The present study visualized the knowledge map of research hotspots and changes of keywords by importing literatures from The American Journal of Clinical Nutrition (2000 ～ 2011) into CiteSpace.Analysis of the research hotspots (keywords),evolution of clinical nutrition,and front-line research based on tf-idf algorithm was then performed.

Objective To determine the median effective target plasma concentration (Cp50) of remifentainil inhibiting body movement evoked by puncture during brachial plexus block in pediatric patients.Methods Pediatric patients of both sexes,aged 5-12 yr,who grown normally,scheduled for elective forearm or hand surgery,were enrolled in this study.Children were premedicated with oral midazolam 0.2 mg/kg at 30 min before anesthesia.The initial target Cp of remifentainil was 5.0 ng/ml.The target Cp was determined by up-and-down sequential method.Each time Cp increased/decreased by 20％ in the next patient depending on the response of the previous patient to puncture.The ratio between the two successive concentrations was 1.2.The puncture was performed after the target effect-site and plasma concentrations were balanced.Body movement was defined as puncture-induced movement of truncus,limbs and/or head and neck.The Cp50 and 95 ％ confidence interval of remifentainil were calculated by Dixon method.Results Cp50 of remifentainil inhibiting body movement evoked by puncture during brachial plexus block was 3.9 ng/ml,and 95 ％ confidence interval was 3.6-4.2 ng/ml.Conclusion Cp50 of remifentainil inhibiting body movement evoked by puncture during brachial plexus block is 3.9 ng/ml in pediatric patients.

Objective To explore the risk factors and the recurrence of spontaneous bacterial peritonitis after taking intestinal probiotics.Methods Fifty-six patients with spontaneous bacterial peritonitis were randomly divided into control group and probiotics group,and each group were 28 cases.Patients in control group were treated by regular hepatoprotective drug,while in probiotics group were administrated with Jinshuangqi orally,every time 0.5 g × 4 tablets,2 times a day besides regular hepatoprotective drug.The course of the treatment was for 3 months.The symptoms and other risk factors,and the relief time were recorded.Results Incidence of spontaneous bacterial peritonitis in probiotics group and control group were 21.4％ and46.4％ respectively(x2 =3.784,P ＜ 0.05).Rate of gastric ulcer were 17.9％ and 42.9％ respectively and the difference was significant(x2 =4.139,P ＜ 0.05).The relief time of fever in probiotics group was (2.52 ± 0.78) d,lower than that of control group ((4.21 ± 1.34) d,t =2.029,P ＜ 0.05).Meanwhile the relief time of abdominal tenderness was (4.02 ± 0.96) d in probiotics group,and (6.34 ± 1.27) d in control group (t =2.433,P ＜ 0.05).Conclusion Intestinal probiotics treatment can significantly reduce the recurrence rate of spontaneous bacterial peritonitis,shorten the relief time of each symptom and reduce the incidence of other risk factors.

Objective To determine the content of protocatechuic acid in Spatholobus suberectus Dunn.Methods HPLC method was developed for the determination of protocatechuic acid in Spatholobus suberectus Dunn.The separation was performed on C18 column with acetonitrile-water-orthophosphoric acid(8 ∶92 ∶0.1) as a mobile phase with the flow rate being 1.0 mL/min.The detection wavelength was set at 260 nm.Results A satisfactory separation between protocatechuic acid and impurity was obtained.The calibration curve was linear in the range of 0.020～2.008 ug,r=0.999 9.The average recovery was 98 %,and RSD was 0.1 %(n=5).Conclusion The method is accurate and can be used for the detemrmination of protocatechuic acid in Spatholobus suberectus Dunn.

Objective To study the effect of sanguinarine on the growth and radiosensitivity of ovarian cancer SK-OV-3 cells.Methods Cell growth was determined by MTT and clonogenic assay.Cell cycle analysis was performed by flow cytometry assay.The cell apoptosis was analyzed by Annexin V/PI assay.Results Sanguinarine inhibited SK-OV-3 cell growth in a dose-and time-dependent fashion and its IC50 values were 3.02 and 1.11 μmol/L at 24 and 48 h,respectively. Sanguinarine also significantly triggered a sub-G1 peak,an indicator of apoptosis,and caused a G0/G1 arrest.Furthermore,the cell apoptosis induced by X-irradiation was significantly increased at 6 Gy when the cells were pre-treated with sanguinarine,in which the early apoptotic population increased from 10.28％ to 43.28％ (t =19.41,P ＜0.01 ) and the late apoptotic population increased from 20.26％ to 30.80％ ( t =8.78,P ＜ 0.01 ).The multi-target click model was used to fit survival curves and the SER of sanguinarine treatment approached to 1.625 at the dose of D0. Conclusions Sanguinarine could inhibit SK-OV-3 cell growth by inducing apoptosis and cell cycle arrest and enhance cell radiosensitivity at low doses.

【Objective】To devise the optimal method and the optimal water content for the storage of seeds of Aquilaria sinensis(Lour.) Gilg..【Methods】The seeds of Aquilaria sinensis(Lour.) Gilg.were stored in plastic bag,drying apparatus,wet sand and dry sand separately.And then the germination capacity of the seeds with different water content was detected at 4℃ and room temperature(30℃) in different time.【Results】The germination capacity of Aquilaria sinensis(Lour.) Gilg.decreased with the prolongation of storage time and with the decrease of water content.The seeds with water content being 9.34% and 7.35% had a higher germination capacity when stored at 4℃ for 35 days than that stored at room temperature.The fresh seeds stored in wet sand sprouted and the seeds stored in drying apparatus and dry sand had lower germination capacity and went mouldy.【Conclusion】Low temperature and moderate water content are benificial to the storage of the seeds of Aquilaria sinensis(Lour.) Gilg..

【Objective】To explore the long-term storage method for the seeds of Aquilaria sinensis(Lour.)Gilg..【Methods】The seeds of Aquilaria sinensis(Lour.)Gilg.with different water contents were preserved with liquid nitrogen for 55 days.And then the seeds were taken out to detect their germination capacity.The effect of cryopreservation methods on the germination capacity was also observed.【Results】The seeds with water content being 16.30% lost their germination capacity completely,the seeds with water content being 13.02% and 9.34% had a lower germination capacity,and the seeds with water content being 7.35% had a higher germination capacity.Quickly-frozen seeds had a higher germination capacity than the slowly-frozen seeds.【Conclusion】Cryopreservation with liquid nitrogen is suitable for the long-term preservation of the seeds of Aquilaria sinensis (Lour.)Gilg.with water content being 7.35%.

OBJECTIVETo assess the feature of pulmonary blood flow distribution after total cavopulmonary connection (TCPC) of different types, and to provide the selection of the best type.

METHODSThirty-two consecutive survival patients after TCPC underwent radionuclide lung perfusion imaging. According to the radionuclide counts in the left and right lungs, analyses of the distribution of blood flow from superior venous cava (SVC) and inferior venous cava (IVC) and the whole pulmonary blood flow in both lungs were made. All patients were divided into 4 groups by the the anastomosis between IVC and pulmonary artery.

RESULTSGroup I: The flow ratio of the IVC to left lung was greater than that to the right lung, P < or = 0.01; the flow ratio of the SVC to right lung was greater than that to the left lung, P < or = 0.01; and the whole pulmonary blood flow went dominantly to the left lung, P < or = 0.05, which is not in line with physiological distribution. Group II: the flows from the SVC and IVC were mixed in the middle of the junction and ran evenly into the right and left lungs, the whole pulmonay blood flow went to both lungs, P > or = 0.05. Group III: the flow ratio of the SVC to both lungs were the same, P > or = 0.05, and major part from IVC went to the right lung, P < or = 0.01; the pulmonary blood flow go dominantly to the right lung, P < or = 0.05, which is in accord with physiological distribution. Group IV: the flows from the right SVC went to right lung by 100%, P < or = 0.01, and that from the left SVC went to left lung by 100% too, P < or = 0.01; the flows from IVC went dominantly to the left lung, with little part to the right lung, P < or = 0.05.

CONCLUSIONSDifferent types of TCPC can result in different pulmonary blood distributions. The best flow distribution between the left and right lungs can be obtained by an offset of the IVC anastomosis toward the RPA with widening anastomosis for the patients without persist left superior venous cava (PLSVC).

Adult ; Child ; Child, Preschool ; Female ; Fontan Procedure ; methods ; Heart Defects, Congenital ; physiopathology ; surgery ; Humans ; Lung ; blood supply ; diagnostic imaging ; Male ; Pulmonary Artery ; surgery ; Radionuclide Imaging ; Regional Blood Flow ; Vena Cava, Inferior ; surgery ; Vena Cava, Superior ; surgery

Objective To compare the impacts of subtotal nephrectomy and ischemiareperfusion injury on renal stem cells and progenitor cells of rats,and to explore the significance of renal stem cells and progenitor cells for renal repair and the possible mechanisms of prognosis in rats with acute renal failure (ARF) or chronic renal failure (CRF).Methods Rats of CRF or ARF model underwent 5/6 nephrectomy or renal artery ligation and repedusion respectively,and rars in control group underwent sham operation.Scr,BUN and 24 hour urine protein were regularly measured.Kidney specimens were obtained at the set time for HE staining and fluorescence staining.Expressions of CD24,CD133 and podocin were detected by immunofluorescence.RT-PCR was performed to quantify the expression of transforming growth factor β1 (TGF-β1),Notch2,hepatocyte growth factor (HGF),bone morphogenetic protein 7 (BMP7) and Pax-2 mRNA in renal tissue and the expression of podocin mRNA in renal cortex.Correlation among the expressions of Pax-2 mRNA,podocin mRNA and glomemlosclerosis index were analyzed.Results The rats of two models presented typical ARF or CRF in renal pathology and function.Glomerulosclerosis index in CRF group increased gradually with time,which were (2.34±0.28)％,(25.12±5.67)％,(89.42±12.28)％ and (171.23±32.28)％ at day 14,day 30,day 60 and day 90 respectively.Compared with sham group,the CD24+CD133+ cells of the ARF rats showed no significant change in quantity and distribution,while the CRF rats showed gradual reduction of CD24 +CD133+ cells.The expression of podocin in glomerulus decreased temporarily and recovered finally after ischemiareperfusion injury,but decreased gradually after 5/6 nephrectomy.Compared with sham group,expression of TGF-β1,Notch2 mRNA in renal tissue was increased in CRF group,while the expression of HGF,BMP7 mRNA in renal tissue of ARF group were increased.Between the expression of Pax-2 mRNA in renal tissue and the expression of podocin mRNA in renal cortex,there was positive correlation in CRF group,while they both were negatively correlated with glomerulosclerosis index.Conclusions Ischemia-reperfusion injury makes no obvious impairment to renal progenitor cells.Having progressively injured the living environment of renal progenitor cells,subtotal nephrectomy reduces renal progenitor cells,and causes podocytes to repairing incompetently,which may be the main pathogenesis of CRF with poor prognosis.

Objective To investigate the clinical value of transanal endoscopic microsurgery (TEM) for the treatment of elderly patients with colorectal adenoma.Methods Totally 21 patients with colorectal villous adenoma underwent TEM from Dec.2007 to Sep.2010.The distance of adenoma from the anal verge was 4-20 cm (average 8.9 cm) and tumor size was 1.1-3.5 cm (average 1.9 cm).There were 12 cases with tubular adenoma and 9 cases with villous adenoma according to pre-operative diagnosis by colonoscopy and endoanal ultrasonography (EUS).Appropriate position and posture were dictated by the location of the tumor under general anesthesia.A special rectoscopy was inserted into the anus with CO2 insufflation to keep the rectum open.Under the stereoscopy and lapaoscopy-type instruments,the tumor was completely resected (submucosal or full-thickness excision) using a 5 mm ultrasonic dissector.The operative wound was closed with intra-lumen continuous sutures.Results The tumor was completely removed with negative resection margins in all the 21 patients (submucosal excision in 12 cases and full-thickness excision in 9 cases).The operating time was 40-100 min (average 76 min) and the intraoperative blood loss was 10-80 ml (average 50 ml).The post-operative stay was 2-10 d (average 4.5 d).The postoperative pathological stages were pT0 in 16 cases and pTia in 5 cases.The postoperative pathological diagnosis were tubular adenoma in 12 cases,villous adenoma in 9 cases,low-grade intraepithelial neoplasia (IN) in 5 cases and high-grade IN in 5 cases.Follow-up checkups in the 20 patients for 2-20 months (average 11 months) revealed no local recurrence.Conclusions TEM is safe and effective with little complication for the treatment of elderly patients with colorectal adenoma.Pre-operative EUS is very important for TEM.