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@#Implantable left ventricular assist device (LVAD) has become an essential treatment for end-stage heart failure, and its effect has been continuously improved. In the world, magnetic levitation LVAD has become mainstream and is increasingly used as a destination treatment. China has also entered the era of ventricular assist device. The continuous improvement of the ventricular assist device will further improve the treatment effect. This article reviews the current situation and development trend of LVAD treatment in China and abroad.
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Objective:To investigate the effect of preoperative pulmonary hypertension (PH) on right ventricular function in patients with heart transplantation(HTx) one year after surgery.Methods:A total of 120 patients who underwent HTx in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2017 to January 2020 were retrospectively recruited.According to the mean pulmonary arterial pressure (mPAP) obtained by preoperative right heart catheterization, the research subjects were divided into the pulmonary hypertension group (PH group, n=81) and without pulmonary hypertension group (NPH group, n=39). Conventional echocardiographic indices of right ventricular function such as right ventricular area change (RV-FAC), tricuspid annular plane systolic excursion (TAPSE), tricuspid lateral annular systolic velocity (S′), and two-dimensional speckle tracking imaging (2D-STI) strain parameters including right ventricular global longitudinal strain (RV-GLS), right ventricular free wall longitudinal strain (RV-FWLS) were obtained to assess the right ventricular function of grafted hearts. The echocardiographic parameters one year after the operation of the two groups were analyzed to compare the differences in right ventricular function and their correlation with preoperative mPAP. Results:The grafted heart RV-GLS and RV-FWLS were significantly decreased in the PH group (all P<0.01), while RV-FAC, TAPSE, and S′ were similar between the two groups (all P>0.05). RV-FWLS and RV-GLS correlated with preoperative hemodynamic parameter mPAP( rs=-0.46, -0.54; all P<0.05)while RV-FAC, TAPSE, and S′ were not significantly correlated with mPAP (all P>0.05). Conclusions:Preoperative PH correlates with right ventricular function in HTx patients 1 year after the operation. The absolute values of RV-FWLS and RV-GLS in HTx patients with preoperative PH decrease 1 year after the operation. 2D-STI is more sensitive than conventional echocardiography to monitor the changes in right ventricular function in HTx patients after the operation.
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Objective:To investigate the improvement and possible mechanism of dl-3-n-butylphthalide (NBP) on the emotional memory of chronic alcoholism model mice.Methods:Twenty-four adult male C57/BL6 mice were randomly divided into control group (CON, n=8), model group (AT, n=8), treatment group (AT+ NBP, n=8). Mice in AT group and AT+ NBP group were administrated with alcohol to establish chronic alcoholism model. In the AT+ NBP group, the mice was administrated with NBP (40 mg/kg) by gavage once a day for 14 days during the alcohol modeling period. Ang the mice in AT group and CON group was given the same dose of corn oil by gavage.Open field test was used to evaluate anxiety-like behavior, tail suspension test to evaluate depression-like behavior, Morris water maze and new object recognition to evaluate memory ability, and TUNEL staining to evaluate the number of neuron apoptosis. The primary cultured neurons were interfered by alcohol and NBP at the cell level, and the calcium concentration in the neurons was detected by fluorescence calcium imaging. Descriptive analysis, t-test and one-way ANOVA were processed by SPSS 17.0. Results:The results of open field test showed that the exploration time of AT+ NBP group was longer than that of AT group ((50.68±7.82)s, (38.50±13.93)s; t=-2.16, P<0.05)). In the spatial memory test, the target quadrant exploration time of AT+ NBP group was longer than that of AT group ((28.02±7.13)s, (20.98±5.58)s; t=-2.20, P<0.05). In short memory test, the cognitive coefficient RI (0.83±0.08) of AT+ NBP group was higher than that of AT group (0.68±0.10) ( t=-3.13, P<0.05). Compared with CON group, the number of neuron apoptosis in prefrontal cortex in AT group increased ((17.33±2.51), (115.67±6.50); t=-24.41, P<0.001), and that in AT+ NBP group decreased compared with AT group((45.00±5.57)) ( t=14.29, P<0.001). The number of apoptosis neurons in the dentate gyrus of the hippocampus in AT group (13.75±4.79) was also less than that in the AT+ NBP group (5.75±3.30) ( t=2.75, P<0.05). Calcium concentration in nerve cells was detected that the three concentrations of alcohol (100 mmol/L, 200 mmol/L and 300 mmol/L) led to a significant increase in the RFU within the nerve cells (△F/F) ((1.43±0.32), (2.31±1.39), (1.21±0.73); t=-7.67, -2.85, -2.86, all P<0.05). In comparison, the changes of RFU in the three groups treated with NBP treatment were relatively stable ((0.04±0.01), (-0.03±0.01), (-0.04±0.02); t=7.96, 2.96, 2.92, all P< 0.05). Conclusion:The 3-n-Butylphthalide can improve the learning and memory ability of chronic alcoholism model mice, which may be related with the inhibition of neuron apoptosis and the influence of intracellular calcium homeostasis.
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Objective:To investigate the application value of fixation mesh with suture anchor in the repair of parailiac hernia.Methods:The retrospective and descriptive study was conducted. The clinical data of 5 patients with parailiac hernia who were admitted to Shaoxing People′s Hospital from March 2016 to February 2019 were collected. There were 4 males and 1 female, aged from 23 to 67 years, with a median age of 49 years. Patients underwent repair of parailiac hernia, in which mesh with suture anchor was fixed on the outside of the defect to the inner side of the ilium. Observation indicators: (1) surgical and postoperative conditions; (2) follow-up. Follow-up using outpatient examination or telephone interview was conducted at postoperative 1 week, at postoperative 2 weeks, at postoperative 1, 3, 6 months, at postoperative 1 and 2 years, respectively. The follow-up was up to July 2019. During the follow-up, the conditions about drainage tube removal, incision infection, hernia recurrence, and chronic pain were observed. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M (range). Results:(1) Surgical and postoperative conditions: 5 patients underwent surgeries successfully, without blood transfusion. The volume of intraoperative blood loss was 100 mL(range, 20-300 mL). The operation time and duration of drainage tube placement were (129±13)minutes and (13.8±1.9)days. Patients were discharged from hospital, without postoperative complications during the hospital stay. The duration of hospital stay was 13 days(range, 8-19 days). (2) Follow-up: patients were followed up for 4-39 months, with a median follow-up time of 16 months. One of the 5 patients was removed drainage tube during the hospital stay and other 4 patients were removed at the outpatient after discharge from the hospital. One patient felt numbness in the surgical site at postoperative 1 month without aggravation during the follow-up, and received no specific treatment. Four patients completed computed tomography examination at postoperative 6 months, without hernia recurrence. There was no incision infection or chronic pain.Conclusions:It is safe and effective to use fixation mesh with suture anchor in the repair of parailiac hernia.
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Tumor associated macrophage (TAM), as the main type of immune cells in tumor microenvironment, becomes an active participant in the development of breast cancer. MicroRNA (miRNA) can regulate post-transcriptional gene expression, modulation of macrophage function by affecting its polarization typing and transformation, and ultimately contribute to the occurrence and development of breast cancer. It could provide a new diagnosis and clinical treatment strategy for the treatment of breast cancer by summarizing the mechanisms of miRNA in the polarization of TAM.
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Objective To summarize the surgical strategies of orthotopic cardiac transplantation for congenital dextrocardia .Methods Three patients with congenital dextrocardia suffered from endstage heart failure and underwent orthotopic cardiac transplantation from March 2014 to September 2017 .They were aged 10 ,29 ,13 years respectively .Donor hearts were from brain death donors and procured with extra length on inferior vena cava , aorta and pulmonary artery tissues . After cardiectomy , left atrial-atrial anastomosis was performed initially between donor ' s left-upper pulmonary vein orifices and recipient's left-lower pulmonary vein orifices .Apex was orientated at a 90 degrees' clockwise to right . Then aorta ,inferior and superior vena cava and last pulmonary artery were anastomosed continuously . The prosthetic conduits were also used owing to a lack of tissue . Results All operations were successful . The cold ischemic time was (130-375 ) (251 .00 ± 122 .53) min ,cardiopulmonary bypass time (127-212 )(179 .67 ± 55 .72 ) min and aortic clamp time (38-105 ) (65 .33 ± 35 .166) min . Two patients had stable hemodynamics and recovered well after HTx .During a follow-up period of 1 .5-3 .5 years , echocardiography showed excellent cardiac functions without blood flow obstruction . Chest radiology showed well-placed donor heart in right mediastinum .One left-sided patient with total cavopulmonary connection before HTx died at 59 days after HTx because of pneumonia and multiple organ failure .Conclusions Heart transplantation is curative for patients with congenital dextrocardia and surgical strategies are the key factor of successful treatment .
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Objective:To compare the efficacy of morphine with intravenous injection and subcutaneous injection in the treatment of advanced cancer,and explore the indications of different drug delivery methods for high-dose morphine. Methods: A prospective study was performed,and 46 cases of patients with advanced cancer pain were collected and divided into intravenous group and subcutaneous group according to the administration route. Pain was assessed during the administration,and the analgesic efficiency and the incidence of adverse reactions were observed to compare the efficacy and safety of two different ways to give high-dose morphine. Results:No statisti-cally significant differences were found in the number of outbreaks needed to be rescued,the frequency of morphine-induced drug deliver-y,the efficiency of analgesia after opioid transfer,and the incidence of opioid-related side effects between the groups (P>0.05). The dose of morphine in the subcutaneous group was higher than that of the intravenous group(P<0.05). Conclusion:The continuous ad-ministration of morphine with intravenous injection and subcutaneous injection can quickly,safely and effectively relieve pain. With the same analgesic efficacy,patients can choose appropriate administration route according to the dose of morphine, the influence degree of primary diseases and the individual will.
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Objective To study the effects of Xihuang pills combined with sodium cantharidinate and vitamin B6 injection in the treatment of tumor-induced fever. Methods A total of 100 patients with tumor-induced fever in our hospital from March 2015 to January 2017 were enrolled in this study. The subjects were divided into the control group (n=50) and the treatment group (n=50) randomly. The control group were treated with aspirin-D L-Lysine injection, and the treatment group were treated with Xihuang pills combined with sodium cantharidinate and vitamin B6 injection. The two groups were treated for 2 periods. The clinical effects of the two groups after treatment were compared. The life quality of the two groups after treatment were compared. The serum TNF-α and IL-1β of the two groups before and after treatment were compared. The adverse reaction rates of the two groups during treatment were compared. Results The total efficacy rate of defervescence of the treatment group was 88.0％(44/50) significantly higher than 56.0％(28/50) of the control group (χ2=12.698, P=0.000). After treatment, the daily life score (1.10 ± 0.18 vs. 2.47 ± 0.21, t=35.025), social communication score (1.21 ± 0.13 vs. 2.53 ± 0.25, t=33.124), mental state score (1.08 ± 0.15 vs. 2.75 ± 0.21,t=45.758), appetite score (1.13 ± 0.16 vs. 2.56 ± 0.19, t=40.708), sleep score (1.22 ± 0.17 vs. 2.71 ± 0.20, t=40.139) of the treatment group were significantly lower than those of the control group (P<0.05). After treatment, the serum TNF-α (1.98 ± 0.07 μg/L vs. 2.86 ± 0.13 μg/L, t=42.144), IL-1β (9.20 ± 1.89 μg/L vs. 13.51 ± 2.36 μg/L, t=10.080) of the treatment group were significantly lower than those of the control group (P<0.05). There was no significantly differences of the adverse reaction rates of the two groups during treatment (χ2=0.211, P=0.646). Conclusions The Xihuang pills combined with sodium cantharidinate and vitamin B6 injection for patients with tumor-induced fever has a good efficacy and low incidence of adverse reactions, can improve the quality of life and reduce the serum levels of TNF-α and IL-1β.
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Objectives To research clinical effects of severe brain injury patients treated by acupuncture and herb combine mild hypothermia,discuss the new approach of severe brain injury patients treatment combine Chinese traditional and Western medicine.Methods Investigated 68 severe traumatic brain injured patients,randomly divided into three groups,acupuncture and herb combine mild hypothermia group (n =22),mild hypothermia group (n =24) and normal temperature routine treatment group (n =22).Dynamic intracranial pressure,brain damage index (cytoskeletal protein),immunologic function (IL-6,β2 microglobulin),combine rate of complications (including irritable ulcer,lung infection,epilepsy,sugar metabolism disorder,and so on),and long-term GOS score were analyzed.SPSS12.0 software was used for statistical processing,and the standard deviation of the measurement data were expressed as the standard deviation.The counting data were expressed as apercentage,and the chi-square test was used for the comparison between group.Results There were significant differences between three groups of intracranial pressure,immunologic function,complication occurring rate (P ＜0.05),but there had no significant difference between acupuncture and herb combine mild hypothermia group and mild hypothermia group of brain damage index and GOS,and there have significant difference between these two groups and normal temperature routine treatment group.Conclusions Acupuncture and herb combined mild hypothermia might be better in reducing intracranial pressure,the incidence of complication,and improving immune function of severe brain injury,than mild hypothermia group and normal temperature routine treatment group.
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Objective:To evaluate the association of oral lichen planus (OLP) with Candida albicans infection by Meta-analysis,and to provide basis for the antifungal treatment of OLP.Methods:Bibliographic searches were conducted in PubMed,EMBase,Medline,The Cochrane Library,CNKI,VIP,and Wanfang databases from inception to December 30 in 2016.The literatures were screened according to the inclusion and exclusion criteria by two reviewers independently,the methodology quality was evaluated after data abstraction,and then the RevMan 5.3 and Stata 12.0 software were used for Meta-analysis to calculate the crude odd ration (OR) and 95％ confidence intervals (95％ CI).Funnel plot and Egger's methods were used for the evaluation on the publication bias of papers.Results:Thirteen trials were included in this study.Collectively,1 073 OLP patients and 766 controls were available for analysis.The detection rate of Candida albicans in the OLP patients was significantly higher than that in healthy controls (OR:2.30,95％ CI:1.60-3.31,P＜0.01).Seven studies of these included literatures were performed on clinical typing of the OLP patients,and the risk of Candida albicans infection in the patients with erosive-atrophic OLP (E-OLP) was significantly increased (OR =10.12,95％ CI:4.05-25.28,P＜0.01).Conclusion:OLP has a clear association with Candida albicans infection,and this association is particularly significant in the E-OLP patients.
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Objective:To evaluate the association of oral lichen planus (OLP) with Candida albicans infection by Meta-analysis,and to provide basis for the antifungal treatment of OLP.Methods:Bibliographic searches were conducted in PubMed,EMBase,Medline,The Cochrane Library,CNKI,VIP,and Wanfang databases from inception to December 30 in 2016.The literatures were screened according to the inclusion and exclusion criteria by two reviewers independently,the methodology quality was evaluated after data abstraction,and then the RevMan 5.3 and Stata 12.0 software were used for Meta-analysis to calculate the crude odd ration (OR) and 95％ confidence intervals (95％ CI).Funnel plot and Egger's methods were used for the evaluation on the publication bias of papers.Results:Thirteen trials were included in this study.Collectively,1 073 OLP patients and 766 controls were available for analysis.The detection rate of Candida albicans in the OLP patients was significantly higher than that in healthy controls (OR:2.30,95％ CI:1.60-3.31,P＜0.01).Seven studies of these included literatures were performed on clinical typing of the OLP patients,and the risk of Candida albicans infection in the patients with erosive-atrophic OLP (E-OLP) was significantly increased (OR =10.12,95％ CI:4.05-25.28,P＜0.01).Conclusion:OLP has a clear association with Candida albicans infection,and this association is particularly significant in the E-OLP patients.
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Objective To compare the clinical outcomes between two different femur rotating osteotomy methods for kneeling ability recovery after total knee arthroplasty (TKA).Methods From January 2012 to December 2014,88 patients underwent TKA were selected for a retrospective study and were divided into two groups based on the methods to determine femoral rotation.Forty-eight patients were in measured resection group,while 40 patients in gap balancing group.The patients in both groups underwent fixed-bearing tibia prosthesis.There were no statistical significance between the two groups in gender,age,BMI and knee varus angle (P＞0.05).The knee varus angle,ROM,Oxford knee score (OKS) and American Knee Society (KSS) knee score were collected to assess malformation correction,kneeling ability and functions at pre-operation,one and two years postoperatively.Results The operation duration and blood loss in measured resection group were 80±19 min and 348±121 ml,while these data in gap balancing group were 82±23 min and 315 ± 100 ml respectively (P＞0.05).Patients in measured resection group were followed up 24-59 months (mean 43± 11 months),while the followed-up duration in gap balancing group was 25-58 months (mean 47±10 months).No major complications such as infection loosen and instability were occurred.Varus angles in measured resection group at postoperative 1 year and 2 year postoperative were 1.2°±0.4° and 1.0°±0.2° respectively,while those in gap balancing group were 0.9°±0.2° and 0.8°±0.3° (P＞0.05).The scores of the seventh item of OKS in measured resection group at 1 year and 2year follow-ups were 2.79±1.02 and 2.75± 1.03 respectively,while those in the gap balancing group were 1.90±0.85 and 1.80±0.83 (P＜0.01).ROM in the measured resection group at 1 year and 2 year postoperative were 102.08°± 15.60° and 102.08°±15.60° respectively,while those in the gap balancing group were 112.50°±18.32° and 113.00°±18.09° (P＜0.05).KSS in measured resection group at postoperative 1 year and 2 years were 154.63±31.12 and 154.63±31.26 respectively,while those in the gap balancing group were 170.55±22.67 and 173.45±22.52 (P＜0.05).Conclusion The method of measured resection and gap balancing to confirm femoral rotation during TKA can both achieve favorable kneeling ability and clinical outcomes,while gap balancing show superiority on kneeling ability recovery,ROM and clinical outcomes at 2-year postoperative improvement.
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Objective To summarize the experience in diagnosis and treatment of popliteal vein entrapment syndrome (PVES). Methods A total of 57 patients with PVES were selected from the Department of Vascular Surgery in Xinxiang Central Hospital from March 2009 to October 2015. Of which 43 patients were severe stenosis of popliteal vein (stenosis degree>90%), and another 14 cases were with stenosis less than 90%. All the patients underwent ascending venography of low limb to confirm the clinical classification after admission. Forty-three cases with severe stenosis of the popliteal vein were treated with releasing popliteal vein of entrapment and stripping varicose veins. The static pressure and dynamic pressure of popliteal vein and foot dorsal vein were measured before and after operation. Another 14 patients were treated with medical circulation driven sock and medical therapy. Results The degrees of popliteal vein stenosis were more than 75% in all patients. The patients were divided into bove-knee stenosis (n=9), knee stenosis (n=18), and below-knee stenosis (n=30) according to the different parts of stenosis. Forty-three patients treated with surgery showed relief of leg swelling and pain, and ulcer healing. And the imaging examination showed that there were no obvious compression and stenosis of popliteal vein, and vascular filling was well. The static pressure and dynamic pressure of the popliteal vein and dorsal vein were lower than those before surgery (P<0.05). The lower limb swelling and pain were relieved, and varicose veins of lower limbs were no longer continued to increase in 14 patients with conservative treatment. Conclusion PVES is easy to be misdiagnosed, which should be paid attention to, and satisfactory clinical results can be achieved by releasing popliteal vein of compression combined with stripping varicose veins in patients with serious symptoms .
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[ ABSTRACT] AIM:To investigate whether kaempferol protects against acute lung injury induced by swine -origin influenza A H9N2 virus via down-regulation of NF-κB signaling pathway .METHODS:BALB/c mice were used to estab-lish the animal model of acute lung injury by nasal inoculation of swine-origin influenza A H9N2 virus.After the interven-tion with kaempferol , the pulmonary edema was evaluated by determining the lung wet weight /dry weight ( W/D) ratio, the pathological changes of the lung tissues were observed , the concentrations of TNF-α, IL-1βand IL-6 in the bronchoalveolar lavage fluid (BALF) were measured, and superoxide dismutase (SOD) activity, myeloperoxidase (MPO) activity and MDA content in the homogenate of the lung tissues were detected .NF-κB P65 levels were determined by Western blot , and the NF-κB P65 and NF-κB P50 nuclear translocation in the nuclear extracts from mouse lung tissue homogenate was detec-ted by ELISA .RESULTS:Treatment with kaempferol decreased the morality of infected mice , and significantly prolonged the survival time of the infected mice .Kaempferol also relieved the pathological changes of the lung tissues , the lung W/D ratio and the lung index in swine-origin influenza A H9N2 virus-infected mice.Treatment with kaempferol significantly de-creased the infiltration of inflammatory cells including macrophages , lymphocytes and neutrophils in the BALF .The levels of TNF-α, IL-6, IL-1βand MDA and the activity of MPO were also decreased .Treatment with kaempferol also significantly increased the SOD activity .NF-κB P65 levels were decreased , and the NF-κB P65 and NF-κB P50 nuclear translocation in the nuclear extracts from the mouse lung tissue homogenate were also decreased by treatment with kaempferol .CONCLU-SION:The protective effect of kaempferol on the mice with acute lung injury induced by swine -origin influenza A H9N2 vi-rus is related to suppression of the oxidative stress and inflammatory responses by down-regulation of NF-κB signaling path-way.
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Objective To analyze the cases of brucellosis in non-occupational population in Tongxiang City of Zhejiang Province,and to provide a scientific basis for making strategies in brucellosis prevention and control.Methods Rose bengal plate agglutination test (RBPT) and serum tube agglutination test (SAT) were used to detect brucellosis in the general population who were closely contacted with cases in non-occupational groups and who had brucellosis-related symptoms.If the pathogen result was positive,Brandt strain type identification should be done to analyze the reasons for non-occupational population who infected with brucellosis.Results A total of 7 cases of brucellosis were detected in the non-occupational groups,which accounted for 14.58％ of the total number of cases (7/48).Misdiagnosis was common,seasonal incidence was not obvious,transmission route and population infected were diverse.Conclusion The incidence rate of brucellosis is an upward trend,public brucellosis prevention knowledge should be strengthened,and training in diagnostic and treating skills for medical professionals should be provided.
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Objective To obtain different fragments of human carboxypeptidase H,and evaluate the diagnostic application of the recombination carboxypeptidase H in detecting autoantibody.Methods The coding gene of carboxypeptidase H was ob-tained by RT-PCR.The corresponding prokaryotic expression vectors were constructed and transformed into E.coli to in-duce the expression of the recombination different fragments of carboxypeptidase H.Using these antigen fragments as the coating antigens,the enzyme-linked immunosorbent assay (ELISA)was established for the detection of carboxypeptidase H autoantibody in 95 newly diagnosed type 2 diabetes patients.Results Three fragments of human carboxypeptidase H were obtained,in which the 42~476aa fragment antigen was ideal one.Using the full-length carboxypeptidase H as coating anti-gen,the positive rate of carboxypeptidase H autoantibody was 8.42%.Conclusion Because of the favorable antigenicity,the 42~476aa fragment antigen of carboxypeptidase H could be the candidate antigen for discrimination and diagnosis of latent autoimmune diabetes in adults.
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Objective To analysis the positive rates of glutamic acid decarboxylase autoantibody (GADA)and zinc transporter 8 autoantibody (ZnT8A)in newly diagnosed type 2 diabetes patients.Methods GADA and ZnT8A were detected in 101 ca-ses of newly diagnosed type 2 diabetes mellitus patients using ELISA.Results The positive rate of GADA was 21.78%,the positive rate of ZnT8A was 17.82%,and the common positive rate of GADA and ZnT8A was 8.91%.There were no corre-lations between GADA or ZnT8A autoantibodies and the patient’s sex (t=-0.724,-0.550;0.903,1.359,P >0.05),age (t=-0.724,-0.550;0.903,1.359,P >0.05),blood glucose (r=0.290,0.110;-0.264,-0.047,P >0.05),cholesterol (r=-0.047,0.004;0.154,-0.138,P >0.05),triglyceride (r=-0.092,-0.054;-0.217,-0.023,P >0.05),and low density lipoprotein (r= - 0.045,- 0.027;0.202,- 0.025,P > 0.05).Conclusion It should be screened autoantibodies timely for newly diagnosed type 2 diabetic patients in order to diagnosis the Latent autoimmune diabetes in adults early.
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AIM:To investigate the effects of N-acetylcysteine (NAC) on acute lung injury induced by H9N2 swine influenza virus ( SIV) in mice.METHODS: BALB/c mice were used to establish the animal model of acute lung injury by nasal inoculation of H9N2 SIV.The mice were divided into control group (without SIV infection), H9N2 SIV group (inoculation of H9N2 SIV) and NAC group (inoculation of H9N2 SIV plus pretreatment with NAC).The pulmonary edema was evaluated by determining the lung wet weight /dry weight ( W/D) ratio.The pathological changes of the lung tis-sues were observed .The concontrations of TNF-α, IL-1βand IL-6 in bronchoalveolar lavage fluid ( BALF) were meas-ured.The virus titer, T-SOD activity, MPO activity and MDA content in the homogenate of the lung tissues were detected . RESULTS:Treatment with NAC decreased the morality of infected mice , and significantly prolonged the survival time of infected mice .The pathological changes of the lung tissues , the lung W/D ratio and the lung index were relieved when SIV infected the mice treated with NAC .Treatment with NAC significantly decreased the infiltration of inflammatory cells inclu-ding macrophages, lymphocytes and neutrophils in the BALF .The levels of TNF-α, IL-6, IL-1βand MDA and the activity of MPO were also decreased.Treatment with NAC also significantly increased the T-SOD activity.CONCLUSION: The protective effect of NAC on the acute lung injury mouse model is related to suppression of the oxidative stress and inflamma -tory responses .
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Objective To investigate surgical treatment and effect of secondary endocardial fibroelastosis,based on respective analysis of clinical data and follow-up data of patients with secondary endocardial fibroelastosis (SEF) between 2010 and 2012.Methods A retrospective analysis was performed including 10 patients with secondary endocardial fibroelastosis from January 2010 to December 2012 in Wuhan Union Hospital.All patients were diagnosed by Untrasonic Cardiogram and/or CT angiography of heart and great vessel,and had cardiac insufficiency in different degree [EF 0.37 ± 0.08 (0.26 ～ 0.48)].All patients except 2 patients with anomalous origin of the coronary artery received treatment of digitaloid drugs before operation,which promoted preoperative cardiac function.5 patients with SEF complicated with Congenital Coarctation of the Aorta (CoA),2 patients underwent correction of CoA,2 patients underwent correction of CoA and partial resection of endocardium,1 patient underwent correction of CoA,partial resection of endocardium and mitral vavuloplasty.2 patients with SEF complicated with anomalous origin of the left coronary artery from the pulmonary artery,who were underwent correction of anomalous origin of coronary artery.2 patients with SEF complicated with aortic stenosis,who were underwent aortic commissurotomy and partial resection of endocardium.1 patient with SEF complicated with mitral stenosis and insufficiency,who underwent mitral valve replacement.The intraopertive gross appearance of endocardium was opaque greyish-white not transparent pink.The postoperative pathological examination showed obviously positive dyeing of elastic fibers.In 3,6,12 and 24 months after operation,Untrasonic Cardiogram evaluated cardiac function and endocardium.Results one 6 months patients with origin of left coronary from pulmonary artery died of severe post-operative low cardiac output syndrome,while another 1 months patients with origin of left coronary from pulmonary artery obtained post-operative good recovery,and the Untrasonic Cardiogram show disappearance of endocardial fibroelastosis.The post-operative mean time of using respirator(4.0 ± 1.5) days (2-7 days).Compared with the preoperative data,the cardiac function index (EF) was not significantly better at 2 weeks and 3-6 months[0.38 ± 0.07 (0.28 ～ 0.48),P ＞ 0.05 ; 0.39 ± 0.08 (0.30 ～ 0.50),P ＞ 0.05],and the non-resected fibroelatic endocardium still existed and were not attenuated.But the cardiac function index (EF) significantly increased [0.44 ± 0.08 (0.38 ～ 0.55),P ＜ 0.05] than the pre-operative EF,and the 3 of 5 cases the fibroelatic endocardium were attenuated or disappeared,while 2 of 5 cases the fibroelatic endocardium still existed.Conclusion SEF is the important causes of the infant intractable heart failure,which has the characteristic of high mortality and limited therapy.For SEF patients with anomalous origin of the coronary artery,the SEF is completely reversed by early diagnosis and early correction of the malformation.For SEF patients with CoA or aortic stenosis,the surgical treatment could promote recovery of cardiac function,but whether the SEF were reversed is still subject to further follow-up.The heart transplantation is the best therapy for SEF with severse heart failure.