Objective: To determine whether reduction in central pressure augmentation and central systolic blood pressure by nitroglycerine (NTG) results from effects on pre-load or is due to arterial dilation. Methods: We compared effects of NTG with those of lower body negative pressure (LBNP). Hemodynamic measurements were made at rest, during LBNP (10, 20 and 30 mmHg, each for 15 min) and after NTG (10, 30 and 100 μg/min, each dose for 15 min) in ten healthy volunteers. Cardiac pre-load, stroke volume and cardiac output were assessed by echocardiography. Central pressure augmentation and central systolic pressure were obtained by radial tonometry using a transfer function. Results: LBNP (20 mmHg) and NTG (30 μg/min) reduced pre-load (as measured by the peak velocity of the S wave in the superior vena cava) to a similar degree [by (26.8 ± 3.8)% and (23.9 ± 3.4)%, respectively]. Compared to LBNP, NTG reduced systemic vascular resistance [by (32.9± 7.5)%, P<0.01], decreased peripheral and central pressure augmentation [by (20.8 ± 3.4)% units and (12.9 ± 2.9)% units, respectively, each P<0.01]. Conclusion: These results suggest that a reduction in pre-load does not explain reduction in pressure augmentation and central systolic blood pressure by NTG and that these effects are mediated through arterial dilation.

Objective: To determine whether reduction in central pressure augmentation and central systolic blood pressure by nitroglycerine (NTG) results from effects on pre-load or is due to arterial dilation. Methods: We compared effects of NTG with those of lower body negative pressure (LBNP). Hemodynamic measurements were made at rest, during LBNP (10, 20 and 30 mmHg, each for 15 min) and after NTG (10, 30 and 100 μg/min, each dose for 15 min) in ten healthy volunteers. Cardiac pre-load, stroke volume and cardiac output were assessed by echocardiography. Central pressure augmentation and central systolic pressure were obtained by radial tonometry using a transfer function. Results: LBNP (20 mmHg) and NTG (30 μg/min) reduced pre-load (as measured by the peak velocity of the S wave in the superior vena cava) to a similar degree [by (26.8 ± 3.8)% and (23.9 ± 3.4)%, respectively]. Compared to LBNP, NTG reduced systemic vascular resistance [by (32.9± 7.5)%, P<0.01], decreased peripheral and central pressure augmentation [by (20.8 ± 3.4)% units and (12.9 ± 2.9)% units, respectively, each P<0.01]. Conclusion: These results suggest that a reduction in pre-load does not explain reduction in pressure augmentation and central systolic blood pressure by NTG and that these effects are mediated through arterial dilation.

Objective:To investigate the clinical experience about the transconjunctival lower eyelid blepharoplasty with correction of the eyelid orbital sulcus deformity.Methods:This group received 67 cases from June 2016 to July 2018, including 3 males and 64 females. The average age was 22 years. All the cases were diagnosed as lower eyelid bag with different degrees of fat herniation after orbital septum, with no or slight lower eyelid skin relaxation. Orbital sulcus of different degree appeared with outline of bony orbital margin, or accompanied by underdevelopment of the suborbital region. Through a transconjunctival incision or with short external canthal incision, the adipose mass was fully exposed behind the anterior wall of lower eyelid, the arcuate edge was released, and the pedicled orbital fat was transferred to the gap between the orbital eyelid sulcus and fixed in the lower orbital margin. If there was insufficient fat behind the orbital septum, a retroauricular fascia graft was used to make up.Results:No postoperative complications occured in all cases. After followed up for more than 3-month, 3 of 67 cases showed mild fat bulging pouch deformity in bilateral eyelids and 1 case was in unilateral eyelid. In other cases, deformity of the pouch and the eyelid orbital sulcus were improved significantly, and dynamic expression (orbicularis muscle contraction) showed no local uplift in lower eyelid morphology.Conclusion:The transconjunctival lower eyelid blepharoplasty with correction of the eyelid orbital sulcus deformity can obtain good clinical results in lower eyelid area.

ABCC8,KCNJ11,and GLUD1 gene mutations were investigated in a male patient with congenital hyperinsulinism and his parents were also investigated.A 1484 G＞A mutation was found in the 10th exon of ABCC8 gene in the patient,which leads to amino acid substitution at the 495 residue of the sulphonylurea receptor SUR1 protein.The patient's father also carried the same heterozygous inactive mutation,while the genotype of the mother was normal,indicating that the gene mutation of the patient was paternally inherited.According to that mutation,it is deduced that the patient may suffer from the focal type of congenital hyperinsulinism.

Objectives To explore the relationship between serum leve ls of hepatocyte growth factor (HGF) and matrix metalloproteinase-9 (MMP-9) and the disease activity of systemic lupus erythematosus (SLE), and study the mechan isms of these two factors in the pathogenesis of SLE. Methods The serum levels of HGF and MMP-9 were measured by ELISA. The growth curve of normal ECV304 cell line was obtained, and the action concentration of recombinant human hepatocyte growth factor (rhHGF) was determined. MMP-9 expression level in cells was detec ted by flow cytometric analysis. Results The serum level of HGF increased sign ificantly in SLE patients as compared with that in healthy controls (P 0.05). The area of ROC curve was 0.707 and the sensitivity was 66 .7% when using the serum level of HGF as diagnostic standard. The area under ROC curve was 0.984 and the sensitivity was 97.2% when using the serum level of MMP-9 as diagnostic standard. The sensitivity was 66.7% (24/36) when two markers (H GF and MMP-9) were examined simultaneously. Additionally, the action concentrati on of rhHGF was 8 ng/mL, and the expression level of MMP-9 was 39.74% in normal ECV304 cells and increased to 40.32% after rhHGF stimulation. Conclusions It i s suggested that HGF and MMP-9 may be involved in the pathogenesis of SLE, and s erum levels of HGF and MMP-9 might be used as markers for monitoring the disease activity, renal damage, disease progression and improvement in SLE. The sensiti vity might be higher when serum level of MMP-9 is used as diagnostic standard, a nd rhHGF can enhance MMP-9 expression in ECV304 cell line.

Objective To investigate the relationship between serum level of MMP-9(matrix metalloproteinase-9) and the disease activity of systemic lupus erythematosus(SLE).Methods Serum level of MMP-9 of 30 controls and 36 SLE patients were measured by Enzyme Linked Immuno Sorbent Assay.Results Significantly decreased serum level of MMP-9 was found in SLE patients as compared to that in healthy controls(108?113) ng/ml vs (352?155) ng/ml (P0.05).Conclusion The present data suggests that MMP-9 may be involved in the pathogenesis of SLE,and serum MMP-9 level may be a marker of disease activity,renal damage,disease progression and amelioration in SLE.

Objective To investigate the effect of Kangaroo care(KC)on diminishing neonatal pain during heel lancing. Methods Sixty neonates were divided randomly into two equal groups:intervention group and control group,which 30 cases in each group.In the intervention group,neonates were treated with KC(neonates were put in direct and continuous skin-to-skin contact with his/her mom)from 20 mins before heel lancing to 1 mins after the end of the lancing.In the control group,neonates were treated with regular care.The differences in heart rate,blood oxygen saturation,facial pain expression,crying duration and DAN(Douleur Aigue Nouveaune)scores between two groups were compared at 7 time points from 10s before the heel lancing to 10s after the lancing. Results The results of repeated measu te at 7 time points after heel lancing.There were significant interaction effect between time and main effect(P<0.01),which showed that the heart rate of two groups were not equal at different time points.Compared with the time effects(P<0.01)which showed that two groups of neonatal heart rate of the two groups would accelerate with time extension. There were significant differences(all P<0.05)in heart rate at 7 time points between two groups and smaller heart rate varied range in intervention group.The results of repeated measures analysis for neonatal blood oxygen saturation at 7 time points after heel lancing. There were significant interaction effect between time and main effects(P<0.01),which showed that the blood oxygen saturation of two groups were not equal at different time points.Compared with the time effect(P<0.01),which showed that two groups of neonatal blood oxygen saturation would reduce with time extension.There were significant differences(all P<0.05)in blood oxygen saturation of two groups at 30s,40s and 50s after heel lancing and smaller blood oxygen saturation varied range in intervention group.The crying duration and DAN scores in intervention group were significantly reduced compared with the controls(all P<0.05).Conclusions
Heel lancing could lead to moderate to severe pain of neonates.KC could effectively diminish the neonatal pain degree caused by heel lancing.

Objective 99Tcm-4,9-diaza-3,3,10,10-tetramethyldodecan-2,11-dione dioxime(HL91),a new type of hypoxic agents,accumulates in tumor hypoxic tissue specifically.The aim of this study was to evaluate the value of 99Tcm-HL91 imaging in the diagnosis of bone metastasis.Methods Nineteen cases with bone metastasis(without any treatment)and 8 cases with benign lesions underwent SPECT imaging at 4 h after injection of 740 MBq of 99Tcm-HL91 along with 99Tcm-methylene diphosphonic acid(MDP)imaging.Regions of interest(ROIs)were drawn in tumor tissue and contralateral normal tissue respectively,and the radioactivity ratios of tumor-to-normal(T/N)were calculated.The t-test was used for data analysis with SPSS 11.0.Results There were visible uptake of 99Tcm-HL91 in 79 out of 85 focuses in 19 patients of bone metastasis;however,there was no obvious uptake of 99Tcm-HL91 in 12 focuses of 8 patients of benign lesions.Significant difference existed between the T/N values of malignant(1.877±0.288)and benign lesions[(0.735±0.236);t=13.065,P＜0.05].However,the T/N value of bone metastasis from lung cancer did not differ with that from prostate cancer(1.915±0.344 and 1.825±0.175,respectively;t=1.378,P＞0.05).Conclusion The results indicated that 99Tcm-HL91 was useful in diagnosing the malignant and benign bone lesions.

Objective To analyze the relationship between obstructive sleep apnea syndrome (OSAS) and metabolic syndrome (MS) in petrol field workers.Methods A total of 100 cases of OSAS patients of petrol field workers were enrolled as the study objects from March 2013 to August 2015 in emergency and respiratory department in Daqing Longnan Hospital and were divided into three groups:simple snoring group (Group A,n =26),mild OSAS group (Group B,n =42),and severe OSAS group (Group C,n =32).The comparison of dietetic status score,sleep status score and the patients with MS among 3 groups were carried out.The relationship between OSAS and MS was analyzed by using univariate and multivariable Logistic regression analyses were used.Results In Group C,sleep status score (8.3 ± 1.2) and dietetic status score (7.6 ± 1.4) and the rates of MS (23/32) were higher than those in the other two groups (P ＜ 0.05).Univariate and multivariable Logistic regression analyses,showed OSAS was the risk factorofMS [r=11.211 (OR =9.412,95％ CI:5.992～15.202)].Conclusions Dietetic status and sleep status were obviously influenced by OSAS in petrol field workers.The incidence of MS were more common in petrol field workersevere with OSAS and OSAS was a risk factor of MS.

ObjectiveTo evaluate the influence of different hemoperfusion (HP) intensity on 7-day and 28-day mortality for patients with paraquat (PQ) poisoning, and examine the factors that may affect the decision of the clinicians to prescribe a high intensity HP.Methods A retrospective cohort study was conducted. The patients admitted to the department of critical care medicine of Anhui Provincial Hospital Affiliated to Anhui Medical University with the diagnosis of PQ poisoning from August 2012 to August 2014, fulfilling the following criteria were enrolled in the study: older than 18 years, interval from ingestion PQ to hospital admission shorter than 12 hours, and receiving HP treatment within 24 hours, and expecting surviving time exceeding 24 hours after admission, and data of the patients available for at least 28 days after admission. Depending on the intensity of HP, patients were assigned to either lower intensity HP group (LHP, defined as receiving HP for less than 4 hours, 2 columns) or higher intensity HP group (HHP, defined as receiving HP longer than 6 hours, 3 columns). Patients' data were retrieved from hospital's electronic database after hospital admission, and the results at 7th day and 28th day were recorded. Multiple logistic regression model was used to determine factors with which the clinician decided to choose the intensity of HP for the patients, and Cox regression model was used to evaluate 7-day and 28-day mortality.Results Data of 60 patients was finally available for this study. LHP group consisted of 28 patients, with a 7-day mortality of 53.6%(15 patients) and 28-day mortality of 64.3% (28 patients); 32 patients were assigned to HHP group with 7-day mortality of 43.8% (14 patients) and 28-day mortality of 62.5% (20 patients). Twenty-eight patients constituted as the HHP group, with higher PQ concentration in plasma, higher incidence of respiratory alkalosis and acute kidney injury (AKI), and higher level of lactate (Lac) compared with LHP group. However, a lower 7-day mortality was observed in the HHP group. Multiple logistic regression model indicated that at admission, interval from ingestion PQ to hospital admission longer than 4 hours [odds ratio (OR) = 1.461, 95% confidence interval (95%CI) = 1.132-1.435,P< 0.001], younger than 50 years old (40-49 years old:OR = 1.397, 95%CI = 1.251-1.703,P = 0.002;< 40 years old:OR = 1.701, 95%CI = 1.253-1.836,P< 0.001), PQ plasma concentration≥ 2 mg/L (OR = 3.140, 95%CI = 1.511-3.091,P< 0.001), white blood cell (WBC)> 10×109/L (OR = 1.222, 95%CI = 1.032-1.275, P = 0.018), Lac> 2.0 mmol/L (OR = 2.392, 95%CI = 2.090-2.734,P< 0.001), AKI on admission (stage 2:OR = 2.350, 95%CI = 2.160-3.910,P< 0.001; stage 3:OR = 2.821, 95%CI = 1.932-3.651,P< 0.001), accompanying hypoxia (OR = 2.420, 95%CI = 2.131-2.662,P = 0.003) were more likely to receive higher intensity of HP. Furthermore when compared with patients survived for 28 days, patients who were older, with higher levels of PQ concentration at admission or after 4 hours of HP, accompanied by AKI, increased serum creatinine (SCr), WBC, Lac, and acute physiology and chronic health evaluationⅡ (APACHEⅡ) score, lower arterial partial pressure of carbon dioxide (PaCO2) and lower pH value were more likely to die. After adjusted for con-variables in COX regression model, HHP was associated with lower 7-day mortality after admission [hazard ratio (HR) = 0.843, 95%CI = 0.732-0.971, P = 0.032], but devoid of lowering effect on 28-day mortality rate (HR = 0.930, 95%CI = 0.632-1.411,P = 0.423). In addition, age> 50 years old (HR = 1.282, 95%CI = 1.050-1.530,P = 0.043), PQ concentration increased by 1 mg/L (HR = 2.521, 95%CI = 2.371-3.825,P = 0.012), AKI on admission (HR = 3.850, 95%CI = 2.071-5.391,P< 0.001), WBC>10×109/L (HR = 1.932, 95%CI = 1.782-2.171,P = 0.006), Lac> 2.0 mmol/L (HR = 2.981, 95%CI =2.210-3.792,P = 0.002), and PaCO2< 35 mmHg (HR = 1.772, 95%CI = 1.483-2.516,P = 0.008; 1 mmHg =0.133 kPa) were independent risk factors for 28-day mortality.Conclusions Though HHP was helpful in lowering mortality rate in patients with PQ poisoning within 7 days, it did not influence on 28-day mortality. Clinicians' decisions on HP intensity need further investigation, and more perfect clinical evaluation system is required for reasonable use of expensive medical resources such as HP.