Objective To assess the feasibility of using plethysmographic waveform variation for estimating the blood volume.Methods After general anesthesia,tracheal intubation and 750ml liquid infusion,the systolic pressure variation(SPV),dDown(delta down),dUp(delta up),SPV plet,dDown plet,dUp plet,cardiac output and other hemodynamic parameters were recorded as control.Then,300ml of blood were drained quickly from radial artery into reservoir bag,and replaced with equal volume Gelofusine.The parameters were recorded again after blood drainage and volume replacement respectively.Results The changes in plethysmographic waveform correlated well with changes in arterial dDown(r==0804 ,P=0005)after acute loss of 300ml blood and dDown and dDown pletincreased from(459?294)mm Hg and (1024?532)% to (700?336)mm Hg and (1611?744)% respectively.Moreover,dDown,SPV plet and dDown pletvaried significantly(P

ObjectiveTo evaluate the effect of shenfu injection on airway resistance and oxygenation during one-lung ventilation (OLV) in patients undergoing lobectomy.MethodsSixty ASA Ⅱ patients of both sexes,aged 50-80,BMI 20-29 kg/m2,scheduled for lobectomy under thoracic epidural block combined with general anesthesia,were randomly divided into 2 groups( n =30 each):normal saline control group (group C) and shenfu injection group (group S).In group S,shenfu injection was infused intravenously at 4.5 ml·kg-1 ·h-1 for 20 min before anesthesia induction.In group C,equal volume of normal saline was infused instead of shenfu injection.Airway peak pressure was recorded and arterial blood samples were taken for determination of PaO2 before OLV,at 30,60 min of OLV and the end of surgery.Oxygenation index was calculated.ResultsCompared with group C,airway peak pressure was significantly decreased and oxygenation index increased at 30,60 min of OLV in group S ( P ＜ 0.05).ConclusionShenfu injection can decrease airway resistance and increase oxygenation during OLV in patients undergoing lobectomy,indicating that shenfu injection has a lung-protective effect.

Background and purpose:Although bortezomib has become one of the major therapeutic agents against newly diagnosed or relapsed multiple myeloma (MM), there are some patients who become resistant to bor-tezomib and then relapse, emerging as a major obstacle to long-term survival of MM patients. It has been found that elevation of intracellular cyclic adenosine monophosphate (cAMP) levels could induce cell cycle arrest and apoptosis in MM cells,which has become an interesting approach to MM therapy. This study aimed to investigate possible effects of forskolin combined with bortezomib on bortezomib-resistant myeloma cells and further explore its mechanisms. Methods:The bortezomib-resistant MM cell lines H929-R and primary cells from patients who do not respond to bortezomib were used asin vitro models. The inlfuences of bortezomib and/or forskolin on MM cells were evaluated through cellular morphology, changes of cell distribution and apoptotic rate. Meanwhile, lfow cytometry analysis was used to detect mitochondrial transmembrane potential (ΔΨm) and the expression levels of apoptosis regulators in these cells before and after the treatment were detected by Western blot.Results:Bortezomib (20 nmol/L) synergized with forskolin (50nmol/L) to induce apoptosis of H929-R cells and bortezomib-resistant primary cells. In addition, borte-zomib synergized with forskolin to induce collapse of mitochondrial transmembrane and facilitate the degradation of anti-apoptosis proteins including Bcl-2 and Mcl-1.Conclusion:Bortezomib could synergize with forskolin to induce apoptosis in bortezomib-resistant MM cells.

Differentiated thyroid cancer can be effectively treated with high-dose 131I and the other head and neck cancer can also be effectively treated with extra-radiotherapy, but these treatments often result in a reduction in salivary gland function, causing xerostomia. Collectively, these effects can lead to severe secondary complications, including difficulty in speaking and swallowing, decreasing appetite even affecting nutrition and sleep. Amifostine, an analog of cysteamine, is a phosphorlyated aminothiol prodrug and its active metabolite, WR-1065 etc, can selectively protect normal tissues from the cytotoxic effects of drugs and/or radiation while preserve antitumor effects. Many studies have demonstrated that amifostine protects normal tissues from both acute and late extra-radiation damage without protecting the tumor. It has been approved by FDA to be used for protecting the salivary gland from xerostomia caused by radiotherapy. It has also show protecting effects on intra-radiotherapy, but there are many problems waiting for study.
Amifostine ; adverse effects ; therapeutic use ; Animals ; Clinical Trials as Topic ; Clinical Trials, Phase II as Topic ; Clinical Trials, Phase III as Topic ; Cytoprotection ; Head and Neck Neoplasms ; drug therapy ; radiotherapy ; Humans ; Rabbits ; Radiation Injuries ; prevention & control ; Radiation-Protective Agents ; pharmacology

Human Sodium/Iodide symporter gene cDNA was amplified from thyroid tissue of the patient suffering from Graves disease by RT-PCR, and T/A cloned into pGEM-TEasy-NIS for sequencing, subcloned into shuttle plasmid pAdTrack-CMV which contained a green fluorescent protein (GFP) gene, and then forwarded to homologous recombinant in the bacteria BJ5183 that already contained AdEasy-1 plasmid. Positive recombinant adenovirus vector was selected, packaged and amplified in the 293 cells to obtain recombinant adenovirus. The results showed that the recombinant AdNIS was correctly constructed and confirmed by restriction enzyme analysis and PCR. The viral titer was 2. 5 - 3 x 10(9) efu/ml. So, the recombinant adenovirus vector carrying hNIS was successfully constructed, thus providing a basis for researches on 131I therapy in nonthyroid carcinoma.
Adenoviridae ; genetics ; metabolism ; DNA, Complementary ; genetics ; Genetic Vectors ; genetics ; metabolism ; Graves Disease ; genetics ; Green Fluorescent Proteins ; genetics ; metabolism ; Humans ; Recombinant Fusion Proteins ; biosynthesis ; genetics ; Symporters ; biosynthesis ; genetics

OBJECTIVETo assess the possibility of using arterial pressure waveform or pulse oximetry plethysmographic waveform variation to estimate the pulmonary arterial wedge pressure (PAWP).

METHODSFourteen American Society of Anesthesiologists grade I - II patients aged 33 - 69 years and weighing 62.0 +/- 9.5 kg scheduled for elective abdominal tumor surgery were studied. Their hemoglobin exceeded 120 g/L and hematocrit exceeded 35 percent. Pre-operative acute hypervolemic hemodilution was applied immediately after general anesthestic induction and tracheal intubation. PAWP, systolic pressure variation (SPV), delta down (dDown), SPV(plet), dDown(plet) and other hemodynamic parameters were measured and recorded when total fluid volume (crystalloid and colloid) infused reached 10 ml/kg and 20 ml/kg and again at the end of the operation. Central venous pressure was maintained at 10 - 12 mm Hg during operation. Systolic blood pressure at the end of Valsalva maneuver (airway pressure was kept at 22 mm Hg) and the systolic pressure before the Valsalva manoeuvre during apnea were used to calculate arterial pressure ratio (APR).

RESULTSAPR, SPV, dDown, SPV(plet) and dDown(plet) all correlated well with PAWP (r = 0.717, -0.695, -0.680, -0.522 and -0.624 respectively, P < 0.01). There was a closer linear correlation between APR and PAWP than between the other parameters. The regression equation was PAWP (mm Hg) = 0.207 x APR (%) - 0.382.

CONCLUSIONDuring positive pressure mechanical ventilation, APR, SPV, dDown, SPV(plet) and dDown(plet) can be used to estimate PAWP effectively.

Adult ; Aged ; Blood Pressure Determination ; methods ; Humans ; Middle Aged ; Oximetry ; Plethysmography ; Positive-Pressure Respiration ; Pulmonary Wedge Pressure

Objective To explore the efficacy and safety of bifidobacterium tetragenous viable bacteria tablets (BTVBT) in blood glucose control in patients with type 2 diabetes mellitus (T2DM).Methods This study was a randomized, double-blind, placebo parallel comparison, multicentre clinical research.The subjects were T2DM patients who were using anti-hyperglycemic drugs.They were randomly divided into observation group and control group according to 1∶1 ratio.The subjects accepted the therapy of BTVBT or placebo by oral administration (3 tablets, tid) for eight weeks, followed up for 4 weeks, during which the basic treatment maintained unchanged.The primary outcomes: the changes of glycosylate hemoglobin A1c (HbA1c) from baseline.Results Totally 234 subjects (116 cases in observation group and 118 cases in control group) from 7 centers were included in the study.The baseline characteristics were comparable between these two groups.The HbA1c was (8.00±1.08)％ and (7.99±1.03)％ in observation group and control group, respectively, at baseline, and was (7.28±1.28)％ and (7.36±1.02)％ after 12 weeks of treatment [(-0.66±1.38)％ vs.(-0.64±1.14)％,P=0.914 5].The secondary outcomes were as follows: the fasting blood glucose (FBG) in the observation group were (7.91±1.87)mmol/L and (8.05±2.33)mmol/L at baseline and after 12 weeks of treatment;while in the control group, the FBG were (8.51±1.68)mmol/L and (8.00±2.02)mmol/L, and comparisons between two groups showed no significant change (P>0.05).The glycated albumin in the observation group and control group were (21.38±5.74)％ and (21.93±6.51)％ at baseline;after 4 weeks of treatment, they were (20.08±6.05)％ and (20.58±7.30)％ (the changes from baseline in these two groups were (-1.19±4.37)％ and (-1.20±5.08)％];after 8 weeks of treatment, they were (19.07±5.56)％ and (20.83±8.74)％ [the changes from baseline were (-2.09±4.51)％ and (-0.98±6.85)％];after 12 weeks of treatment, they were (19.03±5.19)％ and (19.36±6.14)％ [the changes from baseline were (-2.18±4.60)％ and (-2.47±5.20)％], there were no significant differences between two groups (P>0.05).The subgroup analysis showed that in those patients with the characteristics including body mass index (BMI)≥25 kg/m2 at baseline, the duration of diabetes mellitus longer than 8 years, fasting blood glucose less than 8 mmol/L and using insulin at baseline, the changes of HbA1c from baseline to the end of 12 weeks therapy in the observation group were more than in the control group.There were no significant differences between the two groups in terms of safety profiles, including the vital signs and laboratory findings (blood cell counts, liver function, and kidney function, all P>0.05).Conclusion Administration of BTVBT in T2DM patients for 12 weeks does not remarkably improve the HbA1c.

Objective:To develop the supportive care information platform based on full cycle needs of patients and explore the application effect of platform in hemiplegia patients with ischemic stroke.Methods:Based on the supportive care scheme for patients with ischemic stroke in the previous study of the research group, combined with literature review and expert group discussion, the supportive care information platform version 1.0 was developed. After 5 patients with ischemic stroke hemiplegia tried for 3 weeks, it was optimized and upgraded to version 2.0 according to the use experience. From June to December 2020, 64 patients with acute ischemic stroke hemiplegia in the Department of Neurology of the First Affiliated Hospital of Soochow University and the Second Affiliated Hospital of Soochow University hospital were randomly divided into intervention group and control group, 32 cases in each group. Barthel Index and balance ability were compared between the two groups. The control group received supportive care plan, and the intervention group received supportive care information platform.Results:After the intervention, the scores of Barthel index in the intervention group were 85 (75,90), 95 (95,100) at 1 and 3 months of illness, which were significantly higher than 65 (55,75), 75 (70,85) in the control group ( P<0.05). After intervention, the scores of balance ability in intervention group were 37 (28,43), 48 (45,51) at 1 and 3 months after illness, which were significantly higher than 28 (16,36), 31(20,37) in control group ( P<0.05). After the intervention, the scores of stroke related knowledge in the intervention group one day before discharge, one month after illness and three months after illness were 14.97 ± 2.98, 19.00 ± 2.14, 22.81 ± 1.60, which were significantly higher than those in the control group (8.69 ± 1.64), (8.88 ± 1.52), (9.09 ± 1.61) ( t values were 109.37-1 169.84, P<0.05). Conclusions:The application of supportive care information platform can provide targeted nrusing measures for patients at different stages of disease development. The platform has good feasibility, and can significantly improve patients′ Barthel index, balance ability and stroke related knowledge, which shows that the platform has good feasihility and clinical application value.

Objective:To explore supportive care needs of patients with stable stroke in the acute phase and provide guidance for effective supportive care through mixed-methods.Methods:A mixed-method study with convergent parallel design was used. A convenient sampling method was used to select neurological inpatients for questionnaire survey. At the same time, a purposive sampling was used to conduct semi-structured interviews with 15 stroke patients.Results:A total of 176 valid questionnaires were collected, and the average score of supportive care needs were 2.17±0.37, The top 3 were disease-related information needs (2.75 ± 0.40), daily life care needs (2.28 ± 0.51), and social support needs (2.26 ± 0.28). Knowing the causes of stroke ranked first in each entry. The theme of qualitative interviews included: assisting daily activities, management of impaired functions, early functional rehabilitation, disease-related knowledge, psychosocial support, and discharge guidance.Conclusions:Stroke patients have rich and high-level supportive care needs, and provide corresponding information needs based on patient needs. Implement early secondary prevention guidance to prevent stroke recurrence; cooperate with multidisciplinary teams to provide early rehabilitation, reduce functional impairment; timely identify negative emotions of patients, and jointly provide family with patients psychological support. Implement a case management model to promote full-course care for stroke patients.

Objective:To investigate whether autophagy in the inflammatory environment of thrombotic antiphospholipid syndrome (APS) drives polymorphonuclear neutrophils (PMNs) to release neutrophil extracellular traps (NETs) and whether IFN-λ1(IL-29) has a function of inhibiting NETs-related thrombin production.Methods:PMNs isolated from peripheral blood of healthy volunteers were in vitro stimulated by serum samples of patients with active APS. IL-29 and 3-methyladenine (3-MA) were used to regulate NETs release and autophagy. NETs expression was evaluated by immunofluorescence technique (IFT) and flow cytometry (FCM). Autophagy-related proteins were detected by Western blot. The levels of thrombin-antithrombin (TAT) complexes were determined by enzyme-linked immunosorbent assay (ELISA). Results:The percentages of NETs released from PMNs of healthy volunteers after stimulation with serum samples of APS patients were (22.8±3.1)% according to IFT and (10.1±2.7)% according to FCM and used as control group. IL-29 and 3-MA inhibited the release of NETs from PMNs stimulated by serum samples of APS patients and the percentages of NETs were (5.3±2.2)% and (4.9±2.4)% detected by IFT, and (2.1±1.3)% and (2.7±1.4)% by FCM, respectively. There were significant differences with the control group ( q=9.89, 10.67, 11.74, 9.61, all P<0.01). IL-29 inhibited the expression of LC3B, but promoted the expression of p62 on PMNs of healthy volunteers after stimulating with serum samples of APS patients, and the differences with the group without IL-29 pretreatment were statistically significant [LC3B/GAPDH: (0.28±0.03)% vs (0.77±0.06)%, q=8.65; p62/GAPDH: (0.63±0.05)% vs (0.33±0.03)%, q=4.78; both P<0.01]. IL-29 and 3-MA reduced the levels of NETs-related TAT complexes from (7.6±0.6) ng/ml to (3.1±0.5) ng/ml and (4.7±0.4) ng/ml, respectively ( q=6.34 and 5.15, both P<0.01). Conclusions:Autophagy was involved in the formation of NETs and subsequent coagulation cascade activation in PMNs of healthy subjects after stimulation with serum samples of APS patients with thrombosis. IL-29 suppressed the production of NETs and NETs-associated thrombin by inhibiting autophagy.