Cardiac Resynchronization Therapy ; China ; Chronic Disease ; Heart Failure ; therapy ; Humans ; Practice Guidelines as Topic

Hepatic fibrosis is a wound healing response to liver injury. Activated hepatic cell is thekey evidence in the pathological fibrosis,which results in synthesis of large quantities of extracellular matrix components. Cytokines secreted mostly by activated Kupffer cell were remarkabe factors which have been proposed to stimulate and inhibit the fibrosis process.The close relationship between hepatic fibrosis and cytokines has been investigated. The article summarizes some important cytokines and the cytokines which can be used as target of antifibrotic therapy.

The MLN64 gene,which is localized in q12-q21 of the human chromosome 17,encodes a novel transmembrane protein containing 445 amino acids .The C-terminus of MLN64 shares significant homology with the steroidogenic acute regulatory (StAR)protein,while its N-terminal domain exhibits a function of targe-ting the protein to late endosomes .MLN64 is likely to be involved in cholesterol transport and synthesis of steroid hormones.MLN64 gene,coamplified with C -erbB-2,is overexpressed in certain breast carcinomas and exerts an influence on biological characteristics of breast cancer cells .The high levels of MLN 64 observed in some breast carcinomas could contribute to the growth and progression of these tumors through increased intratumoral steroido -genesis,and is considered as a predictive factor of breast cancer prognosis .

Objective The study is mainly on the effect and outcome of 131 I treatment for children and adolescents with differentiated thyroid cancer .Methods We compared the difference between rhTSH -aided ra-dioiodine treatment and L -thyroxin withdrawal .Our study collected 87 patients in a retrospective study .In order to analysis the effect,we divided into two groups.The experimental group has 46 patients,and control check has 41 patients.We compared the basic characteristics and mortality in different groups by χ2 -test,t-test and F-test based on data type .Results The thyroid stimulating hormone concentrations of experimental group patients have significant differences in the first ,the third and the sixth day after the injected of rhTSH ,the third day is the highest.The TSH concentration has significant difference between the two groups before 131I treatment(t=2.362, P=0.023).For the Tg(thyrobolulin)negative patients,Tg concentration in control check is higher than the third day after injected of rhTSH in the experiment group (1.5 ±1.2 vs.0.7 ±1.4,P=0.034).Whole body image has been done by scintigraphic after 3~8 months of 131I treatment.Thirty four(84%)patients have no radioiodine up-take in experiment group,and 40(87%)patients have no radioiodine uptake in control check ,there is no differ-ence between the two groups (χ2 =0.277,P=0.599).There is no difference between the two groups on the rea-son for retreatment(P=0.875).Conclusion The outcome of rhTSH -aided radioiodine treatment is similar to L-thyroxin withdrawal in short -term recurrences ,and rhTSH-aided radioiodine treatment with 131 I therapy for children and adolescents with DTC is a better method .

Objective To compare the efficacy of the streamlined liner of the pharynx airway (SLIPA) and the proseal laryngeal mask airway (PLMA) in airway management in elderly patients undergoing laparoscopic cholecystectomy.Methods One hundred and twenty patients aged 60-75 years with American Society of Anesthesiologists (ASA) grade] or Ⅱ undergoing laparoscopic cholecystectomy were randomly divided into three groups:the endotracheal intubation group (Group T,n=40),the SLIPAgroup (GroupS,n=40) and the PLMA group (GroupP,n=40).Endotracheal intubation and laryngeal mask airway insertion were conducted after induction of anesthesia.All the patients were ventilated with intermittent positive pressure ventilation.Mean arterial pressure and heart rate were recorded at before induction (T0),successful insertion (T1),ten minutes after pneumoperitoneum (T2),successful extubation (T3),and ten minutes after extubation (T4).The rate of successful placement at first attempt,time taken for placement,airway sealing pressure,and side effects were recorded.The incidences of post-extubation cough,backflow,aspiration,larynogospasm,bleeding,gastric distension and sore throat within 2 days after intubation were also recorded.Results The successful rates of insertion were 92.5 ％,92.5 ％,95.0 ％,respectively,at first attempt and 100.0％ at second attempt in the three groups (x2 =0.268,P＜0.05).Changes in hemodynamic parameters were significantly different between Group T and Group S or P after induction (t=4.076,P＜0.05).Time taken for placement was shorter in Group S than in Groups T and P,meaning that the placement of SLIPA was easier than that of endotracheal intubation or PLMA (t=43.561,P＜0.05).The airway sealing pressure was higher in Group P than in Group S,but had no statistically significant difference between the two groups (t=0.363,P＞0.05).There was no significant difference in post extubation complications,including backflow,aspiration,laryngospasm and gastric distension (t=0.321,P＞0.05),among the three groups,but incidences of postextubation cough and pharyngalgia were higher in Group T than in Group S and Group P (x2 =26.674,10.568,P＜0.05).Conclusions SLIPA and PLMA can both provide adequate ventilation during operation,with few complications.SLIPA placement is the easiest,while PLMA has good airway sealing and thus is more suitable for elderly patients undergoing laparoscopic cholecystectomy.

Objective To evaluate the clinical efficacy of tigecycline combinated with isepamicin for treatment of pneumonia caused by multidrug-resistant Acinetobacter baumannii.Methods A retrospective analysis was performed in adult patients with multidrug-resistant Acinetobacter baumannii pneumonia in two general hospitals from January 2012 to January 2014.Total eighty-four patients with MDR-Acinetobacter baumannii pneumonia were randomly divided into two groups(n=42).One group was treated with tigecycline combinated with isepamicin(termed combination therapy group),and another group was administrated with cefoperazone sulbactam (termed control group ).The clinical cure rates,microbiological eradication rates and adverse events were collected and compared. Results There was no difference in APACHEⅡ score between two groups.The clinical cure rates in combination therapy group was significantly higher than that in control group(88% vs 61%,P<0.05),and with a higher rate of microbiological eradication(59.5% vs 35.7%,P <0.05 ).However,the occurence rate of adverse events was similar in the two groups (7.1% vs 1 1.9%). Conclusion With a higher rate of clinical efficacy and a lower rate of adverse events,the combination therapy with tigecycline and isepamicin would be a promising alternative for treatment with MDR-Acinetobacter baumannii pneumonia.

Objective To assess whether urapidil (anα1 receptor blocker)is more effective than ni-troglycerin in treatment of non-valvular heart failure accompanying hypertension and diabetes mellitus (DM ) in elderly female patients .Methods Fourty-six elderly female patients with non-valvular heart failure accompanying hypertension and DM were randomly divided into urapidil treatment group (n= 24) and nitroglycerin treatment group (n= 22) .Patients in urapidil treat-ment group were treated with urapidil (50 -300 μg/min) and those in nitroglycerin treatment group were treated with nitroglycerin (5 -20 μg/min) for 48 -140 h according to their blood pressure (BP) and cardiac function .Their BP ,HR ,and metabolic activity were observed before and on days 1 ,2 ,3 and 7 after treatment .Results The effect of urapidil was significantly lower than that of nitroglycerin on SBP on day 7 after treatment (P<0 .05) .The serum NT-proBNP level was significantly lower in nitroglycerin treatment group than in control group (P<0 .01) . Conclusion The effect of urapidil is better than that of nitroglycerin on reducing and stabilizing SBP ,attenuating cardiac afterload ,and improving cardiac function in elderly female patients .Ura-pidil can thus be used as one of the first choiced drugs in treatment of elderly female patients with non-valvular heart failure accompanying hypertension and DM .

P2X receptors are ligand gated ion channels, extracellular ATP is their natural extracellular ligand. When any of the subtypes of P2X receptors and extracellular ATP are combined, P2X channel opens, allowing cations (calcium, sodium, potassium, etc. ) pass through. Enteric nervous system is composed of the gut myenteric plexus and submucosal plexus, in both of which P2X receptors exist, mediating different effects under physiological and pathological conditions. In this paper, the enteric nervous system,P2X receptor distribution and related functions are reviewed in order to further explore the P2X receptor in the diagnosis and treatment of intestinal diseases.

Objective To investigate precaution effect of ephedrine on protamine's untoward reaction. Meth-ods Forty patients, who were scheduled to have mitml valve replacement operation were randomly divided into two groups: ephedrine group(group A, n = 20) and control group (group B, n = 20). 50ml solution, mixed with protamine and 5% glucose,was injected through internal jugular vein in five minutes to neutralize the effect of heparin. In group A,3mg ephedrine was added into neutralization solution while in group B nothing was added. Arterial pressure(AP) , heart rate(HB) peripheral hemoglobin oxygen saturation(SpO2) and airway resistance(AR) were measured before injection and 1,3,5,10 minutes after injection in both groups. Results In group A, the AP, HR, SpO2 and AR had no significant difference before and after injection (P >0.05) ;while in 6 eases of group B, the AP, HR, SpO2 and AR have significant difference before and after injection. Conclusion Ephedrine can significantly improve protamine's untoward reaction, and neutralize the effect of heparin.