The inflammation factors and roles of them in acute coronary syndrome (ACS) were explored. The similarity between the theory of pathogenic toxin in Chinese Medicine and the inflammation response theory in ACS was discussed. The exploration of new inflammatory factors may be helpful for Chinese Medicine in the research of ACS.
Acute Coronary Syndrome ; complications ; diagnosis ; prevention & control ; therapy ; Humans ; Inflammation ; complications ; etiology ; pathology ; therapy ; Inflammation Mediators ; physiology ; Medicine, Chinese Traditional ; Prognosis ; Toxins, Biological ; adverse effects

Objective To investigate the dynamic distribution changes of fungi responsible for the deep infection and antifungal susceptibility to provide a basis for the empirical antifungal treatment.Methods Medical records were reviewed from cases suspectedof deep fungal infection at our hospital from January 1998 to December 2004.3122 isolates of 13 species were analyzed with SPSSll.0.Etest was used for the antifungal susceptibility test.Results Candida albicans was the most commonly isolated organism,while the prevalence of Candida albicans decreased(76.3% vs 66.8%,x~2=34.33,P

Objective:To observe the effect of fluid therapy on volume and coagulation function in patients with severe postpartum hemorrhage during cesarean section of placenta accreta under the guidance of inferior vena cava diameter (IVCD) and inferior vena cava collapse index (IVC-CI).Methods:A prospective randomized controlled study was conducted in 60 pregnant women with severe postpartum hemorrhage (blood loss ≥ 1 000 mL) who were hospitalized for delivery or referred for delivery in the Peking University Third Hospital from December 2018 to July 2019. The patients were divided into routine fluid replacement group and goal-oriented fluid resuscitation group (goal-oriented fluid replacement therapy was given) according to the different ways of fluid replacement. The hemodynamics, blood gas analysis, coagulation function, total fluid replacement, urine volume, prognosis, intraoperative vasoactive drugs utilization rate and postoperative adverse events were recorded before skin incision, after the fetus delivered, postpartum hemorrhage and at the end of operation, and the differences of these indices between the two groups were compared.Results:① Hemodynamics: the heart rate (HR) of the two groups were reached the peak during postpartum hemorrhage, but there was no significant difference in HR at each time point between the two groups. The mean arterial pressure (MAP) was decreased at first and then increased in both groups, and reached the trough at postpartum hemorrhage, but the MAP in the goal-oriented fluid resuscitation group was significantly higher than that in the routine fluid replacement group [mmHg (1 mmHg = 0.133 kPa): 75.6±10.7 vs. 69.2±8.9, P < 0.05]. In the goal-oriented fluid resuscitation group, the central venous pressure (CVP) was increased slightly after the fetus delivered and then stabilized, while in the routine fluid replacement group, the CVP was increased at first and then decreased, and reached the peak in postpartum hemorrhage. During postpartum hemorrhage, CVP in the goal-oriented fluid resuscitation group was significantly lower than that in the routine fluid replacement group [cmH 2O (1 cmH 2O = 0.098 kPa): 9.5±3.9 vs. 11.4±3.4, P < 0.05]. ② Arterial blood gas: partial pressure of oxygen (PaO 2) and partial pressure of carbon dioxide (PaCO 2) in arterial blood at the end of operation in both groups were higher than those in postpartum hemorrhage. There was no significant difference in PaO 2 at the end of operation between the goal-oriented fluid resuscitation group and routine fluid replacement group (mmHg: 189.3±100.5 vs. 240.2±126.3, P > 0.05). The PaCO 2 in the goal-oriented fluid resuscitation group was significantly lower than that in the routine fluid replacement group (mmHg: 34.6±4.6 vs. 36.8±4.1, P < 0.05). The lactic acid (Lac) at the end of operation of the goal-oriented fluid resuscitation group was significantly lower than that of the routine fluid replacement group (mmol/L: 2.2±0.6 vs. 2.6±1.1, P < 0.05). ③ Liquidintake and output volume: the total infusion volume, crystal fluid infusion volume and suspended red blood cell infusionvolume in the goal-oriented fluid resuscitation group were significantly less than those in the routine fluid replacement group [total infusion volume (mL): 3 385.9±1 144.1 vs. 4 448.3±1 194.4, crystal infusion volume (mL): 2 635.6±789.7 vs. 3 160.0±860.3, suspended red blood cell input volume (mL): 695.6±366.2 vs. 911.1±284.7, all P < 0.05], and the utilization rate of vasoactive drugs in the goal-oriented fluid resuscitation group was decreased significantly during operation [13.3% (4/30) vs. 60.0% (18/30), P < 0.05]. The amount of bleeding in the goal-oriented fluid resuscitation group was also significantly less than that in the routine fluid replacement group (mL: 1 451.7±373.8 vs. 1 725.9±372.8, P < 0.05), but there was no significant difference in urine volume between the goal-oriented fluid resuscitation group and the routine fluid replacement group (mL: 369.0±262.7 vs. 485.0±286.8, P > 0.05). ④ Coagulation function: at the end of operation, the prothrombin time (PT) in the goal-oriented fluid resuscitation group was significantly shorter than that in the routine fluid replacement group (s: 10.9±0.6 vs. 11.2±0.6), and the fibrinogen (Fib) in the goal-oriented fluid resuscitation group was significantly higher than that in the routine fluid replacement group (g/L: 3.7±0.5 vs. 2.9±0.8), and the differences were statistically significant (both P < 0.05).⑤ Prognostic index: compared withthe routine fluid replacement group, the proportion of patients transferred to intensive care unit (ICU) at the end of operation in the goal-oriented fluid resuscitation group was significantly lower [16.7% (5/30) vs. 66.7% (20/30), P < 0.05], and ICU length-of-stay was significantly shorter [hours: 0 (0, 24) vs. 24 (0, 24), P < 0.05], but there was no significant difference in the incidence of disseminated intravascular coagulation (DIC), acute renal injury (AKI) or hysterectomy between the goal-oriented fluid resuscitation group and the routine fluid replacement group [the incidence of DIC: 0% (0/30) vs. 6.7% (2/30), the incidence of AKI: 0% (0/30) vs. 3.3% (1/30), the hysterectomy rate: 10.0% (3/30) vs. 26.7% (8/30), all P > 0.05]. Conclusion:Fluid resuscitation guided by IVC-CI can effectively reduce the volume of blood and fluid transfusion and blood loss in patients with severe postpartum hemorrhage and improve their blood coagulation function.

Objective To explore the role of serum S-100B concentration of umbilical cord blood and blood on the 24 h after admission in the early diagnosis and development of newborn hypoxic-ischemic encephalopathy(HIE).Methods Forty-six HIE newborns(31 cases with mild HIE and 15 cases with moderate and severe HIE)were selected as HIE group,and 43 normal full-term newborns were selected as control group.The umbilical cord blood sample and blood sample were aquired on the 24 h after admission.The serum S-100B concentration was detected by enzyme-linked immunosorbent assay(ELISA)analysis.Results 1.There was no significant difference of serum S-100B concentration between the male sub-group and female sub-group of normal group and their birth weight had no significant relative to the serum S-100B concentration.2.The serum S-100B concentration of umbilical cord blood of control group and HIE group were(1.03?0.32)and(2.53?1.1)?g/L,respectively,there was significant difference between two groups(t'=8.848 P

RT-PCR amplification of ginseng ?-amyrin synthase gene was successfully performed based on the total RNAs extracted from ginseng hairy roots induced by Agrobacterium rhizogenes A4 using a modified guanidine isothiocyanate-method. Sequence analysis of this gene revealed that its sequence was consistent with the sequence of a previously reported ginseng ?-amyrin synthase gene (GenBank No. AB009030). This gene was inserted into pMD-119T simple vector and transformed into E.coli DH5?. Furthermore antisense plant expression vector of this gene was constructed using the pBI121 vector, laying foundation for studies on antisense regulation of ginseng ?-amyrin synthase gene.

Genetic engineering is a powerful tool in Panax ginseng breeding.Genetic transformation and plant regeneration are the premise and foundation involved in genetic engineering of Panax ginseng.Ginseng can be regenerated through organogenesis or somatic embryogenesis and indirect somatic embryogenesis is mainly used for its regeneration.Summurized the factors influencing plant regeneration such as different explants,different carbohydrates,somatic embryo optimization and hormone-free approach.Ginseng transformation has been achieved by Agrobacterium tumefaciens and Agrobacterium rhizogenes and transgenic ginseng with good characters was obtained by introducing genes associated with biosynthesis of ginsenosides or herbicide gene.Hairy root culture system can supply large scale of ginsenosides,thus effect of rolC genes on ginseng hairy root induction,regeneration and bioreactor culture of hairy root were discussed.Additionally,problems that are present in genetic engineering of Panax ginseng were also discussed in this review.

Purpose:To study the effect of early restrictive fluid resuscitation (EFR) on inflammatory and immune factors in patients with severe pelvic fracture (SPF).Methods:A total of 174 SPF patients in the Department of Orthopaedics,the First Affiliated Hospital of Chengdu Medical College from July 2015 to June 2018 were involved in this study and divided into EFR group (n =87) and control group (n =87) using the random number table method.Conventional fluid resuscitation (CFR) was performed in control group,and EFR was performed in EFR group.The incidences of acute respiratory distress syndrome (ARDS) and multiple organ dysfunction syndrome (MODS) during rescue,successful rescue rate,blood transfusion volume,fluid input,and resuscitation time were compared between the two groups.The parameters including prothrombin time (PT),hematocrit (HCT),platelet (PLT) and blood lactate (BL) at the 4th hour after fluid resuscitation were recorded.The levels of inflammatory factors (TNF-α,IL-6,CRP) and immune factors (CD3+,CD4+,CD8+,CD4+/CD8+) were compared between the two groups before treatment and 7 days after treatment.The revised acute physiologic and chronic health evaluation system and the sequential organ failure assessment scores were adopted for evaluation before treatment and 7 days after treatment.Results:The incidences of ARDS and MODS during rescue in EFR group were significantly lower than those in control group (p=0.015 and 0.010 respectively),and the successful rescue rate in EFR group was significantly higher than that in control group (p =0.011).The blood transfusion volume,fluid input,resuscitation time in EFR group were significantly lower than those in control group (p =0.016,0.002 and 0.001 respectively).At the 4th hour after fluid resuscitation,PTand BL in EFR group were significantly lower than those in control group (p =0.021 and 0.003 respectively),while HCT and PLT in EFR group were significantly higher than those in control group (p =0.016 and 0.021 respectively).On day 7 after treatment,TNF-α,IL-6,CRP and CD8+ in EFR group were significantly lower than those in control group (p =0.003,0.004,0.007 and 0.003 respectively),while CD3+,CD4+ and CD4+/CD8+ in EFR group were significantly higher than those in control group (p =0.004,0.000,0.007 respectively).On day 7 after treatment,the revised acute physiologic and chronic health evaluation (APACHE) system and the sequential organ failure assessment (SOFA) scores in EFR group were significantly lower than those in control group.Conclusion:EFR can effectively eliminate inflammatory factors,improve immune function,maintain the stability of blood components,reduce the incidences of ARDS and MODS,and elevate the successful rescue rate in patients with SPF.

AIM: To observe the clinical therapeutic efficiency of 1g/L sodium hyaluronate eye drops on ocular surface disorders in patients with proliferative diabetic retinopathy(PDR)after 20G pars plana vitrectomy(PPV).

METHODS: Randomized single blind case control study was used. Patients with type 2 diabetes who were admitted to the department of ophthalmology, Xi'an No.4 Hospital for PDR and underwent 20G PPV surgery by the same surgeon were randomly divided into PDR control group(Group A)and sodium hyaluronate treatment group(Group B). Group B received continuous 1g/L sodium hyaluronate eye drops from 1d to 2mo after surgery. Before and 1wk, 1, 3mo after surgery, OSDI, SⅠt, BUT, fluorescein cornea staining(FL)and the tear film and corneal epithelial cell layer under corneal laser scanning confocal microscopy of the two groups were compared.

RESULTS:A total of 90 cases and 90 eyes were studied. In preoperative time, the two groups showed obvious dry eye syndrome, and compared with the control subjects, there were no significant difference existed between the two groups(P>0.05). In group A, ocular surface injury was further aggravated after surgery and failed to recover with time extension during the observation period.Some indexes of Group B improved at different observation time after surgery compared with those before surgery, and there were significant differences between group A and Group B after surgery(P<0.05).

CONCLUSION: Applying 1g/L sodium hyaluronate eye drops could relief the uncomfortable feeling of ocular surface in patients with PDR after 20G vitrectomy and accelerate the recovery of ocular surface disorders.

The method of isolating filaments of the dorsal cutaneous branches was used to observe the effects of antidromic electrical stimulation of the spinal nerves on the discharge of remote A delta and C mechanoreceptive units in rats. Seventy-nine mechanoreceptive units were recorded from the T12 nerve filaments after stimulation of the dorsal cutaneous branches of T9 spinal nerve. It was found that the discharge frequency of 59.3% (16/27) A delta-units and 71.2% (37/52) C-units significantly increased during 90-120 s after the stimulation. Sixty-four mechanoreceptive units were recorded from the T12 nerve filaments after stimulation of the dorsal cutaneous branches of T8 spinal nerves. The discharge frequency of 47.8% (11/23) A delta-units and 36.6% (15/41) C-units significantly increased during 120-150 s after the stimulation. In addition, the threshold of the majority of these mechanoreceptors (78.3%, 18/23) decreased after the stimulation. The results suggest that antidromic electrical stimulation of the dorsal cutaneous branches of spinal nerves leads to sensitization of A delta and C mechanoreceptive units of the remote peripheral nerve endings, which results in an increase in afferent discharge of these units.
Animals ; Electric Stimulation ; Electrophysiology ; Female ; In Vitro Techniques ; Male ; Mechanoreceptors ; physiology ; Rats ; Rats, Sprague-Dawley ; Spinal Nerves ; anatomy & histology ; physiology

OBJECTIVEX-linked adrenoleukodystrophy (ALD) is a genetically determined disorder that involves the nervous system white matter, axons, adrenal cortex and testes. The typical clinical manifestations are progressive psychomotor regression, vision and/or auditory impairment and adrenal insufficiency. The clinical manifestation, biochemical change and genetic counseling work of X-linked ALD were analyzed.

METHODSThe clinical features of 29 cases with ALD were summarized and analyzed, including symptoms and signs, measurement of blood very long chain fatty acids (VLCFA), adrenal function, cranial magnetic resonance imaging (MRI) and pedigree investigation.

RESULTSAmong these 29 cases, the clinical phenotype could be classified into childhood cerebral (22 cases), adolescent cerebral (4 cases), adrenomyeloneuropathic (1 case), Addison's disease (1 case) and asymptomatic or presymptomatic (1 case) types. Nine of them had positive family history. Pedigree investigation was consistent with typical sex-linked recessive inheritance. There were 45 ALD patients in these 29 pedigrees. The neurological manifestations varied among members of the same family. Nine cases died during follow up. The causes of death were central respiratory failure or other complications of ALD and so on. Laboratory tests demonstrated abnormally high plasma levels of VLCFA in ALD patients; MRI demonstrated symmetric butterfly-like low T(1) and high T(2) signals in the parieto-occipital white matter. The impairment in the splenium of corpus callosum made the bilateral lesion region converge into one. It could progress anteriorly and injure the bilateral posterior limb of internal capsule and the temporal lobe, and could injure the brainstem inferiorly. Following intravenous injection of contrast material, thin stripe of lacelike enhancement could be observed.

CONCLUSIONSThe atypical initial symptom of ALD was seizures. The MRI showed abnormal signal in the cerebellar white matter. This disease can influence the normal development of children, this was more pronounced in the childhood cerebral ALD type. It tended to progress rapidly with dementia, vegetative state or death. Since antenatal diagnostic method is available now, emphasis should be made on the antenatal examination in order to make an early diagnosis and abort pregnancy if necessary.

Adolescent ; Adrenoleukodystrophy ; blood ; diagnosis ; therapy ; Child ; Child, Preschool ; China ; Fatty Acids ; blood ; Female ; Follow-Up Studies ; Humans ; Male ; Pedigree ; Treatment Outcome