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 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 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.

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.

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 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 investigate low plasma total cholesterol concentration in hospitalized patients,which is associated with malnourishment.Methods A total of 358 inpatients who were treated in our hospital from January 1 to February 1,2009,were enrolled.The relationships between low plasma total cholesterol (TC) level and other parameters were analyzed.Results Irrespective of women or men,the morbidities of low plasma TC,low plasma albumin,low plasma total proteins,low plasma triglyceride (TG) and low hemoglobin (Hb) levels were highly consistent with the result of subjective global assessment (SGA) (P ＜0.05).Plasma TC concentration was positively correlated with albumin,TG,Hb,lymph cells number,and body mass index (P＜0.05).TC levels were different between men and women (P ＜0.0001).Meanwhile,low plasma TC level was not correlated with age,but it was correlated with total parenteral nutrition.Conclusion Low plasma TC concentration may relate to malnourished hospitalized patients.

Cancer-related fatigue is one of the most common and refractory clinical sympotoms in patients with cancer. Investigators have tried to study the molecular pathogenesis of cancer-related fatigue, and the cytokine has become a research focus. At present, a number of cytokines, including transformation growth factor, tumor necrosis factor, interleukin, proteolytic inducing factors, inflammatory cytokine are proved to be correlated to cancer-related fatigue.

Objective To investigate serum amino acid spectrum in patients with acute stroke in response to different nutritional support strategies and its effects on neurological function.Methods A total of 60 cases of acute stroke with dysphagia were randomly distributed into two groups:enteral nutrition group (30 cases) and control group (30 cases) using simple randomized design.Serum amino acid spectrum,hemoglobin,total protein,albumin,prealbumin,immunoglobulins,complement,and infection rate were assessed at three time points:within 48 hours,(7 ± 1) days and (14 ± 1) days after admission,and neurological deficit and activities of daily living are scored according to National Institutes of Health Stroke Scale (NIHSS) and Barthel Index (BI).Results (7 ± 1),(14 ± 1) days after admission,serum amino acid spectrum,hemoglobin,total protein,albumin,prealbumin,immunoglobulins,complement,and neurological deficit scores of enteral nutrition group patients were significantly better than those of non-enteral nutrition control group; and infection rate was lower than that of control group.Follow-up for a month,3 months,NIHSS of enteral nutrition group patients (9.0 ± 1.4,7.9 ± 1.3) were significantly better than nonenteral nutrition control group(11.1 ± 1.5,10.6 ± 1.4,F =46.042,P ＜ 0.05).While BI score seemed to be not insignificant different between enteral nutrition group (50.1 ± 1.8,52.0 ± 2.4) and control group (49.0±2.1,51.3 ±2.8,F=2.707,P＞0.05).Conclusion For patients suffering acute stroke with dysphagia,enteral nutrition support could reduce infectious complications,improve short-term neurological function and long-term prognosis by improving serum amino acids level and thus the whole body' s nutritional status.