BACKGROUND: To tonify qi, benefit spleen and primary qi, strengthen tendons and bones and promote circulations in meridians and collaterals are the classical principles in Chinese medicine for anti-kinetic fatigue.OBJECTIVE: To observe the efficacy of compound Chinese herbal medicine on anti-kinetic fatigue.DESIGN: Randomized controlled experiment based on animals.SETTINGS: Animal Experimental Center of Wenzhou Normal University and Zhejiang College of Traditional Chinese Medicine.MATERIALS: The experiment was performed in Animal Experimental Center of Zhejiang College of Traditional Chinese Medicine from February to June 2001, in which, 80 ICR mice of either sex, body weighted(22±2) g and 40 SD male rats, body weighted(194±7) g were employed.ETHODS: ① Eighty mice were randomized into two groups, of which, 40 mice was gastric-infused with Chinese herbal fiang li fang(experimental group) and 40 mice was with physiological saline (the control) . After bred for 15 days, they were randomized into 3 groups for anti-fatigue experiment ( n = 15, swimming time), anti-hypoxia ability( n = 15) and determination of hemoglobin(n=10). ② Determination of testosterone: Forty rats were randomized into 4 groups, named the control with physiological saline infusion, herbal infusion group, exercise group, exercise-herbal infusion group. In herbal infusion group, the rats were infused once a day. In exercise group and exercise-herbal infusion group, the rats exercised once a day, swimming till being exhausted at the tolerance of 3% body weight at 28 ℃ of water temperature. After bred for 20 days, heart blood 2 mL was collected with chest opened and the serum was centrifuged and placed in refrigerator at 4 ℃. Minigamma 1275γ counter and VCS method were applied for determina tion.MAIN OUTCOME MEASURES: ① Determination of swimming time of mice in every group. ③ Time of anti-hypoxia. ③ Levels of hemoglobin and testosterone in rats.RESULTS: Forty rats and 80 mice were all entered the result analysis. ①Observation of swimming time in mice: The time was remarkably prolonged in experimental group compared with the control[ (125.2±13.7), (108.9 ±12.6) minutes, P＜0.01] . ② Anti-hypoxia ability: It was much improved in experimental group compared with the control[(25.0±l.5),(23.1 ±1.8) minutes, P ＜0.05] . ③ Level of hemoglobin: The level of hemoglobin in experimental group was higher than that in the control, but the difference was not significant[(162.1 ±5.2), (159.3 ±5.3) g/L] . ④Level of testosterone: That in exercise group of rats was remarkably lower than exercise-herbal infusion group[(4.69 ±0.92), (6.03 ±0.77) nmol/L,P ＜ 0.05 ] . The difference in testosterone level was not significant between the control with infusion of physiological saline and herbal infusion group [(6.59 ±0.91), (6.98 ±0. 88) nmol/L, P ＞ 0.05].CONCLUSION: Under fatigue state, fian lifang can prolong the time of swimming in mice, improve work time and efficacy, increase hemoglobin content and benefit anti-hypoxia ability, which indicates rather strong anti-fatigue action. The combination of Chinese herbal jian lifang and exercise training can much' significantly increase serum testosterone level in rats compared with exercise group, which explains that fian li fang can increase testosterone level in rats, prevent testosterone decrease induced by exhausted exercise and accelerate the recovery of physical function.

Objective To analyze the clinical features of fungal septicemia in premature infants in a hospital,and provide reference for clinical diagnosis and treatment.Methods Clinical data of 18 premature infants with fungal septicemia in a hospital between January 2011 and December 2013 were analyzed retrospectively.Results Gesta-tional ages of 18 premature infants were 27-36 weeks,birth weights were 1 050 g-3 100 g,8 of whom were very low birth weight infants(VLBWI);all premature infants were treated with broad-spectrum antimicrobial agents,and were given long-term parenteral nutrition before infection,10 with mechanical ventilation,2 with peripherally insert-ed central catheters(PICC).The main clinical manifestations were apnoea,twitch,feeding difficulty,and poor reac-tion;manifestations appeared 3 hours-52 days after birth.13(72.22%)premature infants had abnormal white blood cell count,12 (66.67%)had thrombocytopenia (< 100 × 109/L),18 (100.00%)had elevated C-reactive protein (CRP),the average CRP level was (41 .90 ±26.77)mg/L.The main pathogens were Candida spp .(n = 17, 94.44%),including Candida parapsilosis (n=7),Candida albicans (n =5 ),biovariety of Candida albicans (n =4),and Candida famata (n=1);premature infants were treated with fluconazol and amphotericin B,15 (83.33%) were cured,2 (11 .11 %)improved,and 1 (5.56%)died.Conclusion Fungal septicemia in premature infants are mainly caused by Candida,there is no specific clinical manifestations,clinical symptoms in premature infants with high risk factors should be closely observed,blood routine and CRP should be detected periodically,timely treat-ment with antifungal agents should be given,which are beneficial to achieve good therapeutic effect.

This study is to investigate the therapeutic effect and mechanism of indole-3-carbinol (I3C) on pig serum-induced liver fibrosis of rats. The liver fibrotic model of rats was induced by pig serum. After models were successfully established, rats in the treatment groups were administered with I3C through intraperitoneal injection or curcumin by intragastric administration, daily for 17 days. Hepatic hydroxyproline (Hyp) content was measured. The liver histology and immunohistochemistry with a-smooth muscle actin (alpha-SMA) were assayed. Hepatic stellate cells line, HSC-T6 was incubated with different concentrations of I3C (25, 50, and 100 micromol x L(-1)) for 24 h. The effect of I3C on cell apoptosis was identified by FITC-Annexin V/PI double labeled assay. And the mRNA expressions of Bax and Bcl-2 were measured by real time RT-PCR. The results showed that hepatic content of Hyp decreased by I3C treatment, as compared with the fibrotic model control. Histopathological changes, such as steatosis, necrosis, deposition of collagenous fiber reduced remarkably and the expression of alpha-SMA was significantly down-regulated in the I3C-treated groups (P < 0.01). Apoptosis analysis showed that I3C significantly increased HSC-T6 apoptosis rate and the expressional ratio of Bax to Bcl-2. The results indicated that I3C could effectively cure pig serum-induced liver fibrosis in vivo by inducing HSC apoptosis and promoting ECM degradation.

Objective To investigate the effect of illness severity on preterm infant's hypothalamusputituary-adrenal (HPA) axis, we measured the serum concentration of cortisol,aldosterone and adrenocorticotropic hormone (ACTH). Methods Ninety preterm infants who were transferred to our hospital within 72 hours after birth were involved. These preterm infants were divided into two groups:gestational age (GA) ≥34 weeks' preterm infants and GA <34 weeks' preterm infants. We evaluated these preterm infants at the time of admission,day 7 and day 14 after birth with neonatal critical illness score (NCIS). Then they were divided into mild group and severe group by the lowest score. We measured their serum cortisol,aldosterone and ACTH at the time of admission,day 7 and day l4 after birth. Results (1) The serum cortisol concentration of preterm infants with severe illness was higher than that of preterm infants with mild illness. Among the GA ≥34 weeks' preterm infants,the serum cortisol concentration of preterm infants with severe illness was significandy higher than that of preterm infants with mild illness within 72 hours after birth (t = -2.263,P =0. 029). Among the GA <34 weeks' preterm infants,the serum cortisol concentration of preterm infants with severe illness was significantly higher than that of preterm infants with mild illness on day 14 after birth (t =-2. 913 ,P =0. 006). (2) Among the preterm infants with severe illness,the serum cortisol concentration of the GA≥34 weeks' was significantly higher than that of the GA < 34 weeks' within 72 hours after birth (t =-2. 641 ,P =0. 010) ;the serum cortisol concentration of the GA <34 weeks' was significantly higher than that of the GA≥34 weeks' on the day 14 after birth(t = -2. 189,P =0. 036) . (3) The serum cortisol concentration was significantly decreased in the GA≥34 weeks'preterm infants (F = 4. 679, P =0. 012). (4) The serum cortisol concentration of aldosterone and ACTH was not significantly different between preterm infants with severe illness and those with mild illness. Conclusion The preterm infant already has the ability to respond to stimuli by regulating cortisol secretion. The serum cortisol concentration increases as disease severity worsens.Serum aldosterone and ACTH concentration are not correlated with the severity of the disease.

Objective To evaluate the effect of dexmedetomidine on gastric mucosal injury induced by intestinal ischemia-reperfusion (I/R) in rats.Methods Thirty-six healthy male Sprague-Dawley rats,aged 4-5 months,weighing 200-250 g,were randomly divided into 4 groups (n =9 each) using a random number table:sham operation group (group S),intestinal I/R group (group I/R),low-dose dexmedetomidine group (group LD),and high-dose dexmedetomidine group (group HD).Intestinal I/R was produced by occlusion of the superior mesenteric artery for 1 h followed by 2 h reperfusion in anesthetized rats.Dexmedetomidine 2.5 and 5.0 μg · kg-1 · h-1 were infused via the caudal vein for 1 h starting from 1 h before ischemia in LD and HD groups,respectively.The rats were sacrificed at 2 h of reperfusion,and the gastric mucosa was obtained for examination of the pathological changes (with light microscope) and for determination of the expression of serine/threonine kinase (Akt),phosphorylated Akt (p-Akt),activated caspase-3 and caspase-3 (by Western blot).The ratio of p-Akt to Akt (p-Akt/Akt)was calculated to reflect the phosphorylation of Akt.The ratio of activated caspase-3 to easpase-3 (activated caspase-3/caspase-3) was calculated to reflect the activation of caspase-3.Results Compared with group S,the expression of Akt was significantly up-regulated,the expression of p-Akt was significantly downregulated,the phosphorylation of Akt was significantly decreased,and the activation of caspase-3 was significantly increased in group I/R,and the expression of p-Akt was significantly up-regulated,and the phosphorylation of Akt and activation of caspase-3 were significantly increased in LD and HD groups (P＜0.05).Compared with group I/R,the expression of Akt was significantly down-regulated,the expression of p-Akt was significantly up-regulated,the phosphorylation of Akt was significantly increased,and the activation of caspase-3 was significantly decreased in LD and HD groups (P＜0.05).The degree of gastric mucosal injury was significantly lower in LD and HD groups than in group I/R,and there was no significant difference in the degree of gastric mucosal injury between group LD and group HD.Conclusion Dexmedetomidine can attenuate gastric mucosal injury induced by intestinal I/R,and the mechanism may be related to activation of PI3K/Akt signaling pathways and inhibition of cell apoptosis in rats.

Objective To compare the application of Shikani optical stylet(SOS)and Clarus Video Sty-let(Tracway)in patient with cervical spine immobilization in tracheal intubation. Method Sixty patients,ASAⅠ~Ⅱ,undergoing cervical internal fixation operation,were randomly divided into Shikani optical stylet group (Group S,n = 30)and Clarus Video Stylet group(Group T,n = 30). MAP,HR and RPP(The rate-pressure product)were recorded at the point before induction of anesthesia(T1),before intubation(T2),at the immediate time of intubation(T3)and 1 min(T4),3 mins(T5),and 5 mins after intubation(T6).The intubation time,one-time success rate of intubation,the number of intubation times and the incidence of sore throat and other complica-tions were observed. Results The one-time intubation time in group S was obviously shorter than that in group T (P<0.05).The incidence of mild sore throat and intubation throat injury rate were lower in group S than those in group T(P<0.05).Compared with those at T1,MAP and RPP decreased significantly at point of T2~T6in both of two groups(P<0.05).There was no significantly difference in MAP,HR and RPP at any points of time between the two groups. The one-time success rate of intubation,the number of intubation times and the incidence of air-way complications in two groups(P>0.05)were no significantly different. Conclusions Compared with Clarus Video Stylet(Tracway),Shikani optical stylet can shorten the intubation time in patients with cervical spine immo-bilization,but no difference was found in regard to the hemodynamic influence on intubation,success rate of intu-bation,the intubation times,the sore throat and the other related complications.

Objective To investigate the effects of different depths of anesthesia on incidence of postopera-tive cognitive dysfunction (POCD). Methods We systematically retrievedPubmed,OVID,CNKI,CBM and Wanfang database and VIP database for randomized controlled trials(RCTs)from inceptionto December 312016, comparing different depths of anesthesia for their impacts on incidence of early POCD. After data extraction and quality evaluation,Revman 5.3 software was used for statistical data analysis. Results A total of 714 patients in 8 eligible RCTs were identified. Results of meta-analysis were as follows.(1)Incidence of POCD of depth anesthesia (NTS=E0-E1)was lower than general anesthesia(NTS=D0-D1)1 d after surgery(OR=0.21,95%CI 0.13~0.35,P < 0.00001).(2)Incidence of POCD of depth anesthesia(NTS = E1)was lower than general anesthesia (NTS=D0)7 d after surgery(OR=0.45,95%CI 0.23~0.91,P=0.03).(3)Incidence of POCD of NTS=E1 was lower than NTS=D07d after surgery(OR=0.42,95%CI 0.24~0.71,P=0.001). Conclusion Comparedwith general anesthesia,depth anesthesia is associated with a lower incidence of early POCD.

Objective:To explore the relationship between the neural development of preterm infants and gut microbiota.Methods:66 premature infants who were hospitalized in the Neonatology Department of Hunan Children′s Hospital from September 2018 to September 2019 were included in the study. Their fecal samples and clinical data from the first admission were collected. According to the neurodevelopment, the patients were divided into normal neurodevelopment group and neurodysplasia group. The bacterial DNA of fecal samples was extracted by 16S rDNA high-throughput sequencing technology and bioinformatics analysis was conducted to compare the composition and diversity of gut microbiota between the two groups.Results:(1) The Shannon index of gut microbiota in normal neurodevelopmental group and neurodysplastic group was 0.89(0.41, 1.51) and 1.01(0.47, 1.31), respectively. There was no significant difference in diversity index between the two groups ( P>0.05). (2) Bifidobacterium, veronica and negativites in the gut microbiota of the normal neurodevelopmental group were significantly higher (all P<0.05), and streptococcus in the gut microbiota of the dysplastic group were significantly higher ( P<0.05). The gut microbiota of the two groups were mainly enterococcus and escherichia shigella. Conclusions:At the genus level, enterococcus and escherichia are the dominant flora of early gut microbiota in preterm infants. Gut microbiota is related to the neural development of preterm infants. The increased abundance of streptococcus, and the decreased abundance of bifidobacterium, veronicus, and negativites may be risk factors for neurodysplasia of preterm infants. The diversity of gut microbiota in early preterm infants may not be significantly related to neural development.

Objective:To analyze the risk factors of hypoparathyroidism after thyroid cancer surgery.Methods:The clinical data of 430 patients who underwent total thyroidectomy and central lymph node dissection due to thyroid cancer from Jan. 2021 to Dec. 2021 in the First Ward of Head and Neck Surgery of Sichuan Cancer Hospital were collected. They were divided into two groups according to their parathyroid hormone levels at day 1 and 6 months after surgery: temporary hypoparathyroidism group ( n = 174) and permanent hypoparathyroidism group ( n = 11). and patients with normal parathyroid function were selected as control group (256 cases on postoperative day 1 and 419 cases on postoperative month 6). Gender, age, body mass index, tumor diameter, invasion, central lymph node dissection, parathyroid transplantation, Hashimoto’s thyroiditis, and lymph node dissection in lateral neck region were monitored. The suspicious risk factors of hypoparathyroidism were evaluated by χ2 test and multivariate logistic regression analysis. Results:Univariate analysis showed that women (86.21% vs 77.34%, χ2 = 5.73, P = 0.022) and parathyroid autotransplantation (44.83% vs 28.91%, χ2 = 11.49, P = 0.001) were associated with postoperative transient hypoparathyroidism. The posterior capsule of tumor invasion (81.82% vs 45.11%, χ2 = 5.81, P = 0.016) was associated with postoperative hypoparathyroidism.Multivariate analysis showed that the independent risk factors of transient hypoparathyroidism were female ( P=0.028, OR=1.870), the largest diameter of tumor ( P=0.043, OR=1.595), extravasation of tumor ( P=0.018, OR=1.587), and parathyroid transplantation ( P=0.001, OR=1.966). The independent risk factor of permanent parathyroidism was the posterior capsule of tumor invasion ( P=0.046, OR=4.658) . Conclusions:Female, the largest tumor diameter, tumor invasion and parathyroid transplantation are independent risk factors for transient hypoparathyroidism after total thyroidectomy. The posterior capsule of tumor invasion is an independent risk factor for permanent hypoparathyroidism after total thyroidectomy.

Objective: To study serum zinc level in pregnancy and umbilical cord blood and their association with newborn birth weight. Methods: Pregnant women accepting obstetric examination in Ma'anshan Maternal and Child Care Center were recruited from May 2013 to September 2014. The follow up was conducted during their first, second and third trimesters of pregnancy and the self-designed questionnaire was used to collect information of social and demographic characteristics. Blood samples in the first, second pregnancy period and umbilical cord blood samples were collected and serum concentrations of zinc were assayed. 3 239 mother-infant entered the final analysis. We divided serum zinc level into low (<P₂₅), medium (P₂₅-P₇₅) and high (>P₇₅) groups according to their exposure concentrations at each trimesters. Non-conditional multivariate logistic regression model was conducted to evaluate the association between serum zinc level in first, second trimesters of pregnancy and umbilical cord blood with small for gestational age (SGA) and large for gestational age (LGA). Results: Serum zinc level in P₅₀ (P₂₅-P₇₅) during the first, second trimesters and cord blood were 1 016.18 (907.09-1 145.60), 813.36 (732.47-897.89) and 903.44 (808.71-1 015.64) μg/L, respectively. The prevalence of zinc deficiency during the first, second trimesters and cord blood were 1.5% (44/2 957), 15.9% (492/3 087) and 6.5% (176/2 707), respectively. The prevalence of total SGA and LGA were 9.7% (313/3 239) and 16.5% (536/3 239), respectively. Compared to high-level serum zinc group, the risk of SGA (OR (95%CI) in low-level serum zinc group during first trimesters was 1.51 (1.05-2.19)). Serum zinc level among second pregnancy period and umbilical cord blood had no statistically significant effect on SGA and LGA (both P values >0.05). Conclusion Zinc nutritional status of pregnant women in Ma'anshan city was at a good level. The low serum zinc level in first trimester increased the risk of SGA.