Left atrial appendage ( LAA) arises from the left atrial free wall. It is the remnant of the original embryonic LA, distinct from the rest of the left atrium. It has a unique anatomical structure, physiological function, hemodynamic characteristics. LAA has complex surrounding structures, great variability, and close relation with thrombosis. This paper reviews the morphological and functional characteristics of LAA. Familiar with adjacent relationship of LAA and correlation between LAA and thrombus formation has important clinical significance that can reduce the risk of postoperative complications in interventional procedures, the incidence of car?dioembolic stroke, the clinical misdiagnosis on LAA thrombosis.

Objective:To prepare injectable interferon ?-2b(IFN-?-2b) loaded microsphere and develop a long-acting dosage form.Methods: IFN-?-2b loaded microspheres were prepared with poly(lactic-co-glycolic acid)(PLGA) as carrier material by double emulsion(w/o/w) method and solid in oil in oil(s/o/o) method separately.Physical and chemical characteristics of microspheres(mean diameter,morphology and drug entrapment efficiency) were evaluated;the in vitro release behavior and influencing factors of the microspheres were determined by micro-BCA(bicinchoninic acid) method;and IFN-?-2b stability during encapsulation and in vitro release was evaluated by sodium dodecyl sulfate polyacrylamide gel electropheresis.Results: The 2 types of microspheres produced had good shape and dispersive quality and a drug entrapment efficiency of more than 80%.IFN-?-2b bulk ultrafitration can significantly influence the mean diameter and in vitro release behavior of microspheres prepared by w/o/w method.The accumulated release(within 1 month) of the microspheres prepared by both methods was significantly improved when using PLGA with lower inherent viscosity.SDS-PAGE test showed aggregation of IFN-?-2b with s/o/o method,while there was no difference between the electrophoretic behavior of bulk IFN-?-2b and IFN-?-2b in microspheres prepared by w/o/w method.Conclusion: IFN-?-2b can be encapsulated into injectable microspheres to yield a one-month continuous release by both w/o/w method and s/o/o method.

A complex disease is rarely a consequence of abnormality in a single gene. It is known that many drugs exhibit a therapeutic effect by acting on multiple targets, produce synergies to intervene the occurrence and development of diseases. Unlike the traditional methods which act on single molecule or pathway, this disease-drug target network constructed with high throughput data vividly showed the complex relationship between drugs, their targets and diseases. However, the networks are usually extremely complex. In order to reduce the complexity, it is necessary to deconstruct the network and identify module structures. In this study, framework of module analysis was summarized from four aspects: module concept, structure and identification methods, importance of disease-drug module identification, and its application. Module-based analysis provides a new perspective for deciphering the drug intervention mechanisms for complex diseases, and provides new ideas and pathways to reveal the mechanisms of multi-target and multi-component drugs.
Drug Delivery Systems ; Drugs, Chinese Herbal ; administration & dosage ; chemistry ; Gene Regulatory Networks ; drug effects ; Humans ; Molecular Targeted Therapy

Objective Allograft vasculopathy (AV), feature of chronic rejection, is a major serious long-term post-operation complication in organ transplantation. The accurate mechanisms for AV have not been definitively established, but extensive basic and clinical studies demonstrate AV is triggered by immune reaction and nonimmunologic factors, and also possibly attributed to the metabolism of branched-chain amino acids (BCAA). Methods The transplanted hearts from Lewis to Sprague-Dawely rats served as allografts and those from Lewis to Lewis rats as isografts based on Ono 's model. The differential proteins in transplanted hearts were separated by comparative proteomic technique, and some enzymes which regulated the metabolism of BCAA were identified and validated.Results All transplanted hearts at second week postoperation were characterized by lumen loss (total area-luminal area/total area) in coronary artery, but more predominant at 8th week. All samples from the left ventricles were analyzed by proteomic techniques and the subunits E1 a, E1β and E3 of branched-chain α-ketoacid dehydrogenase (BCKDH) complex were decreased in the heart allografts.Immunohistological detection also showed the expression of BCKDH was reduced not only in the cardiac muscle but also more significantly in blool vessels with cardiac allograft vasculopathy (CAV).BCAA concentrations were increased in the cardiac allografts, but there was no difference in the serum. Conclusion These findings suggest that the catabolic pathways of the BCAA may be inhibited owing to the reduced expression of BCKDH complex, and elevated intracellular concentrations of leucine. The vascular smooth muscle cell and cardiac muscle cell proliferation is stimulated via mTOR-dependent and mTOR-independent pathways, which is associated with the formation of myocardial hypertrophy and AV in the heart allografts.

Objective: To investigate the changes of myo cardial contractile function during myocardial stunning in calcium overload rats and the protective effects of tetrandrine. Methods: Forty-six rats were randomized into control, myocardial ischemia, myocardial stunning, low and high dose of tetrandrine groups. Another 10 rats were used to identify the calcium overload. vitamin D3 (0.3 million Unit/kg) and nicotinic acid were adm inistered. After 16 d when calcium overload occured, left anterior descending ar tery was ligated. Twenty minutes of myocardial ischemia followed by 60 min of re perfusion was induced. The contractile function parameters were determined dynam ically. At the end of experiment, myocardial cytosolic ［Ca2+］i was deter mined in various groups. In tetrandrine groups, tetrandrine (62.2 or 93.6 μmol/ kg ) was administered by gastrogavage daily.After 16 d, the rats undergone the e xperiments mentioned above. Results: Sixteen days after vitamin D3 , nicotinic acid were given, ［Ca2+］i increased by 2.6 folds (146.8±10.8 ) vs (368.5±22.6) nmol/L, (P<0.01). Whereas, ［Ca2+］i in tetrand rine groups were (210.8±16.4) and (198.6±15.3) nmol/L, which were significantl y lower than that of calcium overload group. Twenty minutes of myocardial ische mia resulted in the decrease of dp/dtmax and Vmax in all groups with the most si gnificant in stunning and calcium overload groups. The contractile function rest ored gradually after reperfusion. At all time points, dp/dtmax and Vmax in both tetrandrine groups were higher than those in both stunning and calcium overload groups. And effect with higher dose of tetrandrine were more significant than in low dose of tetrandrine. After 60 min of reperfusion, dp/dtmax in stunning, cal cium overload, low and high dose of tetrandrine groups were 49.7%, 51.5%, 71.0% and 83.4% of that in control, respectively， and Vmax were 55.0%, 49.8%, 73.9% and 77.5% of that in control, respectively. Conclusion: T he myocardial contractile function in vitamin D3-induced calcium overload gro up is impaired. On basis of myocardiocyte calcium overload, transient ischemia l eads to myocardial stunning. At the stage of ischemia, the impaired degree of my ocardial contractile function is similar to that in stunning group, suggesting a t this stage the effect of ischemia on myocardial function is greater than that of calcium overload. Tetrandrine chronically improves the myocardial function in Vitamin D3-induced calcium overload rats.

Objective To explore the application of medical bottle opener box (authorized patent for utility model) in nurses dispensing operations of opening the plastic bottle cap. Methods Put five self-made medical bottle opener box sample into the hospital emergency department for use. The nurses were divided into control group and experimental group according to the different way of open bottle caps; both groups were 33 nurses who did not turn out of emergency department 2 years nurses for a common object of study. The control group was the 33 nurses adopting the method of unarmed open medicine plastic bottle cap from April 2013 to March 2014. The experimental group was the 33 nurses with medical bottle opener box to open medicine plastic bottle caps from March 2014 to March 2015. The method of comparing two groups was to compare the nurse hands skin wear parts and wear symptoms for opening bottle caps, and make the nurses′satisfaction survey. Results For two groups, the nurse hands skin wear parts were in right hand, index finger and thumb;the number of nurses with finger thick skin in experimental group was lower than that in control group [21.2%(7/33) vs. 78.8%(26/33)], and there was significant difference,χ2=21.87, P<0.05.The number of pain [12.1%(4/33) vs. 54.5%(18/33)] and peeling [15.2%(5/33) vs.69.7%(23/33)] in experimental group were lower than those in control group, and there were significant differences, χ2=13.36, 20.09, P < 0.05. The experimental group eliminated the blisters and scratches, avoided hand bleeding trauma. The nurses′overall satisfaction in experimental group was 93.9% (31/33), and 63.6% (21/33) in control group,and there was significant difference, χ2=9.06, P<0.05. Conclusions Nurses using medical bottle opener box when opening the medicine bottle cap can relieve and reduce occupational injury on the finger skin of nurses, improve the nurse hand skin comfort, provide convenient operation safety, it is worth promoting.

15mm~2)of dural sac cross-sectional area to values smaller than 75 mm~2 was found during examination in axial loading,or if a suspected disc herniation,narrow lateral recess,narrow intervertebral foramen,or intraspinal synovial cyst changed to being obvious at the axial loading examination,they were regarded as additional information.Results After axial loading CT examination,AVI was found in 16 of 40 patients.A significant decrease of dural sac area was found in 13 patients.Intervertebral disc herniation was more severe in 7 patients,lateral recess or interverbral foramen narrowed in 4 patients,no intraspinal synovial cyst was found.After axial loading MRI examination,AVI was found in 19 of 60 patients.A significant decrease of dural sac area was found in 13 patients.Intervertebral disc herniation became severe in 10 patients,lateral recess or interverbral foramen narrowed in 8 patients,no intraspinal synovial cyst was found.AVI was found in 32 of 79(40.5%)patients with sciatica and 2 of 20(10.0%)patients with low back pain(?~2=7.45 P

Objective:To observe influence of exercise rehabilitation combined diet guidance on cardiac function and quality of life (QOL) in patients after heart valve replacement .Methods:A total of 120 patients after heart valve replacement were selected and randomly divided into control group (n=60 ,received routine health education ) and experiment group (n=60 ,received diet guidance and exercise rehabilitation based on routine health education ) .After discharge ,patients re‐ceived outpatient follow‐up for six months ,body weight ,cardiac function and QOL on six months after surgery were fol‐lowed up and observed in two groups ,and the results were statistically compared .Results:Compared with control group six months after discharge ,there were significant rise in left ventricular ejection fraction [ (51.75 ± 9.30)% vs .(57.73 ± 6.13)% ] andoxygenmetabolicequivalent [(7.05±1.85)METsvs.(11.34±2.18)METs],andeachitemscoreofQOL and total score of QOL [ (4.98 ± 0.40) scores vs .(6.49 ± 0.53) scores] ,P<0.05 or <0.01;and significant reduction in body weight [(67.75 ± 10.67) kg vs .(61.25 ± 10.34) kg] in experiment group ,P<0.01. Conclusion:Exercise rehabili‐tation combined diet guidance can avoid rapid increase in body weight after surgery ,promote recovery of cardiac function and improve quality of life after surgery in patients with heart valvular diseases .

Objective To discuss the efficacy of Compound Anisodine Injection combined with Iodized Lecithin Tablets in treatment of central serous chorioretinopathy.Methods Totally 60 patients with CSC were selected,and divided into two groups randomly.The patients in control group (29 cases) were given Iodized Lecithin Tablets.The patients in observation group (31 cases) were given Iodized Lecithin Tablets and Compound Anisodine Injection.The efficacy of Compound Anisodine Injection combined with Iodized Lecithin Tablets in treatment of central serous chorioretinopathy was evaluated by efficacy,visual acuity,light sensitivity,and adverse reaction during treatment.Results After treatment,the effective rates of observation and control groups were 93.5％ and 79.3％,and the observation group was significantly higher than control group (P ＜ 0.05).There were no statistical significance on visual acuity between two groups.After treatment,rhe visual acuity of two groups was increased and the visual acuity in the observation group was better (P ＜ 0.05).Before treatment,there were no statistical significance on light sensitivity between two groups.After 2 and 4 weeks treatment,the light sensitivity of two groups were increased and the light sensitivity in the observation group was higher (P ＜ 0.05).During treatment,there was no statistical significance on adverse reaction between two groups.Conclusion Compound Anisodine Injection combined with Iodized Lecithin Tablets has a curative effect on central serous chorioretinopathy.It could increase the visual acuity and improve the light sensitivity of eyes with good security.It is worthy of clinical use.

Objective To explore the preparation and quality control of As2 O3 nanoparticle .Methods PEG‐PLA was used as the vector material to prepare As2 O3 nanoparticle with ultrasonic emulsification method ,and the VEGFR‐2 was coupled to obtain VEGFR‐2/As2 O3‐PEG‐PLA nanoparticle .The particle size distribution ,Zata potential ,loading efficiency (LE) ,encapsulation effi‐ciency(EE) ,drug release in vitro and stability was determined ,and morphological characteristics was observed by transmission elec‐tron microscope(TEM) .Tweety‐four hepatocellular carcinoma nude mices were randomly divided into VEGFR‐2/As2O3‐PEG‐PLA nanoparticles group and As2 O3‐PEG‐PLA nanoparticles group ,by tail vein injection of nanoparticles .High performance liquid chro‐matography was used to determine content of As2 O3 .After 21 d ,six nude mices in each group were killed ,and the immunohisto‐chemistry and western blot method was used to detect the expression of VEGFR‐2 .Results The particle size of VEGFR‐2/As2 O3‐PEG‐PLA was determined to be (141 .9 ± 13 .2)nm ,Zata potential was (10 .2 ± 1 .1)mV .It was found to spherical or oval shape , with uniform size and dispersibility under TEM .LE and EE was (5 .51 ± 1 .83)% and (62 .12 ± 5 .98)% ,respectively .Drug release in vitro showed that VEGFR‐2/As2 O3‐PEG‐PLA exhibited controlled release effect ,with half of the release time as 10 h .Besides , VEGFR‐2/As2 O3‐PEG‐PLA showed a good stability in 3 days .Compared with As2 O3‐PEG‐PLA nanoparticles group ,the concen‐tration of As2 O3 in tumor and liver tissue was high ,the concentration of As2 O3 in blood ,heart ,kidney tissue was low ,the expression of VEGFR‐2 in tumor tissue was low in VEGFR‐2/As2O3‐PEG‐PLA nanoparticles group(P< 0 .05) .Conclusion The prepared As2 O3 nanoparticle using PEG‐PLA as vector and VEGFR‐2 as target showed uniform size ,high EE and LE ,good stability .And it preliminarily proved that VEGFR‐2 could be targeted in nude mice .