An originate angiotensin Ⅱreceptor-neprilysin inhibitor sacubitril/valsartan with double effect and a new active mode can not only promote the protection of heart and neuroendocrine system , but also inhibit renin-angiotensin-aldosterone system .Sacubi-tril/valsartan is the first and only one conformed by clinical trials with better efficacy when compared with standard therapy drug enala -pril, and its safety is higher as well .Sacubitril-valsartan represents a promising new treatment option for heart failure patients with low-ered risk of cardiovascular death and hospitalization for heart failure .

In the framework of ensemble, a partial least squares(PLS) regression ensemble algorithm in subspace(MIESPLS), which is the combination of bootstrap and variable selection based on mutual information(MI), was proposed. The key of the proposed algorithm is to introduce the diversity of member models by bootstrap re-sampling on the training set and the subsequent MI calculation. Each time, those variables whose MI are lower than a defined threshold are first eliminated;then, a member model can be trained on a smaller subspace of original spectral variables. Two kinds of model fusion strategies, i.e., simple average fusion(SAF) and weighted average fusion(WAF), were adopted and compared. By two experiments concerning quantitative application of near-infrared(NIR) spectroscopy, MISEPLS is confirmed to be superior to the full-spectrum PLS and MIPLS method, i.e., PLS combined with MI-induced variable selection. The proposed MISEPLS can produce a more accurate and robust calibration model, but without increasing the complexity.

Emergency Treatment ; Humans ; Male ; Middle Aged ; Multiple Organ Failure ; complications ; therapy ; Myocardial Infarction ; complications ; therapy ; Pancreatitis ; complications ; therapy ; Treatment Outcome

Objective To study the mechanism of spontaneous rupture of hepatocellular carcinoma(HCC).Methods Articles have been reviewed to find out the theory of spontaneous rupture of HCC.Results Researchful results suggested that the injury of small arteries was usually followed in patients of spontaneous rupture of HCC.In this review,the immune complex,which composed of hepatitis B virus e antigen,complement C1q and immunoglobulins,was found deposited in the elastic membrane of arteries.Likely as a result of immune complex deposition,vascular injury occurs mainly in the small arteries where the deposition of immune complex was present.The small arteries in which immune complex deposited are readily injuried and cause hemorrhage and rupture of HCC during vascular load increase. Conclusion We would conclude that immune complex deposition in vessel wall led to the small arteries injury may be the factor involved in the pathogenesis of spontaneous ruptured HCC.

OBJECTIVE:To analyze the volatile components of Cladia aggregate by SPME-GC-MS. METHODS:The column was ZB-5 MSI 5% benzene-95% dimethylpolysiloxane fused silica capillary column,programmed temperature was heated from 5 ℃/min to 220 ℃(maintaining 2 min),detector was flame ionization detector,carrier gas was high purity He(99.999%),the column flow rate was 1.0 ml/min,vaporization room temperature was 250 ℃,splitless injection. MS conditions:ion source was electron ionization source,ionizing voltage was 70 eV, interface temperature was 280 ℃,ion source temperature was 230 ℃, quadrupole temperature was 150℃,emission current was 34.6μA,multiplier voltage was 1 502 V,solvent delay time was 1.5 min, and quality range was 30-500 amu. RESULTS:19 volatile chemical components were separated and identified from C. aggregate, mainly olefins an aldehydes,alcohols,ketones,furans oxygenated volatile chemical components,relative contents accounted for 63.55% to all chromatographic peaks in total ion chromatogram,in which,2,4-octadiene(29.66%),hexanal(5.93%),3-meth-yl-1,4-heptadiene(5.45%)and furan(4.65%)showed the highest contents. CONCLUSIONS:The study has basically made clear the main volatile components in C. aggregate,which provide certain scientific basis for further exploring C. aggregate.

Although children with differentiated thyroid cancer ( DTC) are in a high proportion of cure, due to the absence of the standard management of the evaluation, treatment and follow-up of children with thyroid neoplasia, the aggressive therapy including total thyroidectomy followed by radioactive iodine ( RAI) ablation with iodine-131 ( 131 I) could not be ignored. For the majority of children, total or near-total thyroidectomy is recommended. Central neck dissection is recommended for children with malignant cytology and clinical evidence of gross extrathyroidal invasion and/or loco-regional metastasis on pre-operative. Selective use of 131 I in children with DTC was based on pre-and post-operative staging. Multi-disciplinary collaborative management is needed to improve their outcomes and to minimize adverse effects as far as possible.

BACKGROUND:Titanium aloy and stainless steel are two common internal fixation materials, but there are some difference in their therapeutic effects and biocompatibility. OBJECTIVE:To explore the therapeutic effects and biocompatibility of titanium aloy and stainless steel internal fixation materials for the treatment of spinal tuberculosis. METHODS:Seventy-one spinal tuberculosis patients, 35 males and 36 females, aged 17-81 were enroled. Among them, 35 patients received titanium aloy internal fixation, and the 36 patients underwent stainless steel internal fixation. At the end of 12-month folow-up, Cobb angle changes, therapeutic effect and Frankel grade were analyzed in the two groups. RESULTS AND CONCLUSION:Before treatment, there was no difference in the spinal kyphosis angle and Frankel grade between the two groups. At the last folow-up, the Frankel grade and Cobb angle were both improved in the two groups (P < 0.05), but there was stil no difference between the two groups. The cure rate was 97% (n=34) in the titanium aloy group and 92% in the stainless steel group (n=33), and no significant difference was found between the two groups. These two kinds of internal fixation materials exhibited good biocompatibility, and no infection and other adverse reactions occurred. These findings indicate that both titanium aloy and stainless steel as internal fixation materials have good biocompatibility and therapeutic effects.

Objective To evaluate the bedside index for severity in acute pancreatitis (BISAP) and harmless acute pancreatitis (HAP) scoring system in predicting prognosis of acute pancreatitis (AP).Methods A total of 442 AP patients,who were admitted to The First Affiliated Hospital of Sun Yat-sen University from January 2003 to December 2010,were retrospectively studied.BISAP and HAP scores were evaluated respectively.The value of BISAP and HAP scores in predicting severity,local complications,organ failure and mortality were measured by the area under the curve (AUC) of receiver operator characteristic curve (ROC),and it was compared with that of traditional Ranson's score.Results Among 442 patients,73 patients (16.5％) were diagnosed to have severe acute pancreatitis (SAP).AUC for BISAP score in predicting SAP,local complications,organ failure and mortality were 0.90 (95％ CI:0.86 ～ 0.93),0.82(95％ CI:0.76 ～ 0.89),0.93 (95％ CI:0.89 ～ 0.96),0.93 (95％ CI:0.87 ～ 0.98).There were no statistically significant differences in AUCs of the four prognostic parameters between BISAP and Ranson's score.The specificity,positive predictive value (PPV),and AUC of HAP score in predicting mild AP were 85％,95％ and 0.73 (95％ CI:0.67 ～ 0.79).The risk of dismal prognosis increased when both BISAP and HAP score were abnormal.Conclusions BISAP and Ranson's score have comparable ability in predicting prognosis of patients with AP.However,BISAP score is simpler.HAP score is a simple and accurate method for predicting prognosis of patients with mild AP.Combination of BISAP score with HAP score can better help predict the prognosis of AP patients.

BACKGROUND:There remains controversy that whether patel ar resurfacing in total knee arthroplasty and whether patel ar chondromalacia has influence on clinical outcomes.
OBJECTIVE:To evaluate anterior knee pain, clinical function and effects of patel ar chondromalacia on clinical outcomes after total knee arthroplasty without patel ar resurfacing for degenerative osteoarthritis.
METHODS:Clinical data of 162 patients (162 knees) with degenerative osteoarthritis undergoing total knee arthroplasty without patel ar resurfacing from June 2008 to February 2010 were retrospectively analyzed. Outerbridge classification was used for patel ar chondromalacia, Visual Analogue Scale for anterior knee pain, and the Knee Society clinical scoring system for clinical function.
RESULTS AND CONCLUSION:The incision of al patients reached stage-I healing. The patel ar chondromalacia:grade I in 18 patients, grade II in 36 patients, grade III in 62 patients, and grade IV in 35 patients. At the final fol ow-up, there were six (4.0%) patients with anterior knee pain, including four cases of mild pain and two cases of moderate pain, no severe pain. The mean Knee Society clinical scoring system scores and patel ar score were obviously elevated. Outerbridge classification did not affect the incidence of anterior knee pain after replacement (χ2=0.42, P=0.94), the Knee Society clinical scoring system score (knee score:F=1.83, P=0.14;functional score:F=0.56, P=0.64) and partel ar score (F=0.78, P=0.51). These data suggested that total knee arthroplasty without patel ar resurfacing for degenerative osteoarthritis can obtain satisfactory clinical outcomes, and the patel ar chondromalacia may not affect the clinical outcomes.

Objective To observe the effects of progesterone on the mRNA and protein expressions of nerve growth factor(NGF) and brain-derived neurotrophic factor(BDNF) in the focal cerebral ischemia-reperfused rats,and to explore its mechanism of brain protection. Methods Totally 96 healthy male SD rats were randomly divided into sham surgery group,ischemic reperfusion group,vehicle-treated group and progesterone-treated group (n=24 for each).The model of focal brain ischemia-reperfusion injury was induced by middle cerebral artery occlusion (MCAO).After 2 h temporary MCAO,rats were subjected to reperfusion for 3 h,6 h,12 h and 24 h,respectively.The mRNA and protein expressions of NGF and BDNF were analyzed by real time-PCR and Western blot,respectively. Results In the injured cortex,the mRNA and protein expressions of NGF and BDNF in ischemic reperfusion group came to the peak at 6 h after reperfusion,and then gradually declined to the level of sham operation group at 24 h after reperfusion.In progesterone treatment group,BDNF and NGF mRNA and protein expressions reach the peak at 12 h after reperfusion,and were still higher at 24 h after reperfusion than in ischemic reperfusion group(P＜0.05). Conclusions Progesterone plays a protective role in focal cerebral ischemia-reperfusion by increasing the expressions of BDNF and NGF in rats.