ObjectiveTo evaluate the efficacy of PEEP set according to pressure-volume (P-V) curve for one lung ventilation (OLV) in patients undergoing thoracic surgery.MethodsOne hundred and twenty ASA Ⅱ or Ⅲ patients of both sexes aged 20-60 yr weighing 40-80 kg undergoing lobectomy under general anesthesia were enrolled in this study.Double lumen tube was inserted.Correct positioning was verified by fiberoptic bronchoscopy.The patients were mechanically ventilated.P-V curve was determined at 3 min of two-lung ventilation (TLV).Lower inflection point (LIP) was measured and the pressure at LIP (PLIP) was recorded.The patients were randomly divided into 5 groups (n ＝ 24 each):control group (group C) and 4 lung protective ventilation regimen groups ( groups P1-4 ).PEEP was set at 0 and VT was set at 10 ml/kg in group C.PEEP was set at 0 and VT was set at 6 ml/kg in group P1.PEEP was set at PLIP- 2 cm H2O and VT was set at 6 ml/kg in group P2.PEEP was set at PLIP and VT was set at 6 ml/kg in group P3.PEEP was set at PLIP + 2 cm H2O and VT was set at 6 ml/kg in group P4.Peak airway pressure (Ppeak),plateau airway pressure (Pplat),airway resistance (Raw) and lung compliance (CL ) were measured and recorded during OLV and TLV after a period of stabilization.Arterial blood samples were taken before induction of anesthesia and at 20 min of TLV and 20 min of OLV for blood gas analysis.Qs/Qt was calculated.Arterial blood samples were collected at the beginning and end of OLV for determination of plasma concentrations of IL-6 and TNF-α(by ELISA).ResultsCompared with group C,Ppeak and Pplat were significantly increased while Raw was decreased and plasma IL-6 concentration was significantly decreased at the end of OLV in group P4.PaCO2 was significantly higher during TLV and OLV in groups P1-4 than in group C.There was no significant difference in the parameters of respiratory mechanics,blood gases and plasma IL-6 and TNF-α concentrations among groups P1,2.3.Compared with groups P1,2,3,Ppeak and Pplat were significantly increased while plasma IL-6 concentration was decreased at the end of OLV in group P4.ConclusionMechanical ventilation with VT set at 6ml/kg and PEEP at PLIP + 2 cm H2 O provides best venfilatory efficacy for OLV in terms of oxygenation and inhibition of inflammatory response.

BACKGROUNDCoronary artery lesions (CALs) are known to be the main complication in children with Kawasaki disease (KD). Instead of intravenous immunoglobulin (IVIG), corticosteroid therapy has been accepted to be used for children with KD who are unresponsive to IVIG. This study aimed to evaluate risk factors for CALs in children with KD.

METHODSWe retrospectively reviewed the clinical records of 2331 children with KD from January 2005 to December 2014. To identify the independent risk factors for CALs, multivariable logistic regression models were constructed using significant variables identified from univariate logistic regression analysis.

RESULTSThe incidence of CALs was 36.0% (840 of 2331), including 625 (26.8%) coronary artery dilations and 215 (9.2%) coronary artery aneurysms (CAAs). Multivariable logistic regression analysis identified that male, incomplete KD, longer fever duration, and C-reactive protein (CRP) >100 mg/L were independent risk factors for coronary artery dilatations. On the other hand, male, incomplete KD, longer fever duration, prolonged days of illness at the initial treatment, corticosteroid therapy, sodium ≤133 mmol/L, and albumin <35 g/L were the independent risk factors for CAAs. In addition, corticosteroid therapy, prolonged days of illness at the initial treatment, and albumin <35 g/L were the independent risk factors for giant CAAs.

CONCLUSIONSCALs might be associated with male sex, incomplete KD, longer fever duration, prolonged days of illness at the initial treatment, albumin <35 g/L, sodium ≤133 mmol/L, CRP >100 mg/L, and corticosteroid therapy. Corticosteroid therapy was an independent risk factor for CAAs and giant CAAs. Thus, corticosteroids should be used with caution in the treatment of KD with the risk for CALs.

Adolescent ; Adrenal Cortex Hormones ; adverse effects ; Child, Preschool ; Coronary Aneurysm ; chemically induced ; Female ; Humans ; Infant ; Logistic Models ; Male ; Mucocutaneous Lymph Node Syndrome ; drug therapy ; Retrospective Studies

T polymorphism,was selected as putative promoter.The recombinant constructions containing-1328-+812 of TGF-?_1 gene and CAT reporter gene(phTGF2.14T,phTGF2.14C)were constructed and transfected into HepG2 cells with liposomal trans- fection method,then the transfected HepG2 cells were treated with IL-10(4 ng/ml),HGF(10 ng/ml)or IFN-?(20 ng/ml). Reporter gene activity was analyzed by ELISA.Results:Reporter gene activity in cells transfected with phTGF2.14C was sig- nificantly higher than those transfected with phTGF2.14T(P

Objective To explore the effects of therapeutic communication on the quality of life of chronic renal failure (CRF) patients. Methods Eighty CRF patients were randomly divided into two groups: study group and control group. The patients in the study group received therapeutic communication besides routine therapy and nursing while those in the control group only receive routine therapy and nursing. After six months, the differences in the quality of life collected by using SF-36 between two groups were compared. Results The quality of life in the study group were obviously improved ( P < 0. 01 ). Conclusions The therapeutic communication can effectively improve the quality of life of CRF patients.

OBJECTIVETo investigate glycometabolism of patients with depression at first episode.

METHODSOral glucose tolerance test (OGTT) was performed in 100 patients with depression at first episode and 50 healthy subjects; the levels of fast blood plasma insulin were also measured.

RESULTThere were no statistically significant differences in fast blood plasma insulin levels and postprandial blood glucose levels at 0 h, 1 h and 3 h (P>0.05); the fasting blood glucose (FBS), postprandial blood glucose levels in 2 h and area under OGTT curve of depression patients were significantly higher than those of healthy controls. The frequency of impaired glucose tolerance (IGT) in depression patients was higher than that in controls (P<0.05).

CONCLUSIONDepression patients at the first episode are abnormal in glycometabolism, which may have clinical implication.

Adolescent ; Adult ; Aged ; Blood Glucose ; metabolism ; Case-Control Studies ; Depressive Disorder ; blood ; complications ; Female ; Glucose Intolerance ; complications ; Glucose Tolerance Test ; Humans ; Male ; Middle Aged ; Young Adult

OBJECTIVETo investigate the effects of overdose fluoride, boron and two factors on the expression of enamelin in rat incisor.

METHODS32 Wistar rats were randomly divided into 4 groups. Group I: The distilled water was given. Group II: 220 mg/L NaF were given. Group III: 382 mg/L Na2B4O2.10H2O were given. Group IV: 220 mg/L NaF and 382 mg/L Na2B4O2.10H2O were given. The rats were sacrificed in the eighth week. HE staining was used to observe the morphology of ameloblasts. Immunohistochemical staining was used for study the expression of enamelin in rat incisors.

RESULTSThe results showed that the expression of enamelin was reduced in the group II (P<0.01). Compared with group I, the expression of enamelin in group IV had no significant difference. The expression of enamelin in group IV and group II had significant difference (P<0.01).

CONCLUSIONThe overdose fluoride can inhibit the expression of enamelin. The effection was weaken when boron added. Boron reduced the toxicity of fluoride on teeth.

Ameloblasts ; Animals ; Boron ; Dental Enamel Proteins ; Fluorides ; Incisor ; Phosphates ; Rats ; Rats, Wistar ; Tooth

Objective: To examine the effects of air pollution on overall mortality, mortality of respiratory diseases, and mortality of circulatory diseases among residents in Hangzhou City. Methods: Residents' mortality data in Hangzhou City from 2014 to 2016 were captured from Zhejiang Provincial Chronic Disease Surveillance Information Management System, and the ambient air quality in Hangzhou City from 2014 to 2016 were collected from Hangzhou Environmental Monitoring Center, while the meteorological monitoring data during the study period were collected from Hangzhou Meteorological Bureau. The effects of PM2.5, PM10, NO2 and SO2 on overall mortality, morality of respiratory diseases and mortality of circulatory diseases were evaluated a generalized additive model (GAM) based on Poisson distribution, and the risk of mortality was described with excess risk (ER) and its 95%CI. Results: The daily M (QR) overall deaths, deaths from respiratory diseases and deaths from circulatory diseases were 111 (30), 16 (9) and 37 (14) persons in Hangzhou City from 2014 to 2016, respectively. A 10 μg/m3 increase in PM2.5, PM10, NO2 and SO2 resulted in 0.47% (95%CI: 0.23%-0.70%), 0.37% (95%CI: 0.21%-0.53%), 1.06% (95%CI: 0.50%-1.61%) and 3.08% (95%CI: 2.18%-3.99%) rises in the risk of overall mortality, 0.60% (95%CI: 0.04%-1.16%), 0.45% (95%CI: 0.06%-0.83%), 2.01% (95%CI: 0.84%-3.20%) and 6.06% (95%CI: 3.80%-8.37%) rises in the risk of mortality of respiratory diseases, and 0.45% (95%CI: 0.08%-0.83%), 0.44% (95%CI: 0.17%-0.71%), 1.43% (95%CI: 0.49%-2.37%) and 3.66% (95%CI: 2.13%-5.22%) rises in the risk of mortality of circulatory diseases, and the greatest effect was observed at a 2-day lag. Multi-pollutant model analysis showed that, after adjustment for PM2.5, NO2 and PM2.5+NO2+SO2, a 10 μg/m3 increase in SO2 resulted in an elevated risk of mortality of respiratory diseases than a single-pollutant model. Conclusions The air pollutants PM10, PM2.5, NO2, and SO2 correlated positively with the risk of overall mortality, mortality of respiratory diseases and mortality of circulatory diseases in Hangzhou City from 2014 to 2016, and the co-existence of multiple pollutants enhanced the effect of SO2 on mortality of respiratory diseases.

Objective To investigate the effect of different pipe flush methods on the life of the filter used in CRRT without heparin.Methods 108 patients of CRRT without heparin were randomly divided into observation group (56 cases) and control group (52 cases).The control group used conventional 100 ml 0.9％sodium chloride solution to flush the filter and pipe once for an hour,while the observation group stopped the treatment every 6 hours,first used heparin saline (50 mg/L),second 0.9％ sodium chloride solution to flush,and then continued the treatment.The number of filter and its average service time were compared during the process.Results The number of filter used to treat patients with secondary renal failure,MODS,severe pancreatitis,poisoning,epidemic hemorrhagic fever and cerebrovascular accident complicated by pneumonia in the observation group was respectively 68,26,39,28,21 and 26,all of which were higher than that of the control group (71,35,55,36,24,30,respectively),and the differences were not statistically significant (x2 =28.34,15.61,18.08,19.31,18.50,respectively; P ＜ 0.05 ).The service time of the filter in the observation group was (11.60 ± 1.51 )h,higher than that of the control group which was (9.48 ± 1.29 )h,and the difference was statistically significant ( t =2.79,P ＜ 0.05 ).Conclusions In the CRRT without heparin treatment,the method of intermittent saline with heparin and 0.9％ sodium chloride solution can reduce the clotting of the filter,extend its life and cut patients' treatment cost.

OBJECTIVEThis work explores the diurnal variation of Solar ultraviolet radiation (UVR) and total solar radiation (TSR) in northeast China, using daily observations of UVR and TSR in Shenyang.

METHODSUVR and TSR measurements were carried out from March 1st, 2006 to December 31st, 2009 in Shenyang, Liaoning province, China (41°51' N, 123°27' E).

RESULTSBoth TSR and UVR showed seasonal variation, reaching the highest levels in summer and the lowest in winter. They showed the greatest fluctuation in summer and autumn. The irradiance of TSR and UVR on clear days around the equinoxes and solstices increased substantially compared with the mean seasonal irradiance, especially in autumn. The whole day accumulated dose of UVR in winter was far less than that during the middle part of a summer day (i.e. between 10:00 and 14:00). It was also less than the accumulated summer dose of morning and afternoon (i.e. between 8:00 and 10:00 and 14:00 and 16:00).

CONCLUSIONThe instant irradiance and daily accumulated amount of UVR are low in Shenyang, especially in autumn and winter. Thus concern about the health effects arising because shortage of UVR in northeast China is warranted.

China ; Radiation Monitoring ; Seasons ; Sunlight ; Ultraviolet Rays

OBJECTIVETo investigate the regulatory effects of Shenfu Injection (SFI, ) on hemodynamic parameters and serum proteins in rats with post-infarction chronic heart failure (CHF).

METHODSForty-five healthy Wistar rats were randomized into three groups: sham, heart failure (model) and SFI group. The CHF was induced by left coronary artery ligation. Seven days after the surgical operation, animals in the sham group and the model group received saline (6.2 mL/kg/d), while animals in the SFI group received SFI (6.2 mL/kg d) intraperitoneally. Four weeks later, cardiac hemodynamic parameters were measured via the carotid route. The expression of serum proteins was analyzed by two-dimensional electrophoresis and matrix-assisted laser desorption/ionization time-of-flight mass spectrometer (MALDI-TOF MS).

RESULTSRecording of hemodynamic parameters showed that left ventricular systolic pressure (LVSP), maximum rate of left ventricular pressure (+dp/dtmax) rise, and maximum rate of left ventricular pressure (-dp/dtmax) decrease, while the left ventricular end diastolic pressure (LVEDP) rose in the model group compared to those in the sham group (P <0.05). The results of the MALDI-TOF MS indicated that haptoglobin (HP), pentraxin 3 (PTX3) and alpha-1-antitrypsin were up-regulated, while serum albumin and 40S ribosomal protein were down-regulated in the model group (P <0.05). Compared with the model group, LVSP, +dp/dtmax and -dp/dtmax were higher, while LVEDP was lower in the SFI group (P<0.05). Expression levels of HP and PTX3 were lower than in the model group (P<0.05).

CONCLUSIONSFI could improve hemodynamic function and decrease inflammatory reactions in the pathophysiology of CHF. The serum proteins HP and PTX3 could be potential biomarkers for chronic ischemic heart failure, and they could also be the serum protein targets of SFI.

Animals ; Blood Proteins ; metabolism ; C-Reactive Protein ; metabolism ; Chronic Disease ; Drugs, Chinese Herbal ; therapeutic use ; Electrophoresis, Gel, Two-Dimensional ; Haptoglobins ; metabolism ; Heart Failure ; blood ; complications ; drug therapy ; physiopathology ; Heart Function Tests ; Hemodynamics ; Hydrogen-Ion Concentration ; Imaging, Three-Dimensional ; Inflammation ; complications ; drug therapy ; Male ; Myocardial Ischemia ; blood ; complications ; drug therapy ; physiopathology ; Phytotherapy ; Proteome ; metabolism ; Rats, Wistar ; Serum Amyloid P-Component ; metabolism ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization