According to the hemodynamic changes,circulatory failure is divided into warm shock and cold shock,and severe circulatory failure often co-exist in both conditions in children.Circulatory failure in children is characterized by rapid change on hemodynamic status,pathologic vasodilation,relative or absolute hypovolemia,myocardial depression,altered blood flow distribution,and metabolic disorders.Therapeutic strategies include improving cardiac output and tissue perfusion,achieving SVO2＞70％ and cardiac index to 3.3～6.0 L/( min· m2 ),ensuring the intravascular blood volume and cardiac load.

The blood lipids and lipid peroxide (LPO) were analysed in rabbits fed with 1% cholesterol in feeding ( n =19) and with standard feeding ( n =15) after 5 weeks of feeding.The plasma LDL was isolated and ox LDL was obtained by thin layer chromatography (TLC).Cerebral ischemia was induced by ligation of left common carotid artery.The antioxidation and antiischemia injury property of RSM was also observed with TLC and electron microscopy.The results showed that the plasma LPO,FFA,CH and PL levels in 1% cholesterol fed rabbits were much higher than those of rabbits with standard feeding( P

Objective To reveal the changes of pre-and post-prandial sigmoid colon motility in irritable bowel syndrome (IBS) patients and healthy comtrols.Methods Twenty consitipation-predominant and sex/age mathched 20 diarrhea-predominant IBS patients and 15 healthy volunteers were enrolled in the experiment.Migrating long spike bursts,and nonmigrating long spike bursts were recorded by a water perfusing manometry apparatus connected with a computer.Results In fasting status,diarrhea-predominant IBS patients had higher motor index mainly due to the elevated wave amplitude and the percentage of the recording time of the migrating long spike bursts.The test meal significantly increased the amplitude and the number of migrating and nonmigrating long spike bursts in all subjects,especially in the volunteers in the first half hour.The gastrosigmoidocolic reflex of the diarrhea-predominant IBS patients lasted longer than that of the consitipation-predominant IBS patients and healthy controls,mainly due to the increased amplitude of migrating long spike bursts and the number of nonmigrating long spike bursts.Conclusion Diarrhea-predominant IBS patients have stronger sigmoid colon motility in fasting state.The gastrosigmoidocolic reflex appears earlier in healthy subjects than in IBS patients and it lasts longer in diarrhea-predominant IBS patients than in consitipation-predominant IBS patients and healthy controls.

Objective To investigate the relationship between the sigmoid colon propagating contractions and the gut hormones cholecystokinin(CCK)and motilin(MTL)in the patients with irritable bowel syndrome(IBS),and to reveal the gut hormones' modulation to the sigmoid colon motility.Methods Twenty diarrea-predominent IBS patients(D-IBS),and sex/age matched 20 constipation-predominent IBS patients(C-IBS)and 15 healthy volunteers were enrolled in the study.From June 2005 to Mar.2006,the high amplitude propagating waves and loger time of the sigmoid colon was measured by means of a liquid-perfused capillary tube connected to a computer.Meanwhile,the concentrations of CCK,MTL of blood plasma and sigmoid colon mucosa were tested by means of immunoassay technology.Results The D-IBS group had higher amplitude of the sigmoid colon propagating waves and their time percentage than that of the C-IBS group and the control group(P

Professor ZHANG Lei is one of the most renowned doctors in traditional Chinese medicine. He is good at treating miscellaneous disease of internal medicine, and summarizes eight clinical therapy from long-term clinical practice, and cleaning turbidity therapy is one of the most characteristic therapy. Cleaning turbidity therapy is founded under today's improvement of living standards and changes of lifestyle where more and more turbidity syndromes are caused. Qianjin Weijing Decoction is used as main prescription and modified according to different zang-fu where turbidity syndromes are located. On account of cleaning turbidity therapy is one of the eliminating pathogens therapy, strengthening healthy qi must be used according to power of healthy qi, especially healthy qi of spleen and stomach.

ObjectiveTo investigate the clinicopathological characteristics of nipple-areolar complex (NAC) involvement in patients with operable breast carcinoma and to determine the indications and risk factors of NAC-sparing modified radical mastectomy. Methods407 female patients with primary breast cancer were included in the study.Data like tumor position, tumor size, the distance from the tumor to the margin of areolar (D) were recorded.NAC sample in vitro was collected and routine pathological examination was performed.Statistical methods were employed to analyze the relation between the clinicopathological factors and NAC involvement.ResultsThe rate of NAC involvement was 13.27％ (54/407).NAC involvement had no statistically significant correlation with age or histological type, but had statistical correlation with tumor position, D value, tumor size, TNM stage, clinical manifestation of NAC, and status of axillary lymph nodes(P ＜ 0.05).ConclusionsTumor position, D value, tumor size, TNM stage, clinical manifestation of NAC and status of axillary lymph nodes are the major influential factors for NAC involvement.The indications of NAC-sparing modified mastectomy:1.in Ⅰ or Ⅱa TNM stage; 2.patients have strong will to preserve NAC or breast appearance; 3.noncentric tumor (D≥2 cm) ; 4.the maximum diameter of tumor should be less than 3 cm; 5.no abnormal manifestation like nipple discharge, eczematoid change or nipple inversion happened.6.no occult involvement in subareolar tissues was found by frozen pathology.

ibits tyrosinase activity and melanogenesis in murine B16 melanoma cells. Hence, N-acetylglucosamine may serve as a skin lightening agent in the future.

Aflibercept is a soluble fusion protein which combines ligand-binding elements taken from the extracellular components of vascular endothelial growth factor (VEGF) receptor-1 and receptor-2 fused to the Fc portion of IgG,and it is a novel antiVEGF drug,which can reduce vascular permeability and inhibit neoangiogenesis by binding VEGF tightly.A large number of phase Ⅲ clinical trials have demonstrated the satisfactory outcomes of aflibercept in the management of neovascular age-related macular degeneration,macular edema secondary to retinal vein occlusion or macular edema and other retinal vascular diseases.Moreover,intravitreal injection of afiibercept can improve the visual acuity and attenuate the fundus lesion,which provides a new drug option for physicians.The review will summarize the chemical properties of aflibercept and its application,safety and efficacy of aflibercept for the treatment of retinal vascular diseases.

24 cases of human placentas were obtained from rivanol-induced abortion, and 6 cases from cesarean section, curettage, and water saccule-induced abortion were chosen for comparative study. All the specimens were proccessed under the same histological and histochemical procedures.In all the specimens from rivanol-induced abortion we observed a reduction in the activity of the ?~5-3?-hydroxysteroid dehydrogenase and of the number of fine lipid droplets in the syncytiotrophoblasts, and in these cells we also observed an increased activity in acid phosphatase in most of the specimens and a decrease of RNA content in a few specimens. A large number of decidual cells and a few trophoblasts showed necrotic changes. The chorionic plate also showed necrosis and distinct inflammatory reactions, and on the fetal surface of the placenta the blood circulation showed disturbance. These changes indicated that rivanol had demaged the placenta and reduced its synthetic function of progesterone which we believed played a rote in terminating pregnancy and caused abortion eventually. It was suggested that the intraamniotic injection of rivanol is preferable to extraamniotic injection.

Objective: To investigte the lipogenic and lipolytic metabolism at dynamic phase of obesity in ventromedial hypothalamus-lesioned obese rats. Methods: Female SD rats were divided into two groups, one group received bilateral electrolytic lesions of ventromedial hypothalamus(VMH),and the other one was used as sham control. Samples of blood, livers and subcutaneous, parametric and mesenteric adipose tissues were collected one week after VMH lesions and sham operations. Results: Activities of microsomal triglyceride transfer protein(MTP) in hepatocytes, and phosphatidate phosphohydrolase (PAP), malic enzyme(ME), glucose-6-phosphate dehydrogenase(G6PDH)in liver, parametric and mesenteric adipose tissue in VMH-lesioned rats were increased as compared to their sham counterparts. Activity of hormone sensitive enzyme(HSL) in parametric and mesenteric adipose tissue in VMH-lesioned rats was not changed when compared to sham group. Activity of HSL in subcutaneons adipose tissue was increased, while activity of HSL in gastrocnemius was decreased. Activity of lipoprotein lipase(LPL) in parametric and mesenteric adipose tissue and gastrocnemius were enhanced significantly compared to sham group. Conclusion: In dynamic phase of obesity of VMH-lesioned rats, hepatic production and transportation of triglyceride in these rats were increased significantly ,and lipogenic metabolism and storage of triglyceride in adipose tissues such as parametric and mesenteric adipose tissues were also enhanced.Meanwhile, lipolytic metabolism in subcutaneous adipose tissue and gastrocnemius was also increased.