To assess the effects of low dose aprotinin on platelets during cardiopulmonary bypass(CPB), 45 Patients, aged 20 to 45 years, ASA grade Ⅱ to Ⅲ,undcrgoing elective operation of cardiac valve replacement under fentanyl-enflurane-atracurium anesthesia, were randomly allocated to receiving aprotinin 2 ?106 KIU (group I,n=23 ) or equivalent volume of normal saline as control (group Ⅱ,n= 22) res12ectively,at the same time as CPB began to work. The blood samples were collected after induction of anes- thesia. 5 mins prior to CPB. 5, 15, 30 and 60 mins following CPB,and immedialely before withdrawal of CPB.to measure such 1parameters of platelet as level of cytoplasmic free Ca2+ (CFCa2+),activities of phosphollpase A2 (PLA2) and cyclouoxygenase (PCO) in membrane,aggregation rate (AGR),adhesion rate (ADR ) and count Individually. The lotal blood volume of postoperative tho- racic drainage solution (TBV ) and the re(]uircd blood volume of transfusioll (RBVT) were recorded. The results ahoys(l that dur lug CP14,the levels of CFCa2+ and activitics of PLA2 and PCO increased significantly,and the AGR,ADR and count of plstclet decreased markedly in both groups (P

The study was designed to evaluate the in vitro effects of aprotinin on platelets functions and arachidonic acid metabolism, Venous blood was drawn from healthy volunteers, and aprotinin was added to the blood at three different dose of aprotinin:50KIU/ml,150KIU/ml(low-dose)and 300KIU/ml (high-dose), respectively. Results demonstrated that aprotinin inhibited significantly the rates of platelet adhesion and aggregation induced by ADP or thrombin. Both the inhibitions were reversible and there was not significantly difference between high-dose and low-dose. The ADP-induced activities ofphospholipase A_2 (PLA_2) and cyclo-oxygenase(CLO)of platelet membrane were significantly suppressed by prophylactic aprotinin,but were not by therapeutic aprotinin. It is suggested that administration of low-dose aprotinin during CPB is reasonable,especially gaved just before the start of CPB.

In recent years, premature birth rate has increased due to the development of medical technology and the change of socioeconomic environment.In order to reduce the possibilities of extrauterine growth retardation and neural development retardation among premature infants, nutrition support should be fully paid attention to in clinical settings.Currently, nutritional intervention for premature infants mainly adopts enteral or parenteral nutrition.Parenteral nutrition is prescribed according to the recommended value in China Neonatal Nutrition Support Application Guide, individualized for premature infants.Enteral nutrition commonly uses breast milk, milk supplements, premature infant formula milk, hydrolyzed protein milk and formula milk after discharge.In this review, we summarized the clinical application of nutritional intervention in premature infants.

Objective To explore the change of dietary intake and nutritional status before and after hematopoietic stem cell transplantation (HSCT) in pediatric patients to assess the importance of nutritional interventions.Methods In this observational cohort study,65 children undergoing HSCT between January 2012 and November 2012 in the Department of Hematology and Oncology,Shanghai Children's Medical Center were enrolled.The data collected before preconditioning were considered as the baseline data.We also collected data twice a week between preconditioning and 30 days after HSCT,and once a week from 30 days to 100 days after HSCT.Dietary analysis and urea nitrogen analysis were conducted in parallel.Results The baseline level of energy intake was (5 844.9 ±2 490.4) kJ/d,protein intake was (56.4 ±28.6) g/d,fat intake was (49.7 ±38.9) g/d,and carbohydrate intake was (190.9 ± 91.1) g/d.With the hematopoietic reconstruction,the oral nutrients intake significantly decreased compared with the baseline levels (all P =0.000).During the recovery period after HSCT,the energy intake showed no significant difference when compared with the baseline level in the 6th postoperative week,protein in the 13th week,carbohydrate in the 4th week,and fat in the 6th week.The urine nitrogen was (3.9 ± 2.4) g/d before HSCT,which increased to (16.7 ± 11.0) g/d after preconditioning (P=0.000).In the 1st postoperative week,the weight (P =0.000),triceps skin fold thickness (P =0.003),mid-upper arm circumference (P =0.000),serum albumin (P =0.000) and prealbumin (P =0.000) of the patients all significantly decreased compared with the baseline levels.In the 9th postoperative week,the fat-free body weight percentage (P =0.010),muscle percentage (P =0.001) and protein percentage (P =0.000) were significantly lower than the baseline levels,while the body fat percentage was higher than the baseline level (P =0.002).Conclusions Children undergoing HSCT exhibit a marked reduction in nutrient intakes at the early stage of HSCT,which may gradually return normal during the recovery period.This process may be slow,especially for the protein,and therefore may affect the serum protein level in these pediatric patients.Thus,more careful nutrition guidance is necessary during HSCT for pediatric patients,emphasizing oral nutrients intakes,and high protein dietary or formula may be helpful.

Objectiye To optimize the depth of the microchannel and the time point for sperm collection,and improve the efficiency of sperm screening on a microfluidic device. Methods Microchannels with four different depths of 25, 50, 100 and 200 μm were tested. Mice sperm were added to the inlet of the microchannel. The relative quantity and motility of sperm in the outlet were recorded at different collection times, i.e. ,5, 15, 30 and 60 min. Statistical method one-way ANOVA and appropriate post-hoc testing were applied to analyze differences between different groups, and further to select the best-fit depth of the microchannel and the time point for collection. Results In microchannels with depths of 25, 50, 100 and 200 μm, the sperm motilities measured in each outlet were (85.4 ± 2.3)%, (85.8 ± 5.8)%,( 87. 2 ± 2. 8 ) %, (76. 5 ± 2. 8 ) % respectively with statistical significance ( F = 5.8, P ＜ 0. 05 ). No obvious differences were found among 25-100 μm channels, however the motility dramatically decreased in the 200 μm group. The relative sperm quantities were (5.2 ±2.0)%, (7.2 ±2.5)%,(12.3 ±2.0)%,(7. 7 ± 1.1 ) % respectively with statistical significance ( F = 6. 9, P ＜ 0. 05), which increased with channel depth from 25 to 100 μm,while it decreased in the 200 μm channel Taking 2 indexes into account, 100 μmwas the most fit channel depth for sperm motility screening. The sperm motility in the outlet gradually decreased with time. At the time points of 5, 15, 30 and 60 min after adding sperm, the sperm motilities were (99. 6 ±0. 7)%, (87.2 ±2. 8)%, (79. 3 ±2. 2)% and (62. 6 ±8.0)% respectively with statistical significance ( F = 37. 3, P ＜ 0. 01 ). Yet the relative quantities of sperm in the outlet increased almost three times in this process. At the time points mentioned above, the relative quantities of sperm were (5.8±1.1)%, (10.6 ± 0.9)%, (12.1 ± 1.7)%, (17.9 ± 3.4)% respectively with statistical significance ( F = 17.8, P ＜ 0. 01 ). Thus 15-30 min was the ideal screening time. Conclusion An effective microdevice for sperm screening with optimized depth and collection time period is developed,which may contribute significantly for the screening of healthy sperm on microfluidic chips.

AIM: To detect the effects of resveratrol (RSV) on the expression of microRNA-21 (miR-21) in primarily cultured neonatal rat atrial myocytes with electric remodeling induced by rapid electrical stimulation (RES).Furthermore, to find out the possible mechanism of miR-21 regulating electrical remodeling.METHODS: The neonatal rat atrial myocytes were isolated by double-enzyme (trypsin and collagenase I) digestion and differential adhesion method.The atrial fibrillation (AF) model was induced by RES.Atrial myocytes were randomly divided into 4 groups: control group, RSV group, RES group, and RSV+RES group.To further detect whether RSV regulated electric remodeling by miR-21, except the 4 groups, we add miR-21 over-expression group and miR-21 inhibitor group: RES+negative control (NC) group, RES+miR-21 mimics group, RES+miR-21 mimics+RSV group, RES+miR-21 inhibitor group, and RES+miR-21 inhibitor+RSV group.The optimal concentration and pretreatment time of resveratrol were determined by CCK-8 assay.The expression of miR-21 and the mRNA expression of L-type calcium channels CACNA1C and CACNB2 in atrial myocytes were detected by qPCR.The protein expression of L-type calcium channels Cav1.2 and Cavβ2 in the atrial myocytes was analyzed by Western blot.RESULTS: The expression of miR-21 in RES group was significantly increased compared with control group, while preconditioning with RSV decreased the expression of miR-21.Compared with RES+miR-21 mimics group, the expression of miR-21 in RES+miR-21 mimics+RSV group was significantly decreased.Meanwhile, the mRNA expression of CACNA1C and CACNB2, and the protein levels of Cav1.2 and Cavβ2 were increased (P<0.05).Compared with RES group, the expression of miR-21 in RES+miR-21 inhibitor group and RES+miR-21 inhibitor+RSV group was decreased, while the mRNA expression of CACNA1C and CACNB2, and the protein levels of Cav1.2 and Cavβ2 were increased.However, no difference of the expression of miR-21, the mRNA expression of CACNA1C and CACNB2, and the protein levels of Cav1.2 and Cavβ2 among RSV+RES, RES+miR-21 inhibitor and RES+miR-21 inhibitor+RSV groups was observed (P<0.05).CONCLUSION: In AF model induced by RES, RSV may reduce electric remodeling by inhibiting the expression of miR-21 and regulating the downstream target genes.

AIM:To investigate the effects of Akt1 gene transfection into myocardium after ischemia-reperfusion (I/R) on mitochondrial permeability transition. METHODS:Forty adult male SD rats were divided randomly into five groups with 8 rats each:control group,I/R group,Ad-gene group,Ad-blank group and Ad-inhibitor group. The rats in Ad-gene group were injected with 30 μL Lipofectamine 2000 solution including Akt1 gene to the myocardium 48 h before ischemia while those in control group and I/R group were injected with PBS of the same volume. Rats in Ad-blank group were injected with Lipofectamine 2000 of the same volume into myocardium. In Ad-inhibitor group 30 μL Lipofectamine 2000 and gene complexes with LY294002 were injected. Hemodynamics,apoptotic index,the concentrations of lactate dehydrogenase,creatine kinase,the expression of Akt1,cytosolic,mitochondrial cytochrome C and MPT were also measured. RESULTS:The lowest level of Akt1 protein expression was observed in control group. The protein expression of Akt1 in Ad-gene group was higher than that in I/R group,Ad-blank group and Ad-inhibitor group. The AI,LDH and CK in Ad-gene group were significantly lower than those in other groups except control group. Transfection of Akt1 markedly reduced the loss of mitochondrial cytochome C after I/R injury. Ad-gene transfection led to a significant increase in absorbance at 540 nm compared to I/R group,Ad - black group and Ad-inhibitor group (P<0.05). CONCLUSION:Akt1 gene prevents myocardial apoptosis after I/R injury. Akt1 gene also inhibits the opening of mitochondria permeability transition and protects mitochondrial functions of myocardium in I/R injury.

Objective:This study aims to survey the changes of the nutritional status of the children with primary acute lymphoblastic leukemia (ALL) using L-asparaginase (L-Asp) and evaluate the effect of Oral nutritional supplements (ONS) added high protein and medium-chain triglyceride (MCT)(FSMP) improving their nutritional status and clinical outcome.Methods:121 ALL patients receiving the L-Asp chemotherapy were randomized administered conventional low-fat formula (control group, 63 cases) and high protein and MCT FSMP (intervention group, 58 cases). We recorded the one-week diet and performed dietary analysis. The changes of body weight and albumin were recorded on admission and discharge, and the body composition was determined, the nutritional status, number of hospitalization days, and medical costs were assessed.Results:ALL patients had lower intake than the guideline′s recommended value during chemotherapy. The control group was significantly lower in calorie intake and nutrients intake than the intervention group. Weight changes during chemotherapy were positivelycorrelated with calorie intake ( P=0.009), protein intake( P=0.014), and carbohydrate intake( P=0.003). Conclusions:ALL children have different degrees of weight loss and protein level decline during chemotherapy, and their nutritional status was closely related to nutritional intake.ONS is an important nutritional therapy. The appropriate addition of high protein and MCT FSMP can alleviate the loss of thin body weight and the decline of albumin in ALL children.

Objective:To analyze the paradigm and changes of enteral nutrition support for hospitalized children in Shanghai Children's Medical Center affiliated to School of Medicine of Shanghai, Jiao Tong University in last ten years, so as to provide guidance for nutritionists and dietitians on the application and management of enteral nutrition.Method:Relevant data were collected and analyzed from 2011 to 2020 in the Clinical Nutrition Department of Shanghai Children's Medical Center, including the implementation status of parenteral and enteral nutrition as well as the types and distribution of different enteral nutrition formulas and diet.Results:The Clinical Nutrition Department of our hospital provided seventy-five types of diet for hospitalized children. The utilization of ordinary diets and specialized diets has been stable at about 76,000 cases per year. In the past decade, twenty-one ordinary formulas and special formulas were provided every year by the Clinical Nutrition Department in our hospital and the utilization has been stable at 46,000 cases per year. The total consumption of ordinary formulas and the proportion of ordinary formulas users showed a descending trend. The proportion of specialized formulas users among discharged patients remained at 10%, with an upward trend in the proportion of high-calorie formulas and extensively-hydrolyzed formulas.Conclusions:The enteral nutrition formulas and inpatient diets are important components of nutritional treatment. The evolution of its clinical application to some extent reflects the changes of disease spectrum and the development of clinical disciplines. In short, the dietitians play a significant role in the nutrition support team.

Objective To investigate the effects of probiotics combined with sacubitril valsartan and amiodarone on short-term and long-term efficacy of patients with atrial fibrillation after radiofre-quency ablation.Methods A total of 90 patients with atrial fibrillation after radiofrequency ablation in the First Hospital of Zhangjiakou City from June 2021 to June 2022 were selected and randomly di-vided into three groups,with 30 cases in each group.Control group was treated with amiodarone,sacubitril valsartan group was treated with amiodarone and sacubitril valsartan,and probiotics group was treated with probiotics,amiodarone and sacubitril valsartan.The recurrence situation,atrial struc-ture indexes[left atrial diameter(LAD),left ventricular ejection fraction(LVEF),left ventricular end systolic volume index(LVESVI),left atrial volume(LAV),left ventricular end diastolic volume index(LVEDVI)],myocardial fibrosis indexes[galactin-3(Gal-3),soluble growth stimulation expression gene 2 protein(sST2)],inflammatory response indexes[intercellular adhesion mole-cule-1(ICAM-1),C reactive protein(CRP),interleukin-6(IL-6)],neuroendocrine hormone in-dexes[aldosterone,norepinephrine(NE),angiotensin Ⅱ(Ang Ⅱ)],metabolites of gut microbiota[total bile acids,trimethylamine oxide(TMAO)]and incidence of adverse events were compared among the three groups.Results At 12 months after treatment,the recurrence rate of the probiotics group was significantly lower than that of the sacubitril valsartan group and the control group(P＜0.05);after 3,6 and 12 months of treatment,the LAD,LAV,LVESVI,LVEDVI,sST2 and Gal-3 in the probiotics group were significantly lower than those in the sacubitril valsartan group and the control group(P＜0.05),and these indexes in the sacubitril valsartan group were also significantly lower than those in the control group(P＜0.05);after 3,6 and 12 months of treatment,the LVEF of the probiotics group was significantly higher than that of the sacubitril valsartan group and the con-trol group(P＜0.05),and the LVEF of the sacubitril valsartan group was also significantly higher than that of the control group(P＜0.05);after 3,6 and 12 months of treatment,the CRP,IL-6,ICAM-1,NE,aldosterone and Ang Ⅱ in the probiotics group were significantly lower than those in the sacubitril valsartan group and the control group,and these indexes in the sacubitril valsartan group were also significantly lower than those in the control group(P＜0.05);after 3,6 and 12 months of treatment,the TMAO and total bile acids in the probiotics group were significantly lower than those in the control group and the sacubitril valsartan group(P＜0.05);there was no significant difference in the incidence of adverse events among the three groups(P＞0.05).Conclusion Pro-biotics combined with sacubitril valsartan and amiodarone can improve atrial structure after radiofre-quency ablation of atrial fibrillation,inhibit myocardial fibrosis,reduce inflammatory response,reg-ulate neuroendocrine hormones and metabolites of gut microbiota,prevent long-term recurrence of atrial fibrillation,and have a high safety.