Comparable prognosis in different neonatal histidine-tryptophan-ketoglutarate dosage management / 中华医学杂志(英文版)

BACKGROUND@#Histidine-tryptophan-ketoglutarate (HTK) is a solution commonly used for organ transplantation. However, there is no certified fixed regimen for on-pump heart surgery in neonates. We aimed to retrospectively evaluate the outcomes related to different HTK dosages and to analyze the safety of high-dosage perfusion.@*METHODS@#A total of 146 neonates who underwent on-pump heart surgery with single-shot HTK perfusion were divided into two groups according to HTK dosages: a standard-dose (SD) group (n = 63, 40 mL/kg 60 mL/kg). Propensity score matching (PSM) was performed to control confounding bias.@*RESULTS@#The SD group had a higher weight (3.7 ± 0.4 vs. 3.4 ± 0.4 kg, P  0.05). The incidences of post-operative complications were not significantly different between the two groups. There were no significant differences in ventilation time, intensive care unit stay, and post-operative hospital stay (P > 0.05). Follow-up echocardiography outcomes at 1 month, 3 to 6 months, and 1 year showed that left ventricular ejection fraction and end-diastolic dimension were comparable between the two groups.@*CONCLUSIONS@#In neonatal on-pump cardiac surgery patients, single-shot HD (>60 mL/kg) HTK perfusion had a comparable heart protection effect and short-term post-operative prognosis as standard dosage perfusion of 40 to 60 mL/kg. Thus, this study provides supporting evidence of the safety of HD HTK perfusion.

Association of Overlapped and Un-overlapped Comorbidities with COVID-19 Severity and Treatment Outcomes: A Retrospective Cohort Study from Nine Provinces in China / 生物医学与环境科学（英文）

Objective@#Several COVID-19 patients have overlapping comorbidities. The independent role of each component contributing to the risk of COVID-19 is unknown, and how some non-cardiometabolic comorbidities affect the risk of COVID-19 remains unclear.@*Methods@#A retrospective follow-up design was adopted. A total of 1,160 laboratory-confirmed patients were enrolled from nine provinces in China. Data on comorbidities were obtained from the patients' medical records. Multivariable logistic regression models were used to estimate the odds ratio ( @*Results@#Overall, 158 (13.6%) patients were diagnosed with severe illness and 32 (2.7%) had unfavorable outcomes. Hypertension (2.87, 1.30-6.32), type 2 diabetes (T2DM) (3.57, 2.32-5.49), cardiovascular disease (CVD) (3.78, 1.81-7.89), fatty liver disease (7.53, 1.96-28.96), hyperlipidemia (2.15, 1.26-3.67), other lung diseases (6.00, 3.01-11.96), and electrolyte imbalance (10.40, 3.00-26.10) were independently linked to increased odds of being severely ill. T2DM (6.07, 2.89-12.75), CVD (8.47, 6.03-11.89), and electrolyte imbalance (19.44, 11.47-32.96) were also strong predictors of unfavorable outcomes. Women with comorbidities were more likely to have severe disease on admission (5.46, 3.25-9.19), while men with comorbidities were more likely to have unfavorable treatment outcomes (6.58, 1.46-29.64) within two weeks.@*Conclusion@#Besides hypertension, diabetes, and CVD, fatty liver disease, hyperlipidemia, other lung diseases, and electrolyte imbalance were independent risk factors for COVID-19 severity and poor treatment outcome. Women with comorbidities were more likely to have severe disease, while men with comorbidities were more likely to have unfavorable treatment outcomes.

Comparison of Volatile Oil of Domestic and Foreign Panacix Quinquefolii Radix by HS-SPME/GC-MS / 中国实验方剂学杂志

Objective: To determine the volatile chemical constituents of Panacix Quinquefolii Radix of different origins and different growth years,in order to provide the theoretical basis for the further development and utilization of Panacix Quinquefolii Radix. Method: Headspace solid phase microextraction (HS-SPME) combined with gas chromatography-mass spectrometry (GC-MS) was used to extract,analyze and identify the volatile constituents of Panacix Quinquefolii Radix. The chromatographic peak area normalization method was used to determine the relative amount of ingredients. Result: A total of 151 compounds were identified in Panacix Quinquefolii Radix samples,including 99 hydrocarbons,21 alcohol phenols,7 aldehydes,8 ketones,1 ester,15 heterocyclics and other compounds. Totally 68 kinds of compounds were identified in the roots of three-year-old Jilin Baishan,and the mass fraction accounted for 98.27%,67 compounds were identified in the roots of four-year-old Jilin Baishan,and the mass fraction accounted for 98.79%,65 compounds were identified in 3-year-old Panacix Quinquefolii Radix root,and the mass fraction accounted for 95.81%,and 63 compounds were identified in 4-year-old Panacix Quinquefolii Radix root,and the mass fraction accounted for 99.67%. The specific components of the volatile oil components of the four Panacix Quinquefolii Radix samples were 24,23,19,and 23,respectively,and the total composition was 16 species. Conclusion: The content and composition of volatile chemical constituents of Panacix Quinquefolii Radix of different origins are very different. This experiment provides a reference for the future quality evaluation of Panacix Quinquefolii Radix medicinal materials,rational development and utilization of resources.

Absorbed components analysis of Zhitong Huazheng Capsules in rat serum by UPLC-Q-TOF/MS / 中国中药杂志

To identify and analyze the constituents in rat serum after oral administration of Zhitong Huazheng capsule (ZTHZC), and provide a reference for its further research on pharmacodynamics material basis. Female Wistar rats were selected as experimental animals, and received intragastric administration of ZTHZC at a dose of 1.5 g·kg⁻¹. After the serum samples were collected, the absorbed prototype components in rat serum were identified and analyzed by using ultra-high performance liquid chromatography-quadrupole-time-of-flight/mass spectrometry (UPLC-Q-TOF/MS) combined with multivariate statistical analysis．The results showed, a total of fifteen absorbed constituents were identified, all of which were prototype components, including Danshensu, salvianolic acid A, B, C, D, 9,12-dihydroxy-15-nonadecanoicacid, linoleic acid, ethyl palmitoleate, tetrahydropalmatine, fumarate A, astragaloside A, astragaloside II, saponin, locustin and luteolin. This experiment showed that these fifteen components absorbed into blood may be the potential bioactive components in ZTHZC, providing a scientific basis for clarifying its material basis in pharmacodynamics.

Application of Endoscopic Vein Harvesting in Obese Patients Undergoing Coronary Artery Bypass Grafting / 华中科技大学学报（医学）（英德文版）

This study aims to evaluate the clinical outcomes of endoscopic vein harvesting (EVH) for coronary artery bypass grafting (CABG) in obese patients.Totally,153 obese patients who underwent EVH (n=81) or standard bridging technique (SBT,n=72) in CABG surgery from May 2012 to October 2014 in our hospital were enrolled in this retrospective non-randomized controlled study.The general situation of operation,postoperative complications and short medium-term outcomes were analyzed.The baseline characteristics were similar between these two groups (P＞0.05).There were no statistical differences in total operation time (226±28 min vs.224±30 min,P＞0.05),number of damaged vessels (0.12±0.05 vs.0.16±0.06,P＞0.05) and short medium-term outcomes including revascularization rate (1.25％ vs.2.78％,P＞0.05),vessel dysfunction rate (11.25％ vs.11.11％,P＞0.05) and mortality (0.00％ vs.0.00％,P＞0.05).Use of EVH was associated with significant reduction of total harvesting time (41±6 min vs.63±11min,P＜0.05),incision length (4.4±1.1 cm vs.18.2±4.5 cm,P＜0.05) and postoperative lower extremity complications (P＜0.05).EVH can reduce the risk of wound complications,whereas does not influence short-and medium-term outcomes in obese patients.It can be considered a reliable procedure of harvesting vessel conduits for obese patients undergoing CABG.

Application of Endoscopic Vein Harvesting in Obese Patients Undergoing Coronary Artery Bypass Grafting / 华中科技大学学报（医学）（英德文版）

This study aims to evaluate the clinical outcomes of endoscopic vein harvesting (EVH) for coronary artery bypass grafting (CABG) in obese patients.Totally,153 obese patients who underwent EVH (n=81) or standard bridging technique (SBT,n=72) in CABG surgery from May 2012 to October 2014 in our hospital were enrolled in this retrospective non-randomized controlled study.The general situation of operation,postoperative complications and short medium-term outcomes were analyzed.The baseline characteristics were similar between these two groups (P＞0.05).There were no statistical differences in total operation time (226±28 min vs.224±30 min,P＞0.05),number of damaged vessels (0.12±0.05 vs.0.16±0.06,P＞0.05) and short medium-term outcomes including revascularization rate (1.25％ vs.2.78％,P＞0.05),vessel dysfunction rate (11.25％ vs.11.11％,P＞0.05) and mortality (0.00％ vs.0.00％,P＞0.05).Use of EVH was associated with significant reduction of total harvesting time (41±6 min vs.63±11min,P＜0.05),incision length (4.4±1.1 cm vs.18.2±4.5 cm,P＜0.05) and postoperative lower extremity complications (P＜0.05).EVH can reduce the risk of wound complications,whereas does not influence short-and medium-term outcomes in obese patients.It can be considered a reliable procedure of harvesting vessel conduits for obese patients undergoing CABG.

Cerebral Metabolic Profiling of Hypothermic Circulatory Arrest with and Without Antegrade Selective Cerebral Perfusion: Evidence from Nontargeted Tissue Metabolomics in a Rabbit Model / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Antegrade selective cerebral perfusion (ASCP) is regarded to perform cerebral protection during the thoracic aorta surgery as an adjunctive technique to deep hypothermic circulatory arrest (DHCA). However, brain metabolism profile after ASCP has not been systematically investigated by metabolomics technology.</p><p><b>METHODS</b>To clarify the metabolomics profiling of ASCP, 12 New Zealand white rabbits were randomly assigned into 60 min DHCA with (DHCA+ASCP [DA] group, n = 6) and without ( DHCA [D] group, n = 6) ASCP according to the random number table. ASCP was conducted by cannulation on the right subclavian artery and cross-clamping of the innominate artery. Rabbits were sacrificed 60 min after weaning off cardiopulmonary bypass. The metabolic features of the cerebral cortex were analyzed by a nontargeted metabolic profiling strategy based on gas chromatography-mass spectrometry. Variable importance projection values exceeding 1.0 were selected as potentially changed metabolites, and then Student's t-test was applied to test for statistical significance between the two groups.</p><p><b>RESULTS</b>Metabolic profiling of brain was distinctive significantly between the two groups (Q 2 Y = 0.88 for partial least squares-DA model). In comparing to group D, 62 definable metabolites were varied significantly after ASCP, which were mainly related to amino acid metabolism, carbohydrate metabolism, and lipid metabolism. Kyoto Encyclopedia of Genes and Genomes analysis revealed that metabolic pathways after DHCA with ASCP were mainly involved in the activated glycolytic pathway, subdued anaerobic metabolism, and oxidative stress. In addition, L-kynurenine (P = 0.0019), 5-methoxyindole-3-acetic acid (P = 0.0499), and 5-hydroxyindole-3-acetic acid (P = 0.0495) in tryptophan metabolism pathways were decreased, and citrulline (P = 0.0158) in urea cycle was increased in group DA comparing to group D.</p><p><b>CONCLUSIONS</b>The present study applied metabolomics analysis to identify the cerebral metabolic profiling in rabbits with ASCP, and the results may shed new lights that cerebral metabolism is better preserved by ASCP compared with DHCA alone.</p>

Pediatric Heart Transplantation: Report from a Single Center in China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Although heart transplantation (HTx) has become a standard therapy for end-stage heart diseases, experience with pediatric HTx is limited in China. In this article, we will try to provide the experience with indications, complications, perioperative management, immunosuppressive therapy, and survival for pediatric HTx based on our clinical work.</p><p><b>METHODS</b>This is a retrospective chart review of the pediatric patients undergoing HTx at Department of Cardiovascular Surgery of Union Hospital from September 2008 to December 2014. We summarized the indications, surgical variables, postoperative complications, and survival for these patients.</p><p><b>RESULTS</b>Nineteen pediatric patients presented for HTx at Union Hospital of Tongji Medical College, of whom 10 were male. The age at the time of transplantation ranged from 3 months to 18 years (median 15 years). Patient weight ranged from 5.2 kg to 57.0 kg (median 38.0 kg). Pretransplant diagnosis included cardiomyopathy (14 cases), complex congenital heart disease (3 cases), and tumor (2 cases). All recipients received ABO-compatible donor hearts. Postoperative complications occurred in 12 patients, including cardiac dysfunction, arrhythmia, pulmonary infection, renal dysfunction, and rejection. Two of them experienced cardiac failure and required extracorporeal membrane oxygenation. The immunosuppression regimen was comprised of prednisone, a calcineurin inhibitor, and mycophenolate. All patients recovered with New York Heart Association (NYHA) Class I-II cardiac function and were discharged. Only one patient suffered sudden death 19 months after transplantation.</p><p><b>CONCLUSION</b>Orthotopic HTx is a promising therapeutic option with satisfying survival for the pediatric population in China with end-stage heart disease.</p>

Inhibitory effects of suppressor of cytokine signaling 3 on inflammatory cytokine expression and migration and proliferation of IL-6/IFN-γ-induced vascular smooth muscle cells / 华中科技大学学报（医学）（英德文版）

The main pathogenesis of saphenous vein graft neointimal hyperplasia after coronary artery bypass grafting (CABG) is inflammation-caused migration and proliferation of vascular smooth muscle cells (VSMCs). Janus kinase 2/signal transducer and activators of transcription 3 (JAK2/STAT3) pathway is an important signaling pathway through which VSMCs phenotype conversion occurs. Suppressor of cytokine signaling 3 (SOCS3) is the classic negative feedback inhibitor of JAK2/STAT3 pathway. Growing studies show that SOCS3 plays an important anti-inflammatory role in numerous autoimmune diseases, inflammatory diseases and inflammation-related tumors. However, the effect and mechanism of SOCS3 on vein graft disease is unclear. The purpose of this study was to investigate the effects of SOCS3 on the inflammation, migration and proliferation of VSMCs in vitro and the mechanism. The small interference RNA plasmid targeting rat SOCS3 (SiRNA-rSOCS3) and the recombinant adenovirus vector carrying rat SOCS3 gene (pYrAd-rSOCS3) were constructed, and the empty plamid (SiRNA-control) and vector (pYrAd-GFP) only carrying GFP reported gene were constructed as control. The rat VSMCs were cultured. There were two large groups of A (SOCS3 up-regulated): control group, IL-6/IFN-γ group, IL-6/IFN-γ+pYrAd-rSOCS3 group, IL-6/IFN-γ(+)pYrAd-GFP group; and B (SOCS3 down-regulated): control group, IL-6/IFN-γ group, IL-6/IFN-γ+SiRNA-rSOCS3 group and IL-6/ IFN -γ+SiRNA-control group. The pYrAd-rSOCS3 and SiRNA-rSOCS3 were transfected into VSMCs induced by IL-6/IFN-γ. After 24 h, real-time reverse transcription polymerase chain reaction (RT-PCR) and Western blotting were used to detect the mRNA and protein expression of SOCS3, STAT3 (only by Western blotting), P-STAT3 (only by Western blotting), IL-1β, IL-6, TNF-α, MCP-1 and ICAM-1. The MTT, Transwell assay and flow cytometry were used to examine VSMCs proliferation, migration and cell cycle progression, respectively. As compared with control group, the mRNA and protein expression of SOCS3, STAT3, P-STAT3, IL-1β, IL-6, TNF-α, MCP-1 and ICAM-1 was significantly up-regulated in VSMCs stimulated by IL-6/IFN-γ. However, in VSMCs transfected with pYrAd-rSOCS3 before stimulation with IL-6/IFN-γ, the expression of SOCS3 mRNA and protein was further up-regulated, and that of STAT3, P-STAT3, IL-1β, IL-6, TNF-α, MCP-1 and ICAM-1 was significantly down-regulated as compared with IL-6/IFN-γ group and IL-6/IFN-γ+pYrAd-GFP group. The expression of those related-cytokines in IL-6/IFN-γ+SiRNA-rSOCS3 group was markedly increased as compared with IL-6/IFN-γ group and IL-6/IFN-γ+SiRNA-control group. The absorbance (A) values, the number of cells migrating to the lower chamber, and percentage of cells in the G2/M+S phase were increased in VSMCs stimulated by IL-6/IFN-γ. In VSMCs incubated with pYrAd-rSOCS3 or SiRNA-rSOCS3 before IL-6/IFN-γ stimulation, the A values, the number of cells migrating to the lower chamber, and the percentage of cells in the G2/M+S phase were significantly decreased, and increased respectively. These results imply that IL-6/IFN-γ, strong inflammatory stimulators, can promote transformation of VSMCs phenotype form a quiescent contractile state to a synthetic state by activating JAK2/STAT3 pathway. Over-expresssed SOCS3 might inhibit pro-inflammatory effect, migration and growth of VSMCs by blocking STAT3 activation and phosphorylation. These data in vitro confirm that SOCS3 may play a negatively regulatory role in development and progression of vein graft failure. These conclusions can provide a novel strategy for clinical treatment of vein graft diseases and a new theoretic clue for related drug development.

Inhibitory effects of suppressor of cytokine signaling 3 on inflammatory cytokine expression and migration and proliferation of IL-6/IFN-γ-induced vascular smooth muscle cells / 华中科技大学学报（医学）（英德文版）

The main pathogenesis of saphenous vein graft neointimal hyperplasia after coronary artery bypass grafting (CABG) is inflammation-caused migration and proliferation of vascular smooth muscle cells (VSMCs). Janus kinase 2/signal transducer and activators of transcription 3 (JAK2/STAT3) pathway is an important signaling pathway through which VSMCs phenotype conversion occurs. Suppressor of cytokine signaling 3 (SOCS3) is the classic negative feedback inhibitor of JAK2/STAT3 pathway. Growing studies show that SOCS3 plays an important anti-inflammatory role in numerous autoimmune diseases, inflammatory diseases and inflammation-related tumors. However, the effect and mechanism of SOCS3 on vein graft disease is unclear. The purpose of this study was to investigate the effects of SOCS3 on the inflammation, migration and proliferation of VSMCs in vitro and the mechanism. The small interference RNA plasmid targeting rat SOCS3 (SiRNA-rSOCS3) and the recombinant adenovirus vector carrying rat SOCS3 gene (pYrAd-rSOCS3) were constructed, and the empty plamid (SiRNA-control) and vector (pYrAd-GFP) only carrying GFP reported gene were constructed as control. The rat VSMCs were cultured. There were two large groups of A (SOCS3 up-regulated): control group, IL-6/IFN-γ group, IL-6/IFN-γ+pYrAd-rSOCS3 group, IL-6/IFN-γ(+)pYrAd-GFP group; and B (SOCS3 down-regulated): control group, IL-6/IFN-γ group, IL-6/IFN-γ+SiRNA-rSOCS3 group and IL-6/ IFN -γ+SiRNA-control group. The pYrAd-rSOCS3 and SiRNA-rSOCS3 were transfected into VSMCs induced by IL-6/IFN-γ. After 24 h, real-time reverse transcription polymerase chain reaction (RT-PCR) and Western blotting were used to detect the mRNA and protein expression of SOCS3, STAT3 (only by Western blotting), P-STAT3 (only by Western blotting), IL-1β, IL-6, TNF-α, MCP-1 and ICAM-1. The MTT, Transwell assay and flow cytometry were used to examine VSMCs proliferation, migration and cell cycle progression, respectively. As compared with control group, the mRNA and protein expression of SOCS3, STAT3, P-STAT3, IL-1β, IL-6, TNF-α, MCP-1 and ICAM-1 was significantly up-regulated in VSMCs stimulated by IL-6/IFN-γ. However, in VSMCs transfected with pYrAd-rSOCS3 before stimulation with IL-6/IFN-γ, the expression of SOCS3 mRNA and protein was further up-regulated, and that of STAT3, P-STAT3, IL-1β, IL-6, TNF-α, MCP-1 and ICAM-1 was significantly down-regulated as compared with IL-6/IFN-γ group and IL-6/IFN-γ+pYrAd-GFP group. The expression of those related-cytokines in IL-6/IFN-γ+SiRNA-rSOCS3 group was markedly increased as compared with IL-6/IFN-γ group and IL-6/IFN-γ+SiRNA-control group. The absorbance (A) values, the number of cells migrating to the lower chamber, and percentage of cells in the G2/M+S phase were increased in VSMCs stimulated by IL-6/IFN-γ. In VSMCs incubated with pYrAd-rSOCS3 or SiRNA-rSOCS3 before IL-6/IFN-γ stimulation, the A values, the number of cells migrating to the lower chamber, and the percentage of cells in the G2/M+S phase were significantly decreased, and increased respectively. These results imply that IL-6/IFN-γ, strong inflammatory stimulators, can promote transformation of VSMCs phenotype form a quiescent contractile state to a synthetic state by activating JAK2/STAT3 pathway. Over-expresssed SOCS3 might inhibit pro-inflammatory effect, migration and growth of VSMCs by blocking STAT3 activation and phosphorylation. These data in vitro confirm that SOCS3 may play a negatively regulatory role in development and progression of vein graft failure. These conclusions can provide a novel strategy for clinical treatment of vein graft diseases and a new theoretic clue for related drug development.

Effect of danshensu on expression of STAT1, PPARγ and hepatocyte growth factor in the liver of mice with streptozotocin-induced diabetes / 第二军医大学学报

Objective To study the effect of Danshensu on the expressions of signal transducer and activator of transcription 1 (STAT1), pero xiome proliferators-activated receptor-γ (PPAR-γ) and hepatocyte growth factor (HGF) in streptozotocin-induced diabetic mice, and to assess its protective effect on the liver of mice. Methods Diabetic mice were induced by intraperitoneal injection of 500 mg streptozotocin (200 mg/kg). Then the diabetic mice were randomly divided into four groups: diabetic model group, low-dose Danshensu (15 mg/kg) group, middle-dose Danshensu (30 mg/kg) group and high-dose Danshensu (60 mg/kg) group, with 10 mice in each group. Danshensu (sodium salt of Danshensu) was administered intragastrically once a day for 12 weeks. Ten normal mice were taken as controls. The fasting blood glucose, insulin and glycosylated hemoglobin (GHb) levels were examined at 12 h after the last administration of the drug. The aspartate transaminade(AST) and alanine transaminade (ALT) levels in sera drawn from inner canthus were determined by automatic biochemical analyser. Western blotting analysis was used to examine the expression of STAT1, PPARγ and HGF in the liver tissues. Results (1) Compared with control group, the diabetic model group and Danshensu groups had significantly higher blood glucose and GHb levels (P<0. 01) and significantly lower insulin level (P<0. 01). There were no significant differences between the three Danshensu groups concerning the three parameters. (2) The levels of AST and ALT in diabetic model group were significantly higher than those in the control group (P<0.05); their levels in the three Danshensu groups were significantly lower than those of the diabetic model group (P<0.05); there were no significant differences among the three Danshensu groups. (3) The expression of STAT1 in diabetic model group was significantly higher and the expression of PPARy and HGF was significantly lower than those in control group (P<0.01). Compared with the diabetic model group, PPARγ and HGF expression in the liver tissues was significantly increased and STAT1 expression was significantly decreased in a dose-dependent manner with Danshensu (P < 0.01). Conclusion The protective effect of Danshensu on liver tissues in streptozotocin-induced diabetic mice might be associated with increase of PPARy and HGF expression and decrease of STAT1 expression.

Effect of mannitol combined with bone marrow mesenchymal stem cells on cognitive function and the expression of brain-derived neurotrophic factor of vascular dementia rats / 中国脑血管病杂志

Objective: To investigate the effect of mannitol combined with the vein graft supported with bone marrow mesenchymal stem cell (BMSC) on the cognitive function and the expression of brain-derived neurotrophic factor (BDNF) in brain tissue of vascular dementia (VD) rats. Methods: The BMSCs of rat were isolated and purified by whole bone marrow culture and adherence screening methods. Seventy nine healthy male SD rats were randomly assigned to sham operation group (n = 10) and model (n = 69) groups. A VD model was established by the ligation of the bilateral common carotid arteries at an interval of 3 days. Four weeks after modeling, the 32 rats in the model group were randomly allocated into mannitol pretreatment BMSC transplantation group (tail intravenous injection of mannitol 1.5 g/kg, tail intravenous injection of 1 × 106 mL BMSCs 1 mL after pretreatment for 1 to 30 minutes), BMSC transplantation group (injecting the same amount of BMSCs but not mannitol), and medium control group (injecting the same amount of basal medium). After removing the dead rats, there were 9, 11, and 8 rats, respectively in the above 3 groups. Seven rats were included in the sham operation group. Morris water maze test was used to detect cognitive function of the rats, and an enzyme-linked immunosorbent assay was used to detect the BDNF content in brain tissue 4 weeks after intervention. Results: Circled Digit oneComparing the 4 groups at the same time points, the escape latency in the BMSC transplantation group was shorter than that in the medium control group (all P 0.05). Circled Digit twoThe BDNF content in the BMSC transplantation group was significantly higher than that in the medium control group in the frontal cortical and hippocampal regions (P < 0.01). The mannitol pretreatment BMSC transplantation group was more significantly higher than the BMSC group (P < 0.01), however, they were lower than the level in the sham operation group (P < 0.01). Conclusion: Compared with intravenous injection of BMSCs alone, the improvement of cognitive function of the VD rat model treated with mannitol combined with BMSC transplantation is much better; the BDNF expression in cortex and hippocampus is higher.

SLAM family predicting the initiation potential of human acute lymphoblastic leukemia in NOD/SCID mice / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The SLAM family recently has been reported to show an important biological role in lymphocyte development and immunological function, and it is efficient to highly purify hematopoietic stem cells using a simple combination of SLAM family members. To elucidate the presence of this family on acute lymphoblastic leukemia (ALL), as well as its relationship with the leukemia-initiating potential, we analyzed the expression pattern of this family members on human ALL progenitor cells, combined with serial xenotransplantation assay.</p><p><b>METHODS</b>Expression analysis was carried out by flow cytometry. We combined the expression pattern of human CD(150), CD(244) and CD(48) with serial xenotransplantation of B-ALL progenitor cells to indicate their relationship.</p><p><b>RESULTS</b>CD(48) and CD(244) were expressed on most B-ALL progenitor cells, the percentage being (93.08 ± 6.46)% and (63.37 ± 29.31)%, respectively. Interestingly, the proportion of CD(150)(+) cells declined obviously in engrafted cases ((24.94 ± 7.32)%) compared with non-engrafted cases ((77.54 ± 5.93)%, P < 0.01), which indicated that only blast cells with low percentage of CD(150)(+) population were able to reconstitute leukemia into primary, secondary and tertiary NOD/SCID mice.</p><p><b>CONCLUSIONS</b>SLAM family members are present on B-ALL progenitor cells and the leukemia-initiating potential of leukemic blasts is correlated negatively with the proportion of CD(150)(+) cells, the percentage of which can serve as a useful predictor for engraftment success of B-ALL to immune deficient mice.</p>

The analysis of the recent effectiveness of the total anomalous pulmonary venous connection repairs on infants / 中华外科杂志

<p><b>OBJECTIVE</b>To review the efficacy of total anomalous pulmonary venous connection (TAPVC) repair and to conclude the factors impacting the peri-operative death rate.</p><p><b>METHODS</b>The clinical data of 145 infants under 1 year old who underwent the TAPVC repair from January 2001 to July 2008 was analyzed. There were 94 male and 51 female patients. The mean age when the repair was performed was (7 ± 3) months, and the average weight was (6.3 ± 1.6) kg. As to the pulmonary connection type, 77 patients were supracardiac (53.1%), 47 patients were cardiac (32.4%), 9 patients were intracardiac (6.2%), and the remaining 12 patients were mixed (8.3%). Pre-surgery echocardiography showed that 21 patients had pulmonary venous obstruction (12 patients were supracardiac type, 3 patients were cardiac type, 3 patients were intracardiac type, and 3 patients were mixed type).</p><p><b>RESULTS</b>All patients underwent two-ventricle anatomy correction (the cases of complex malformations had been excluded). Peri-operative mortality was 11.7% (17/145). Because of the significant improvement in the surgical techniques, anesthesiology, cardiopulmonary bypass and the management of ICU in January 2006, the population was divided into two groups: A (before January 2006) and B (after January 2006). Peri-operative mortality decreased from 19.0% in group A to 6.2% in group B(P = 0.020). After analysis, it was determined that the factors impacting mortality were which group the patient belongs to, whether he/she had preoperative pulmonary vein obstruction and how big the atril septel connection was. The operative technique to keep the anastomotic aperture adequate and prophylaxis pulmonary hypertensive episodes contributed to the improvement on the mortality rate. There had been no case of repeating the surgery because of pulmonary venous obstruction during peri-operative care period.</p><p><b>CONCLUSIONS</b>Improvements of the surgical technique as well as the treatment in preoperative and postoperative have led to the reduction of the mortality. Preoperative pulmonary vein obstruction is still an important factor that contributes to early mortality.</p>

Pulmonary artery perfusion with HTK solution prevents lung injury in infants after cardiopulmonary bypass / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Pulmonary artery perfusion during cardiopulmonary bypass (CPB) is a novel adjunctive method, which can minimize the lung ischemic-reperfusion injury and inflammatory response. This study evaluated the protective effect of pulmonary perfusion with hypothermic HTK solution in corrections of congenital heart defects with pulmonary hypertension.</p><p><b>METHODS</b>Between June 2009 and December 2009, 24 consecutive infants with congenital heart defects and pulmonary hypertension were randomly divided into perfused group (n = 12) and control group (n = 12). Oxygen index, alveolar-arterial O2 gradient, serum levels of malondialchehyche (MDA), interleukin (IL)-6, -8, -10, soluble intercellular adhesion molecule-1 (sICAM-1), and P-selectin were measured before commencement and serially for 48 hours after termination of bypass.</p><p><b>RESULTS</b>Oxygenation values were better preserved in the perfused group than in the control group. The serum levels of IL-6 increased immediately after CPB in both groups and returned to baseline at 48 hours after CPB,but it was restored faster and earlier in the perfused group. The serum levels of IL-8, sICAM-1, and MDA remained at baseline at each point after CPB in the perfused group and elevated significantly immediately after CPB in the control group, except for sICAM-1. The serum level of IL-10 increased immediately after CPB and decreased to baseline at 48 hours after CPB in both groups, but the IL-10 level in the perfused group was significantly higher than in the control group at 12 hours after CPB. The serum P-selectin levels in the control group immediately after CPB were significantly higher than prebypass levels. Moreover, there were no significant differences in postoperative clinical characters, except for the intubated time.</p><p><b>CONCLUSION</b>In infants with congenital heart defects, pulmonary perfusion with hypothermic HTK solution during cardiopulmonary bypass could ameliorate lung function and reduce the inflammatory response.</p>

Retrospective analysis of 100 patients managed by extracorporeal membrane oxygenation / 中华外科杂志

<p><b>OBJECTIVE</b>To describe the experience with extracorporeal membrane oxygenation (ECMO) for cardiorespiratory support of 100 patients.</p><p><b>METHODS</b>Retrospective analysis of the medical files of 100 patients submitted to the implant of extracorporeal membrane oxygenation system for cardiorespiratory assistance of acute and refractory cardiogenic shock from December 2004 to September 2008. There were 67 males and 33 females, age ranged from 5 d to 76 years with a mean of (28+/-26) years, body mass ranged from 3.8 to 100.0 kg with a mean of (42+/-30) kg. The inter-surface of the ECMO equipment system was completely coated by heparin-coating technique. All patients were applied veno-artery ECMO and activated clotting time was maintained between 120 and 180 s and heparin usage dose was 5 to 20 Uxkg(-1)xh(-1). Mean blood flow was 40 to 220 mlxkg(-1)min(-1) during ECMO assistant period.</p><p><b>RESULTS</b>The shortest ECMO time was 12 to 504 h with a mean of (119+/-80) h. Sixty-one patients (61.0%) weaned off successfully from ECMO, 55 of them (90.2%) were discharged and 6 died of post-operative complications. Thirty-nine patients could not weaned off from ECMO. Total survival discharge rate was 55.0%. Mean aortic pressure before ECMO in survived patients was significantly higher than that of dead patients (P=0.038). Lactic acid concentration of artery blood before ECMO in survived patients was significantly lower than that of dead patients (P=0.005).</p><p><b>CONCLUSIONS</b>ECMO is an effective mechanical assistant therapy method for cardiac and pulmonary failure after cardiac surgery. Earlier usage of ECMO for heart lung failure patient and avoiding the main organs from un-recovery trauma are key success.</p>

Outcome of surgery for interrupted aortic arch combined cardiac anomaly / 中华外科杂志

<p><b>OBJECTIVE</b>To retrospectively review the experience in repair of interrupted aortic arch (IAA) and associated cardiac anomaly.</p><p><b>METHODS</b>From January 1997 to January 2008, 36 patients with interrupted aortic arch and associated cardiac anomaly underwent surgical treatment. There were 22 male and 14 female. Mean age of the 35 children patients was 2.8 years, with a range from 2 months to 7 years. There was a 31 years old adult patient. Types of interrupted aortic arch include 30 cases of type A and 6 cases of type B. In all 36 patients, 33 cases had patent ductus arteriosus (PDA) and intracardiac abnormality, including 28 cases of simple anomaly as ventricular septal defect and 5 cases of complex anomaly, two cases were single IAA arch without PDA and other cardiac defect, one case had no intracardiac anomaly but PDA. For 33 patients with PDA and intracardiac anomaly, median sternotomy was used to simultaneously repair interrupted aortic arch and intracardiac defect in 31 cases, left thoracotomy and median sternotomy were applied to repair IAA and intracardiac anomaly respectively in one case, one patient had palliative repair. For three patients without intracardiac anomaly, left thoracotomy was applied in two cases, median sternotomy and abdominotomy were used in one adult patient. Techniques of operation for interrupted aortic arch include 16 cases of conduit connection, 9 cases of direct anastomosis, 9 cases of direct anastomosis with patch augmentation, 1 case of subclavian flap aortoplasty. In all 31 cases of one-stage operation through median sternotomy, selective cerebral perfusion was used in 17 patients, deep hypothermia and low flow were applied in 8 cases, deep hypothermia circulatory arrest was performed in 6 patients.</p><p><b>RESULTS</b>There were 5 hospital deaths. Three cases died of pulmonary infection, 1 case died of of pulmonary hypertension crisis, and another case died of postoperative low cardiac output, which was misdiagnosed before operation. Seven cases had other main postoperative complications. Thirty-one survivors were followed up from 3 months to 5 years, there was no late death and reoperation.</p><p><b>CONCLUSION</b>One-stage repair through median sternotomy using selective cerebral perfusion or deep hypothermia and low flow can be applied to most of the cases with associated cardiac anomaly.</p>

Study on excretion of pseudo-ginsenoside GQ / 中国中药杂志

<p><b>OBJECTIVE</b>To determine the pseudo-ginsenoside GQ (PGQ) in rat bile, feces and urine, and to study on the excretion of pseudo-ginsenoside GQ.</p><p><b>METHOD</b>Reverse phase high-performance liquid chromatography (RP-HPLC) method with an evaporative light-scattering detector (ELSD) was performed on Diamonsil C18 column (4.6 mm x 250 mm, 5 microm), and the mobile phase was consisted of methanol-water (24: 7) with flow rate of 1.0 mL x min(-1). ELSD parameters were set as follows: nitrogen gas pressure 3.0 bar, drift tube temperature 50 degrees C.</p><p><b>RESULT</b>The method fulfilled all the standard requirements of precision, accuracy and linearity. The main way of excretion of PGQ in rat administrated through sublingual vein was at the bile. The bile excretion ratio of PGQ was 41.60%, and feces excretion ratio was 9.97%. Only trace amount of PGQ was excreted in urine.</p><p><b>CONCLUSION</b>Almost all unchanged PGQ was excreted in bile, feces and urine.</p>

Surgical treatment of aortic coarctation with intracardiac anomaly in infants and toddlers / 中华外科杂志

<p><b>OBJECTIVE</b>To review the experience in repair of aortic coarctation with intracardiac anomaly in infants and toddlers.</p><p><b>METHODS</b>From January 2000 to December 2006, 84 infants and children diagnosed as aortic coarctation with intracardiac anomaly underwent surgical treatment. Mean age of the patients was 13.5 months, with a range from 1 month to 3 years. Mean body weight was 7.3 kg, with a range from 3.3 to 15 kg. Twelve patients complicated with complex intracardiac anomaly. Seventy-two patients complicated with ventricular septal defect and other simple anomaly. Twenty-one patients had hypoplasia of the aortic arch. Sixty-two patients had one-stage repair. Median sternotomy was used to simultaneously repair coarctation and intracardiac defect in 49 patients. Left thoracotomy and median sternotomy were applied to repair aortic coarctation and intracardiac anomaly respectively in 13 patients. Twenty-two patients had staged repair. Operational techniques for aortic coarctation include 42 patients of patch aortoplasty, 30 patients of resection and end-to-end anastomosis, 6 patients of subclavian flap aortoplasty, 3 patients of vascular bypass, and 1 patient of balloon dilation. In all 49 patients of one-stage operation through median sternotomy, selective cerebral perfusion was used in 43 patients, deep hypothermia low flow was applied in 4 patients, deep hypothermia circulatory arrest was performed in 2 patients.</p><p><b>RESULTS</b>There were 8 hospital deaths. The mortality is 9.5%. Among 8 deaths, 3 patients were misdiagnosed.</p><p><b>CONCLUSIONS</b>Surgeries for aortic coarctation with intracardiac anomaly have satisfactory short-term results in infants and toddlers. One-stage repair through median sternotomy can be applied to most of the patients. Selective cerebral perfusion with deep hypothermia and circulatory arrest in lower body can protect the brain and other vital organs.</p>

Microsurgery for intracranial aneurysm:analysis of 438 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To summarize the experience of surgical therapy in a series of 438 patients with intracranial aneurysms.</p><p><b>METHODS</b>A retrospective analysis was made on the clinical data of 438 patients, in terms of the perioperative management, timing of surgery, surgical skills, and The HUNT-HESS grade.</p><p><b>RESULTS</b>438 patients with 476 aneurysms underwent microsurgery, in which 450 aneurysms were clipped, 14 were wrapped, 8 were isolated,4 were cut. 32 aneurysms were ruptured (6.72%) during the operation. The relation between Hunt-Hess scale and mortality is significant postpone operation (> or =7 d) has got a better curative effect than the early.</p><p><b>CONCLUSIONS</b>Microsurgical treatment is a confirmed effective method with intracranial aneurysms. The higher of HUNT-HESS grade will result to the worse clinical outcome.</p>