L being the optimal concentration.

Adult ; Anesthetics, Intravenous ; administration & dosage ; adverse effects ; Etomidate ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Myoclonus ; chemically induced ; prevention & control ; Piperidines ; administration & dosage

OBJECTIVEThe study was designed to explore the influence of transfected bone marrow mononuclear cells (BMMNC) transplantation on the hematopoietic cells activity and the recipient mice hematopoietic reconstitution.

METHODSThe exogenous mFasL-cDNA gene was transferred to Balb/C mouse BMMNC by liposomes. Then the transferred BMMNC was co-cultured with BMMNC from BAC mouse (H-2d x b, male) at a ratio of 0.625 to 1 for 6 days. In the experimental group (the 3rd group), 1 x 10(7) (0.5 ml) mixed viable cells were injected into whole bodily irradiated ((60)Co-r) mice (6 to 8 week old female Balb/C) via the tail vein. The following grafted mice were simultaneously used in the study, the mice transplanted with 0.5 ml of culture medium, the mice transplanted with the mixture of untransferred Balb/C mouse BMMNC and BAC mouse BMMNC, the mice transplanted with the mixture of transferred Balb/C mouse BMMNC and BAC mouse BMMNC and the mice transplanted with Balb/C mouse BMMNC. The hematopoietic reconstitution, the origin of bone marrow cells responsible for the reconstitution, the graft versus host disease (GVHD), the survival rate for the recipient mice were observed after bone marrow transplantation (BMT).

RESULTSThe counts of leukocytes and platelets in recipient blood of group four on +10 d and +20 d after BMT were higher than those in group three and group two (P < 0.01), but on +30 d after BMT the counts of leukocytes and platelets in recipient blood of group two, group three and group four were at their normal levels. The Y chromosome from donor mice was discovered in BMMNC of recipient mice having survived for over two months after BMT in group two and group three. The survival rate of the recipient mice two mouths after BMT in all groups were 0% for group one, 30% for group two, 80% for group three, and 100% for group four, respectively. The total survival rate of recipient mice in the experimental group was obviously higher than that of group two (P < 0.01). Grade II to III GVHD signs were found on the histology from dead mice after BMT in group three and group two, and the mice having survived for over two months in the group two. Grade I GVHD signs were found on histology from 7 out of 8 mice which survived for over two months after BMT in group three.

CONCLUSIONSThe transplantation of mixed cells into recipient mice made the recipient mice achieve hematopoietic reconstitution from donor BMMNC.

Animals ; Fas Ligand Protein ; genetics ; physiology ; Female ; Graft vs Host Disease ; epidemiology ; etiology ; Hematopoiesis ; Hematopoietic Stem Cell Transplantation ; Leukocyte Count ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Transfection

OBJECTIVETo explore the influence of borneol on intestinal absorption of muscone in rats.

METHODAn in situ intestinal circulation perfusion experiment was used to study the changes in intestinal absorption kinetics of muscone before and after being compatible with borneol.

RESULTCompared with the muscone group (MG), the absorption rate constants (Ka), the half-life period (T1/2) and the absorption rate (A) of muscone in the borneol + muscone group (BMG) were on the rise, but with no significant difference; after being compatible with borneol for a long period, Ka, T1/2 and A in the last borneol on muscone group (LBMG) increased, with significant difference (P < 0.05). in duodenum, LBMG showed better effects than MG (T1/2, P < 0.05); and so did in jejunum (Ka, P < 0.05; T1/2, P < 0.05); in ileum, there was no significant statistical difference between LBMG and MG.

CONCLUSIONBorneol can promote the intestinal absorption of muscone in rats to some extent.

Animals ; Bornanes ; pharmacology ; Cycloparaffins ; pharmacokinetics ; Drug Interactions ; Drugs, Chinese Herbal ; pharmacokinetics ; pharmacology ; Intestinal Absorption ; drug effects ; Intestines ; drug effects ; metabolism ; Male ; Rats ; Rats, Wistar

OBJECTIVETo detect the expression of HBV X gene (HBx mRNA) in extrahepatic biliary tract carcinomas and the adjacent non-cancerous tissues, and to analyzed the relationship between HBV infection and incidence of biliary tract carcinomas, thereby to elucidate the possible role of HBx in the carcinogenesis of biliary tract.

METHODSThe plasmid pSPX46 was digested by appropriate restriction enzyme. HBx fragment was obtained through gel extraction kit. The digoxigenin-labeled DNA probes for HBx mRNA were prepared by a random prime technique. The expression of HBx mRNA was detected in formalin-fixed- paraffin-embedded specimens from 71 cases of biliary tract carcinomas and 39 specimens of non-cancerous tissues adjacent to cancer by in situ hybridization. The correlations between HBx mRNA expression and clinicopathological parameters were statistically analysed in 71 cases of biliary duct carcinomas.

RESULTSForty-three of 71 malignant specimens had detectable HBx mRNA expression with a positive rate being 61%. Only 7 of 39 specimens of non-cancerous tissues adjacent to cancer had weak HBx mRNA expression, with a positive rate being 18%, and all these positive signals were found in the hyperplastic biliary epithelium. No significant correlation was found between HBx mRNA expression and clinicopathological parameters, but a strong positive correlation was found between HBx mRNA and protein expression.

CONCLUSIONThere is a high frequency of HBx mRNA expression in extrahepatic biliary tract carcinomas. HBV infection and its gene integration might play a role to certain extent in the development of biliary tract carcinomas.

Adult ; Aged ; Aged, 80 and over ; Base Sequence ; Bile Ducts, Extrahepatic ; pathology ; Biliary Tract Neoplasms ; complications ; virology ; Female ; Hepatitis B ; complications ; virology ; Hepatitis B virus ; genetics ; Humans ; In Situ Hybridization ; Male ; Middle Aged ; Molecular Sequence Data ; RNA, Messenger ; genetics ; Trans-Activators ; genetics