As a clean, efficient, and renewable energy, hydrogen is regarded as a promising alternative. Because of using biomass as substrate, microbial fermentative hydrogen production can meet the need of sustainable development. The factors affecting the process of microbial fermentative hydrogen production, are analyzed in this paper on the basis of microorganisms, substrates, products and operative parameters. The parameters related to hydrogen production from organic wastes, are also mentioned.

Objective To examine the clinical effects of intravenous lyophilize recombinant human brain natriuretic peptide (rhBNP) in patients with refractory heart failure caused by coronary artery disease.Methods Seven patients with refractory heart failure caused by coronary artery disease were treated with rhBNP.The rhBNP nea grade,symptoms and signs,24 hours urine output,heart rate,blood pressure and central venous pressure were evaluated at 0,15,30 min and 1,2,4,8,12,24,and 48 h.Serum potassium,sodium,creatinine and plasma BNP before and after treatment were measured.Results After rhBNP therapy,dyspnea grade were improved in 5 patients.Symptoms and signs got better in 6 patients.Systolic blood pressure at 15 min of treatment distolic blood pressure was decreased slightly from (112.00±10.42) mm Hg to (105.14±7.76) mm Hg (P＜0.05) and became (108.71±6.63)mm Hg at 30 rain which was the same with that before treatment.There was no statistical significance in heart beat[ ( 88.57±16.92 ) vs.( 86.00±16.21 ) ] beat/min,serum sodium [ ( 133.57±5,38 ) mmol/Lvs.( 133.57±8.16) mmol/L ],serum potassium [ (3.83±0.37) mmol/L vs.(4.19±0.58 ) mmol/L ],ereatinine [ (93.11±27.90) μmol/L vs ( 123.01±93.01 ) μmol/L ] before and after treatment,and BNP[ ( 1218.43±847.83) vs.(1433.71±676.08)ng/L] before treatment and at24 h treatment,as well as urine output [(2329±1573 ) vs.(2126±1074) ml ] ( P ＞ 0.05 ).Urine output was increased during the treatment,but the usage of diuretic was remarkably decreased.Central venous pressure was gradually decreased from 30 rain to 48 h( P ＜ 0.05 ).Condusion rhBNP can decrease central venous pressure and increase urine output with exerts little side effects on electrolytes and renal function.Therefore rhBNP has positive clinical effects on refractory heart failure which is caused by coronary artery disease.

Objective To analyze causes of death and risk factors of acute myocardial infarction(AMI)、Methotis 118 AMI patients who died f selected from 1252 hospitalized patients with AMI from January 2003 to June 2008)were retrospectively enrolled for analysis of risk factors and death causes.Resuits The overall mortality of hospitalized patients with AMI was 9.42%(118/1252).The mortality rate in the males was 8.91%(84/943)while in the females was 11.00%(34/309)which was higher than the males but there was no statistical difieFence (P=0.2739).Mortality rate rose along with age and showed significant statistical difference(P＜0.0001)among different age group[＜40 yrs:6.45%(2/31),40～54:2.56%(6/234),55～64:5.11%(16/313),≥65:13.95%(94/674)].Pump failure occurred in 77 cases(65.25%)which was the main cause of death,cardiac arrest occurred in 21 cases(17.80%)and heart rupture in 13 cases(11.02%).There existed other causes of death including cerebral hemorrhage.digestive tract bleeding and pneumonia in 7 cases(5.93%).The mortality of patients with PCI was 4.24%(39/920)while23.80%(79/332)of those witbout PCI(P＜0.0001).Rate of cardiac rupture was 1.04%(13/1252),2.91%(9/309)in females and 0.42%(4/943)in males(P＜0.0001).The time was＜24 h(23.72%.28/118)when death occurred from onset,24 h～1 week(55.93%,66/118)and 1～4 week (20.34%,24/118).There was no statistical difference of mortality related to different infarction locations[antior 12.47%(59/473),anteroseptal 9.23%(12/130),inferior 6.73%(28/416),lateral 8.70%(4/46),ventricle postwall 5.97%(4/67),and ST-segmental elevated myocardial infarction 9.17%(11/120)(P=0.0852)].Conclusions There is a high mortality in aged patients with AMl with heart failure as the most common cause of death which usually occurs at early stage of AMI.The females have more cardiac ruptures than the males.PCI significantly decreases rates of mortality and cardiac rupture.Moreover.gender and location of AMI might be another important risk factor which affect mortality.

Objective To investigate the disease situation of adult carotid atherosclerosis in water-related endemic fluorosis areas in Heilongjiang province in 2008 so as to explore the relationship between water-related endemic fluorosis and incidence of carotid atherosclerosis disease. Methods A total of 266 participants over the age of 40 from four villages in Zhaozhou county with water fluoride ≥ 1.0 mg/L in a fluorosis area and 283 residents over the age of 40 from four villages in Tailai county with water fluoride ＜ 1.0 mg/L in a nonfluorosis area were investigated. A portable-type B mode color ultrasound was used to examine the left carotid artery of all participants.The carotid atherosclerosis was diagnosed and graded through the ultrasonograms. Results The prevalence rates of carotid atherosclerosis in the 4 fluorosis villages(Xinfeng, Taipingshan, Baochan and Houzheng villages) were 47.3% (35/74), 63.5%(40/63), 73.3%(33/45) and 60.7%(51/84), respectively, and in the 4 nonfluorosis villages(Hala,Qianxing, Sanjia and Ailin villages) were 32.7% (17/52), 32.9% (24/73), 39.2% (31/79) and 30.4% (24/79),respectively. The prevalence rates of carotid atherosclerosis in every villages standardized by age were 47.3% ,63.5%,73.3% ,60.7% and 34.7% ,36.3% ,43.0% ,41.3%, respectively. Statistic method used was Wilcoxon two sample test and the differences were significant(T = 26, P ＜ 0.05 ). Total carotid atherosclerosis positive rate standardized by age in the 4 fluorosis villages was significantly higher than that in the 4 nonfluorosis villages[57.5%(153/266) ,37.8% (107/283), x2 = 21.36, P ＜ 0.01 ]. After standardized by age, the severity of carotid atherosclerosis was significantly different between fluorosis villages and nonfluorosis villages (x2 = 36.15, P ＜ 0.01 ). Conclusion The prevalence rate of carotid atherosclerosis in endemic fluorosis area is higher than that in nonfluorosis area.

Objective To prospectively study the difference of urinary N-acetyl-β-D-glucosaminidase( UN-AG) and retinol binding protein(URBP) in contrast-induced nephropathy (CIN). Methods The clinical data of 150 patients undergoing coronary angiography were documented. The urine and blood samples before,24 hours after and 48～72 hours after the procedure were collected;Serum creatinine (SCr) and urinary ereatinine (UCr)were tested by enzymic method. UNAG and URBP were tested by ELISA in CIN and control group. CIN was defined as an increase in SCr of ≥44 μmol/L or >25% from baseline 48 ～72 h after the procedure. 27 age- , sex- , results of coro-nary angiography-matched cases were taken as control group. Results CIN was diagnosed in 13 of 150 patients (8.7%). In CIN group, UNAG/UCr were significantly higher than that in control group[ 1.97 (1.06,2.64) U/mmol vs 1.07 (0, 68,1.88 ) U/mmol, Z = 2.076, P = 0.039 ] before ;24 hours after the procedure, UNAG/UCr was signifi-cantly up-regulated in CIN group from baseline level [ 2.82 ( 1.88 ,4.26) U/mmol vs 1.97 (1.06,2.64) U/mmol, Z =2.607,P =0. 009]. ROC curve analysis showed that baseline UNAG could be used as an early predictor for CIN, the AUC =0. 776 ,P =0.023 ;when cut off value = 8.08 U/L,the sensitivity and specificity of UNAG were 0. 771 and 0. 713 respectively. The percentage of patients of UNAG over 8.08 U/L in CIN group was significantly higher than that in control group[77.1% (10/13) vs 29.6% (8/27) ,Z =2. 564,P =0. 011 ] ,the related risk factor is 5.58,95% CI was 1.24 ～ 25.08. Conclusion UNAG could be used as a predictor of CIN before the procedure and its postprocedure 24 h level maybe useful in early diagnosis after the procedure.

OBJECTIVETo study the effect of a low level of galacto-oligosaccharides (GOS) on intestinal bifidobacteria and lactobacilli, and fermentation characteristics in term infants by comparing with human milk and a standard infant formula without GOS.

METHODSA total of 371 term infants from four hospitals of China were enrolled. The infants started with breast feeding. After 1-2 weeks, some of the infants were changed to feeding with formula milk and then were randomly assigned to two formula-feeding groups: with or without GOS supplementation (2.4 g/L). Growth, stool characteristics, and side effects were recorded in a 3-month-follow-up. Faecal samples were collected for analysis of intestinal bacteria (culture technique), acetic acid (gas chromatography) and pH (indicator strip) at postnatal 3 months.

RESULTSCompared with the formula-feeding group without GOS, the contents of bifidobacteria, lactobacilli and acetic acid and stool frequency increased, and faecal pH decreased significantly in the GOS-formula-feeding and the human milk group. There were no significant differences between the GOS-formula-feeding and the human milk groups. Supplementation with GOS did not lead to an increase in the incidence of crying, regurgitation and vomiting.

CONCLUSIONSA supplementation of low levels of GOS in infant formula seemed to improve stool frequency, decrease faecal pH, and stimulate intestinal bifidobacteria and lactobacilli up to levels as found in breast-fed infants.

Bifidobacterium ; isolation & purification ; Dietary Supplements ; Galactose ; administration & dosage ; Humans ; Hydrogen-Ion Concentration ; Infant Formula ; Infant, Newborn ; Intestines ; microbiology ; Lactobacillus ; isolation & purification ; Oligosaccharides ; administration & dosage

Objective To evaluate the surgical treatment for renal cell carcinoma with inferior vena cava tumor thrombus and the clinical significance of multidisciplinary treatment. Methods Two cases of renal cell carcinoma with inferior vena cava thrombus diagnosed by Doppler ultrasonography and CT were included in this retrospective analysis. The tumor thrombus was in level Ⅱ in one case and in level Ⅳ in the other. Coagulation test and complete blood count were done again before surgery. Human albumin, fibrinogen, prothrombin complex, plasma, platelet, UW and irrigating solution were prepared before the operation.Under general anesthesia, surgery was performed using abdomen inverted Y shaped incision. Right radical nephrectomy was finished by the urological surgeon; the vena cava was completely dissected from the renal vein level to the secondary porta of the liver by the hepatobiliary surgeon, the vena cava and the surrounding branch vein were blocked in the upper and lower vena cava tumor thrombus; tumor thrombus was removed completely by the vascular surgeon. In one case (patient with level Ⅳ thrombus ) where the tumour thrombus invaded the wall of the vena cava, the thrombus was found to be extending to the cavo-atrial junction but not into the right atrium. The left femoral venous-right atrial bypass was established, the cardiopulmonary bypass lasted for 241 mia, and the aorta was blocked for 18 min. Salvage autotransfusion was used during surgery, and the hepatic vein of the secondary liver porta was anastomosed to artificial vascular graft.The data for surgical indication, operation time, operative blood loss and postoperative hospital stay were analyzed. Results Right radical nephrectomy and inferior vena cava thrombectomy were performed successfully, and the two patients were discharged on the 15th and 27th day after surgery, respectively. The two patients were followed up for 1 and 16 months after surgery, respectively, and both survived without local recurrence and distant metastasis. Conclusion Radical nephrectomy and inferior vena cava thrombectomy is the preferred method for patients without metastasis, and multidisciplinary cooperation could shorten the operation time, reduce the tumor recurrence and increase the survival rate of patients.

OBJECTIVETo explore the effect of different nutrition therapies on abnormal glucose metabolism during pregnancy and pregnancy outcomes.

METHODSThe 83 cases of pregnant women with abnormal glucose metabolism who came to nutrition clinic were randomly divided into two groups before 30 weeks pregnancy: 42 cases in traditional food exchange serving group (FES) and 41 cases in food exchange serving based on glycemic load group (FES + GL). Traditional food exchange serving and food exchange serving based on glycemic load were used as the different nutrition therapies for two groups respectively until the time of delivery. The influence of two nutrition therapies on the blood glucose and pregnancy outcomes were observed.

RESULTSThe daily food glucose load (GL) after nutrition therapy in the FES + GL group (145.9 ± 26.3) were significantly decreased than that of the FES group (179.9 ± 28.9, t = 5.602, P < 0.01). Fasting plasma glucose (FPG) and 2 h postprandial glucose (2 h PG) ((4.63 ± 0.97) and (6.15 ± 1.07) mmol/L, respectively) after nutrition therapy in the FES + GL group were significantly lower than that in pre-nutrition therapy ((4.96 ± 0.81) and (9.13 ± 1.61) mmol/L, t = 2.237, 11.202, respectively, all P values < 0.05). The 2 h PG in the FES + GL group ((6.15 ± 1.07) mmol/L) after nutrition therapy was significantly lower than that of the FES group ((6.86 ± 1.26) mmol/L, t = 2.760, P < 0.05). 19.51% (8/41) of the total incidence of complications in the FES + GL group was lower than that (11/42, 26.19%) in the FES group, but the difference was not significant (χ² = 0.524, P > 0.05).

CONCLUSIONFES based on GL was much easier to reduce blood glucose compared with FES. Two nutrition therapies can improve maternal and neonatal outcomes in pregnant women with abnormal glucose metabolism.

Adult ; Blood Glucose ; metabolism ; Diabetes, Gestational ; diet therapy ; metabolism ; Female ; Glucose Metabolism Disorders ; diet therapy ; metabolism ; Humans ; Nutritional Support ; methods ; Pregnancy

OBJECTIVETo evaluate clinical effects of knee osteoarthritis with the treatment of the isometric quadriceps femoris contraction exercises, which aims at establishing the exercise prescription of knee osteoarthritis,and promoting its clinical application.

METHODSFrom January 2008 to September 2010, 120 patients with knee osteoarthritis were divided into two groups according to visiting sequence, including 39 males and 81 females, ranging in age from 40 to 85 years, with an average of 62.50 years, the disease course ranged from 1 month to 30 years. There were 60 patients in the therapeutic group, including 21 males and 39 females, ranging in age from 40 to 85 years, with an average of (62.27 +/- 8.99) years, the disease course ranged from 2 months to 30 years; and the patients were treated with intra-articular injection of sodium hyaluronate and isometric quadriceps femoris contraction exercises for treatment. There were 60 patients in the control group; including 18 males and 42 females, ranging in age from 41 to 80 years, with an average of (62.72 +/- 8.34) years, the disease course ranged from 1 month to 30 years; and the patients were treated with conventional intra-articular injection of sodium hyaluronate. The index such as the pains,functions and articular dropsy of the knees were observed and the clinical effects were compared respectively.

RESULTSAll the patients were followed up, and the duration ranged from 1 to 3 years, with an average of 18 months. According to standard of JOA about evaluating the therapeutic effects of knee osteoarthritis: in the therapeutic group, 12 patients got an excellent result, 33 good, 14 poor and 1 bad; and in the control group, 7 patients got an excellent result, 14 good, 31 poor and 8 bad. The clinical results of therapeutic group was better than that of control group. There were 7 recurrent cases in the therapeutic group and 31 recurrent cases in the control group; the recurrence rate in therapeutic group was lower than that of control group.

CONCLUSIONThe isometric quadriceps femoris contraction exercises has obvious effect in alleviating the symptoms, improving joint function, strengthening the joint stability and slowing down joint degeneration process for the treatment of knee osteoarthritis, which has a good effect in the long-term clinical effects.

Adult ; Aged ; Aged, 80 and over ; Case-Control Studies ; Exercise Therapy ; Female ; Humans ; Hyaluronic Acid ; administration & dosage ; Isometric Contraction ; Male ; Middle Aged ; Osteoarthritis, Knee ; therapy

OBJECTIVETo investigate the therapeutic effect and safety of acupuncture at points of The Liver and Gallbladder Meridians for treatment of migraine.

METHODSMulti-central, randomized and controlled trial was used and 253 cases of migraine were divided into an acupuncture group and a western medicine group. The acupuncture group was treated with acupuncture at points of The Liver and Gallbladder Channels with Taichong (LR 3), Yang-lingquan (GB 34), Fengchi (GB 20), Ququan (LR 8) selected as main points, and the western medicine group with oral administration of Flunarizine tablets for 4 therapeutic courses. The total therapeutic effects 3 and 6 months after the treatment, the scores of various symptoms of migraine before and after treatment, and the stability of therapeutic effect in one-year following-up survey were observed in the two groups.

RESULTSAfter treatment, mean times and duration of the headache attack were significantly improved in the two groups (all P < 0.01) with the acupuncture group better than the western medicine group (P < 0.05). The total effective rates for stopping pain after treatment, 3 months and 6 months after treatment in the acupuncture group were 93.0%, 93.0% and 87.7%, respectively, which were better than 85.6%, 86.5% and 69.2% in the western medication group (all P < 0.01). One year later, the stability of the therapeutic effect in the acupuncture group was better than that in the western medicine group (P < 0.05); the adverse reaction and the compliance in the acupuncture group were significantly superior to those in the western medicine group.

CONCLUSIONAcupuncture at points of The Liver and Gallbladder Meridians for treatment of migraine is safe, effective, and with stable long-term therapeutic effect.

Acupuncture Points ; Acupuncture Therapy ; methods ; Administration, Oral ; Adolescent ; Adult ; Aged ; Female ; Flunarizine ; administration & dosage ; therapeutic use ; Gallbladder ; pathology ; Headache ; prevention & control ; Histamine H1 Antagonists ; administration & dosage ; therapeutic use ; Humans ; Liver ; pathology ; Male ; Meridians ; Middle Aged ; Migraine Disorders ; drug therapy ; pathology ; therapy ; Treatment Outcome ; Young Adult