Allelic Imbalance ; Genetic Techniques ; Humans

Objective To discuss significance of continuous monitoring of jugular venous oxygen saturation(S_(jv)O_2)in the course of mild hypothermia treatment(MHT)for severe traumatic brain injury (sTBI).Methods Intracranial pressure(ICP),S_(jv)O_2 and brain tissue pressure(P_(bt)O_2)were contin- uously monitored in 36 cases with sTBI for analyzing the correlation between S_(jv)O_2 and P_(bt)O_2.Results (1)There was negative linear correlation between P_(bt)O_2 and ICP(r=-0.978,P＜0.05),negative lin- ear correlation between S_(jv)O_2 and ICP(r=-0.947,P＜0.05)and positive linear correlation between P_(bt)O_2 and S_(jv)O_2(r=0.965,P＜0.05)within 24 hours and at 36 hours and 48 hours after injury.(2) The cases with decreased S_(jv)O_2 value had a worse outcome than those with normal S_(jv)O_2.meanwhile,the cases with abnormal increase of S_(jv)O_2 value had worse prognosis.Prognnsis was improved significantly with increase of S_(jv)O_2 in certain range(P＜0.05).Conclusion Continuous monitoring of S_(jv)O_2 can reflect the condition of hemicerebral oxygen metabolism and guide treatment and predicting outcome.

Objective To investigate the protective effects of Ulinastatin (UTI) and 1, 6 fructose diphosphate (FDP) on cerebral ischemia-reperfusion injury, and to discuss the protective mechanisms of UT1 and FDP on cerebral ischemia-repeffusion injury. Method Rabbit ischemia-repeffusion injury models were prepared by"four arteries occlusion". All rabbits were divided into four groups (n=6): control group, UTI (10 U/kg) group, FDP (200 mg/kg) group, UTI+ FDP group. Salt water, UTI, FDP and UTI + FDP were respectively used immediately after ischemia-reperfusion. Plasmic MDA and GSH-Px were measured at 30 minutes, 1 hour, 3 hours and 6 hours after reperfusion. Results The concentrations of plasmic MDA in every group were significantly improved compared with those in control group (P0.05 ), but significant difference could be found after 3 hours (P

Objective To study the association between clinical symptoms,psychosomatic factors and autonomic nervous function in patients with gastroesophageal reflux disease (GERD).Methods Thirty-four patients with GERD diagnosed by reflux disease questionnaire (RDQ) and endoscopy and 15 healthy control subjects were enrolled in this study.All the subjects were divided into two groups,one with normal scores of Zung's self-rating anxiety scale (SAS) and Zung's depression scale (SDS) as GERD (-) and the other with abnormal scores of SAS and SDS as GERD (+).Reflux symptom score was recorded for both groups at the same time.Autonomic nervous function was assessed by their heart rate variability (HRV) on dynamic electrocardiogram (DCG).The time domain parameters analyzed included standard deviation (SD) of average R-R interval during 24 hours (SDNN),SD of average 5-minute sinus heart rate (SDANN),mean square root of the difference of adjoining two R-R interval (rMSSD),and proportion of the heart beats with difference of R-R interval more than 50 ms from the total heart beats (PNN 50),and the frequency domain parameters analyzed included low-frequency (LF),high-frequency (HF) and ratio of LF to HF.Results Average scores of SAS and SDS were significantly higher in patients with GERD than those in healthy controls (48?9 vs 38?6 and 48?11 vs 41?6,respectively,P

AIMTo establish separation methods of five sulfonamides by using capillary high performance liquid chromatography(mu-HPLC) and electrochromatography. The effect of mobile phase varies such as methanol content, pH, buffer solution concentration and voltage on their chromatographic behavior and electroosmesis flow was investigated. Capillary electrochromatography (CEC) was compared with mu-HPLC at the same condition.

METHODSStationary phase was ODS, mobile phase was methanol and 2 mmol.L-1 H3PO4 buffer solution (pH 3.0-7.0), voltage was 0- -15 kV, flow rate was 10 microL.min-1, pressure was approximately 70 MPa and UV detection wavelength was 254 nm.

RESULTSSeparations on base line have been respectively accomplished for five sulfonamides by mu-HPLC with mobile phase of methanol-2 mmol.L-1 H3PO4 buffer solution (30:70) at pH 5.0 in 67 min, and CEC with the same mobile phase at -5 kV voltage in 25 min.

CONCLUSIONElectroosmesis flow of CEC decreased with the increase in methanol content, buffer solution concentration, increased with the increase in voltage and increase slightly with the increase in pH of mobile phase. Retention values (k) of solutes to be examined decreased with increasing methanol content of mobile phase in mu-HPLC and CEC. Retention values (k) of solutes increased slightly with increasing buffer solution concentration, decreased with increasing voltage in CEC. Trimethoprim(TMP) decreased obviously with increasing voltage in CEC. The effect of pH of mobile phase on retention values (k) was more complex. Five sulfonamides were separated at the same mobile phase condition by mu-HPLC and CEC. And separation speed of CEC was much faster than that of mu-HPLC. CEC was very fit for rapid separation of sulfonamides.

Anti-Infective Agents ; isolation & purification ; Buffers ; Chromatography, High Pressure Liquid ; methods ; Chromatography, Micellar Electrokinetic Capillary ; methods ; Hydrogen-Ion Concentration ; Sulfonamides ; isolation & purification ; Trimethoprim ; isolation & purification

OBJECTIVETo evaluate the efficacy and safety of entecavir (ETV) as a long-term treatment in patients with lamivudine (LAM)-refractory chronic hepatitis B (CHB).

METHODSIn this phase II study of ETV-056, 32 CHB patients with resistance to LAM monotherapy were administered ETV at 1.0 mg/day and monitored over a period of 8 years. The virologic, serologic and biochemical responses were measured throughout the treatment course. Outcomes analysis was conducted according to intention-to-treat principles.

RESULTSAt baseline and treatment weeks 8, 12, 24, 48, 96, 144, 192, 240, and 420, the proportion of patients with HBV DNA less than 300 copies/ml was 0, 6.3% (2/32), 9.4% (3/32), 18.8% (6/32), 18.8%(6/32), 46.9% (15/32), 43.8% (14/32), 50.0% (16/32), 50.0% (16/32), and 62.5% (20/32). At treatment weeks 48, 96, 168, 192, 240, and 420, the proportion of patients experiencing virological breakthrough was 6.1% (2/32), 9.4% (3/32), 12.5% (4/32), 18.8%(6/32), 25.0%(8/32), and 28.1% (9/32). In the 8 year study period, 32.3% (10/31) of patients achieved HBs seroconversion and four patients achieved HBe seroconversion.

CONCLUSIONWhile treatment with 1.0 mg/day ETV for up to 8 years resulted in mild HBV DNA suppression and increase of HBeAg seroconversion, the safety profile of this therapy was good but the economic cost was high and virological breakthrough rates were high.

Adolescent ; Adult ; Antiviral Agents ; adverse effects ; therapeutic use ; Drug Resistance, Viral ; Female ; Guanine ; adverse effects ; analogs & derivatives ; therapeutic use ; Hepatitis B, Chronic ; drug therapy ; Humans ; Lamivudine ; therapeutic use ; Male ; Middle Aged ; Treatment Failure ; Treatment Outcome ; Young Adult

OBJECTIVETo evaluate the efficacy and safety of five-year trail of entecavir for chronic hepatitis B patients failed with lamivudine therapy in the Chongqing area.

METHODS32 patients failed with lamivudine therapy were enrolled in this study. In the double-blind phase, patients were randomly divided into entecavir 1.0 mg/d group (n = 28) and placebo group(n = 4) for 12 weeks. In the open-lable phase, patients received ETV 1.0 mg/d for 240 weeks. HBV DNA level, liver function, HBV serology were observed.

RESULTSThe mean reduction in HBV DNA level at week 12 was 4.05 log10 copies/ml in ETV group, and 0.08 log10 copies/ml in placebo group (P less than 0.05). The mean of HBV DNA level after 240 weeks of ETV treatment was decreased to 2.58 log10 copies/ml. The proportion of patients with HBV DNA less than 3 log10 copies/ml was 0, 6.25%, 15.6% , 50%, and 57.14% at 0, 8, 24, 96 and 240 weeks respectivfely. There were 2 patients with HBsAg seroconversion and 4 patients with HBeAg seroconversion at the end of the study. The ALT level returned to normal at week 12 and remained normal throughout the following 240 weeks. One patient had a severe adverse event during the trail.

CONCLUSIONEntecavir is effective and safe for the chronic hepatitis B patients failed with lamivudine therapy.

Adult ; Alanine Transaminase ; blood ; Antiviral Agents ; administration & dosage ; therapeutic use ; DNA, Viral ; blood ; Double-Blind Method ; Drug Resistance, Viral ; Female ; Guanine ; administration & dosage ; analogs & derivatives ; therapeutic use ; Hepatitis B Surface Antigens ; analysis ; Hepatitis B e Antigens ; analysis ; Hepatitis B, Chronic ; drug therapy ; virology ; Humans ; Lamivudine ; administration & dosage ; therapeutic use ; Male ; Time Factors ; Treatment Outcome ; Virus Replication ; drug effects ; Young Adult

OBJECTIVETo evaluate the efficacy and safety of entecavir (ETV) in treating lamivudine refractory chronic hepatitis B (CHB) patients.

METHODSThis was part of a multicenter, double-blinded, randomized (4:1) and placebo-controlled trial comparing the safety and efficacy of ETV (1.0 mg once q.d.) for 12 weeks in lamivudine refractory CHB patients. All patients were treated with ETV (1.0 mg q.d.) for 168 weeks. During the treatment period, HBV DNA levels were regularly measured by quantitative PCR. Liver function tests, HBV serology and safety assessments were also conducted.

RESULTSThe mean of HBV DNA log10 decreased from 9.14 to 6.27 at week 2, decreased to 6.28 at week 4, to 5.46 at week 8, to 5.10 at week 12, to 4.49 at week 24, to 4.41 at week 48, to 3.91 at week 96, to 4.05 at week 144, and decreased to 4.21 at week 168. The proportion of HBV DNA more than 10(5) copies/ml gradually dropped from 100% at baseline to 46.43% at week 12 and to 17.86% at week 96. HBV DNA less than 10(3) copies/ml raised from 0 at baseline to 7.14% at week 8, to 10.71% at week 12, to 46.43% at week 96, and raised to 57.14% at week 168. The proportion with HBeAg seroconversion was 10.07% at the end of the study. The mean of ALT became normal at week 12 and remained normal throughout week 168. There was one patient who had a severe adverse event during the trial.

CONCLUSIONETV can effectively inhibit the replication of HBV DNA and normalize the levels of ALT in lamivudine refractory CHB patients, and from our study we think the use of ETV is safe.

Adult ; Antiviral Agents ; therapeutic use ; DNA, Viral ; blood ; Double-Blind Method ; Female ; Guanine ; analogs & derivatives ; therapeutic use ; Hepatitis B virus ; drug effects ; physiology ; Hepatitis B, Chronic ; drug therapy ; Humans ; Lamivudine ; therapeutic use ; Treatment Failure ; Virus Replication ; drug effects ; Young Adult

OBJECTIVETo study the factors affecting extracellular glycerol (Gly) in patients with severe traumatic brain injury (STBI).

METHODSPerilesional extracellular Gly and cerebral blood flow (CBF) in 53 patients with STBI were consecutively monitored. Simultaneously, the intracranial pressure (ICP) and cerebral perfusion pressure (CCP) were monitored. The hourly minimum of CCP and CBF and the hourly maximum of ICP levels were matched with the hourly Gly. Gly values were divided into several groups according to regional ICP (less than 15 mm Hg or larger than 15 mm Hg), CCP (less than 70 mm Hg or larger than 70 mm Hg), CBF (less than 50 AU or 50-150 AU) and the outcomes (death or persistent vegetative state group, severe or moderate disability group, and good recovery group).

RESULTSIn comparison with the severe or moderate disability group, the Gly concentration of the death or persistent vegetative state group increased significantly, but CBF and CCP decreased significantly. In comparison with the good recovery group, the Gly concentration of the severe or moderate disability group increased significantly, but CBF and CCP decreased significantly. The Gly concentrations in patients with ICP larger than 15 mm Hg, CCP less than 70 mm Hg and CBF less than 50 AU were respectively higher than those of patients with ICP less than 15 mm Hg, CCP larger than 70 mm Hg and 50 AU less than CBF less than 150 AU. In patients with diffuse axial injury, the mean Gly concentration was (201.17+/-55.00) micromol/L, which was significantly higher than that of the patients with epidural hematoma (n equal to 7, 73.26+/-8.37, P less than 0.05) or subdural hematoma (n equal to 9, 114.67+/-62.88, P less than 0.05), but it did not increase significantly when compared with those in patients with contusion(n equal to 24, 167.48+/-52.63).

CONCLUSIONGly can be taken as a marker for degradation of membrane phospholipids and ischemia, which reflects the severity of primary or secondary insult.

Adolescent ; Adult ; Biomarkers ; analysis ; Brain Chemistry ; Brain Injuries ; diagnostic imaging ; metabolism ; Extracellular Space ; chemistry ; Female ; Glycerol ; analysis ; Humans ; Male ; Microdialysis ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed

OBJECTIVETo study the effect of mild hypothermia on glucose metabolism and glycerol of brain tissue in patients with severe traumatic brain injury (STBI) using clinical microdialysis.

METHODSThirty-one patients with STBI(GCS less than or equal to 8) were randomly divided into hypothermic group(Group A) and control group(Group B). Microdialysis catheters were inserted into the cerebral cortex of perilesional and normal brain tissue. All samples were analyzed using CMA microdialysis analyzer.

RESULTSIn comparison with the control group, lactate/glucose ratio(L/G), lactate/pyruvate ratio(L/P) and glycerol(Gly) in perilensional tissue were significantly decreased; L/P in normal brain tissue was significantly decreased. In control group, L/G, L/P and Gly in perilensional tissue were higher than that in normal brain tissue. In the hypothermic group, L/P in perilensional tissue was higher than that in relative normal brain.

CONCLUSIONSMild hypothermia protects brain tissues by decreasing L/G, L/P and Gly in perilensional tissue and L/P in "normal brain" tissues. The energy crisis and membrane phospholipid degradation in perilensional tissue are easier to happen after traumatic brain injury, and mild hypothermia protects brain better in perilensional tissue than in normal brain tissue.

Adolescent ; Adult ; Brain ; metabolism ; Brain Injuries ; metabolism ; therapy ; Glucose ; metabolism ; Glycerol ; analysis ; Humans ; Hypothermia, Induced ; methods ; Microdialysis ; Middle Aged