Electrophysiologic-electropharmacologic Method for Evaluating the Effects of Antagonizing Ventricular Tachyarrhythmic Drugs

Objective To establish a canine model of electrophysiologic - electropharmacology as assessed by programmed electrical stimulation (PES),and to observe the electrophysiologic effects of Procainamide(PA) on normal and ischemic myocardium in case of ischemic ventricular tachyarrhythmia in this model. Methods A ishemic ventricular tachyarrhythmias canine model was established in open-chest dogs subjected to programmed electrical stimulation(PES)for 5-8 days after acute myocardial infarction. The electrophysiologic effects of procainamide were observed in this model. With routine methods of PES,ventricular tachycardia(VT) and ventricular fibrillation (VF) could be reproducibly initiated. Results Procainamide distinctly lengthened the QTc interval (P【0.01) and effective refractory period(ERP) of normal and ischemic ventricular myocardium(NERP and IERP) respectively (P【0.01), decreased the dispersion of ERP in ischemic myocardium and the dispersion of ERP in left ventricle (P【0.01), and increased the diastolic excitability threshold of normal and ischemic ventricular myocardium remarkably (P【0.01). Procainamide effectively prevented the PES-induced VT or VF (P【0.05) and ischemia-induced VF (P【0.05). Conclusion The results indicated that PES-induced VT/VF were highly reproducible and reliable, this canine model is a worthy and reliable one, procainamide may be effective in preventing the onset of VT and VF after myocardial ischemic damage, and deserves further attention as an antifibrillatory agent.

双软管软袋大输液灌封生产线所存问题及其解决措施

通过对双软管软袋大输液灌封生产线的简单介绍,总结了其在灌封生产中存在的问题,包括缺管、软袋切割不正确、焊伤、装量误差大、缺塞、外盖破损、产品可见异物检查不合格等,分析了这些问题产生的具体原因,并提出了相应的解决措施。

Antiarrhythmic Efficacy of Neferine Assessed by Programmed Electrical Stimulation in a Canine Model of Electropharmacology

An ishemic ventricular tachyarrhythmias canine model was established in open-chest dogs subjected to programmed electrical stimulation (PES)for 5-8 days after acute myocardial infarction. The electrophysiologic effects of neferine (Nef) and procainamide (PA) were observed in this model. With routine methods of PES,ventricular tachycardia (VT)and ventricular fibrillation (VF) could be reproducibly initiated. Both drugs lengthened the QTc interval (P【0.01) and effective refractory period(ERP)of normal and ischemic ventricular myocardia (NERP and IERP) respectively (P【0.01), decreased the dispersion of ERP in ischemic myocardium and the dispersion of ERP in left ventricle (P【0.01), and increased the diastolic excitability threshold of normal and ischemic ventricular myocardia (P【0.01). The two compounds prevented the PES-induced VT or VF (Nef group P【0.01, PA group P【0.05) and ischemia-induced VF (P【0.05). The results indicated that neferine and procainamide may be effective in preventing the onset of reentrant ventricular tachyarrhythmias after myocardial ischemic damage in dogs.

Protective Effect of Tetrandrine and Fructose-1,6-diphos phate on the Model of Focal Cerebral Ischemia in Rats

The effect of tetrandrine (Tet) on the infarction area and volume of rat brain induced by middle cerebral artery occlusion (MCAO) was investigated. The treatment with Tet 7.5, 12.0 or 15.0 mg·kg 1 , or with fructose 1,6 diphosphate (FDP) 200 and 350 mg·kg 1 ip immediately after MCAO, respectively, significantly reduced the infarction area and volume in a dose dependent manner. MK801 and FDP also displayed a protective effect on brain ischemia. A combination of Tet and FDP administered immediately after MCAO, produced a more potent protective effect than those treated with Tet or FDP alone. When Tet or FDP was administered 1 h and 2 h after MCAO, respectively, they could still significantly reduce the infarction area and volume of brain tissue. But, there was no significant protective effect when these two compounds were given 3 h after MCAO.

Large pedinculated antral hyperplastic gastric polyp traversed the bulbus causing outlet obstruction and iron deficiency anemia: endoscopic removal

We present here a large (3 cm) hyperplastic gastric polyp prolapsed into duodenum and caused outlet obstruction and iron deficiency anemia in 60 years old male patient.Endoscopic removal was performed successfully.

Failure of P-selectin blockade alone to protect the liver from ischemia-reperfusion injury in the isolated blood-perfused rat liver

AIM： To determine if blockade of P-selectin in the isolated blood-perfused cold ex vivo rat liver model protects the liver from ischemia-reperfusion injury. METHODS： The effect of P-selectin blockade was assessed by employing an isolated blood-perfused cold ex vivo rat liver with or without P-selectin antibody treatment before and after 6 h of cold storage in University of Wisconsin solution. RESULTS： In our isolated blood-perfused rat liver model, pre-treatment with P-selectin antibody failed to protect the liver from ischemia-reperfusion injury, as judged by the elevated aspartate aminotransferase activity. In addition, P-selectin antibody treatment did not significantly reduced hepatic polymorphonuclear leukocyte accumulation after 120 min of perfusion. Histological evaluation of liver sections obtained at 120 min of perfusion showed significant oncotic necrosis in liver sections of both ischemic control and P-selectin antibody-treated groups. However, total bile production after 120 rain of perfusion was significantly greater in P-selectin antibody-treated livers, compared to control livers. No significant difference in P-selectin and ICAM-1 mRNAs and proteins, GSH, GSSG, and nuclear NF-kB was found between control and P-selectin antibody-treated livers. CONCLUSION： In conclusion, we have shown that blockade of P-selectin alone failed to reduced polymorphonuclear leukocyte accumulation in the liver and protect hepatocytes from ischemia-reperfusion injury in the isolated blood-perfused cold-ex vivo rat liver model.

Relationship between serum S-100 protein level and ischemic damage degree in patients with acute cerebral infarction

Objective: To investigate the time course of serum S-100 concentrations of patients with acute cerebral infarction,and their relation with the clinical data and the prognosis. Methods: Serum S-100 levels were serially determined in 36 patients with acute cerebral infarction within 12 h, at 24 h and day 2, 3, 4, 5, 7 and 10 after acute cerebral infarction and in 20 age- and sex-matched control subjects. An S-100 content assay was performed using a two-site radioimmunoassay technique. The clinical status was assessed using NIH Stroke Scale. The functional deficit at 4 weeks after acute cerebral infarction was scored using the modified Rankin scale. A cranial computed tomography was performed initially. Results: Elevated concentrations of S-100 (>0.2 μg/L) were observed in 29 of 36 patients with acute cerebral infarction,but none of the control subjects. The S-100 peak levels were at day 2 and 3 after acute cerebral infarction and were significantly high in those patients with severe neurological deficit at admission, with extensive infarction or with space-occupying effect of ischemic edema as compared with the rest of the populations. Conclusion: Serum S-100 level assay can be used as a peripheral marker of ischemic brain damage, and may be helpful for evaluation of therapeutic effects in acute ischemic stroke.

Two cases of duodenal obstruction due to a congenital web

We present two cases of windsock deformity;both were rare in location and one had a rare associated anomaly. In the first case, the windsock was observed in the fourth part of duodenum, causing partial intestinal obstruction. In the second case, the windsock was located in the third part of the duodenum.

Delayed ischemic gangrene change of distal limb despite optimal decompressed colostomy constructed in obstructedsigmoid colon cancer:A case report

Creating blow-hole colostomy for decompression could provide a time-saving and efficient surgical procedure for a severely debilitated case with a completely obstructed colorectal cancer. Complications are reported as prolapse, retraction, and paracolostomal abscess. However, complication with an ischemic distal limb has not been reported. We report a case of critical intra-abdominal disease after decompressed colostomy for relieving malignant sigmoid colon obstruction; a potential fatal condition should be alerted. A 76-year-old male visited our emergency department for symptoms related to obstructed sigmoid colon tumor with foul-odor vomitus containing fecal-like materials. An emergent blow-hole colostomy proximal to an obstructed sigmoid lesion was created, and resolution of complete colon obstruction was pursued. Unfortunately, extensive abdominal painful distention with board-like abdomen and sudden onset of high fever with leukocytopenia developed subsequently. Such surgical abdomen rendered a secondary laparotomy with resection of the sigmoid tumor along with an ischemic colon segment located proximally up to the previously created colostomy. Eventually, the patient had an uneventful postoperative hospital stay. In the present article, we have described an emergent condition of sudden onset of distal limb ischemia after blow-hole colostomy and concluded that despite the decompressed colostomy would resolve acute malignant colon obstruction efficiently; impending ischemic bowel may progress with a possible irreversible peritonitis. Any patient, who undergoes a decompressed colostomy without resection of the obstructed lesion, should be monitored with leukocyte count and abdominal condition survey frequently.

Inhibition of p38 mitogen-activated protein kinase may decrease intestinal epithelial cell apoptosis and improve intestinal epithelial barrier function after ischemia- reperf usion injury

AIM: To investigate the role of p38 mitogen-activated protein kinase in rat small intestine after ischemia-reperfusion (I/R)insult and the relationship between activation of p38 MAPK and apoptotic cell death of intestine.METHODS: Ninety Wistar rats were divided randomly into three groups, namely sham-operated group (C), I/R vehicle group (R) and SB203580 pre-treated group(S).In groups R and S, the superior mesenteric artery(SMA)was separated and occluded for 45 min, then released for reperfusion for0.25, 0.5, 1, 2, 6, 12 and 24 h. In group C, SMA was separated without occlusion. Plasma D-lactate levels were examined and histological changes were observed under a light microscope. The activity of p38 MAPK was determined by Western immunoblotting and apoptotic cells were detected by the terminal deoxynucleotidyl transferase (TdT)-mediated dUDP-biotin nick end labeling (TUNEL).RESULTS: Intestinal ischemia followed by reperfusion activated p38 MAPK, and the maximal level of activation (7.3-fold vs sham-operated group) was reached 30 min after I/R. Treatment with SB 203580, a p38 MAPK inhibitor,reduced intestinal apoptosis (26.72±3.39% vs62.50±3.08%in I/R vehicle, P＜0.01) and decreased plasma D-lactate level (0.78±0.15 mmol/L in I/R vehicle vs0.42±0.17 mmol/L in SB-treated group) and improved post-ischemic intestinal histological damage.CONCLUSION: p38 MAPK plays a crucial role in the signal transduction pathway mediating post-ischemic intestinal apoptosis, and inhibition of p38 MAPK may attenuate ischemia-reperfusion injury.

Effect of Socio-Demographic Factors on Zinc Status of Infants and Preschool Children in East Gojjam, Amhara Region of Ethiopia

Zinc deficiency is a public health concern and is the most prevalent micronutrient deficiencies in developing countries. The main objective of this study was to assess the prevalence and risk factors of zinc deficiency among infants and preschool children. Based on a community, the cross-sectional study was conducted in East Gojjam between October 2011 and April 2012. Two hundred and forty infants and preschool children were randomly selected in the study. Data on potential determinants of zinc deficiency were collected using a structured questionnaire. Serum zinc concentration was measured using atomic absorption spectrometer. Statistical analysis was done using ANOVA, independent sample student＇s t-test and linear regression model. The mean serum zinc concentration of infants and preschool children was 62.98 （±13.03） μg/dL in 95% confidence interval （CI） between 61.32 and 64.63 （i.e., 95% CI： 61.32, 64.63）. About 57,1% of the subjects were zinc deficient. The main determinants of low serum zinc status of infants and preschool children were age and number of family members living on the same land. Zinc status of older children was 3.67 μg/dL （95% CI： -5.58, -1.77） lower than children who were aged 6-10 months. Serum zinc status of infants and preschool children is decreased by 0.83 p.g/dL （95% CI： -1.36, -0.30） with each additional family member. Food insecurity, dietary diversity, sex, child health, anthropometric indices, maternal education and wealth index were not associated with serum zinc status. Zinc deficiency among infants and preschool children is highly prevalent. Such potential deficiencies require urgent attention, including complementary food preparation education, traditional phytate reduction method and family planning implementation recommended in the study area.

A novel dynamic call admission control policy for wireless network

To address the issue of resource scarcity in wireless communication, a novel dynamic call admission control scheme for wireless mobile network was proposed. The scheme established a reward computing model of call admission of wireless cell based on Markov decision process, dynamically optimized call admission process according to the principle of maximizing the average system rewards. Extensive simulations were conducted to examine the performance of the model by comparing with other policies in terms of new call blocking probability, handoff call dropping probability and resource utilization rate. Experimental results show that the proposed scheme can achieve better adaptability to changes in traffic conditions than existing protocols. Under high call traffic load, handoff call dropping probability and new call blocking probability can be reduced by about 8%, and resource utilization rate can be improved by 2%-6%. The proposed scheme can achieve high source utilization rate of about 85%.

Alpha-1 Antitrypsin Deficiency Family Study

According to the latest World Health Organization report 64 million people suffer from Chronic Obstructive Pulmonary Disease （COPD）, 3 million people died from COPD and it is predicted that COPD will become the third leading cause of death worldwide by 2030. The alpha-1 antitrypsin deficiency is a rarely diagnosed hereditary disease caused by a genetic mutation and it is one of the most prevalent genetic disorders primarily affecting the lungs, especially in the form of COPD or emphysema, but in some cases also the liver or skin. The Global Initiative for Chronic Obstructive Lung Disease recommends all patients with COPD at a young age or significant family history to be examined for alpha-1 antitrypsin deficiency. This article presents the case of a 42 year old, female patient, Portuguese, with history of Chronic Obstructive Pulmonary Disease, 40 pack units/year smoker, with unknown family history, coming to her family doctor with breath shortness, especially during physical activities, with unsatisfying response to pharmacological prescribed therapy. Physical examination was normal. Alpha- 1 antitrypsin deficiency was confirmed by blood testing. All patient＇s first degree relatives were investigated showing low alpha-1 antitrypsin blood concentrations thus genetic tests were later performed. This case reinforces the need for primary care physicians to be aware of alphal-antitrypsin deficit as an underdiagnosed clinical entity.

Evaluation on Inducible Effect of pOp6 Promoter in Transgenic Rice

In order to analyze the Oslbglu4 phenotype, the inducible promoter of the transgenic rice which knock-down the Oslbglu4 expression was assessed. The result showed that 30 μM dexamethasone（DEX） had the stronger induction effect than 10 μM DEX by β-Glucuronidase （GUS） staining, qRT-PCR further verified the Oslbglu4 gene deletion. The effect of DEX and its solvent absolute ethanol on seed development was measured, and no significant effect was observed. The conclusion is that final concentration of DEX at 30 μM is suitable for pOp6 promoter induction.

Meta analysis on ischemic stroke treated with scalp acupuncture

Objective To evaluate the efficacy and safety of scalp acupuncture in the treatment of ischemic stroke. Methods The method recommended in the Cochrane Collaboration was used for the systematic evaluation of the randomized controlled trials （RCTs） of scalp acupuncture in the treatment of ischemic stroke. Results One thousand three hundred and ninety-five cases from 13 papers in Chinese version were in compliance with the inclusive criteria and all of them were the low-quality trials. The results of the included 5 trials in Meta analysis indicated that the efficacy of scalp acupuncture was superior to medication in the treatment of ischemic stroke （RR=1.27, 95% CI 1.06, 1.51）. The results of 3 trials in Meta analysis suggested that the recovery in the nerve function defect of the patients with ischemic stroke treated with scalp acupuncture was apparent as compared with medication （WMD = -2.96, 95% C1-4.00, -1.92）. The results of 5 trials in Meta analysis showed that the efficacy of scalp acupuncture on ischemic stroke was potentially superior to body acupuncture （RR=I.10, 95% CI 0.93, 1.28）. Conclusion It is seen in the Meta analysis results of the included 13 RCTs that scalp acupuncture achieves the definite efficacy on ischemic stroke. Due to the limitation of the inclusive numbers and quality of the research, especially the lack of long-term indices, the conclusion reliability of this research is relatively low. Hence, it is required much more evidences for a further confirmation from the large scale and multiple central RCTs with high quality and intrinsic authenticity.

Epac2-deficiency leads to more severe retinal swelling, glial reactivity and oxidative stress in transient middle cerebral artery occlusion induced ischemic retinopathy

Ischemia occurs in diabetic retinopathy with neuronal loss, edema, glial cell reactivity and oxidative stress. Epacs, consisting of Epac 1 and Epac2, are cAMP mediators playing important roles in maintenance of endothelial barrier and neuronal functions To investigate the roles of Epacs in the pathogenesis of ischemic retinopathy, transient middle cerebral artery occlusion （tMCAO） was performed on Epacl-deficient （Epacl-/- ） mice, Epac2-deficient （Epac2-/-） mice, and their wild type counter-parts （Epacl＋/＋ and Epac2＋/＋）. Two-hour occlusion and 22-hour reperfusion were conducted to induce ischemia/reperfusion injury to the retina. After tMCAO, the contralateral retinae displayed similar morphology between different genotypes. Neu-ronal loss, retinal edema and increase in immunoreactivity for aquaporin 4 （AQP4）, glial fibrillary acidic protein （GFAP）, peroxiredoxin 6 （Prx6） were observed in ipsilateral retinae. Epac2 / ipsilateral retinae showed more neuronal loss in retinal ganglion cell layer, increased retinal thickness and stronger immunostaining of AQP4, GFAP, and Prx6 than those of Epac2＋/＋. However, Epacl-/- ipsilateral retinae displayed similar pathology as those in Epacl＋/＋ mice. Our observations suggest that Epac2-deficiency led to more severe ischemic retinopathy after retinal ischemia/reperfusion injury.

One-stage apertura thoracis superior approach for fourvessel occlusion in rats

Objective：There are a great number of modified models based on the four-vessel occlusion（4VO）model of Pulsinelli and Brierley which has been used worldwide for brain ischemia research.However,up to now the problems of collateral circulations of 4VO and the difficulty in arranging a surgery to occlude the basilar artery in other models are not satisfactorily solved yet.In this study,an improved 4-vessel occlusion（I4VO）rat model which is easy to handle and able to decrease the effect of collateral circulation is reported.Methods：The common carotid arteries and the beginning of the subclavical arteries of rats were occluded for different time by one-stage apertura thoracis superior approach.Neurological deficit scores defined by the modified Garcia scoring system and histopathological method were used to evaluate the effects of this model up to 7 days after reperfusion.Results：The neurological scores in the 15-min and 25-min groups decreased significantly at 24,48 and 72 hours after reperfusion（P〈0.05）,and the histopathologic study showed that there were stable,symmetrical changes of lesions in bilateral hippocampus in all the ischemia samples from two ischemia groups compared with sham operated group（P〈0.05）.Conclusion：This modified model is safe,easy,reliable,stable,mini-invasive as well as time-saving in making bilateral hemispheric ischemia,which can effectively decrease collateral circulations and meanwhile lead to stable lesions in hippocampus and cortex.

Effect of electroacupuncture at Ganshu(BL 18) and Shenshu(BL 23) on the expression of EphB2 protein in cortex around cerebral infracted area of rat

Objective： To observe the effect of electroacupuncture （EA） on the expression of erythropoie-tin-producing hepatocyte receptor B2 （EphB2） in the cortex around the infracted area of middle cerebral artery occlusion （MCAO） rats at different timing, and to reveal the possible mechanism of acupuncture in the treatment of cerebral ischemia. Methods： A total of 180 male Sprague-Dawley （SD） rats were randomly divided into a sham operation group, a model group, an acupoint group and a non-acupoint group, with 45 rats in each group. Rats in each group were further divided into three subgroups： postoperative 3 d, postoperative 14 d and postoperative 2l d groups, with 15 rats in each subgroup. The MCAO model was made by the modified occlusion method. The neurological function score, 2,3,5-triphenyl tetrazolium chloride （TFC） staining, immunohistochemistry assay, immunofluorescence double labeling method and Western blot were used to detect the corresponding indicators. Results： The neurological impairment of rats was most obvious at postoperative 3 d, and then gradually improved with time, which was more significant in the acupoint group （P〈0.05）. The change of infarcted volume was consistent with the neurological function impairment. The number of EphB2 positive cells （EphB2＋） around the infarcted area was decreased significantly at postoperative 3 d, and then gradually improved with time, which returned to the same level as that in the sham operation group at postoperative 21 d. The increase was most significant in the acupoint group （P〈0.05）, and the positive cell number was higher than that in the sham operation group （P〈0.01）. Western blot and immunohistochemistry results were basically consistent. Immunofluorescence displayed that EphB2＋ and postsynaptic density-95 positive （PSD-95＋） were co-expressed, after the MCAO operation, in the cortical neuron around the infracted area, and the number of co-expressing cells was increased gradually with time, which was most significant in the acupoint group （P〈0.05）. Conclusion： Electroacupuncture at Ganshu （BL 18） and Shenshu （BL 23） can significantly improve the neurological function and cerebral infarcted volume ratio of MCAO rats, which may be related to the activation of EphB2 expression in cortex around the infracted area and the promotion of synaptic remodeling.

Effect of electroacupuncture on expressions of VEGF and CD31 in MCAO model rats

Objective： To investigate the effect of electroacupuncture （EA） at Ganshu （BL 18） and Shenshu （BL 23） on vascular endothelial growth factor （VEGF） and platelet endothelial cell adhesion molecule-1 （PECAM-1）/CD31 around the cerebral infarction focus in middle cerebral artery occlusion （MCAO） rats and the possible mechanism, thus to provide a new strategy for the treatment of cerebral ischemic stroke by acupuncture. Methods： A total of 180 healthy male Sprague-Dawley （SD） rats were randomly divided into a sham operation group, a model group, an acupoint group and a non-acupoint group, 45 rats in each group. MCAO model was established using the modified line-embolus method in all rats except for those in the sham operation group; rats in the acupoint group were treated with EA at Ganshu （BL 18） and Shenshu （BL 23）; rats in the non-acupoint group were treated with EA at the control points; rats in other 2 groups were only subjected to bundling without treatment. Ten rats in each group were randomly selected on the 3rd day, the 14th day and the 21st day after acupuncture stimulation to test the neurological function impairment. The expression levels of CD31 and VEGF were also detected. Results： Compared with the model group and non-acupoint group, the neurological function score of the acupoint group was decreased at each time point, and the differences were statistically significant （P〈0.05, P〈0.01）. The expressions of VEGF and CD31 in each group were the lowest on the 3rd day, reached the peak on the 14th day and still remained at high level on the 21st day. And the differences among groups were statistically significant both on the 14th day and the 21st day （P〈0.05, P〈0.01）. Compared with the model group and the non-acupoint group, the expressions of VEGF and CD31 in the acupoint group were increased, and the differences were statistically significant （all P〈0.05）. Conclusion： EA at Ganshu （BL 18） and Shenshu （BL 23） can significantly improve the neurological function score of MCAO model rats, and shows protective effect on cerebral ischemia. The protective mechanism may be related to the up-regulation of CD31 and VEGF expression around the cerebral infarction focus in the MCAO model rats and induction of angiogenesis.