Changes in structure of oral solid dosage forms (OSDF) elementally determine the drug release and its therapeutic effects. In this research, synchrotron radiation X-ray micro-computed tomography was utilized to visualize the 3D structure of enteric coated pellets recovered from the gastrointestinal tract of rats. The structures of pellets in solid state and in vitro compendium media were measured. Pellets in vivo underwent morphological and structural changes which differed significantly from those in vitro compendium media. Thus, optimizations of the dissolution media were performed to mimic the appropriate in vivo conditions by introducing pepsin and glass microspheres in media. The sphericity, pellet volume, pore volume and porosity of the in vivo esomeprazole magnesium pellets in stomach for 2 h were recorded 0.47, 1.55 × 10⁸ μm³, 0.44 × 10⁸ μm³ and 27.6%, respectively. After adding pepsin and glass microspheres, the above parameters in vitro reached to 0.44, 1.64 × 10⁸ μm³, 0.38 × 10⁸ μm³ and 23.0%, respectively. Omeprazole magnesium pellets behaved similarly. The structural features of pellets between in vitro media and in vivo condition were bridged successfully in terms of 3D structures to ensure better design, characterization and quality control of advanced OSDF.

Objective:To explore the effect of the implantation of absorbable stents on the prognosis of patients with inferior knee artery balloon dilatation.Methods:From March 2018 to January 2021, twenty-five patients with drug absorbable stent implantation after inferior knee artery balloon dilatation (stent group) and 25 patients without absorbable stent implantation after inferior knee artery balloon dilatation (control group) were included in Qingdao Haici Medical Group Affiliated to Qingdao University. The improvement of symptoms, ankle brachial index, Rutherford classification and claudication distance before and after operation were compared. The symptoms, ankle brachial index, Rutherford grade, claudication distance and patency rate of the two groups were compared 6 months after operation. The preoperative and postoperative data were analyzed by independent sample t-test, and the patency rate was analyzed by χ 2 test. Results:The ankle brachial index in the stent group and the control group on the first day after operation was significantly higher than that before operation (0.18±0.11 vs. 0.85±0.15, t=18.5, P<0.05, 0.22±0.15 vs. 0.87±0.10, t=20.8, P<0.05), and the Rutherford classification decreased significantly (4.66±0.21 vs. 2.1±0.11, t=9.2, P<0.05, 4.58±0.33 vs. 2.3±0.22, t=12.9, P<0.05), the limp distance increased significantly ((27±8) m vs. (300±43) m, t=20.8, P<0.05, (42±14) m vs. (320±18) m, t=32.6, P<0.05). There was no significant difference in preoperative ankle brachial index, postoperative ankle brachial index, Rutherford grade and claudication distance between the two groups ( P>0.05). Six months after operation, the ankle brachial index (0.72±0.03 and 0.54±0.12; t=10.2, P<0.05), Rutherford classification ((1.72±0.17) and (3.23±0.22); t=12.8, P<0.05) and claudication distance ((580.00±137.00) m and (267.00±54.00) m; t=8.2, P<0.05) in the stent group and the control group were significantly better than those in the control group. The patency rate of stent group at 6 months was 68% (17/25), which was better than that of ordinary balloon dilatation group by 56% (14/25). Conclusion:Implantation of drug absorbable stents can significantly improve the prognosis of patients undergoing arterial balloon dilatation.

To explore the effect of growth hormone releasing peptide (GHRP) on myocardial cell apoptosis in heart failure (HF) rats. Methods: Rat's HF model was established by the ligation of left anterior descending coronary artery induced ischemia. 40 male SD rats were randomly assigned into 4 groups: Normal control group, Sham operation group, HF group and GHRP treated HF group. n=10 in each group and the rats were fed for 4 weeks after the operation. Cardiac function was examined and myocardial cell morphology was observed; protein expressions of Smac/DIABL0 and Bcl-2 were measured by Western blot analysis; cell apoptosis was evaluated by FCM technique. The differences for above parameters were compared among groups to explore the effect of GHRP on myocardial cell apoptosis in HF rats. Results: Compared with HF group, GHRP treated HF group showed the less heart dilation, higher LVEF, lighter pathological changes in myocardial cells and decreased protein expression of Smac/DIABL0, all P<0.05. Bcl-2 level was lower in HF group than the other 3 groups, P<0.05. Compare with Normal control group, GHRP treated HF group had elevated Bcl-2 level, all P<0.05. Myocardial cell apoptosis index was different between HF group and GHRP treated HF group, P<0.05. Conclusion: The effect of GHRP on anti-HF should be via inhibiting myocardial cell apoptosis; the mechanism may partly be through promoting Bcl-2 protein expression and depressing Smac/DIABLO mediated mitochondrial pathway of apoptosis.

ObjectiveThis paper reported our experience with thoracoscopic management of isolated atrial fibrillation to define the efficacy and safety of this approach.MethodsThirtytwo patients ( 17 mem,15 women) with isolated atrial fibrillation underwent thoracoscopic surgery.All procedures were finished under 3 port incisions on left posterior chest.Among them 18 cases are paroxysmal and 8 persistent.ResultsThere was no operative death or major perioperative complications.One case was converted to limited thoracotomy because of bleeding.Operation time was 87 - 238 min.Paroxysmal atrial fibrillation occurred in 9 cases in hospital and all the cases were sinus rhythm after discharge.Followup 4 to 20 months,One persistent case was converted paroxysmal.ConclusionPatients with isolated atrial fibrillation can benefited by Videoassisted thoracoscopic left posterior approach with better exposure of left atrial and resection of the left atrial appendage,with decreased operative trauma and better results.

ObjectiveTo summarize the clinical results of totally thoracoscopic cardiac surgery for mitral valve diseases.MethodsFrom May 2004 to October 2011,272 patients underwent totally thoracoscopic cardiac surgery for mitral valve diseases through three ports.Summarize the indication and contraindication are used and for the operation date.Results There was 1 case in-hospital deaths.The time of operations was 2.1 ～ 3.9 (3.0 ± 1.2 ) h.Time of cardiopulmonary bypass and aortic cross-clamp was 76 ～ 158 (98 ± 22) minites and 38 ～ 78 (52 ± 13 ) minites.Time of mechanical ventilation and intensive care unit stay was 5.8 ～ 34.5 ( 11.2 ± 3.6 ) hours and 14 ～ 67 ( 28.2 ± 7.6 ) hours.The volume of drainage was 20 ～ 1200(370 ± 80) ml.The hospital days were 7 ～ 18 ( 10.2 ± 2.1 ) days.The postoperative complications occurred in 14 cases.ConclusionTotally thoracoscopic cardiac surgery for mitral valve diseases is technically feasible and safe with less drainage and shortened hospital stay.

Objective The risk for coronary artery bypass surgery is reported to be increased with age and associated with diabetes. We examined the outcomes of coronary artery bypass grafting (CABG) in patients with diabetes who were older than 70 years of age and evaluate the effect of diabetes on CABG in those patients. Methods From March 2000 to March 2008, the data of 649 patients older than 70 years of age were collected retrospectively and divided into diabetic group or non-diabetic group based on pre-operative diagnosis. The blood glucose level of patients was maintained between 7.0 mmol/L ( 126mg/dl) and 10.0 mmoL/L ( 180 mg/dl) porioporatively. Stats 7.0 was used for statistical analysis. The t test and χ~2 test were used to determine the differences in the numerical variables and categorical variables respectively. Results No statistical differences were observed between the two groups in the baseline variables, such as age [ ( 74.78±3.67 ) years for diabetic group vs. ( 75.00±3.65 ) years for non-diabetic group, P = 0. 4877 ], female patients ( 34.76% vs. 29.22%, P =0. 1663 ), ejection fraction [ ( 57.02±10. 10 ) % vs. ( 58.49±10. 39 ) %, P = 0. 1004 ) ], myocardial infarction history (26.20% vs. 28.35%, P =0. 5795), though there were more left main diseases in the diabetic group (52.41% vs.26.41%, diabetic vs. non-diabetic, P = 0. 0000 ). The overall in-hospital mortality was 6.32% (8.02% in the diabetic group vs. 5.63% in the non-diabetic group, P = 0. 2571 ). The main causes of death were sudden respiratory and cardiac arrest,low cardiac output syndrome ( LCOS), malignant arrhythmia, respiratory failure, renal failure, central nervous system compli-cations, and multiple organ failure. Major post-operative complications were bleeding, atrial fibrillation, plural effusion and pulmonary infection. Post-operative variables, such as EF (0.59±0. 13 in the diabetic group vs. 0. 61±0.15 in the non-dia-betie group, P =0. 1807), re-revascularization due to bleeding (2. 14% vs. 4.76%, P = 0. 1232), blood transfusion (89.84% vs. 84.63%, P = 0.0820) and the administration of vasoactive agent (21.93% vs. 27.71%, P= 0. 1286),were found no significant difference between the two groups. Conclusion Conclusions The early outcomes of CABG in aged patients are acceptable. The surgical consequences in diabetic patients may be similar to those in non-diabetic patients.

Objective To summarize surgical experience of eight patients with pentalogy of Cantrell. Methods Six male and two female patients with pentalogy of Cantrell,aged from 4 months to 26 years old, average 7.35 years old, underwent surgical therapy for intracardiac anomalies and extracardiac anomalies from July 2007 to June 2009. Eight case with intracardiac anomalies include one case with only VSD, one case with only ASD, two cases with DORV, four cases with VSD and ASD or PTO. Experts majoring in cardiovascular surgery cooperated with doctors majoring in thoracic surgery and general surgery for satisfactory correction of intracardiac anomalies and extracardiac anomalies and repositioning heart to thoracic cavity. Results Ectopic heart of the first patient was simply repositioned into thoracic cavity following surgery of double outlet of right ventricle in another hospital two years before. Correction of introcardiac anomaly and reposition of ectopic heart finished at one time in 7 cases. Eight patients got full recovery except that residual shunt occurred in the second case which also got full recovery after transcatheter therapy. Ventricular diverticulum was removed in the fourth case because of difficult reposition of ectopic heart.With the help of general surgeon and thoracic surgeon, partial coronary ligament of liver and falciform ligament of liver in the left was cut in the first case and the left half lobe of liver was pushed downward. Bilateral pleural and marginal costal costochondral was cut and make thoracic wall upward so that ectopic heart can reset into thoracic cavity. And then, defect of diaphragm and abdominal wall were repaired with Proceed patch. In the other seven cases, bilateral pericardium and mediastinal pleura was cut and the 7th and 8th cartilage was transected and bilateral costal arch was closed so for complete thoracic angioplasty.Left ventricular dysfunction occurred in the fifth case with DORV and also got full recovery after symptomatic treatment. Full recovery was got in all cases after followingup from 1 to 23 months. No adverse complications occurred and every case live a wonderful life. Conclusion Pentalogy of Cantrell can be cured at one time by accurate correction of cardiac anomalies, cutting of bilateral pleural and marginal costal costochondral to make thoracic wall upward and enlarge thoracic space for repositinning of ectopic heart and using artificial patch to repair defect of diaphragm when necessary.

Objective To explore the protective effects of erythropoietin (EPO) on cardiomyocytes against hypoxia/reoxygenation (HR) injury. Method Isolated and cultured rat eardiomyocytes were subjected to 2-hour hypoxia followed by 1 hour reoxygenation to establish model of HR injury. Cardiomyocytes were randomly divided into 4 groups: sham group, HR group, HR + EPO-treated group (EPO 10 U/ml), and HR + EPO + UO126-treated group (U0126 10?mol/L). The concentration of lactate dehydrogenase (LDH) in culture medium was detected by automatic biochemical analyzer; viability of eardiomyocytes was measured by MTT assay; apoptosis ratio was determined by TUNEL technology and Annexin-V-FITC with flow cytometer (FCM); level of extracellular signal- regulated kinase 1/2 (ERK_(1/2)) and phospho-ERK_(1/2) were measured by Western-blot analysis. Results EPO significantly decreased the leakage of LDH, enhanced activity, reduced apoptosis ratio, and increased level of phospho-ERK_(1/2).However, the effects were blocked by U0126, an inhibitor of MAPK. Conclusions EPO has the protective effects on cardiomyocytes against HR injury possibly via the mechanism of activation of ERK_(1/2) and inhibition of apoptosis.

Objective To investigate the feasibility of aortic and mitral valves replacement under video-assisted thoracoscope.Methods The subjects included 16 dogs(Experimental Group) and a clinical volunteer(Clinical Group).The procedure was performed under extracorporeal circulation with femoral artery and vein intubation.An incision 4~5 cm in length and two 1.5 cm ports were made in the right chest wall.The superior and inferior vena cava were cross-clamped by a self-made clamp and the myocardium was protected by cold cardioplegic coronary perfusion.Artificial mechanical aortic and mitral valves were intermittently sutured.Results In the Experimental Group: the time of extracorporeal circulation was 104~196 min(143.2?46.5 min) and the ascending aorta cross-clamped time was 58~128 min(82.4?26.1 min).Autopsy findings showed satisfactory valve suture fixation,without thread loosing or paravalvular rupture.In the Clinical Group: the time of extracorporeal circulation was 157 min,the ascending aorta cross-clamped time was 112 min,the time of mechanical ventilation was 10 h,and the drainage volume,150 ml.The patient was discharged from hospital on the 10 postoperative day.Follow-up observations for 9 months found no paravalvular leakage or other complications.Echocardiography showed normal prosthetic valve movement.Conclusions Video-assisted thoracoscopic aortic and mitral valves replacement is technically feasible.