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Objective To evaluate the clinical effect of hypothermic machine perfusion (HMP) in the storage of renal grafts from deceased donor (DD) with high-risk delayed graft function (DGF). Methods Clinical data of 52 donors with high-risk DGF were collected in this prospective randomized controlled study. Two renal grafts from each donor were randomly divided into the HMP group (n=52) and static cold storage (SCS) group (n=52). In the HMP group, the renal grafts were stored by LifePort under HMP, whereas the renal grafts in the SCS group were preserved in University of Wisconsin solution (UW solution). The incidence of DGF and primary nonfunction (PNF) after renal transplantation was statistically compared between two groups. The recovery of renal graft function, the survival rates of the recipients and renal grafts within postoperative 1 year were observed in two groups. Results The incidence of DGF in the HMP group was 4%(2/52), significantly lower than 17% (9/52) in the SCS group (P < 0.05). No PNF was reported in the HMP group and 1 case of PND was noted in the SCS group, the difference was not statistically significant (P > 0.05). The recovery time of graft function of the recipients in the HMP and SCS groups were (7.2±0.6) d and (7.7±1.0) d with no statistical significance (P > 0.05). In the HMP group, the urine volume of the recipients on the day of operation, postoperative 1 and2 d was significantly larger than that in the SCS group (all P < 0.05). In the HMP group, the levels of serum creatinine at each time point after operation were significantly lower than those in the SCS group (all P < 0.05). The 1-year survival rates of the recipient and kidney were 98.1%, 92.3% and 100%, 96.2% in the HMP and SCS groups with no statistical significance (all P > 0.05). Conclusions HMP can significantly reduce the incidence of DGF after renal transplantation from DD with high-risk DGF and promote the early recovery of graft function.
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Objective To investigate the relationship between body mass index (BMI) and all-cause mortality in hypertensive population.Methods All participants were selected from a prospective cohort study based on a rural population from Henan province,China.Cox proportional hazards regression models were used to estimate the associations of different levels of BMI stratification with all-cause mortality.Restricted cubic spline models were used to detect the doseresponse relation.Results Among the 5 461 hypertensive patients,a total of 31 048.38 person-years follow-up was conducted.The median of follow-up time was 6 years,and 589 deaths occurred during the follow-up period.Compared to normal weight group (18.5 kg/m2＜BMI＜24.0 kg/m2) the multivariate-adjusted hazard ratios for all-cause mortality associated with BMI levels (＜ 18.5 kg/m2,24-28 kg/m2,and ≥28 kg/m2) were 0.83 (95％CI:0.37-1.87),0.81 (95％CI:0.67-0.97),and 0.72 (95％CI:0.56-0.91),respectively.The dose-response analysis showed a nonlinear,reverse "S" shaped relationship (non-linearity P＜0.001).Conclusion Overweight or obese might have a protective effect on all-cause mortality in hypertensive population,which supports the "obesity paradox" phenomenon.
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Objective To investigate the relationship between body mass index (BMI) and all-cause mortality in hypertensive population.Methods All participants were selected from a prospective cohort study based on a rural population from Henan province,China.Cox proportional hazards regression models were used to estimate the associations of different levels of BMI stratification with all-cause mortality.Restricted cubic spline models were used to detect the doseresponse relation.Results Among the 5 461 hypertensive patients,a total of 31 048.38 person-years follow-up was conducted.The median of follow-up time was 6 years,and 589 deaths occurred during the follow-up period.Compared to normal weight group (18.5 kg/m2＜BMI＜24.0 kg/m2) the multivariate-adjusted hazard ratios for all-cause mortality associated with BMI levels (＜ 18.5 kg/m2,24-28 kg/m2,and ≥28 kg/m2) were 0.83 (95％CI:0.37-1.87),0.81 (95％CI:0.67-0.97),and 0.72 (95％CI:0.56-0.91),respectively.The dose-response analysis showed a nonlinear,reverse "S" shaped relationship (non-linearity P＜0.001).Conclusion Overweight or obese might have a protective effect on all-cause mortality in hypertensive population,which supports the "obesity paradox" phenomenon.
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Purpose To evaluate features of the left ventricular twist in patients with atrial septal defect (ASD) using speckle tracking imaging (STI) in order to guide clinical application.Materials and Methods Fifty-eight patients with ASD confirmed by ardiac ultrasound in Shanghai Children's Medical Center from October 2015 to January 2016 were enrolled in this study as case group,which were further divided into group ASD-A with 30 cases and group ASD-B with 28 cases according to the volume of right ventricular.The volume of right ventricular was significantly increased in the group ASD-A,but the volume of right ventricular was not significantly increased in the group ASD-B.At the same time,30 normal children with matched age and sex were chosen as control group.The parameters of left ventricular twist motion in each group were measured and compared by using STI.Results In group ASD-A,The basal and apical part of 6 children rotated counterclockwise.Compared with those in the control group,the basal rotation angle and apical rotation angle of left ventricular in group ASD-A were significantly higher (P＜0.01),and the peak twist and torison of left ventricular in group ASD-A were also higher (P＜0.05).Compared with those in the control group,only the apical rotation angle in group ASD-B was higher (P＜0.05),but the rest parameters of the left ventricular twist motion in group ASD-B were not statistically significantly higher (P＞0.05).Conclusion The significant increase in the volume of right heart load in ASD impacts on the basal and apical rotation of left ventricular.
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Objective: To study changes of ultrastructure of atrial endothelial cells during acute atrial fibrillation (AF) in canines, and explore the possible mechanism of AF left atrial thrombosis. Methods: A total of 16 healthy adult mongrel canines were randomly and equally divided into blank control group (only received thoracotomy without pacing) and rapid atrial pacing (RAP) group (established acute AF model). Myocardial tissue of left and right appendage were taken from two groups and received hematoxylin eosin (HE) staining, then myocardial cell morphological changes was observed under ordinary light microscope; morphological changes of appendage endothelial cells was observed under electron microscope. Results: (1) Paroxysmal AF was successfully induced in all canines of RAP group; (2) There were no significant difference in morphology of appendage and endocardial tissue under ordinary light microscope between two groups; 3. Under transmission electron microscope, endothelium cell of appendage tissue presented defect of different extent, and some shedding in RAP group; while endothelial cell layer was complete with absence of necrosis and shedding in blank control group. Compared with blank control group, there was significant rise in endothelial cell incompleteness (12.5% vs. 75.0%) in RAP group, P=0.041. Conclusion: When acute atrial fibrillation occurs, endothelial cell ultrastructure has already changed, which may be related to thrombosis adhered to wall during atrial fibrillation.
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Objective: To explore the effects of monocrotaline (MCT) on right ventricular function and expression of cardiac canonical transient receptor potential channels (TRPC) subfamily in experimental rats. Methods: The SD male rats were randomly divided into 2 groups:Control group, the rats were normally fed and MCT group, the rats received a single dose injection of MCT 60 mg/kg to induce myocardial hypertrophy. n=10 in each group and all animals were treated for 3 weeks. The right ventricular hemodynamics parameters and right ventricular hypertrophy index (RVHI) were measured, right ventricular myocardium tissue section was observed by HE staining, the mRNA and protein expressions of TRPC subfamily were examined by RT-PCR and Western blot analysis. Results: Compared with Control group, MCT group had increased RVSP, RVHI, RV+dp/dtmax and decreased RV-dp/dtmax, all P Conclusion:Right ventricular hypertrophy could be induced by 3 weeks MCT treatment, it up-regulating the mRNA and protein expressions of TRPC6 which might be involved in the occurrence and development of cardiac hypertrophy in experimental rats.
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Objective To explore the effect of rational emotive therapy on self-esteem status of breast cancer patients.Methods 118 cases of breast cancer patients were randomly divided into the control group and the observation group with 59 cases in each group.The control group received routine care,and the observation group received rational emotive therapy on the basis of routine care.The self-esteem status of the two groups of patients was assessed before and after the intervention respectively with State Self-Esteem Scale (SSES).Results The score of behavior self-esteem,social self-esteem,appearance self-esteem and the total score of self-esteem of the patients in two groups before intervention showed no significant difference,but the above scores were higher in the observation group than those in the control group after intervention.Conclusions Rational emotive therapy can improve self-esteem status of breast cancer patients,thereby improve the mental health of the patients.
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Objective To explore the application of nursing risk management in the patients with breast cancer during postoperative chemotherapy. Methods Patients with breast cancer during postoperative chemotherapy in our hospital from January to December 2009 were surveyed retrospectively, and analyzed the factors that may cause drug extravasations. Then the appropriate care and risk management measures were implemented by the nursing staff from January to December 2010. Incidence of drug extravasations was compared before and after the implementation of the measures. Results Before the implementation of nursing risk management, the incidence of drug extravasations of the patients with breast cancer of postoperative chemotherapy was 5.77%, the incidence of skin necrosis was 0.64%; after the implementation of nursing risk management,leakage of chemotherapy drugs was 0.59%, no skin necrosis occurs. Conclusions Implementation of nursing risk management can significantly reduce the incidence of chemotherapy drugs leaking in patients with breast cancer during postoperative chemotherapy.
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Objective To evaluate the importance of factors affecting efficiency of image display quality of realtime three-dimensional echocardiography (RT-3DE) and establish an optimized method for RT-3DE examination and image processing in children. Methods Based on corresponding cardiac acoustic characteristics in children, 87 healthy children (46 boys, 41 girls, mean 36.2 ± 44.2 months) were selected. Three aspects of seven factors were selected, including acquisition windows, gain, compress, post process, smoothing, frequency fusion and 3D vision for RT-3DE examination and analysis using orthogonal test design method. The principal effectiveness analysis of orthngonal test design method and its table L_(18)3~7 were used. The efficiency rate of 3D image display quality was used as the inspection index for orthogonal test. Results According to the average deviation orders of the seven factors, the maximal average deviation was gain. The aspects with maximal average deviation of each factor were at via-subcostal and via-apical acoustic windows, 90 of gain, 60 of compress, E of post process, 5 of smoothing, F3 of frequency fusion and A to B of 3D vision, respectively. Conclusions The optimized method for RT-3DE examination and image processing could be achieved by setting acquisition windows, gain, compress, post process, etc. It is helpful to promote clinical application of RT-3DE and benefits the design of multi-parameter presetting of ultrasound system to optimize RT-3DE examination in children.
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Objective To evaluate the influence of psychological status on the quality of life of patients with breast cancer and supply evidence for improving quality of life for these patients. Methods Patients were divided into two groups according to median score of psychological status(11.43) by life quality inventory.The designed data of the quality of life in different domain were statistically analyzed. Restilts The quality of life of patients with good psychological status was higher than that with poor psychological status (P＜0.01). Conclusions Psychological status was the most pivotal factor that influences the quality of life of patients with breast cancer.Selective psychological nursing is expected to improve their quality of life.
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Objective To evaluate the accuracy and value of ventricular function in conotruncal defects(CTD)by three-dimensional echocardiography(3DE).Methods Fifty-two children with CTD and forty-three children with normal hearts were examined by 3DE.The measurements of left ventricular volume and wall mass were outlined and calculated.The measurements of left ventricular volume and wall mass of 3DE in preoperative CTD were compared with those of 2D biplane Simpson-method in preoperative CTD,3DE in control group and 2D biplane Simpson-method in control group.The results of 3DE and 2DE preoperative measurements were also compared with their postoperative clinical cardiac conditions.Results From the findings of analysis of variance and Student-Newman-Keuls(SNK)test,there was no significant difference between 3DE and 2DE measurements of left ventricular function in normal children,but there was significant difference between 3DE and 2DE measurements of left ventricular function in children with CTD.2DE measurements of left ventricular volume and wall mass in the CTD group were significant underestimated and less correlated with their postoperative clinical cardiac conditions(r=0.20,P=0.2086)than 3DE measurements(r=0.39,P=0.0090).Furthermore,left ventricular function in the CTD group was poorer than that in the control group.Stroke volume and effective function were reduced due to increasing end-systolic volume.while left ventricular wall mass was increased due to the possible compensation of its ventricular muscle.With the lower end-diastolic volume,stroke volume and effective function,patients were more likely to have the occurrence of postoperative low cardiac output.Conclusions By making a precise quantitative assessment,3DE is very useful in providing more information for preoperative diagnosis in CTD and predicting such postoperative prognoses as the occurrence of postoperative low cardiac output.
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Objective To study the effect of plant Coleus forskohlii active elements Isoforskolin(ISOF)and CT-E(analogs mixture of Isoforskolin)on human neutrophill(PMN)in vitro in order to uncover the mechanism of their properties of mitigating acute lung injury(ALI).Method The effects of ISOF and CF-E on PMN aggregation induced by N-formyl-methiony-leucyl-phenylalanine(fMLP)was performed by using a 4-channel platelet aggregometer.Cytometry Was applied to analyze the effect of tested samples on adhension between PMN and endothelial cells(ECV-304)activated by using lipopolysaccharides(LPS).Expression of LPS-induced PMN adhension molecules was determined with flow cytometry.Radioimmunoassay Was applied to detect the level of TNT-α liberated bv PMN and intracellular cyclic adenosine monophosphate(cAMP)level of PMN.Results It was found that ISOF(25,50,100 μmnol/L)and CF-E(1.25,2.5,5 mg/ml)inhibitted PMN aggregation induced by fMLP,PMN adhemion to ECV-304 indeed by LPS,expression of PMN adhesion molecules,and TNF-α level released by PMN.ISOF and CF-E also increased intracellular cAMP level of PMN.Condusions ISOF and CF-E inhibit PMN aggregation,adhension and adhension molecules,and TNF-α released by PMN,while they increase intracellular cAniP level of PMN.It suggests that their specific alleviating the ALI by the mechanism of the modulation of PMN function.
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Objective To construct the p300 specific siRNA vector in mice and observe its effect on cardiac transcription factor,GATA4,for further study of the effect of p300-mediated histone acetylation on heart growth. Methods Three recombinant plasmid vectors ( p300 RNAi1,p300 RNAi2,and p300 RNAi3s) ,designed and constructed according to the conservative sequence of mice p300,were respectively tansfected into in vitro cultured cardiac muscle cells of suckling mice. Expression of p300 and GATA4 at mRNA and protein levels was detected by RT-PCR and immunofluorescence,respectively. Results The expression level of p300 mRNA was not significantly decreased in pSOS-HUS and p300 RNAi2 groups,but significantly decreased in p300 RNAi1 and p300 RNAi3 groups ( 0. 220 8 ? 0. 020 0 and 0. 170 8 ? 0. 040 0 vs 0. 509 5 ? 0. 030 0,P
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It is now generally recognized that repairing of defect bones is one of the major issues in bone tissue engineering research.However,nowadays massive bone defect because of injury,infection or tumor removal has not been effectively solved in clinic.One of the key issues in bone tissue engineering is finding suitable biodegradable materials substitutes and scaffolds for seeding cells and guiding the subsequent growth of bone.The design and fabrication of bone tissue engineering scaffolds are overviewed as well as the development of the scaffold materials.
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0.05 ) between the left ventricular stroke volume with RT-3DE ( 24.58 ? 3.44 )ml,the right ventricular stroke volume with RT-3DE ( 23.58 ? 3.18 )ml and those values measured with Swan-Ganz pulmonary thermodilution method ( 25.64 ? 3.18 )ml.Furthermore,there was well correlation between the left ventricular stroke volume and the right ventricular stroke volume with RT-3DE (r= 0.93 ).They were also well correlated with those values with Swan-Ganz pulmonary thermodilution method (r= 0.85 ,r= 0.92 ).However,there was significant difference (P
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Objective To explore the feasibility of using unilateral continuous spinal anesthesia (CSA) in elderly patients undergoing hip replacement.Methods Forty-two ASA Ⅰ-Ⅲ patients (14 males, 28 females) aged 60-93yr were randomized to one of two groups: group 1 unilateral CSA (n = 21) and group 2 continuous epidural anesthesia (CEA,n = 21 ) . The patients in both groups were all premedicated with oral diazepam 5 mg and intramuscular scopolamine 0.3 mg. In group 1 unilateral CSA was performed at L2,3 or 3,4 interspace with the patients in the lateral position with the diseased leg upper most. The patients received a 27 gauge continuous spinal catheter, which was threaded through a 22 gauge spinal needle into subarachnoid space. Hypobaric 0-375% bupivacaine solution (0.75 % bupivacaine: sterile water = 1:1) 0.5-1.0ml was injected. If analgesia did not reach T10 after 5-10 min the same dose was repeated. In group 2 epidural catheter was placed also at L2.3or3,4. A test dose of 3 ml of 2% lidocaine was injected and then a mixture of 2% lidocaine and 0.5% bupivacaine (1:1) 8-10 ml was injected into the epidural space. The level of sensory block and degree of motor blockade were measured and recorded. The intraoperative and postoperative complications associated with spinal or epidural anesthesia were recorded. Results The demographic data, duration of operation and intraoperative blood loss were comparable between the two groups.In group 1 sensory block was confined to the diseased leg and no motor blockade of the healthy leg was observed. MAP was slightly decreased after initial dose of local anesthetics as compared to the baseline MAP in both groups. There was no significant change in SpO2 during operation in both groups. The incidences of hypotension, which needed treatment with intravenous ephedrine and shivering during operation and nausea and vomiting after operation were significantly lower in group 1 than in group 2. Conclusion Unilateral CSA produces satisfactory sensory block with stable hemodynamics and less complications and is anesthesia method of choice in elderly patients undergoing hip replacement.
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Four kinds of tea made in Feng-Qing, Yunnan province have been proved as a good preperation for anticoagulation, increasing the aclivity of fibrinolysis and inhibiting platelet aggregation. It need to study further whether the tea has an effect on the antiatherosclerosis.