Humans ; Inflammation ; Lipoproteins, HDL ; blood ; chemistry

Objective To design an experimental model of endoleak after endovascular exclusion(EVE). Methods Infrarenal aortic aneurysms were created with bovine jugular vein segements or patches. Then they were undergone endovascular stent graft exclusion of the aneurysm. Using modification of prosthetic vessel and changing the attachment site, endoleaks were formed druing the course of aneurysm exclusion. Results All the 6 aneurysms possessed satisfactory configuration just as clinical patterns. Intraoperative arteriography revealed endoleaks in 5 dogs after the exclusion, two of which were proximal and three were distal.Conclusions This experiment shows the hemodynamics and treatment of endoleak for EVE.

Objective The studies on tissue culture and cytological observations of leaf explants of Curculigo orchioides were conducted in order to provide the basis for the rapid propagation of C. orchioides. Methods Young leaf explants of C. orchioides were cultured on MS basal media. Differences in the callus induction and plantlet regeneration rate were observed by different light treatment as well as chemical factors like different phytohormones, casein hydrolysate (CH), and activated charcoal (AC) concentrations. Paraffin method was used to cytological observation. Results For callus induction of leaf explants of C. orchioides, dark treatment gave better results compared to light treatment; among the media tested, the suitable phytohormone combinations were 2.0 mg/L 2, 4-D or 6-BA 1.5 mg/L+2, 4-D 2.5 mg/L, and 300 mg/L CH+0.2% AC was good for plantlet regeneration from leaf explants. The callus from leaf explants mainly originated from midrib. The parenchyma cells near epicuticle of midrib firstly were initiated to division. Then the parenchyma cells of vascular bundle sheath and mesophyll cells on each side of vascular bundle were also divided to form callus. The buds developed on the peripheral parts of the calli, but the roots developed in the regions deep within the calli. Conclusion Tissue culture of young leaf explants of C. orchioides can make the propagation of C. orchioides rapid.

Objective To explore the clinical characteristics of children with serious pneumonia with ventilatory support,and combined with heart failure,encephalopathy,hyponatramia,acute respiratory distress syndrome(ARDS) and multiple organ dysfunction syndrome(MODS).Methods One hundred and fifteen children(81 males,34 females) with serious pneumonia in ICU from Jul.2005 to Jul.2007 were reviewed,The duration of ventilation support was over 48 h.And blood electrolyte,blood gas,cerebrospinal fluid and CT were detected.Results Ninety-three cases had a good outcome,7 cases were given up,15 cases were dead.The complications included heart failure in 60 cases(52.17%);encephalopathy in 40 cases(34.78%),in which tics type in 38 cases(95%),apnea type in 11 cases(27.5%);hyponatremia in 42 cases(36.52%),of which tics type in 31 cases(73.81%),syndrome of inappropriate secretion of antidiuetic hormone in 27 cases(72.97%)resulted in hyponatremia;ARDS in 8 cases(6.96%),pa(O2)/FiO2

Objective To investigate the clinical features of capillary leakage syndrome ( CLS ) occurring in critically ill newborns in Guangzhou. Methods Three tertiary hospitals in Guangzhou were chosen as research field;critically ill newborns with diagnosis as CLS in NICU of three hospitals were retro-spectively studied from January 2011 to December 2015; and the morbidity,mortality,causes,treatment and outcome of CLS neonates were analyzed. Results There were 49 cases diagnosed as CLS, accounting for 1. 62%(49/3 029)of the total number of critically ill newborns admitted to NICUs in the same period. The common primary factors were preterm low birth weight(34 cases,69. 4%),respiratory distress syndrome(38 cases,77. 5%),congenital anomaly(19 cases,38. 8%),asphyxia(17 cases,34. 7%),and intrauterine infec-tion(12 cases,24. 5%). The 83. 7%(41/49) of CLS occurred within 72 hours after admission. The overall mortality of CLS was 30. 6%( 15/49 ) . The main lethal cause was multiple organ dysfunction syndrome (60. 0%,9/15). Treatment included antibiotics,vasoactive drugs,fluid resuscitation,corticosteroids,and me-chanical ventilation. Conclusion CLS is a common critical illness in NICU with high mortality and poor prognosis. Early prediction and early intervention could improve survival and prognosis in critically ill neonates with CLS.

It is crucial to improve the health care quality during the progress of constructing the new health care system in both urban and rural area.On the condition of increasing government commonweal investment for the basic health care,the standardized training program for the district medical practitioners will become the pivotal step to improve district health care in urban and rural area,standardize medical service,reduce the medical cost and optimize the accessibility to medical care for the mass.Taking the consideration on the personal resource of district medical service in the urban and rural area in China,certain strategic proposals related to the standardized training program for the fundamental medical practitioners are discussed.

OBJECTIVETo explore the mechanisms of Qianjing Decoction in the treatment of oligoasthenospermia (OAS).

METHODSWe randomly divided 100 SPF male rats into five groups of equal number: normal, model, Huangjingzanyu, levocarnitine, and Qiangjing. OAS models were established in the animals followed by intragastrical administration of normal saline, ornidazole, Huangjingzanyu Capsules (200 mg per kg body weight per day), levocarnitine (100 mg per kg body weight per day), and Qianjing Decoction (10 g per kg body weight per day), respectively, qd, for 4 successive weeks. Then, we detected the concentration and motility of the epididymal sperm, obtained the contents of superoxide dismutase (SOD), malonaldehyde (MDA), glutathione peroxidase (GSH-Px), lactate dehydrogenase (LDH), α-glucosidase, and fructose in the epididymis, and determined the mRNA expressions of nuclear factor erythroid 2-related factor 2 (Nrf2) and succinate dehydrogenase (SDH) in the epididymal tissue of the rats by real-time PCR.

RESULTSThe concentration and motility of the epididymal sperm in the model, Huangjingzanyu, levocarnitine, and Qianging groups were (35.34 ± 4.22) x 10(6)/ml and (40.04 ± 7.05)%, (48.12 ± 5.56) x 10(6)/ml and (62.46 ± 7.12)%, (47.14 ± 4.87) x 10(6)/ml and (63.23 ± 6.34)%, and (50.25 ± 5.08) x 10(6)/ml and (66.34 ± 7.58)%, respectively, all significantly lower than in the normal group ([53.05 ± 4.55] x 10(6)/ml and [70.20 ± 8.54]%) (P < 0.05), but remarkably higher in the Huangjingzanyu, levocarnitine, and Qiangjing groups than in the model rats (P < 0.05). Compared with the thinned epididymal lumen walls, decreased sperm count, and disorderly and loose arrangement of the lumens in the OAS models, the rats in the Huangjingzanyu, levocarnitine, and Qiangjing groups showed evidently thicker epididymal lumen walls, with the lumens full of sperm cells and arranged regularly and compactly, similar to those of the normal rats. The levels of SOD and GSH-Px were significantly lower but that of MDA markedly higher in the model rats ([84.12 ± 23.25], [10.56 ± 3.02], and [14.04 ± 2.06] nmol/mg) than in the normal group ([110.04 ± 19.56], [17.25 ± 3.56], and [8.87 ± 1.35] nmol/mg) (P < 0.05), while the former two indexes remarkably higher and the latter one significantly lower in the animals treated with Qiangjing Decoction ([120.56 ± 23.68], [16.34 ± 3.12], and [8.45 ± 1.56] nmol/mg), Huangjingzanyu Capsules ([115.34 ± 21.35], [15.23 ± 3.67], and [8.33 ± 1.54] nmol/mg), and levocarnitine ([116.67 ± 22.67], [15.35 ± 3.45], and [8.05 ± 1.78] nmol/mg) than in the models (P < 0.05). The levels of fructose, LDH and α-glucosidase were decreased markedly in the OAS models ([100.22 ± 12.12] mg/[ ml x g], [322 ± 46.13] U/[ ml x g], and [10.48 ± 2.33] U/[ml x g]) as compared with the normal rats ([128.12 ± 13.45] mg/[ml x g], [428 ± 35.12] U/[ml x g], and [15.34 ± 3.12] U/[ ml x g]) (P < 0.05), remarkably higher in the rats treated with Qiangjing ([130.23 ± 13.67] mg/[ml x g] [455 ± 51.50] U/[ml x g], and [18.56 ± 4.67] U/[ml x g]), Huangjingzanyu ([124.16 ± 14.02] mg/[ml x g], [ 419 ± 43.14] U/[ml x g], and [17.64 ± 4.08] U/[ml x g]), and levocarnitine ([123.34 ± 14.02] mg/[ml x g], [430 ± 31.80] U/ [ml x g], and [16.85 ± 5.55] U/[ml x g]) than in the models (P < 0.05). The Nrf2 mRNA expression was significantly reduced in the models as compared with the normal rats (P < 0.05) but remarkably increased in the Huangingzanyu, Qiangjing and levocarnitine groups as compared with the model and normal animals (P < 0.05). The SDH mRNA expression was significantly lower in the model than in the normal rats (P < 0.05) but markedly elevated in the Huangjingzanyu, Qiangjing and levocarnitine groups as compared with the model and normal animals (P < 0.05), remarkably higher in the Qiangjing than in the Huangjingzanyu group (P < 0.05).

CONCLUSIONOrnidazole induces OAS in rats, which is closely associated with excessive oxidation and energy metabolism dysfunction. Qiangjing Decoction can improve and even reverse ornidazole-induced OAS in rats as well as improve the ultrastructure of their testicular and epididymal tissues. Antioxidation and improvement of energy metabolism are probably the action mechanisms of Qiangjing Decoction in the treatment of OAS.

Animals ; Antioxidants ; Asthenozoospermia ; chemically induced ; drug therapy ; metabolism ; Carnitine ; pharmacology ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacology ; Energy Metabolism ; drug effects ; Epididymis ; metabolism ; Glutathione Peroxidase ; metabolism ; L-Lactate Dehydrogenase ; metabolism ; Male ; Malondialdehyde ; metabolism ; Oligospermia ; chemically induced ; drug therapy ; metabolism ; Ornidazole ; Random Allocation ; Rats ; Sperm Count ; Sperm Motility ; Spermatozoa ; drug effects ; physiology ; Succinate Dehydrogenase ; metabolism ; Superoxide Dismutase ; metabolism ; alpha-Glucosidases ; metabolism

Objective To analyze the dynamic evolution of brain MRI in patients with mitochondrial myopathy,encephalopathy,lactic acidosis,and stroke-like episodes (MELAS) syndrome.Methods A retrospective study was performed on 58 MELAS cases with pathologically and (or) molecularly confirmed diagnosis.MRI were repeated within 60 days after the onset of stroke-like episodes (SLE) and the evolution changes of cerebral lesions were accessed.Brain atrophy index (BAI) was calculated in the remission stage from 31 patients with MELAS,and the correlation between BAI,age and disease duration was analyzed.Results The proportion of lesions expansion,migration and shrink within 30 days after the onset of SLE was 64.1％ (25/39),10.2％ (4/39),17.9％ (7/39),respectively,and 13％ (3/23),21.7％ (5/23),56.5％ (13/23),between 30-60 days after the onset of SLE respectively.In the recovery stage of SLE,the BAI in 31 patients with MELAS was 15.2％ ±2.8％.The correlation coefficient between BAI and the age,total disease course and duration of encephalopathy was 0.329 (P =0.043),0.405 (P =0.012) and 0.649 (P =0.000).Conclusions Brain atrophy in the studied MELAS patients gradually develops and strokelike lesions shrink with progression of the disease.However,the migration of lesions is persistent.

Objective Multiple carboxylase deficiency(MCD) is an autosomal recessively inherited defect of organic acid metabolism.The underlying mechanism is biotinidase(BT) or holocarboxylase synthetase(HLCS) deficiency.The authors reported 15 cases of MCD(clinical characteristics,diagnosis and treatment) and outcomes of long-term follow-up.Methods The clinical data of 15 patients with MCD admitted to Guangzhou Women and Children's Medical Center between Aug.2001 and Feb.2013 were analyzed.The diagnosis was confirmed by urinary organic acid analysis with gas chromatography/mass spectrometry (GC/MS),blood enzymatic determination and gene analysis.The patients consisted of 12 male and 3 female.The onset age ranged from newborn infants to 16 months.Results 1.Remarkable elevations of urinary lactate,3-oxy-butyric acid,3-OH-isovalerate,methylcitrate,3-methylcrontonylglycine,3-OH-propionate were detected in all of 15 cases.Fourteen cases with HLCS deficiency and 1 case with BT deficiency were confirmed by gene analysis.2.Most of patients with HLCS deficiency presented in the neonatal period or early infancy.The main clinical manifestations were skin rash (14 cases),tachypnea (9 cases),developmental retardation (8 cases),vomiting(5 cases),poor feeding (3 cases),developmental regradation (1 case),convulsion (1 case).Laboratory evaluation showed persistent metabolic acidosis and varied degree of ketosis,lactic acidosis,hyperuricacidemia,ammoniemia and hypoglycemia.Biotin was given to 13 patients in 10 mg/d and their metabolic disorders were corrected within 48 h,except one who gave up treatment and died.Treatment with Biotin in 5 mg/d provided clinical stability and normal neurodevelopmental outcome on follow-up for 3-11 (6.47 ± 2.70) years.3.One patient with BT deficiency presented with severe neurological symptoms(impaired consciousness,limbs trembling,tachypnea with irregular respiratory rhythm) at 16 months old.Demyelination of corpus callosum was evident on magnetic resonance imaging.Biotin treatment was given to him on the second of onset,and 1-year follow-up indicated significant improvement of his clinical symptoms,but the right limb weakness did not completely recover.Conclusions The main clinical features of HLCS deficiency include frequent skin rash,tachypnea,and metabolic disorders.BT deficiency may produce variable neurologic manifestations including demyelination of corpus callosum.Urinary organic acid analysis with GC/MS is critical to the early diagnosis of MCD.Prompt biotin treatment is recommended to correct metabolic derangements and continued therapy is essential to the improvement of long-term prognosis.Delayed commencement of therapy in BT deficiency can result in irreversible neurological damage.

Objective To determine the differences of risk factors for non-albicans candida and candida albicans infections among patients in the intensive care unit (ICU). Methods One hundred and three patients with ICU-acquired candida infections were retrospectively analyzed from February 2003 to April 2009. These patients were divided into non-albicans candida species group and candida albicans group.Multiple risk factors were analyzed between two groups. Results Of these patients, 46 patients (44.7%)had infections of non-albicans candida species and 57 patients (55.3%) had candida albicans infection.Among non-albicans candida species, candida glabrata, candida parapsilosis, candida tropicalis, candida krusei and others candida accounted for 19 patients (18.4%), 13 patients (12.6%), 10 patients (9.7%), 2 patients (1.9%) and 2 patients ( 1.9% ), respectively. Multivariate Logistic regression models revealed that central venous catheter (CVC) insertion time > 2 d (OR = 32.477,95% CI:4.905-215.035,P=0.000),total parenteral nutrition (OR =3.119,95% CI:1.214-8.015,P =0.018) and fluconazole prophylaxis therapy (OR = 5.084,95%CI: 1.319-19.596,P = 0.018) were highly correlated with non-albicans candida species infections. Conclusion CVC insertion time > 2 d, total parenteral nutrition and fluconazole prophylaxis therapy are independent risk factors of non-albicans candida species infections and can be used in empirical antifungal therapy.