Objective To study the cerebral energy metabolism changes of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) through hydrogen magnetic resonance spectroscopy examination (1 HMRS ) and its relationship with partial pressure of oxygen / carbon dioxide tension.Methods Totally 13 cases of AECOPD patients and 10 cases of age-matched healthy people underwent HMRS examination.The ratios of n-acetyl-aspartate(NAA)/creatine(Cr),choline (Cho)/Cr,myo-inositol(MI)/Cr of parieto-temporal and occipital areas of brain were detected.Blood gas analysis were also used to detect partial pressure of oxygen (PaO2) and carbon dioxide (PaCO2).Results NAA / Cr of parieto-temporal and occipital areas of brain (1.32±0.12,1.48±0.12) were lower in AECOPD group than those in control group (1.45±0.11,1.58±0.10) (P＜ 0.05),MI/Cr (0.23±0.07,0.30±0.11) were also decreased compared with control group (0.40±0.14,0.46±0.12) (P＜ 0.01),while Cho/Cr of parieto -temporal and occipital areas of brain between the AECOPD group and control group showed no significant difference (P＞0.05).NAA/Cr of parieto temporal and occipital areas of brain were positively correlated with PaO2 (r=0.46 and 0.44),and MI/Cr of these areas of brain were also positively related with PaO2 (r=0.63 and 0.50),but MI / Cr of parieto tempora was negatively correlated with PaCO2 (r =- 0.472). Conclusions Cerebral metabolite changes may occur in AECOPD patients,and this has relationship with hypoxia and carbon dioxide retention.

Hepatocellular carcinoma(HCC)is one of the most common malignancies worldwide.Due to the difficulty of diagnosis in the early stage of HCC, most HCCs are diagnosed in intermediate-advanced stage.Moreover, the high invasion, metastasis and recurrence rate of HCC result in the high mortality of HCC.MicroRNAs(miRNAs) are a class of highly conserved, endogenous, small, non-coding ,single stranded RNA with the length of 22 nucleotides.There are plentiful of miRNAs in liver.MiRNAs not only can regulate the growth and development of liver, but also are closely related to the formation of HCC.In the process of HCC formation, miRNAs could function as oncogenes or tumor suppressor genes to regulate multiple biological processes related to HCC, including cell differentiation,proliferation,tumorigenesis,angiogenesis,invasion,and metastasis.With the intensive study of molecular mechanisms of miRNAs in the process of HCC formation, increasingly studies have revealed that miRNAs could become sensitive biomarkers and effective therapeutic targets for HCC.

Objective To investigate the risk factors of pulmonary fungal infection in intensive care unit(ICU),and discuss the strategy of prevention and treatment.Methods Forty children with pulmonary fungal infection in ICU of Wuhan Children's Hospital from Jan.2003 to Jan.2007 were analyzed retrospectively,including primarily diseases,application of antibiotics,adrenal cortical hormone and virulence operation,therapy and turnover.Results All children were accepted the therapies of broad spectrum antibiotics and glucocorticoids for long time before definite diagnosis of pulmonary fungal infection.Seventy-five percent children were received invasive operations or therapies.Their average time of stayed in hospital was 37.8 d.The clinical symptoms and imaging examinations were untypical.Blastomyces albicans was the main pathogen.After the antifungal agents and supportive treatment used in time,35 cases(87.5%) were cured and 5 cases(12.5%) died.Conclusions The major risk factors of children pulmonary fungal infection are long-time use of broad spectrum antibiotics and glucocorticoids.The pulmonary fungal infection can decrease by rational use of broad spectrum antibiotics and glucocorticoids,decreasing the unnecessary invasive operations,strengthening the supportive therapies of micro-ecosystem,and applying the antifungal agents in time.

0.05).But after the treatment,there were significant increases in pa(O2),SaO2 and PCIS(Pa0.05).Conclusions Early application of hyperoxia liquid could decrease multiple organ anoxia and the damage of lipid peroxidation.It has obviously protective effects on multiple organ damage during ischemic reperfusion in infants with muggy syndrome.

Objective To study the epidemiological characters and risk factors of nephrolithiasis in an island area,Putuo district, Zhoushan city.Methods With stratified cluster random sampling method,5 915 residents aged above 15 yrs and resided 5 yrs and above in Putuo district,Zhoushan city were selected,and surveyed with Ultrasound examination and questionnaire.X~2 tendency test and non-condition Logistic regression were conducted by means of SPSS software.Results After single factor analysis and Multi- factor analysis,the factors entered the model finally were sex(OR=0.543,95%CI:0.454~0.649),education status(OR=1.253,95%CI: 1.151～1.364),dietary habit(OR=0.882,95%CI:0.823～0.944),BMI(OR=1.274,95%CI:1.142～0.1.421),urinary tract infection(OR= 2.126,95%CI:1.663～2.718).Conclusion Risk factors for nephrolithiasis include dietary habit,education status,and urinary tract infection.The vegetables are the protection factor.

AIM To study the effects of Biejiajian Pills (Colla Carapacis Trionycis,Asini Corii Colla,Nidus Vespae,etc.) on NF-κB,p65,p50 and IκB in NF-κB signaling pathway and target gene expression in HSC-T6 cells of rats.METHODS HSC-T6 cells were cultured with Biejiajian Pills drug serum for 24 hours,the expressions of p65,p50,VEGF and TIMP-1 mRNA were determined by qPCR;the expression of p65 was measured by immunofluorescence;the expressions of IκBα,IκBβ and α-SMA were determined by Western blot.RESULTS The Biejiajian Pills middle-,high-dose and positive control groups showed significantly lower expressions of p65,VEGF and TIMP-1 mRNA as compared with the blank control group and negative control group,the expressions of p50 mRNA among various groups showed no significant differences.But immunofluorescence showed that the expression of p65 in cytoplasm was decreased.Meanwhile,Biejiajian Pills showed significantly higher IκBα protein expression and obvious down-regulation of α-SMA expression in a dose-dependent manner,but had no significant influence on the expression of IκBβ.CONCLUSION Biejiajian Pills' therapeutic effects on hepatic fibrosis may be related to influencing NF-κB signaling pathway and inhibiting the expression of down-stream target gene.

AIM To determine the dynamic changes of monoamine neurotransmitters and their metabolites in various brain regions of cerebral ischemia reperfusion mice. METHODS Concentrations of monoamine neurotransmitters such as norepinephrine (NE), dopamine (DA), serotonin (5-HT) and metabolites were determined by HPLC-ECD on d 0,1,3,5 and d 20 after cerebral ischemia reperfusion by common carotid artery occlusion. RESULTS The cerebral ischemia reperfusion mice showed decreased concentrations of NE, MHPG, DA, DOPAC, 5-HT and 5-HIAA in various brain regions, especially in hippocampus. CONCLUSION Several neuron systems play an important role in neurons damage of cerebral ischemia reperfusion, especially the NE and DA in hippocampus which is sensitive to the ischemia damage. The data offer useful guides for clinical treatments of cerebral ischemia diseases.

OBJECTIVETo observe the efficacy and safety of modified Shengma Biejia Decoction (MSBD) combined with CAG program in treating elderly acute myeloid leukemia (AML) patients with yin deficiency toxin stasis syndrome (YDTSS).

METHODSTotally 46 elderly AML patients were assigned to the treatment group (24 cases; treated with MSBD + CAG) and the control group (22 cases; treated with CAG + placebos of Chinese medicine) according to random digit table. The therapeutic course of CM placebo or MSBD was 21 days. The clinical efficacy and adverse reactions were observed. Meanwhile, physical state (ECOG Score), transfusion dependency, and TCM syndrome score were compared before and after treatment.

RESULTS(1) The complete remission rate was 54% (13/24) and the objective response rate (ORR) was 71% (17/24) in the treatment group, obviously higher than those of the control group [36% (8/22); 54% (13/24)], with statistical difference (P = 0.036, 0.042). When comparing the efficacy based on risk level, the moderate and poor ORR was 71% (10/14) and 67% (6/9) in the treatment group, and 57% (8/14) and 33% (2/6) in the control group, with statistical difference between the two groups (P = 0.048; P = 0.010). (2) Compared with before treatment in the same group, the ECOG score significantly decreased, the average infusion time of red cells and platelets were markedly prolonged in the treatment group after treatment (P < 0.05). ECOG score, the average infusion time of red cells and platelets were significantly better in the treatment group than in the control group after treatment (P < 0.05). (3) Compared with before treatment in the same group, scores of fever, hemorrhage, and bone pain were markedly reduced in the control group (P < 0.05); scores of fever, fatigue, hemorrhage, dry mouth, and bone pain were markedly reduced in the treatment group (P < 0.05). Better effect in relief of fever, fatigue, hemorrhage, dry mouth, and so on was obtained in the treatment group than in the control group (P < 0.05). (4) In aspect of hematotoxicity, the incidence of neutropenia, anemia, thrombocytopenia was obviously lower in the treatment group than in the control group [29.2% (7/24) vs 54.5% (12/22); 16.7% (4/ 24) vs 45.5% (10/22); 33.3% (8/24) vs 63.6% (14/22); P < 0.05]. The incidence of fatigue and anorexia was obviously lower in the treatment group than in the control group [37.5% (9/24) vs 63.6% (14/22), 37.5% (9/24) vs 81.8% (18/22); P < 0.05].

CONCLUSIONMSBD combined with CAG program in treating elderly AML patients with YDTSS, with efficacy enhancing toxicity reducing effect, had distinct advantages in improving physical condition and clinical symptoms, and reducing transfusion dependency.

Aclarubicin ; therapeutic use ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cytarabine ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Granulocyte Colony-Stimulating Factor ; therapeutic use ; Humans ; Leukemia, Myeloid, Acute ; drug therapy ; Medicine, Chinese Traditional ; Phytotherapy ; Yin Deficiency ; drug therapy

Objective The aim of this study was to explore the clinical value of dual-source CT(DSCT)in the diagnosis of coronary artery fistula(CAF)before and after surgery. Methods A retrospective analysis was performed in 15 cases of patients with CAF,11 cases of which was treated by surgery during extracorporeal circulation. Results CAF arose from right coronary artery in 8 cases and left coronary artery in 7 cases,with the latter including 3 cases of ramus nodi sinuatrialis fistula,2 cases of anterior descending branch fistula,and 2 cases of left circumflex fistula. CAF entered into right atrium(6 cases),right ventricle(5 cases),left ventricle(4 cases)and left atrium(1 case). There were dilatation of coronary artery in 8 cases,localized aneurysm in 4 cases,normal coronary artery in 3 cases,single fistula orifice in 11 cases,and multiple fistula orifice in 4 cases. 11 patients underwent surgery under cardiopulmonary bypass(CPB).The postoperative imaging revealed fistula has been sutured in 10 patients with no residual fistula,including fistula vascular ligation in 3 cases,the proximal imaging and distal occlusion in right coronary artery angioplasty in 1 case,and pseudo diverticulum in 2 cases. Conclusion DSCT examination has significant value in preoperative diagnosis and postoperative follow-up for CAF.

Objective To determine the factors influencing the results of open reduction and internal fixation for displaced intra-articular calcaneal fracture (DIACF).Methods From May 2009 to June 2013, 80 patients with DIACF involving in 91 feet were treated by open reduction and internal fixation.Mean age was 38.7 years (range, 18-72 years).Patients were grouped according to the possible factors related to the operative results, including the Sanders classification of fracture, quality of fracture reduction, postoperative B(o)hler angle, width of postoperative calcaneus, and time to surgery after injury.Clinical result was evaluated and compared within each group.Results Mean duration of follow-up was 18.3 months (range, 14-26 months).The clinical results were excellent for 67 feet (74％), good for 12 feet (13％), fair for 7 feet (8％) and poor for 5 feet (5％), which yielded 87％ good to excellent results.Good to excellent results in Sanders Ⅱ , Ⅲ and Ⅳ groups reached 94％, 85％ and 53％ respectively, in quality of fracture reduction ≤ 2 mm and ＞ 2 mm groups reached 93％ and 30％ respectively, in postoperative B(o)hler angle ＜ 15° and ≥15° groups reached 33％ and 90％ respectively;in broadening of postoperative calcaneus ＜ 1 cm and ≥ 1 cm groups reached 92％ and 17％ respectively, in time to surgery after injury ≤14 days and ＞ 14 days groups reached 91％ and 43％ respectively, in age ≤60 years old and ＞ 60 years old groups reached 85％ and 88％ respectively.Except for the age group, the clinical result differed significantly within group (P ＜ 0.05).Conclusions Fracture type, reduction quality, postoperative B(o)hler angle, width of postoperative calcaneus, time to surgery after injury are the factors influencing on the operative results of patients with displaced intra-articular calcaneal fracture.Thereupon the unfavorable influences should be avoided to improve the operative results.