OBJECTIVETo investigate the protective effects of morphine postconditioning on myocardial ischemia-reperfusion (I/R)injury and the potential mechanisms in rabbits.

METHODSThirty-two New Zealand male white rabbits were randomly assigned into 4 groups: Group 1 (Sham), Group 2 (I/R), Group 3 (ischemic postconditioning), Group 4 (ischemia and morphine postconditioning). Group 1 was perfused for 160 min; Group 2 underwent 40 min ischemia and 120 min reperfusion; Group 3 underwent three cycles of 30 s reperfusion and 30 s left anterior descending coronary artery re-occlusion immediately after 40 min ischemia and before 120 min reperfusion; Group 4 was given morphine 1.0 mg/kg immediately after 40 min ischemia in 1 min and before 120 min reperfusion. Blood samples were taken from arterial line at 20 min before occlusion, 20 min after occlusion, 40 min after occlusion, 1 h after reperfusion and 2 h after reperfusion for determination of the plasma levels of cardiac troponin I (cTnI). At the end of the reperfusion, infarct size (IS) and area at risk were defined by Evans and TTC staining. Plasma SOD activity and MDA were determined at the end of reperfusion.

RESULTThe levels of cTnI were significantly lower during reperfusion in the two postconditioning groups than those in I/R group. The plasma MDA content was significantly lower and SOD activity was significantly higher in the two postconditioning groups than those in I/R group, but there was no difference between two postconditioning groups. Morphine significantly reduced infarct size of the left ventricular area at risk as compared with I/R group (P<0.05).

CONCLUSIONMorphine postconditioning is as effective as ischemic postconditioning in the protection of myocardium against I/R injury in rabbits. Decrease in oxygen free radicals and increased antioxidant activity might be involved in its mechanism.

Animals ; Coronary Artery Disease ; drug therapy ; Ischemic Preconditioning, Myocardial ; Male ; Malondialdehyde ; blood ; Morphine ; therapeutic use ; Rabbits ; Random Allocation ; Reperfusion Injury ; prevention & control ; Superoxide Dismutase ; blood

AIMTo study the effect of antiparallel phosphorothioate triplex-forming oligonucleotide (apsTFO) matching with the shear stress response element (SSRE) of tissue factor (TF) gene promoter region on the expression of TF in endothelial cells (ECs) of rat common carotid artery stenosis.

METHODSThe model of common carotid artery middle segment stenosis was established by silica gel pipe loop ligation in SD rats. The mRNA expression and protein synthesis of TF, early growth response-1 (Egr-1) and specificity protein 1 (Sp1) were measured by in situ hybridization (ISH) and immunohistochemistry (IHC) technique. GT21-apsTFO, GT20-apsTFO, GT20-psTFO and FITC-labeled apsTFO, matching with the SSRE of TF gene promoter region, were designed, and intravenously injected into rats at 0.5 h before operation. TFO was detected 4 h after the operation, and the mRNA expression and protein synthesis of TF, Egr-1 and Sp1 were detected 6 h after the operation.

RESULTSThere were much fluorescence in vascular tissue, especially in the nuclear of ECs 4.5 h after the injection of apsTFO. The mRNA expression and protein synthesis of TF reduced by 22% - 23% with injection of GT20-apsTFO 6.5 h after stenosis (P < 0.01) and by 10% - 11% with GT21-apsTFO at the same time (P < 0.05). The inhibition by GT20-apsTFO was stronger than that of the GT21-apsTFO (P < 0.05). The expression of TF was not inhibited by the GT20-psTFO (P > 0.05). The mRNA expression and protein synthesis of Egr-1 and Sp1 did not change in the rat treated with GT20-apsTFO, GT20-psTFO and GT21-apsTFO (P > 0.05).

CONCLUSIONapsTFO could mero-inhibit the expression of TF gene but could not change the expression of Egr-1 and Sp1 protein.

Animals ; Carotid Stenosis ; genetics ; metabolism ; pathology ; Early Growth Response Protein 1 ; genetics ; metabolism ; Endothelial Cells ; drug effects ; metabolism ; pathology ; Gene Expression ; drug effects ; Immunohistochemistry ; In Situ Hybridization ; Male ; Oligonucleotides ; chemical synthesis ; pharmacology ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Sprague-Dawley ; Shear Strength ; Sp1 Transcription Factor ; genetics ; metabolism ; Stress, Mechanical ; Thromboplastin ; genetics ; metabolism

High-density lipoprotein (HDL), an abundant plasma lipoprotein, has been thought to be anti-inflammatory in both health and infectious diseases. It binds lipopolysaccharide (LPS) and neutralizes its bioactivity. The present study aimed to investigate the potential role of HDL, which was separated from human plasma, in LPS-induced acute lung injury in mice. Kunming mice (18-22 g) were treated with either HDL (70 mg/kg body weight, via tail vein) or saline 30 min after LPS administration (10 mg/kg body weight, intraperitoneally) and were decapitated 6 h after LPS challenge. The arterial blood was collected and analyzed for blood gas variables (PaO(2), pH, and PaCO(2)). The bronchoalveolar lavage fluid (BALF) samples were analyzed for total protein concentration, lactate dehydrogenase (LDH) activity, and white blood cell (WBC) count. The lung samples were taken for histopathological evaluation and for determination of lung wet-to-dry weight ratio (W/D), malondialdehyde (MDA) content, myeloperoxidase (MPO) activity and tumor necrosis factor α (TNF-α) content. Arterial blood gas analysis showed that after LPS challenge, HDL-treated mice exhibited a higher PaO(2), and pH, but a lower PaCO(2) than HDL-untreated ones (P<0.01). LPS-induced increases in total protein concentration, WBC number and LDH activity in BALF were significantly attenuated in HDL-treated mice (P<0.01). HDL treatment also resulted in a significant protection of lung tissues against LPS-induced acute lung injury via decreasing W/D ratio, MPO activity, MDA content, and the content of the pro-inflammatory cytokine TNF-α (P<0.05, P<0.01). Histological examination revealed that HDL treatment resulted in significantly lower scores of acute lung injury induced by LPS, with reduced hemorrhage, intra-alveolar edema and neutrophilic infiltration (P<0.01). It is suggested that HDL plays a protective role in attenuating LPS-induced acute lung injury in mice.
Acute Lung Injury ; chemically induced ; therapy ; Animals ; Bronchoalveolar Lavage Fluid ; chemistry ; Inflammation ; metabolism ; Leukocyte Count ; Lipopolysaccharides ; adverse effects ; Lipoproteins, HDL ; pharmacology ; Lung ; pathology ; Malondialdehyde ; metabolism ; Mice ; Peroxidase ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism

OBJECTIVETo explore the vegetation landscapes in marshland snail habitats using satellite image.

METHODSThe false-color composition image from band 2, 3 and 4 of LANDSAT ETM + images was classified in the ERDAS IMAGINE 8.5 to analyze the vegetation types in the marshland of Jiangning county, using the unsupervised classification. The efficiency of classification was evaluated by the transformed divergence. The overlaid layers of the classified vegetation image and the vector layer of snail habitats distribution were used to analyze the relationship between the snail distribution and the landscape types.

RESULTSThe land-cover of marshland in LANDSAT ETM234 image in Jiangning county could be classified into 10 types, including water, bare soil, sandy and other landscapes while the transformed divergence analysis showed that there were misclassified pixes between some types especially for the non-continuous types. The study indicated that through adding the NDVI image in the process of classification efficiency of classification and eliminate misclassification in the non-continuous type could be improved. Analysis on the overlaid layer of the vector of snail distribution and the classified image proved that the vegetation covers in marshland snail habitats in Jiangning mainly belonged to type 3, 5 and 6, that responded to the beach with sparse vegetation, exuberant weed and bulrush respectively. The density of snails in the bulrush was higher than that in other 2 landscapes.

CONCLUSIONThe vegetation type in the marshland snail habitats could be distinguished from the satellite image, which was helpful for the surveillance of snail habitat in marshland and for the prevention of schistosomiasis.

Animals ; Breeding ; China ; epidemiology ; Disease Vectors ; Ecology ; Environmental Monitoring ; Epidemiological Monitoring ; Humans ; Plants ; Satellite Communications ; instrumentation ; Schistosoma japonicum ; classification ; growth & development ; Schistosomiasis japonica ; epidemiology ; transmission ; Snails ; growth & development ; parasitology ; physiology

OBJECTIVETo analyze the relationship between the normalized difference vegetation index (NDVI) and the snail distribution in marshland of Jiangning county in Jiangsu province, and to explore the utility of Terra-MODIS image map in the small scale snail habitats surveillance.

METHODSNDVI were extracted from MODIS image by vector chart of the snail distribution using ArcView 8.1 and ERDAS 8.5 software. The relationship between NDVI and the snail distribution were Investigated using Bivariate correlations and stepwise linear regression.

RESULTSThe snail density on marshland was positively correlated with the mean NDVI in the first ten-day of May and the maximum NDVI (N(20max)) in the last ten-day of May. Incidence of pixel with the live snail on marshland was positively correlated with the mean NDVI (N(2mean)) in the first ten-day of May. An equation Y(1) = 0.009 47 x N(20max) (R(2) = 0.73), Y(2) = 0.018 6 x N(2mean) (R(2) = 0.906) was established.

CONCLUSIONThis study showed that the Terra-MODIS satellite images reflecting the status of the vegetation on marshland in Jiangning county could be applied to the study to supervise the snail habitat. The results suggested that MODIS images could be used to survey the small scale snail habitats on marshland.

Animals ; Breeding ; China ; epidemiology ; Ecology ; Environmental Monitoring ; Epidemiological Monitoring ; Humans ; Satellite Communications ; Schistosomiasis japonica ; epidemiology ; transmission ; Seasons ; Snails ; growth & development ; parasitology ; physiology

OBJECTIVETo evaluate the effectiveness and safety of ureteroscopic holmium: YAG laser lithotripsy for managing ureteral calculi.

METHODSUreteroscopic holmium: YAG laser lithotripsy was used in 168 ureteral calculi (proximal 27 cases, middle 33 cases, distal 108 cases). Transurethral cystoscopic holmium: YAG laser lithotripsy in 12 bladder calculi.

RESULTSFour to six weeks after operation, The stone-free rate was 93% (25/27) in the proximal ureteral calculi, 94% (31/33) in the middle ureteral calculi, 94% (102/108) in the distal ureteral calculi, respectively. The complication rate was 5% (8 cases). the stone-free rate of bladder calculi was 100% (12/12), no complication.

CONCLUSIONUreteroscopic holmium: YAG laser lithotripsy is a highly effective and safe treatment modality for managing ureteral calculi.

Aged ; Aged, 80 and over ; Holmium ; Humans ; Intraoperative Complications ; Lithotripsy, Laser ; instrumentation ; methods ; Male ; Middle Aged ; Postoperative Complications ; Treatment Outcome ; Ureteroscopy ; Urinary Calculi ; therapy

Objective To better understand the prevalence and geographic distribution of genotypes/subtypes on HCV and the relationship between HCV genotypes/subtypes and HIV infection disease progression in the HIV-1/HCV co-infected individuals living in high HIV-1 prevalent areas in China. Methods 186 plasma samples were collected from HIV-1 seropositive individuals infected through paid blood donors (PBD), injecting drug users (IDUs) or sexual contact, living in most severely affected provinces, Henan, Yunnan, Xinjiang, Jilin and Liaoning provinces. Samples with HCV viral load >1000 cop/ml were amplified by RT-nested PCR, sequenced and phylogenetically analyzed for genotyping/subtyping of HCV. HIV-1, HCV viral loads and CD4 T lymphocytes were measured for all subjects. Results (1) HCV were identified as 1 a (1.7%), 1 b (39.9%), 2a (17.9%), 3a (10.4%), 3b (15.6%), 6a (1.2%), 6n (6.4%), and a newly unclassified subtype (7.5%). HCV 2a and lb subtypes predominated in PBD in Henan, 3a and 3b in IDUs in Xinjiang and Yunnan, and 6 genotype/subtypes in IDU in Yunnan. (2) There were no significant differences in CD4 T cell counts among the different HCV subtypes. (3) The viral load of HCV RNA in lb subtype was higher than that of non-1b subtype, however, no significant differences in HIV-1 viral loads and CD4 T cell counts were found between Ib and non-1b subtype. Both HIV and HCV viral loads were lower in 2a than non-2a subtype. Conclusion The prevalence of HCV genotype/subtype in HIV-1/FICV co-infected individuals was associated with geographic areas and transmission routes. HCV subtypes had no direct correlation with HIV infection disease progression.

Hilar biliary stricture is usually divided into malignant stricture and benign stricture. How to effectively deal with hilar biliary stricture has always been the focus in biliary surgery. Because it involves bile duct, hepatic artery,portal vein and liver parenchyma, the choice of surgical path is very important. The approach based on perihilar surgical technique can better expose the operative area and have the advantage of performing precise treatment, thus effectively improving the radical cure rate of hilar cholangiocarcinoma and reducing the surgical difficulty.

OBJECTIVE: To explore the effect of clinical pathway of emergency respiratory and cardiac arrest on management of patients with sudden respiratory and cardiac arrest. METHODS: The clinical data of patients with sudden respiratory and cardiac arrest admitted to Huashan North Hospital Affiliated to Fudan University from 1 year before to 1 year (started in July 2017) after the implementation of clinical pathway of emergency respiratory and cardiac arrest were retrospectively analyzed. The patients who managed by clinical pathway of emergency respiratory and cardiac arrest (from July 2017 to June 2018) were served as observational group, and those manually managed by 2015 American Heart Association cardiopulmonary resuscitation and cardiovascular emergency guide update and the procession in the management of emergency key diseases (from July 2016 to June 2017) were set as control group. The gender, age, underlying disease, the initiation time of cardiopulmonary resuscitation (CPR), the first time of defibrillation, the completion time of endotracheal intubation, the time of venous access, the usage time of the first dose of adrenaline, the usage time of vasoactive drugs, the completion rate of high quality CPR, the success rate of return of spontaneous circulation (ROSC) and the table procedure of clinical pathway were compared between the two groups. RESULTS: There was no statistically significant difference in gender, age or underlying disease between the two groups. Compared with the control group, the clinical pathway could effectively guide the decision-making of the emergency medical staffs, significantly reduce the variation in the procession of the resuscitation, the first time of defibrillation, the completion time of the deep vein catheterization, the usage time of norepinephrine and the completion time of the blood specimen delivery were significantly shortened [the first time of defibrillation (minutes): 1.28±0.86 vs. 2.93±1.61, the completion time of deep vein catheter (minutes): 15.13±2.73 vs. 17.25±3.02, the usage time of norepinephrine (minutes): 15.43±2.80 vs. 17.88±1.67, the completion time of blood specimen delivery (minutes): 7.81±1.42 vs. 9.00±1.03, all P < 0.05]. There was no statistically significant difference in the initiation time of CPR, the completion time of tracheal intubation, the time of peripheral venous access, the usage time of the first dose of adrenaline or sodium bicarbonate, or the success rate of ROSC between the two groups. However, the usage time of the first dose of adrenaline and sodium bicarbonate was shortened in the observation group [the usage time of the first dose of adrenaline (minutes): 3.81±1.22 vs. 4.00±1.32, the usage time of the first does of sodium bicarbonate (minutes): 8.94±3.49 vs. 11.19±3.54, both P > 0.05], and the success rate of ROSC was relatively increased as compared with those in the control group [15.04% (17/113) vs. 12.50% (12/96), P > 0.05]. CONCLUSIONS The clinical pathway of emergency respiratory and cardiac arrest could effectively guide the clinical decision-making of the emergency medical staffs, significantly reduce the variation in the procession of the resuscitation, improve the quality of the resuscitation, and ensure medical safety of emergency department.
Cardiopulmonary Resuscitation ; Case-Control Studies ; Critical Pathways ; Electric Countershock ; Emergency Service, Hospital ; Female ; Health Services Research ; Heart Arrest/therapy* ; Humans ; Male ; Retrospective Studies