Objective To investigate the clinical characteristics and prognosis of acute myocardial infarction (AMI) combined with ventrical septal perforation (VSP).Methods Fifty-seven AMI + VSP patients were retrospectively analyzed their clinical characteristics and outcomes who were treated in the Fourth People' s Hospital of Shenyang and the First Hospital Affiliated to China Medical University from June 2000 to May 2014.Results Of all patients,43 (75.4％) VSP occurred anterior wall AMI,and 14 (24.6％) were not.Echocardiogram show the end diastolic diameter of left ventricle was (53.7 ± 9.5) mm,left ventricle ejection fraction was (48.5 ± 11.8)％,VSP diameter was (9.8 ±7.9) mm,and 37(64.9％) were with near apex.The level of cardiactroponin I,C-reactive protein,and N terminal of B type natriuretic peptide of patients were (16.7 ± 12.9) μg/L,(99.7 ± 31.40 mg/L,(3 051.2 ± 879.7) μg/L.Total mortality was 71.9％ (41/57) in 30 days and 78.9％ (45/57) in 1 year.The mortality of operation group was 73.9％ (17/23) in 30 days and 91.3％ (21/23) in 1 year.The mortality of consecutive therapy was 64.7％ (22/34) in 30 days and 76.5％ (26/34) in 1 year.Conclusion The mortality of AMI + VSP is higher and operation is the most effective therapeutic method.

Objective To observe the changes and clinical significances of ischemia modified albumin (IMA),cardiac triponin T (cTnT) and creatine kinase MB (CK-MB) in transient myocardial ischemia induced by radio frequency ablation ( RFA ) in patients with arrhythmia.Methods One hundred and twelve patients with arrhythmia undergoing RFA and 91 patients undergoing CAG were evaluated with blood levels of IMA,cTnT and CK-MB before and 3 and 6 hours after operation.Results Serum levels of IMA at 3 h [ (80.62 ± 7.53 )U/ml ] and 6 h [ (76.37 ± 9.21 ) U/ml ] after operation rose significantly (P ＜ 0.05 ) in the 112 cases of RFA compared with the preoperative [ ( 45.42 ± 7.00 ) U/ml ].While the levels of IMA were not significantly different at 3 and 6 hours after CAG in the 91 patients compared with before sugery ( P ＞ 0.05).The levels of cTnT and CK-MB remained unchanged between the two groups after the procedures ( P ＞ 0.05 ).Conclusion The levels of IMA were quickly increased after myocardial ischemia induced by RFA and this change occurred earlier than that of cTnT.IMA is an early diagnostic biochemical marker of myocardial ischemia.

Objective: The aim of this study is to review the experience of using bidirectional Glenn shunt without cardiopulmonary bypass(CPB). Methods: Fifty-eight patients underwent bidirectional Glenn shunt without CPB between May, 2000 and September, 2001. The age was (3.65?1.59) years and the weight was (13.6?4.0) kg. The procedure consists of establishing temporary bypass with cannulae placed in the SVC and right auricular appendage for venous drainage and transection of right SVC. The cardiac end of the SVC is overseen. The cranial end is anastomosed to a longitudinal incision in the superior margin of the right pulmonary artery with absorbable running suture. The anterior wall of the anastomosis is widened with pericardium patch. Results: There was no operative mortality. Five cases had postoperative complications including coma in 1 and chylothorax in 4. The mean SVC crossclamp time was (48?15) mins. The preoperative oxygen saturation and CVP were 0.75?0.09 and (12.8?2.3) mmHg, respectively. While the postoperative oxygen saturation and CVP were 0.93?0.05 and (16.5?2.9) mmHg, respectively. The drainage was (145?103)ml. The average mechanical ventilation time was (13?7) hrs. The mean postoperative hospital stay was (10?5) days. Conclusion: Bidirectional Glenn shunt without CPB is a safe and reliable method, for complicated congenital heart diseases children with inadequate pulmonary blood flow when anatomic and primary physiological correction are not suitable.

Objective: To evaluate the effect of perfusion of pulmonary artery using hypothermic protective solution on the inflammatory response of lung during cardiopulmonary bypass. Methods: 40 children with TOF were divided into control group (n=20) and protective group (n=20). The basic parameters (age, weight, C/T ratio, oxygen saturate) were not different between both groups. In control group, the operation was performed using routine approaches. While in protective group pulmonary artery were infused with 4℃ protective solution during CPB. Plasma TNF-?, IL-6 and IL-8 of tracheal suction was measured. Lung biopsy specimens were obtained after operations for study on histological changes. At same time, patients' pulmonary functions and clinic index were monitored. Results: TNF-? was lower in protective group when compared with control group immediately and at 24h after operations (P

Objective To evaluate the target killing effect and metastasis prevention effect of soluble Fas combined with PKC inhibitor on the growth of human colorectal carcinoma implant in nude mice. Methods Orthotopic implantation and metastasis model of human colorectal carcinoma was reproduced in nude mice. Tumor tissue of tumor cell line HR-8348 with positive expression of FasL was implanted to the colonic wall of nude mice. After one week of tumor growth, mice were randomly divided into four groups according to the different agents injected into the peritoneal cavity. Twelve mice were in each group. The mice in the combined treatment group (recombinant soluble Fas coupled with PKC inhibitor + 5-Fu) were injected intraperitoneally 100?l (3mg/ml) recombinant soluble Fas coupled with PKC inhibitor and 0.5 mg of 5-Fu. (On the day of 0, 4, 8, 12 and16). At the same time, a group of tumor bearing mice were given recombinant soluble Fas coupled with PKC inhibitor only, and another group with 5-Fu only, and in the control group only normal saline was given. One month after implantation, tumor weight, inhibition rate and the presence of metastasis were evaluated respectively after the mice were sacrificed. Results Compared with control group, the orthotopically implanted tumors were significantly reduced in weight in mice treated with 5-Fu, recombinant soluble Fas coupled with the PKC inhibitor, and combined treatment, with respective inhibited rates of 43.1%, 79.9%, and 86.3%. Liver metastasis was also inhibited with significant decrease in incidence in 5-Fu group, recombinant soluble Fas coupled with the PKC inhibitor, and combined group compared with that in control group (75.0% vs 36.4%, 16.7%, and 0%). The incidence of peritoneal metastasis was also decreased significantly in 5-Fu, recombinant soluble Fas coupled with PKC inhibitor, and combined treatment compared with that in control group (100% vs 45.5%, 16.7%, and 8.3%, P

Objective To compare the effect of two different dialysis modalities, hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) on insulin resistance in patients with adult end-stage renal disease (ESRD), and to identify the possible predictive factors for insulin resistance. Methods Fifteen non-diabetic patients with ESRD (ESRD group) were selected. Eight patients were treated with HD (HD group), and 7 patients were treated with CAPD (CAPD group). The insulin inhibition was examined by hyper insulin-euglycemic glucose clamp technique before and after dialysis treatment, and the glucose disposal rate (GDR) was used as an index of insulin sensitivity during the clamp technique. Meanwhile, 8 healthy controls were selected as control group. The biochemical parameters which might be associated with insulin resistance were determined by multiple linear regression. Results The GDR in control group was (9.93 ± 1.33) mg/(kg · min), in ESRD group was (6.44 ± 1.76) mg/(kg·min), and there was statistical difference (P<0.05). The GDR in HD group after treatment was increased from (6.53 ± 1.84) mg/(kg · min) to (9.74 ± 2.88) mg/(kg · min), and there was statistical difference (P<0.01). The GDR in CAPD group after treatment was increased from (6.35 ± 1.65) mg/(kg·min) to (8.18 ± 1.76) mg/(kg·min), and there was statistical difference (P<0.05). Multiple linear regression result showed that the levels of urea nitrogen, hematocrit and bicarbonate were significant predictive factors in insulin resistance (P<0.05). Conclusions CAPD and HD therapy can improve insulin resistance in adult patients with ESRD.

Objective To compare clinical prognosis between intermittent high-volume predilution on-line hemofiltration (HF) and standard intermittent hemodialysis (HD) in critically ill patients with acute kidney injury (AKI).Methods This was a prospective,randomized,controlled single-centre clinical study.The mortality and recovery rate of kidney function were compared in critically ill adult patients with AKI between HF group (using intermittent high-volume predilution on-line HF,50 cases) and HD group (standard intermittent HD,45 cases).The prognosis of 60 d was followed up,including 60-day all-cause mortality,in-hospital all-cause mortality and recovery of kidney function.Results There were no statistical differences in basic clinical characteristics between 2 groups (P ＞ 0.05).The results of 60-day' follow-up showed,the mortality in HF group was 68.0％ (34/50),and in HD group was 82.2％ (37/45).There was statistical difference (risk ratio 0.75,95％ CI 0.80-1.28,P =0.036).There were no statistical differences in the in-hospital mortality and recovery rate of kidney function (P ＞ 0.05).There was no statistical difference in complication rate between 2 groups (P＞ 0.05).Conclusion The mortality is significantly lower in critically ill patients with AKI treated with intermittent high-volume predilution on-line HF,compared those treated with standard intermittent HD.

Current researches indicate that transplanted BM‐MSCs accompanies massive death ,and its effect is unsat‐isfactory .The miRNAs are a class of small non‐coding single‐stranded RNA molecules ,involve therapeutic course of bone marrow mesenchymal stem cell treating myocardial infarction in many respects .The present article made an o‐verview on effect of microRNAs in transplanted BM‐MSCs treating myocardial infarction via mainly illustrating bio‐logical function of microRNAs and its regulation effect on BM‐MSCs differentiation and paracrine secretion .

Background The identification of mesenchymal stem cells(MSCs) have provided exciting prospects for cell-based regeneration after myocardic infraction.However cell therapy have inherent limitations such as low survival rate of transplanted cells and insufficient cell number.It is known that cell-matrix adhesion plays a key role in cell proliferation,differentiation and survival,and chemokine CXCL12 may involved in these prcesses.Transfected mesenchymalstem cells with CXCL12 for local secretion of CXCL12 and then explored CXCL12 triggered adhesion of mesenchymal stem cells to extracellular matrix proteins.Mesenchymal stem cells was transfected with CXCL12.?V and ?3 integrins content was evaluated by Western blot analysis.Cell adhesion to extracellular matrix was examined in vitro and cell prolife-ration after transplantation in vivo.Transfection of CXCL12 resulted increased CXCL12 in situ.Increased CXCL12 induced elevated adhesion to fibronectin in vitro and higher survival in vivo.CXCL12 mediated adhesion and proliferation was established by ?V and ?3 integrin subunits.Chemoattractive mechanisms are involved in adhesion processes of mesenchymal stem cells.Increased CXCL12 leads to enhanced expression of ?V and ?3 integrins,which may augment cell survival,proliferation and differrentiation.

Objectives:To investigate the association and the prognostic significance of the expression of telomerase activity (TA) and apoptosis (APO) in tissues of primary breast cancer.Methods:TRAP-PCR and ELISA were developed to detect the expression of TA,and make quantitative and qualitative analysis respectively.TUNEL was also used to evaluate apoptosis cells in cancer lesions and count apoptosis index (AI).The expression levels of proteins of oncogene Bcl-2 and p53 were measured by means of S-P immunohistochemistry.Results:The mean TA positive expression rate was 89.8%,and its mean optic density was (A) 0.63±0.29,which were significantly higher than those of normal tissues and benign breast lesions (P<0.05).The 5 years survival rate of patients with positive TA expression was lower (60.3%) than those of negative expression (77.4%).There were no relations between TA expression and patients ages,TNM staging,lymph nodes metastasis,size,locations and pathological types of cancer.But TA was positively correlated with APO (r=0.733 1,P<0.05) and the protein expression of oncogene Bcl-2 (r=0.781 4,P<0.05) and negatively correlated with that of p53 (r=-0.625 5,P<0.05).Moreover,in patients receiving preoperative chemotherapy,the levels of TA expression were much lower than those without chemotherapy (64.7% vs 85.1%),and the former had higher AI than the latter (7.19±3.75% vs 3.23±2.04%),intraarterial chemotherapy group were superior significantly to adjuvant group (P<0.05).Multivariate Cox Regression Analysis showed that only TA and AI influenced the survival time of primary breast cancer patients,and patients with higher positive TA expression and AI>4.0% had shorter survival time than those of negative TA expression and AI<4.0% patients.Conclusions:There was a significant correlation between TA and APO and its related oncogene Bcl-2,p53.TA and APO are of great diagnostic values,therapeutic helps and prognostic significance in the formation and the development of primary breast cancer.