BACKGROUND:To evaluate the accuracy of National Early Warning Score (NEWS) in predicting clinical outcomes (28-day mortality, intensive care unit [ICU] admission, and mechanical ventilation use) for septic patients with community-acquired pneumonia (CAP) compared with other commonly used severity scores (CURB65, Pneumonia Severity Index [PSI], Sequential Organ Failure Assessment [SOFA], quick SOFA [qSOFA], and Mortality in Emergency Department Sepsis [MEDS]) and admission lactate level. METHODS: Adult patients diagnosed with CAP admitted between January 2017 and May 2019 with admission SOFA ≥2 from baseline were enrolled. Demographic characteristics were collected. The primary outcome was the 28-day mortality after admission, and the secondary outcome included ICU admission and mechanical ventilation use. Outcome prediction value of parameters above was compared using receiver operating characteristics (ROC) curves. Cox regression analyses were carried out to determine the risk factors for the 28-day mortality. Kaplan-Meier survival curves were plotted and compared using optimal cut-off values of qSOFA and NEWS. RESULTS: Among the 340 enrolled patients, 90 patients were dead after a 28-day follow-up, 62 patients were admitted to ICU, and 84 patients underwent mechanical ventilation. Among single predictors, NEWS achieved the largest area under the receiver operating characteristic (AUROC) curve in predicting the 28-day mortality (0.861), ICU admission (0.895), and use of mechanical ventilation (0.873). NEWS+lactate, similar to MEDS+lactate, outperformed other combinations of severity score and admission lactate in predicting the 28-day mortality (AUROC 0.866) and ICU admission (AUROC 0.905), while NEWS+lactate did not outperform other combinations in predicting mechanical ventilation (AUROC 0.886). Admission lactate only improved the predicting performance of CURB65 and qSOFA in predicting the 28-day mortality and ICU admission. CONCLUSIONS: NEWS could be a valuable predictor in septic patients with CAP in emergency departments. Admission lactate did not predict well the outcomes or improve the severity scores. A qSOFA ≥2 and a NEWS ≥9 were strongly associated with the 28-day mortality, ICU admission, and mechanical ventilation of septic patients with CAP in the emergency departments.

It is well documented that vascular tone is the key determinant of blood vessel resistance and blood flow. But vascular tone could be regulated by modulating the activity of potassium channel directly. Potassium channel openers promote vasodilation by inhibiting the activity of voltage dependent calcium channels and reducing Ca 2+ influx. In this case, inhibition results from membrane hyperpolarisation, which arises due to the stimulation of K + efflux through smooth muscle K + channels. While K + channels are blocked, vasoconstriction could be observed as a result of membrane depolarization, which opens voltage dependent calcium channels. The influx of Ca 2+ can promote smooth muscle contraction by making myosin light chain phosphorylation and arising thick myofilament and thin myofilament relative movements. In this article, the gene structure, current character, Pharmacological and physiological effects of the four subtypes potassium channels are reviewed.

Humans ; Spleen ; injuries ; physiology ; surgery ; Splenectomy

AIM: To observe the effect of curcumin on the retinal structure and the expressions of interleukin-23 (IL-23) and interleukin-17(IL-17) in the rat retina after retinal ischemia-reperfusion injury (RIRI).METHODS:A total of 60 male Sprague-Dawley(SD) rats were randomly divided into normal control group(NCG),model group(MG),low-dose curcumin group (LDCG) and high-dose curcumin group (HDCG) (n=15 per group).RIRI was generated by anterior chamber perfusion of normal saline to the right eye.Rats in LDCG and HDCG received an intraperitoneal injection of 20mg/kg/d and 100mg/kg/d curcumin respectively,at 30min before RIRI and once daily after RIRI.Retinal structure and inflammation were evaluated after hematoxylin and eosin-stained (HE) staining.Western-blot and enzyme-linked immunosorbent assay (ELISA) were used to measure the level of IL-23 and IL-17 expressions after RIRI.RESULTS: The retinal structure of NCG was normal.Retinal edema,empty spaces or loosely packed cells and inflammatory cell infiltration were observed in MG and LDCG groups,whereas the morphological changes in HDCG group were improved as compared to MG and LDCG groups.Western-blot assay and ELISA showed that IL-23 and IL-17 expressions increased significantly after RIRI (vs NCG,P<0.01).Moreover,curcumin reduced IL-23 and IL-17 expressions significantly (vs MG,P<0.01).CONCLUSION: Curcumin can inhibit leukocytes infiltration and improve the retinal pathologic changes.Furthermore,curcumin can reduce retinal IL-23 and IL-17 expressions significantly in a dose-dependent manner.

Abstract?AIM: To characterize the effects of sodium iodate on mouse retinal morphology and function.?METHODS: Sodium iodate at 35mg/kg ( body weight) was administered by tail vein injection into adult 6-8wk C57BL/6J mice. Morphological and functional changes of the retina were assessed at 6h, 1, 3, 5 and 8d after injections by fundus imaging, optical coherence tomography (OCT), ERG and histology. Mice in control group were give tail vein injection of equivalent dose of normal saline. All the eyeballs were removed for paraffin section and H-E staining.?RESULTS: The fundus photographs images at 6h after injection showed obvious changes, which were light red in retina and showed retinal blood vessels radial arranged. At 6h after injection, off-white drusen-like change was found at fundus. While there were no observable changes in OCT image and ERG. At 1d after injection, the fundus lesion aggravated and the drusen increased gradually. There were retinal pigment epithelial ( RPE) disorders, photoreceptors and outer nuclear layer (ONL) damage through OCT. At 3d after injection, the retina lesion aggravated further and the retina became edema. At 5d after injection, the retina edema cleared away, the optic nerve became white and the fundus lesions increased. At 8d after injection, the RPE layer, photoreceptors and ONL were destroyed obviously. In the process, ERG showed the amplitudes of a- and b-wave decreased in a time-dependent manner. H-E staining showed that cells in retina of mice in control group were neatly arranged and well- distributed. The outer layer retina of sodium iodate injection group was wave-like, the normal structure of RPE disappeared and black round sediment could be seen which increased with time. At 8d after injection, there were any normal RPE.?CONCLUSION: The tail vein injection of sodium iodate can well simulate the pathogenesis of age - related macular degeneration which can provide a good animal model for AMD.

The connotation and position of learning and examination resources center in library were elaborated. How to perfect the service system for readers was proposed by introducing the IC ideas and model into library con-struction.The characteristic, cooperative, sharing and developmental principles were pointed out, which should be followed in construction of the learning and examination resources center.The new model for learning together and innovative service should be established by integrating the characteristic databases ,constructing communication plat-forms,strengthening librarian literacy,and bringing the functions of library resources,spaces and manpower into full play.

Purpose:In order to determine the indications for adjuvant treatment in node-negative breast cancer.Methods:We analyzed 233 cases of node-negative breast cancer. Results:The recurrence ratio of node-negative breast cancer was 7.3 percent. The prognosis was connected with age,menstrual history , position, diameter of tumor and pathology. Among invasive lobule cancer, GradeⅢ and lymphocyte-negative cancer, the recurrence ratio was 28 percent in patients with three factors, 16 percent in patient with two factors, 7 percent in patients with one factor.Conclusions:Node-negative breast cancer cases with high recurrence factors need adjuvant treatment.

Objective To evaluate autologous buccal mucosal patch grafting for correcting penile deformity in the surgical treatment of Peyronie's disease. Methods 14 patients with symptoms of Peyronie's disease for more than three months suffered from persistent pain ,severe curvature of the penile shaft and resistant to conservative treatment underwent plaque incision and autologous buccal mucosa patch grafting. Results Postoperative follow up has been 0.5 to 2years.The penile shaft became straight with no narrowing or indentation in 12 patients (86%) . In 14% of cases (2/14) some curvature of the penile shaft persisted and there was pain on erection.In all the patients there was no change in penile length. 86% of patients had overall satisfaction after surgery with improvement in psychological and social well-being. Conclusions The autologous buccal mucosal patch graft provides an anatomical and functional tunied substitute resulting in correction of the penile deformity in Peyronie's disease.

Objective To describe CT and MR apearance of retroperitoneal ganglioneuroma .Methods CT and MR findings ofretroperitoneal tumor in a patient with ganglioneuroma biopsy-proved were retrospectively analyzed,and a literature review was conducted. Results The mass was well-circumscribed,non-enhanced CT showed homogeneous low atenuation, and a punctate calcification was seeninside tumor.Contrast uptake was delayed.Progressive but incomplete enhancement was observed.On MRI,T_2WI showed a high signalintensity and T_1WI show a low signal intensity.Enhanced MR depicted the mild enhancment.Conclusion Retroperitoneal ganglioneuroma is a rare tumor which should nevertheless be included in differential diagnosis of retroperitoneal masses when presenting as a well-delimitedtumor with possible tendency to surroud or displace major blood vessels.Low density on non-enhanced CT,and delayed progressiveenhancement on CT and MRI.

To study the chemical constituents of the methanol portion of the stem of Illicium henryi. The methanol portion was isolated and purified by HP-20, ODS, Sephadex LH-20 column chromatography, and preparative HPLC. Their structures were elucidated by MS and spectral data(1H, 13C-NMR). Five compounds were isolated from the methanol portion and identified as benzyloxy-1-O-beta-D-glucopyranoside (1), 4-hydroxy-phenethyl alcohol-O-beta-D-glucopyranoside (2), 3-methoxyl-4-hydroxyl-phenpropanol-O-beta-D-glucopyranoside (3), 3-methoxyl-4-O-beta-D-glucopyranosyloxy-benzoic acid methyl ester (4), and 4-O-beta-D-glucopyranosyloxy-benzoic acid methyl ester (5). All compounds were isolated from this plant for the first time.
Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Illicium ; chemistry ; Molecular Structure ; Spectrometry, Mass, Electrospray Ionization