Objective To establish the standardization process of acid-base balance analysis, analyze cases of acid-base balance disorder with the aid of acid-base balance coordinate graph.Methods The acid-base balance theory were reviewed systematically on recent research progress, and the important concepts, definitions, formulas, parameters, regularity and inference in the analysis of acid-base balance were studied. The analysis of acid-base balance disordered processes and steps were figured. The application of acid-base balance coordinate graph in the cases was introduced.Results The method of four parameters-four steps analysis was put forward to analyze the acid-base balance disorders completely. Four parameters included pH, arterial partial pressure of carbon dioxide (PaCO2), HCO3- and anion gap (AG). Four steps were outlined by following aspects: ① according to the pH, PaCO2 and HCO3-, the primary or main types of acid-base balance disorder was determined; ② primary or main types of acid-base disorder were used to choose the appropriate compensation formula and to determine the presence of double mixed acid-base balance disorder; ③ the primary acid-base balance disorders were divided into two parts: respiratory acidosis or respiratory alkalosis, at the same time, the potential HCO3- should be calculated, the measured HCO3- should be replaced with potential HCO3-, to determine whether there were three mixed acid-base disorders; ④ based on the above analysis the data judged as the simple AG increased-metabolic acidosis was needed to be further analyzed. The ratio of ΔAG↑/ΔHCO3-↓ was also needed to be calculated, to determine whether there was normal AG metabolic acidosis or metabolic alkalosis. In the clinical practice, PaCO2 (as the abscissa) and HCO3- (as the ordinate) were used to establish a rectangular coordinate system, through origin (0, 0) and coordinate point (40, 24) could be a straight line, and all points on the straight line pH were equal to 7.40. The acid-base balance coordinate graph could be divided into seven areas by three straight lines [namely pH = 7.40 isoline, PaCO2 = 40 mmHg (1 mmHg = 0.133 kPa) line and HCO3- = 24 mmol/L line]: main respiratory alkalosis area, main metabolic alkalosis area, respiratory+ metabolic alkalosis area, main respiratory acidosis area, main metabolic acidosis area, respiratory+ metabolic acidosis area and normal area. It was easier to determine the type of acid-base balance disorders by identifying the location of the (PaCO2, HCO3-) or (PaCO2, potential HCO3-) point on the acid-base balance coordinate graph.Conclusions Four parameters-four steps method is systematic and comprehensive. At the same time, by using the acid-base balance coordinate graph, it is simpler to estimate the types of acid-base balance disorders. It is worthy of popularizing and generalizing.

Objective:To develop a diagnostic analysis software for determining the type of acid-base balance disorder.Methods:Mathematical models were built based on Henderson-Hasselbalch equations and compensation formulas, to determine the important parameters of acid-base balance disorder, and to develope acid-base balance disorder analysis process. The software was compiled using the Visual Basic.NET programming language, and the installation package was generated after debugging. Acid-base balance disorder cases were searched by PubMed, Wanfang and CNKI databases from 1980 to 2015, and the blood gas parameters [pH, arterial partial pressure of carbon dioxide (PaCO 2), HCO 3- and anion gap (AG)] and the types of acid-base imbalance (literature results) were recorded. All cases were reanalyzed by software and the type of acid-base balance disorder was determined (software diagnostic type). Kappa-test and McNemar-test were performed for the two diagnostic results. Results:The "four parameters-four steps" analysis method was used as the analysis process to judge the types of acid-base balance disorder. "Four parameters" included pH, PaCO 2, HCO 3- and AG. "Four steps" were outlined by following aspects:①according to the pH, combined with PaCO 2 and HCO 3-, the primary types of acid-base balance disorder was determined; ② according to the compensation situation, double mixed acid-base balance disorder (DABD) was determined; ③according to AG value, three mixed acid-base disorders (TABD) were determined; ④ the ratio of ΔAG↑/ΔHCO 3-↓ was also calculated to determine whether there was normal AG metabolic acidosis or metabolic alkalosis. The software had the characteristics of simple interface, convenient operation, rapid judgment, and comprehensive analysis. It could judge all acid-base balance disorder types excepted "AG normal metabolic acidosis combined metabolic alkalosis". The software was used to reanalyze 112 cases of acid-base balance disorder reported in the literature, with a consistent rate of 87.50% and better consistency of the diagnostic results (Kappa test: κ = 0.84, P < 0.01; McNemar test: χ2 = 0.87, P = 0.65). Conclusion:The software can be used as an important tool to judge the type of acid-base balance disorder, and provide clinicians with diagnostic reference, which have practical value and application prospect.

10.3969/j.issn.2095-4344.2013.23.001

AIM: To examine the effects of monocyte-endothelium interaction on the expression of CD36 in monocytes and observe the functions of cytokines in this process. METHODS: The monocytes and endothelial cells were cultured alone or cocultured together to form different cell culture conditions. The level of M-CSF in culture medium was determined by enzyme linked immune sandwich assay(ELISA) technique, and the expression of CD36 in monocytes was determined by flow cytometry. RESULTS: The expression of CD36 in monocytes was low in monocytes cultured alone but increased significantly when monocytes and endothelial cells were cocultured(P

Catheter related infection is the most common complication of central venous catheter, which pathogen mainly originate from the pipe joint and the skin around puncture site. How to prevent catheter infection is an important issue in clinical nursing. The utility model disclosed a "disposable nursing applicator-pocket of indwelling central venous catheter", which is mainly used for the fixation and the protection. The main structure consists of two parts, one is medical applicator to protect the skin around puncture site, and the other is gauze pocket to protect the catheter external connector. When in use, the catheter connector is fitted into the pocket, and then the applicator is applied to cover the puncture point of the skin. Integrated design of medical applicator and gauze pocket was designed to realize double functions of fixation and protection. The disposable nursing applicator-pocket is made of medical absorbent gauze (outer layer) and non-woven fabric (inner layer), which has the characteristics of comfortable, breathable, dust filtered, bacteria filtered, waterproof, antiperspirant and anti-pollution. The utility model has the advantages of simple structure, low cost, simple operation, effective protection, easy realization and popularization.

Objective To investigate and analyze the mineral and bone disorder (MBD) in the patients with chronic kidney disease (CKD),reveal the change of related indexes of CKD-MBD.Methods A cross-sectional study was carried out in the First Affiliated Hospital of Harbin Medical University.From October 2011 to May 2014,1318 inpatients and hemodialysis outpatients were enrolled.Parameters related to MBD,including serum phosphorus (P),total calcium (t-Ca),intact parathyroid hormone (iPTH) and alkaline phosphatase (AKP) were analyzed.Last,it was analyzed with multiple regression analysis to related factors of the secondary hyperparathyroidism (SHPT) in patients with CKD.Results Serum calcium,phosphorus and iPTH had no obvious abnormalities at the early stages of CKD [GFR ＞ 60 ml· min-1· (1.73 m2)-1],and relatively stable before GFR ＞ 30 ml· min-1· (1.73m2)-1.After entering the CKD4 stage,serum phosphorus,iPTH increased sharply and serum calcium decreased obviously along with the decreased glomerular filtration rate (GFR).Serum P,t-Ca and iPTH levels were statistically significant in CKD 1 to 5D patients,respectively,serum P:(1.13±0.20) mmol/L,(1.14±0.22) mmol/L,(1.26±0.23) mmol/L,(1.48±0.34) mmol/L,(2.05±0.61) mmol/L and (2.08±0.58)mmol/L;serum t-Ca (mmol/L) (2.35±0.13) mmol/L,(2.35±0.12) mmol/L,(2.35±0.15) mmol/L,(2.26± 0.18) mmol/L,(2.07±0.29) mmol/L and (2.31±0.26) mmol/L;iPTH:57.8(45.6,91.8) ng/L,54.1(37.8,74.6) ng/L,71.6(45.8,102.2) ng/L,131.1(81.7,205.1) ng/L,277.5(173.6,395.3) ng/L and 354.9 (194.4,720.3) ng/L;The stepwise logistic regression analysis showed:hypocalcemia (OR=3.32,P ＜ 0.01) and decreased GFR (OR=5.28,P ＜ 0.01) were independent risk factors of iPTH elevation at stage CKD3～ 5.Conclusions From the beginning of the CKD3 stage,serum t-Ca,P,iPTH level began to be relatively abnormal as renal function declined.Hyperphosphatemia,SHPT has not been improved significantly in CKD5D stage patients even with hemodialysis.The regulation of hemodialysis on serum calcium showed overcorrecting phenomenon.

Aim To observe the physical coupling between transient receptor potential channel vanilloid type 4 (TRPV4 ) and cPLA2 in endothelial cells. Methods We investigated the physical association of TRPV4-cPLA2 coupling by immunofluorescence reso-nance energy transfer (immuno-FRET)to assess the spatial proximity between TRPV4 and cPLA2 in human microvascular endothelial cells (HMEC),primary cul-tured endothelial cells and in thoracic aortas rings from high salt-induced hypertension mice.Results At the cellular level,with high salt treatment,the physical in-teraction of TRPV4 and cPLA2 was significantly en-hanced in primary vascular endothelial cells and HMEC.Furthermore, in thoracic aortas rings from high salt-induced hypertension mice,we found an in-creases interaction between TRPV4 and cPLA2 in en-dothelial cells from arterial segments .Conclusion High-salt treatment increases the endothelial TRPV4-cPLA2 coupling,indicating that this coupling may pro-vide a new target for vascular endothelial dysfunction.

Objective:To investigate the effects of plasma treatment on the surface element,wettability and adhesion properties of aged denture base resin.Methods:42 pieces of 10 mm × 10 mm × 1 mm and 100 cubes of 8 mm × 10 mm × 30 mm polymethyl methacrylate specimens were prepared and thermocycled at 5-55 ℃ for 5 000 cycles.40 pieces were used for surface contact angle measurement and 2 for X-ray photoelectron spectroscopy analysis.The 100 cubes were randomly divided into 5 groups:Control(A) and 4 experimental groups in which the samples were exposed to plasma for 1 min (B),2 min (C),3 min (D) and 4 min (E) (n =20) respectively.After plasma treatment,silicone-based soft liner (3 mm) was packed against 2 resin cubes.Thus,50 tensile test specimens were obtained(n =10),and the tensile bond strength was tested by a universal testing machine.Results:The contact angle (°) of group A,B,C,D,E was 63.60 ± 10.81,46.79 ± 5.08,44.13 ± 4.17,40.11 ± 6.01 and 41.03 ± 8.61 respectively (A vs B,C,D or E,P ＜ 0.05).After plasma treatment,the contents of O =C-O and C-O in the samples were increased from 14.17％ and 20.58％ to 18.32％ and 29.32％,respectively.The tensile bond strength(MPa) of group A,B,C,D and E was 0.884 ±0.130,1.281 ±0.086,1.419 ±0.103,1.871 ± 0.248 and 1.904 ± 0.223 respectively (A vs B,C,D or E,P ＜ 0.05;B or C vs D or E,P ＜ 0.05;B vs C,P ＞ 0.05;D vs E,P ＞ 0.05).Conclusion:Plasma treatment can improve the wettability and adhesion properties of aged denture base resin.

Oligoasthenospermia is the primary cause of infertility. However, there are still enormous challenges in the screening of critical candidates and targets of oligoasthenospermia owing to its complex mechanism. In this study, stem cell factor (SCF), c-kit, and transient receptor potential vanilloid 1 (TRPV1) biosensors were successfully established and applied to studying apoptosis and autophagy mechanisms. Interestingly, the detection limit reached 2.787 × 10^-15 g/L, and the quantitative limit reached 1.0 × 10^-13 g/L. Furthermore, biosensors were used to investigate the interplay between autophagy and apoptosis. Schisandrin A is an excellent candidate to form a system with c-kit similar to SCF/c-kit with a detection constant (K_D) of 5.701 × 10^-11 mol/L, whereas it had no affinity for SCF. In addition, it also inhibited autophagy in oligoasthenospermia through antagonizing TRPV1 with a K_D of up to 4.181 × 10^-10 mol/L. In addition, in vivo and in vitro experiments were highly consistent with the biosensor. In summary, high-potency schisandrin A and two potential targets were identified, through which schisandrin A could reverse the apoptosis caused by excessive autophagy during oligoasthenospermia. Our study provides promising insights into the discovery of effective compounds and potential targets via a well-established in vitro-in vivo strategy.

Multidrug resistance (MDR) mediated by ATP binding cassette subfamily B member 1 (ABCB1) is significantly hindering effective cancer chemotherapy. However, currently, no ABCB1-inhibitory drugs have been approved to treat MDR cancer clinically, mainly due to the inhibitor specificity, toxicity, and drug interactions. Here, we reported that three polyoxypregnanes (POPs) as the most abundant constituents of