Objective To comparie the effects of pre-dilution with post-dilution continuous renal replacement therapy (CRRT) for patients with MODS. Method Thirty-two MODS patients admitted to ICU (Intensive Care Unit ) were randomized and treated with different modes of CRRT. The results of creatinine clearance, acid-base equilibrium, haemodynamic variables before and post therapy were recorded.The maximal pre-filter pressure, the duration of filter unworn out and mortality of patients treated with different modes of CRRT were also recorded. Results Seventeen patients were treated with pre-dilution mode of CRRT and 15 patients treated with post-dilution mode of CRRT. After 24 hours of pre- and postdilution modes of CRRT, the net increase in Ccr (namely the rate of replacement creatinine clearance) were (15.6±4.6) vs. (22.7 ±4. 1) mL/min respectively (P＜0.01); after 48-hour, they were (14.9±3.3)vs. ( 18. 9 ±2. 3) mL/min (p ＜0. 05) . Both dilution modes could improve the blood PH、 HCO3- and BE( P ＜ 0. 05 ) without significant differences between two groups after CRRT therapy ( P ＞ 0. 05 ) . The MAP of patients treated with pre-dilution modes of CRRT therapy for 24 hours and the MAP of patients before therapy were 69. 2 ± 4. 6 and 56. 7 + 9. 1 mmHg respectively ( P ＜ 0. 05 ), and dosage of dopamine used in patients before CRRT therapy and that after CRRT for 24 hours were ( 11.20 +3.45 ) vs (6. 12 +3.41 ) μg ·kg-1 min -1(P＜0.05).The maximal pre-filter pressures of pre-and post-dilution modes were (82.23+9.11) cm H2O, (110.56 +28. 14) cmH2O respectively (P＜0.05), and the durations of lasting effect of filter used in two modes of CRRT were ( 39 + 28. 12 ) vs. ( 25 + 14. 45 ) h respectively ( P ＜0. 05) . Both dilution modes could improve APACHE Scores. There were no significant differences in APACHE Scores and mortalities between two groups after CRRT therapy. Conclusions Post-dilution mode of CRRT has higher filtration rate, but have higher maximal pre-filter pressure and shorter longevity of filter.Pre-dilution mode of CRRT has better effect on improving hemodynamics, reducing usage of vasopressor.Both modes of CRRT can correct acid base equilibrium disorder rapidly. There are no differences in the results of blood gas analysis improved、 APACHE scores and mortality between the two groups.

Twenty eight patients with multiple organ dysfunction syndrome (MODS) underwent continuous venovenous hemofiltration (CVVH)in ICU from June 2003 to June 2008, including 13 cases treated with predilution mode and 15 with postdilution mode. The changes of oxygenate index( PaO2/FiO2 )during CVVH were retrospectively analyzed. The total case fatality rate of this group of patients was 46%(13/28). There was a significant increase in PaO2/FiO2 of 28 cases during the first 48 h of CVVH (P ＜0. 05);the levels of PaO2/FiO2 in predilution group had increased significantly within 48 h during CVVH (P＜0. 05), while those in postdilution group had not significantly changed (P ＞ 0. 05). There was a significant increase in Pa02/FiO2 for the survival patients during the first 48h CVVH( P ＜ 0. 05 ), while no significantly change in the fatal cases(P ＞0. 05 ). In summary, oxygenate function and outcome of patients with MODS can be improved by CVVH, and predilution may be a more effective mode.

Objective To investigate the effect of escitalopram combined neuro-linguistic programming treatment(NLP) on cognitive function in patients with somatoform disorders.Methods 120 cases with somatoform disorders were randomly divided into the escitalopram monotherapy group and escitalopram with NLP combined group,with 60 cases in each group for six weeks.At baseline and after six weeks for treatment,it was respectively assessed that the efficacy using Symptom Checklist 90 and Global Assessment Function,and cognitive function using the Raven Standard Progressive Matrices Test,digit span and digit symbol tests in Adult Wechsler Intelligence Test,while event related potentials P300 were detected.60 cases normal healthy adults as controls.Results Compared with the control group,the Raven scores,digit span,digit symbol scores were lower (P ＜0.01),N1,P3 latent periods were longer (P ＜ 0.01 or ＜ 0.05),N1N2,N2P2,P2P3 amplitudes were less(P =0.00) in patients with somatoform disorders.After treatment,Raven scores(91.25 ± 14.87,95.60 ± 19.95),digit span scores (11.98 ± 1.89,10.90 ± 2.76),digit symbol scores (11.71 ± 2.89,11.92 ± 2.90),N2P2 amplitudes ((11.32 ± 6.67) μV,(13.39 ± 9.31) μV),P2P3 amplitudes ((9.04 ± 6.14) μV,(9.51 ± 7.17) μV) increased,N2 latent periods ((240.60 ± 41.41) ms,(238.31 ± 41.47) ms) prolonged,N1 latent periods shortened (P ＜ 0.05 or 0.01) in the monotherapy group and the combined group.The digit span,P2 latent periods,N1N2,N2P2,P2P3 amplitudes had statistically significant differences between monotherapy group and combined group after treatment(P ＜ 0.05 or 0.01).Conclusion Both escitalopram monotherapy and escitalopram combined NLP have improved cognitive function in patients with somatoform disorders,but combined therapy has more prominent advantage.

Objective To determine the distribution and antibiotic resistance of hospital - associated pneu-monia(HAP) in senile patient,and the high risk factors of HAP,pathogenic bacterium and prognosis,so as to instruct the clinic prevention and treatment. Methods Patients with age over 60 years old,who were diagnosed of HAP with confirmed pathogens. Pathogens were identified, then the antibiotic resistance was determined by Kirty-Baucer disk dif-fusion assay. High risk factors of HAP, pathogenic bacterium and prognosis were analyzed by Logistic regression analy-sis. Results The first 10th pathogens of HAP patients were pseudomonas aeruginosa( 16.1% ),staphylococcus au-reus( 14.6% ) ,klebsiella pneumonia( 10.2% ), escherichia coil (8.8%) ,staphylococcus hemolyticus (7.3%). MR-SA accounted for 90% in staphylococcus aureus. The drug resistance of pseudomonas aeruginosa to imipenem was 29.5%. The high risk factors of HAP were acute brain accident, hypoalbuminemia, tracheal intubation or mechanical ventilation, rennal failure,COPD, gastric tube, anaemia,liver disfunction,long length of stay ( all P < 0.05 ). The mor-tality of senile HAP was 29.2%. Conclusion There are high antibiotic resistance and high mortality of HAP in se-nile patients. Measures should be taken to modify the risk factors.

Objective To evaluate the relationship between the incidence rate of hepatic encephalopathy in patients with cirrhosis and the model for end-stage liver disease (MELD).Methods The total of 120 patients with decompensated cirrhosis were enrolled and followed-up.MELD score was obtained to observe the incidence of hepatic encephalopathy.Results The incidence of hepatic encephalopathy was 44.17％(53/120).MELD score in hepatic encephalopathy patients was significantly higher than that in none hepatic encephalopathy patients[(21.69 ± 9.22) scores vs.(9.32 ± 4.63) scores],and there was significant difference (P ＜ 0.05).With the increase of MELD score,the incidence of hepatic encephalopathy increased (P ＜ 0.01).The best critical value of MELD score was 14.13 scores (the sensitivity of 86.05％ and the specificity of 88.37％),when MELD ≥14.13 scores,the incidence of hepatic encephalopathy within 3 months was significantly higher [63.16％(48/76) vs.11.36％(5/44)] (x2 =30.32,P＜ 0.01).Conclusion MELD can help predicting the incidence of hepatic encephalopathy in decompensated cirrhosis patients.

OBJECTIVETo establish the quality criteria for decoction pieces of salt Alpinia.

METHODDecoction pieces of salt Alpinia were measured with moisture, total ash, acid-insoluble ash, water-extract and volatile oils according to the procedures recorded in the Chinese Pharmacopoeia 2010. The content of Nootkatone was determined by HPLC, and NaCl, by chloridion electrode method.

RESULTWe obtained results of total ash, acid-insoluble ash, water-extract and volatile oils of 10 batches of decoction pieces of salt Alpinia moisture; Meanwhile we set the HPLC and chloridion electrode method.

CONCLUSIONThis research established a fine quality standard for decoction pieces of salt Alpinia.

Alpinia ; chemistry ; Calibration ; Chromatography, High Pressure Liquid ; Electrochemistry ; Oils, Volatile ; analysis ; Quality Control ; Salts ; chemistry ; Solubility ; Water ; chemistry

Purpose: RIOK1 has been proved to play an important role in cancer cell proliferation and migration in various types of cancers—such as colorectal and gastric cancers. However, the expression of RIOK1 in breast cancer (BC) and the relationship between RIOK1 expression and the development of BC are not well characterized. In this study, we assessed the expression of RIOK1 in BC and evaluated the mechanisms underlying its biological function in this disease context. Materials and Methods: We used immunohistochemistry, western blot and quantitative real-time polymerase chain reaction to evaluate the expression of RIOK1 in BC patients. Then, knockdown or overexpression of RIOK1 were used to evaluate the effect on BC cells in vitro and in vivo. Finally, we predicted miR-204-5p could be a potential regulator of RIOK1. Results: We found that the expression levels of RIOK1 were significantly higher in hormone receptor (HR)–negative BC patients and was associated with tumor grades (p=0.010) and p53 expression (p=0.008) and survival duration (p=0.011). Kaplan-Meier analysis suggested a tendency for the poor prognosis. In vitro, knockdown of RIOK1 could inhibit proliferation, invasion, and induced apoptosis in HR-negative BC cells and inhibited tumorigenesis in vivo, while overexpression of RIOK1 promoted HR-positive tumor progression. MiR-204-5p could regulate RIOK1 expression and be involved in BC progression. Conclusion These findings indicate that RIOK1 expression could be a biomarker of HR-negative BC, and it may serve as an effective prognostic indicator and promote BC progression.

Chiral amines are important building blocks for the synthesis of pharmaceutical products and fine chemicals. Highly stereoselective synthesis of chiral amines compounds through asymmetric amination has attracted more and more attention. ω-transaminases (ω-TAs) are a promising class of natural biocatalysts which provide an efficient and environment-friendly access to production of chiral amines with stringent enantioselectivity and excellent catalytic efficiency. Compared with (S)-ω-TA, the research focused on (R)-ω-TA was relatively less. However, increasing demand for chiral (R)-amines as pharmaceutical intermediates has rendered industrial applications of (R)-ω-TA more attractive. Improving the thermostability of (R)-ω-TA with potential biotechnological application will facilitate the preparation of chiral amines. In this study, the dynamic surface loop with higher B-factor from Aspergillus terreus (R)-ω-TA was predicted by two computer softwares (PyMOL and YASARA). Then mutant enzymes were obtained by deleting amino acid residues of a dynamic surface loop using site-directed mutagenesis. The results showed that the best two mutants R131del and P132-E133del improved thermostability by 2.6 ℃ and 0.9 ℃ in T₅₀¹⁰ (41.1 ℃ and 39.4 ℃, respectively), and 2.2-fold and 1.5-fold in half-life (t1/2) at 40 ℃ (15.0 min and 10.0 min, respectively), compared to that of wild type. Furtherly, the thermostability mechanism of the mutant enzymes was investigated by molecular dynamics (MD) simulation and intermolecular interaction analysis. R131del in the loop region has lower root mean square fluctuation (RMSF) than the wild type at 400 K for 10 ns, and mutant enzyme P132-E133del increases four hydrogen bonds in the loop region. In this study, we obtain two stability-increased mutants of (R)-ω-TA from A. terreus by deleting its dynamic surface loop and also provide methodological guidance for the use of rational design to enhance the thermal stability of other enzymes.