AIM: To explore the changes of von Willebrand factor (vWF) and soluble vascular-cellular adhesion molecule-1 (sVCAM-1), and the correlation of vWF, sVCAM-1 with acute myocardial ischemia. METHODS: By means of enzyme linked immunosorbent assay (ELISA), the changes of vWF and sVCAM-1 were measured in 73 patients with unstable angina (UA) during angina attack and relief period (24 h after attack) as well as in 50 controls. RESULTS: The levels of vWF and sVCAM-1 were significantly higher in UA patients than those in controls (P

Objective To investigate how to improve teaching achievement of specified trained doctors with vascular skill. Methods Specified trained doctors were divided into groups(two doctors for one group) and expected vascular surgeon was appointed as majored teacher. Teaching revolution was proceeded with self-made vascular training platform,projected questions according with teaching content,cultivation of solidificatism and refined schema of check. Results After revolution,operative skills of specified trained doctors were improved significantly,basal operative procedures during operations were smooth,skill related theory was solid and compounding during operation was initiative. Conclusion Teaching revolutions of vascular skill can improve basal operative skill of specified trained doctors and develop habits of solidificatism.

Objective To report the clinical features and treatment outcomes of 27 patients with fungal endophthalmitis (27 eyes)over a five year period.Methods The authors retrospectively reviewed the etiology,direct smear examination,fungal cul-ture and treatments of 27 patients with culture-proven fungal endophthalmitis at the affiliated Hospital of Medical College Qing-dao University from 2007 to 2012.Results Exogenous infection was defined in 21 patients (77.8%),including 20 associated with penetrating wound,and 1 following cataract surgery.Endogenous infection was found in 6 patients (22.2%),including 3 associated with recent use of high-dose steroids,1 after abortion,1 following pelvic fracture,and 1 with long-term use of im-munosuppressive agents.Fungal hyphae were found in 17 smears of 27 samples (63.0%)by direct microscopic examination. The fungal strains cultured from 27 samples belonged to 8 genus and 12 species.The most common isolates were Aspergillus , Fusarium and Candida species.A.flavus (22.2%)and A.fumigatus (18.5%)were the predominant Aspergillus species. F .moniliforme (14.8%)and F .oxysporum (11 .1 %)were the most predominant Fusarium species.Two eyes were eviscer-ated immediately due to the serious condition.Among the other 25 eyes,22 (88.0%)got improvement after at least one of such treatments as intravitreal injection of antifungal agent,vitrectomy or penetrating keratoplasty (PK).Conclusions Exoge-nous fungal endophthalmitis is the most common type of fungal endophthalmitis in this hospital.Penetrating wound is the main cause of such infections.Microscopic examination of hyphae and fungal culture were effective for the diagnosis of fungal endophthalmitis.Aspergillus is the predominant pathogens, followed by Fusarium.Intravitreal injection of antifungal a-gent combined with vitrectomy is an effective treatment of fungal endophthalmitis.

Objective To evaluate the effects of ischemic postconditioning on mitochondrial cardiolipin synthesis during myocardial ischemia-reperfusion (Ⅰ/R) in rats in vitro.Methods Healthy male Sprague-Dawley rats,aged 16-20 weeks,weighing 250-350 g,were used in the study.The animals were anesthetized with intraperitoneal pentobarbital sodium 40 mg/kg and received intraperitoneal heparin 250 U/kg.Their hearts were excised and retrogradely perfused in a Langendorff apparatus.Sixty-four isolated rat hearts were randomly divided into 4 groups (n =16 each) using a random number table:control group (group C),Ⅰ/R group,ischemic postconditioning group (group IPO) and 5-hydroxydecanoate (5-HD) plus ischemic postconditioning group (group 5-HD + IPO).After 20 min of equilibration,the hearts were continuously perfused with K-H solution for 70 min in group C.In Ⅰ/R group,after 20 min of equilibration,the hearts were continuously perfused with 4 ℃ ST.Thomas cardioplegic solution 10 ml/kg,and exposed to 40 min of ischemia followed by reperfusion with oxygenated K-H solution at 37 ℃ for 30 min.In group IPO,after 20 min of equilibration,the hearts were subjected to 6 cycles of 10 s reperfusion followed by 10 s ischemia starting from 40 min of ischemia,and then were reperfused with oxygenated K-H solution at 37 ℃ for 28 min.In group 5-HD + IPO,after 20 min of equilibration,the hearts were perfused with K-H solution containing 100 μmol/L 5-HD (mitochondrial ATP-sensitive potassium channel blocker) for 5 min starting from 40 min of ischemia,and then the other procedures were similar to those previously described in group IPO.At 20 min of equilibration (T1) and 30 min of reperfusion (T2),HR,left ventricular developed pressure (LVDP),left ventricular end-diastolic pressure (LVEDP) and coronary flow (CF) were recorded.The coronary effluent 2 ml was collected for detection of lactic dehydrogenase (LDH) and creatine kinase (CK) activities.The mitochondria were extracted for determination of cardiolipin content.Results HR,LVDP,and CF were significantly lower,LVEDP was higher,and the LDH and CK activities in coronary effluent were higher at T2 than at T1 in the four groups.Compared with group C,HR,LVDP and CF were significantly decreased,LVEDP was increased,and the LDH and CK activities in coronary effluent were increased at T2 in the other three groups.Compared with Ⅰ/R group,HR,LVDP and CF were significantly increased,LVEDP was decreased,and the LDH and CK activities in coronary effluent were decreased at T2 in IPO group.Compared with IPO group,HR,LVDP and CF were significantly decreased,LVEDP was increased,and the LDH and CK activities in coronary effluent were increased at T2 in 5-HD+IPO group.Conclusion The mechanism by which ischemic postconditioning reduces myocardial Ⅰ/R injury is related to opening of mitochondrial ATP sensitive potassium channels and increasing mitochondrial cardiolipin synthesis in rats.

AIM: To investigate the effect of diazoxide (D) postconditioning on Cardiac function and mito-chondrial cardiolipin in isolated rat heart and to explore the protective effect of ATP sensitive potassium channel on diazo-xide postconditioning myocardium.METHODS: The myocardial ischemia/reperfusion injury model in isolated rat hearts was established by Langendorff apparatus.The isolated rat hearts were randomized into 4 groups ( n=8): control group ( control) , myocardial ischemia/reperfusion injury group ( I/R) , diazoxide postconditioning group ( I/R+D) , 5-hydroxy decanoic acid (5-HD) plus diazoxide postconditioning group (I/R+5-HD+D).The hearts in each group were started with 20 min perfusion for equilibration.The hearts in control group perfused for 70 min;The hearts in I/R group was global ischemia for 40 min after ischemia reperfusion at 4℃ST.Thomas cardioplegia, then reperfusion for 30 min;The hearts in I/R+D group were treated with diazoxide (50μmol/L) in K-H perfusion for 5 min after global ischemia for 40 min, then reperfusion for 25 min;The hearts in I/R+5-HD+D group were treated with 5-HD (100μmol/L) in K-H perfusion for 5 min before diazoxide postconditioning, then reperfusion for 20 min.The heart rate, coronary outflow volume, heart func-tion, myocardial enzymes and myocardial mitochondrial cardiolipin at the end of perfusion in each group were determined. RESULTS:Compared with control group and I/R+D group, the heart rate, the concentration of heart phospholipid and the coronary outflow volume were reduced, the heart function was significantly impaired the contents of myocardial enzymes were increased in I/R group.However, no significant difference between I/R group and I/R+5-HD+D group was ob-served.CONCLUSION:The diazoxide postconditioning protects the myocardium by increasing mitochondrial cardiolipin content, reducing the release of myocardial enzymes, improving heart function and reducing myocardial reperfusion injury. The myocardial protective effect of diazoxide is completely blocked by 5-hydroxy decanoic acid.

Objective To investigate the effects of diazoxide postconditioning on myocardial ischemiareperfusion (I/R) injury in isolated rat hearts. Methods Male SD rats weighing 250-300 g were anesthetized with intraperitoneal pentobarbital 40 mg/kg. Their hearts were excised and perfused in a Langendorff apparatus with K-H solution saturated with 95% O2-5% CO2 at 37 ℃. Sixty-four isolated rat hearts were randomized into 4 groups after 20 min of equilibration (n = 16 each): group control (group C), group I/R, group diazoxide postconditioning (group D) and group mito-KATP channel blocker 5-hydroxydecanoate (5-HD) + diazoxide postconditioning (group 5-HD + D). Group C received continuous perfusion for another 70 min. In group I/R, D and 5-HD + D, the hearts underwent 40 min of iscbemia followed by 30 min of reperfusion. 4 ℃ ST. Thomas cardioplegic solution was administered prior to ischemia in group I/R. Group D received 5 min of perfusion with K-H solution containing 50μ mol/L diazoxide at 5 min of reperfusion. Group 5-HD + D received 5 min of perfusion with K-H solution containing 50 μmol/L 5-HD before reperfusion with diazoxide. Eight hearts were taken at the end of equilibration and reperfusion and the indexes of cardiac function were recorded. Then the mitochondria were extracted for determination of mitochondrial membrane potential (MMP), reactive oxygen species (ROS) release, and respiratory function indexes. Results Compared with group C, MMP was significantly decreased, ROS release was significantly increased, mitochondrial respiratory function and cardiac function declined at the end of reperfusion in the other three groups ( P ＜ 0.05 or 0.01 ). MMP was significantly increased, ROS release was significantly decreased, mitochondrial respiratory function and cardiac function were improved in group D compared with group I/R and 5-HD + D.Conclusion Diazoxide postconditioning can reduce myocardial I/R injury in rats via the opening of mito-KATPchannels and improving the mitochondrial function.

Objective: To interview the role of CGRP to hepatic microcirculation in acute liver injury induced by coneanavalin A(Con A). Methods: Sixty Kunming rats were divided into three groups randomly(n=20), acute liver injury was established by injection with 20 mg/kg Con A through the tail vein. A saline control group was established by injection with saline. In CGRP-administered group, CGRP was given to rats 30 min before Con A injected. Ten mice in each group were used to observe the average liver blood flow volume and concentration by laser-doppler flow-instrument, and the other ten rats were observed the hepatic microcirculation velocity in vivo by an inverted microscope. Liver damage was assessed by histological evaluation after the rat had been killed. Results: Compared to the injury group, the average liver blood flow volume and velocity were significantly increased in CGRP-administered group, meanwhile, the pathological injury was markedly alleviated, whereas the blood concentration was almost the same. Conclusion: CGRP can decrease the dysfunction of hepatic microcirculation by means of improving the tissue perfusion, and alleviate the pathological damage during acute liver injury.

Objective To observe the ultrastructure of pancreas in the bustard( Otis tarda limaells) . Methods Three bustard's pancreas were observed with electron microscope. Results The exocrine secretory units of bustard's pancreas contain a lobulated tubulo acinar gland in which the lobulation is not so distinct as that of the mammalian gland due to the lack of interlobular connective tissue septa.The space between lobular pancreas is lined directly with pancreatic cells as the duct.Single long spindle shaped connective tissue cell could only be seen among three lobules and its cytoplasm becomes slender and stretches into the space between lobules as a distinct intermediate dense line.The exocrine secretory cells can be divided into two kinds of dark and light.In the light cell,particularly in swelled up rER with very little density are filled the greater part of the cytoplasm and made the cell appearance much lighter than other cells.\;The endocrine cells are divided into two types that are dispersed in pancreatic singly and clustered into pancreatic islets.The dispersed endocrine cells contain a lot of moderate dark electron dense granules in their process near basement membrane.There are two types of islets——A islet and B islet in the bustard pancreas.A islets comprise only one cell type with moderate electron density that contains dark endocrine granules.B islet contains two cell types:B and D cell.B cells are the most numerous cells with a long ovoid nucleus and contains two or three types of granules in the cytoplasm.D cells are relatively rare and can be seen in the periphery nearby basement membrane.Cells keep close to each other and desmosomes can be seen within the islet.The endocrine cells closely contact exocrine cells without basement membrane in the periphery partly.Conclusion\ These are some structural characteristics that adapt to fly and that are different from other animal in bustard's pancreas.

Objective: To investigate the circadian ryhthm variation of 2 125 I iodomelatonin ( 125 I Mel) binding sites in the human peripheral leukocytes in patients with acute cerebral infarction. Methods: Melatonin binding sites in the human peripheral leukocytes were studied using 125 I Mel as a radioligand (radioligand binding assays).All patients [age: (70.18? 11.70) years] were diagnosed by CT according to the standard [Chin J Nerv, 1996,29(6):379]. We also studied 15 age matched healthy old people as the control [age: (68.33?7.76) years]. Results: The circadian ryhthm variation of 125 I Mel specific binding in control remained significant ( P 0.05). The specific binding in the peripheral leukocytes at midlight in the patients with acute cerebral infarction were lower than that of the control. Conclusion: The expression of Mel receptor decreases in the patients with acute cerebral infarction and the circadian ryhthm variation of 2 125 I Mel appears abnormal.

Objective To evaluate the anesthetic efficacy of etomidate target-controlled infusion (TCI) in combination with remifentanil in patients undergoing gynecological laparoscopy.Methods Sixty ASA physical status Ⅰ or Ⅱ patients,aged 25-56 yr,with body mass index 18-27 kg/m2,undergoing elective gynecological lapa-roscopy,were equally and randomly divided into 2 groups:propofol TCI combined with remifentanil group (group PR) and etomidate TCI combined with remifentanil group (group ER).Anesthesia was induced with iv injection ofmidazolam 0.1 mg/kg,fentanyl 4 μg/kg and cisatracurium 0.15 mg/kg in both groups,and with TCI of propofolwith the target effect-site concentration (Ce) of 2.5 μg/ml in group PR or with TCI of etomidate (Ce 0.8 μg/ml) ingroup ER.The patients were mechanically ventilated after endotracheal intubation.Anesthesia was maintained withTCI of propofol (Ce 2.0-2.5 μg/ml) in group PR or with etomidate (Ce 0.5-0.7 μg/ml) in group ER,and with ivinfusion of remifentanil 0.1-0.2 μg· kg-1 · min-1 and intermittent iv boluses of cisatracurium 5 mg.BIS value was maintained at 40-60.Before anesthesia (baseline,T0),at the end of operation (T1),and at 24 and 48 h after operation (T2-3),venous blood samples were collected for determination of serum cortisol and aldosterone concentrations by radioimmunoassay.The emergence time,extubation time and requirement for vasoactive agents during operation were recorded.The development of injection pain and muscle twitch during induction of anesthesia,intraoperative awareness,and post-operative agitation,nausea and vomiting were also recorded.Results Compared with the baseline value at T0,the serum cortisol concentration was significantly decreased at T1 in group ER (P ＜0.05),while no significant change was found in serum aldosterone concentrations at each time point in the two groups (P ＞ 0.05).Compared with group PR,the requirement for vasoactive agents and incidence of injection pain were significantly decreased,and the incidence of muscle twitch was increased (P ＜ 0.05),and no significant change was found in the emergence time,extubation time,and incidences of post-operative agitation,nausea and vomiting in group ER (P ＞ 0.05).Conclusion Compared with propofol TCI in combination with remifentanil,etomidate TCI combined with remifentanil is helpful in maintaining the hemodynamics stable and exerts transient inhibition of adrenocortical function with less injection pain in patients undergoing gynecological laparoscopy.