To find the crystalloid and colloid mixture solution in proper ratio for acute hemodilution.Method:Fourty major surgical adult patients undergoing acute hemodilution were randomly divided into five groups (n=8). The average amounts of blood withdrawn were 20％-30％ of total blood volume. The general anesthesia was maitained,the blood was drawn through left radial artery, and in the meanwhile at the same volume one of the designed diluents was infused intravenously: Single crystalloid or colloid solution,mixture of crystalloid and colloid solution in proportion of 1:1:1:2 and 1:3. Result:Hemodynamics,ECG,SpO_2 P_EtCO_2 remained stable; Hb,Hct,PLC,Fg and blood viscosity decreased significantly following hemodilution in all groups. COP decreased significantly in single crystalloid, 1:1 and 1:2 groups, and remained unchanged in 1:3 and single colloid groups. Conclusion:The crystalloid and colliod mixture at ratio of 1:3 can be more safely applied to acute hemodilution.

Objective Diagnosis related groups ( DRGs) is a system to classify hospital cases into groups , which is effective in the control of medical cost .The article was to explore the DRGs grouping method and quality control indexes of cerebrovascular dis -ease in Nanjing first-class hospitals at grade 3. Methods Polytomous logistic regression for ordinal response was used in the factor analysis of hospitalization cost .E -CHAID decision tree method was applied in the DRGs grouping of cerebrovascular patients . Results Totally 9095 cases were enrolled in this study with the average age was (64.52 ±14.85).The average of stay lengths and expenses were (11.77 ±9.26)d and (25921.04 ±23096.76)rmb respectively.Hospitalization expense was associated with neurologi-cal surgery, main diagnosis, interventional surgery, main complication and ICU days.Taking neurological surgery as the first forced variable, cerebrovascular cases could be divided into 14 DRGs groups. Conclusion The terminal quality control index , the step warning index and case maximum index of cerebrovascular disease established by the DRGs grouping method are suitable in the area .

Objective To quantify the correlation between isometric and isokinetic tests of core muscles during trunk rotation. Methods The strength of the core muscles of 38 healthy males was measured isometrically and isokinetically ( at 60°/s) during trunk rotation.The left and right peak rotation torque ( LPT,RPT) and the ratio of left to right torque (L/R) were analyzed using correlation and regression analysis and paired t-tests. Results The subjects' LPTs and RPTs were positively correlated ( rL =0.644,P ≤ 0.01 ;rR =0.566,P≤0.01 ) There were significant differences in the L/R ratios determined using the two tests (r=0.663,P≤0.01 ).The regression equations predicting LPT and RPT were yL =22.330 + 0.937x and yR =32.752 +0.847x,respectively.Paired t-tests showed that tL =4.562,P≤0.01 and tR =3.855,P≤0.01 during left or right rotation.There was a significant difference,but there was no significant difference in LPT/RPT. Conclusion Isometric and isokinetic tests of core muscles during trunk rotation give results which are strongly correlated.Either can correctly reflect the maximal strength of core muscles during trunk rotation.Clinicinas may reasonably choose either testing method to assess patients and guide treatment according to the patient's clinical symptoms and the severity of the problem.

BACKGROUND AND OBJECTIVEIt has been proven that cytochrome P450 enzyme 2A13 (CYP2A13) played an important role in the association between single nucleotide polymorphisms (SNP) and human diseases. Cytochrome P450 enzymes are a group of isoenzymes, whose sequence homology may interfere with the study for SNP. The aim of this study is to explore the interference on the SNP study of CYP2A13 caused by homologous sequences.

METHODSTaqman probe was applied to detect distribution of rs8192789 sites in 573 subjects, and BLAST method was used to analyze the amplified sequences. Partial sequences of CYP2A13 were emplified by PCR from 60 cases. The emplified sequences were TA cloned and sequenced.

RESULTSFor rs8192789 loci in 573 cases, only 3 cases were TT, while the rest were CT heterozygotes, which was caused by homologous sequences. There are a large number of overlapping peaks in identical sequences of 60 cases, and the SNP of 101 amino acid site reported in the SNP database is not found. The cloned sequences are 247 bp, 235 bp fragments.

CONCLUSIONThe homologous sequences may interfere the study for SNP of CYP2A13, and some SNP may not exist.

Objective:To investigate the expression levels and diagnostic value of platelet parameters, fibrinogen and D-dimer in different Traditional Chinese Medicine (TCM) syndromes of deep venous thrombosis (DVT).Methods:From June 2015 to June 2019, a total of 500 DVT patients were enrolled and collected by two attending TCM doctors and classified according to syndromes differentiation. The differences of platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), platelet crit (PCT), platelet larger cell ratio (P-LCR), fibrinogen (FIB) and D-dimer were detected and compared.Results:According to TCM syndromes differentiation, 500 patients were divided into three groups, including 286 cases (57.2%) of downward flowing of damp-heat group, 132 cases (26.4%) of blood stasis and heavy damp group, and 82 cases (16.4%) of spleen-kidney-yang deficiency group. The levels of MPV, PDW, P-LCR, FIB and D-dimer among the groups were statistically significant difference ( P<0.05 or P<0.01). The MPV level was significantly higher and D-dimer level was significantly lower in blood stasis and heavy damp group than in the downward flowing of damp-heat group ( P<0.05). The levels of MPV, PDW and P-LCR in spleen-kidney-yang deficiency group were significantly higher than those in downward flowing of damp-heat group and blood stasis and heavy damp group ( P<0.05 or P<0.01). The levels of FIB and D-dimer were significantly lower than those in the downward flowing of damp-heat group and blood stasis and heavy damp group ( P<0.05 or P<0.01). The FIB (AUC=0.593) and D-Dimer (AUC=0.673) were statistically significant in the differential diagnosis of DVT between blood stasis and heavy damp group and spleen-kidney-yang deficiency group ( P<0.01). The MPV (AUC=0.601 5), PDW (AUC=0.615 4), P-LCR (AUC=0.606 1), FIB (AUC=0.616 4) and D-Dimer (AUC=0.721 8) were statistically significant in the differential diagnosis of DVT between downward flowing of damp-heat group and spleen-kidney-yang deficiency group ( P<0.01). Conclusion:The MPV, PDW, P-LCR, FIB and D-dimer have a certain correlation with DVT TCM syndrome types, and also have a certain reference value for its differential diagnosis, which can be used as an effective supplement to the objective indicators of Micro syndrome differentiation of traditional Chinese medicine.

The distal femoral fracture, tibial plateau fracture and patellar fracture may all develop into traumatic knee arthritis, which is probably associated with knee dysfunction problems. Total knee arthroplasty (TKA) is an effective treatment for end-stage knee arthritis. The distal femoral valgus cut angle (VCA) is an important reference for distal femoral resection in TKA and significantly affects postoperative prosthesis position and lower extremity alignment after TKA. For VCA, the specific methods for definition, measurement methods, clinical application and influencing factors are currently controversial. Hence, the authors review the research progress in the role of VCA in TKA from the above-mentioned four aspects, hoping to provide a reference for accurate preoperative planning and intraoperative performance of TKA.

Objective:To analyze the value of minute ventilation to carbon dioxide production slope (VE/VCO 2 slope) combined with peak systolic blood pressure (SBP) in predicting prognosis for patients with chronic heart failure (CHF). Methods:A total of 170 patients with CHF who visited the Cardiac Rehabilitation Center of Tongji Hospital Affiliated to Tongji University and completed cardiopulmonary exercise test from March 2007 to December 2018 were enrolled in the study. The clinical data, cardiopulmonary exercise testing results and follow-up information of patients were collected to explore the predictors of all-cause mortality in patients with CHF.Results:The median follow-up time was 647 (182-1 764) days. All-cause death occurred in 34 patients. Compared with surviving patients, the proportion of diabetes and angiotensin-converting enzyme inhibitor/angiotensin Ⅱ receptor blocker (ACEI/ARB) use in fatal patients was significantly higher ( P<0.01). The VE/VCO 2 slope and peak SBP*VE/VCO 2 in the fatal patients were significantly higher, and the peak oxygen consumption (peak VO 2) was lower than those in the surviving patients ( P<0.01). The areas under the receiver operating characteristic curve (AUC) of VE/VCO 2 slope and peak SBP*VE/VCO 2 in predicting all-cause mortality in patients with CHF were 0.648 ( P=0.008) and 0.681 ( P=0.001), respectively; the optimal thresholds were >40.95 ( P=0.008) and > 5 423.50 mmHg (1 mmHg=0.133 kPa, P=0.006), the sensitivity was 0.559 and 0.588, and the specificity was 0.728 and 0.735, respectively. Multivariate Cox regression analysis showed that after adjusting for age, gender, diabetes and ACEI/ARB use, VE/VCO 2 slope ( HR=2.12, P=0.036) and peak SBP*VE/VCO 2 ( HR=2.42, P=0.016) were independent risk factors for all-cause mortality in patients with CHF. Conclusion:Compared to the traditional index VE/VCO 2 slope, a novel index peak SBP* VE/VCO 2 provides a relatively better predictive value for all-cause death of CHF patients.

Inflammatory bowel disease （IBD）， mainly including ulcerative colitis （UC） and Crohn's disease （CD）， is a common chronic inflammatory disease of the gastrointestinal tract， with its incidence increasing year by year. Due to its long treatment duration， difficulty in treatment， prolonged remission， and high costs， it has attracted global attention. Exploring safe， effective， and sustainable treatment regimens has become an urgent global issue. The pathogenesis of IBD is complex， involving intestinal mucosal injury，disturbances in the internal environment， and inflammatory responses. In recent years， research has found that ferroptosis is also one of the important pathogenic factors of IBD. Ferroptosis， as a new form of non-apoptotic cell death， is characterized by iron dependence， lipid peroxidation， and imbalance in the redox system. Studies have shown that inhibiting ferroptosis in intestinal epithelial cells can protect the intestinal mucosa. Targeted intervention in ferroptosis may be a new direction for the treatment of IBD. IBD is mainly treated with drugs， including corticosteroids， aminosalicylates， biologics， and immunomodulators， but drug resistance and adverse reactions are common. Traditional Chinese medicine （TCM） has unique advantages such as low cost， low drug resistance， and fewer side effects， and has accumulated rich experience in the treatment of IBD. Scholars have confirmed that TCM can inhibit ferroptosis， and recent studies have shown that TCM can not only inhibit iron-dependent lipid peroxidation in intestinal cells but also enhance the antioxidant and anti-inflammatory abilities of intestinal mucosa， thus playing a role in the treatment of IBD. Increasing evidence suggests that TCM may treat IBD by interfering with ferroptosis. This article explores the relevance of TCM intervention in ferroptosis and the treatment of IBD， discusses the possible mechanisms of ferroptosis in IBD， and aims to provide a basis for the diagnosis and treatment of IBD.

Echocardiogram is vital for the diagnosis of cardiac disease. The heart has complex hemodynamics requiring an advanced ultrasound imaging mode. Cardiac ultrasound vector flow imaging is capable of measuring the actual magnitude and direction of the blood flow velocity, obtaining the quantitative parameters of hemodynamics, and then providing more information for clinical research and diagnosis. This study mainly reviewed several different vector flow imaging techniques for cardiac flow and presented the implementation difficulties, and proposed a diverging wave based high frame rate cardiac ultrasound vector flow imaging. The study discussed the limitation of current ultrasound technology used in the cardiac flow measurement, analyzed and demonstrated the specific reasons for these implementation difficulties and the potential future development.
Blood Flow Velocity ; Heart/physiology* ; Hemodynamics ; Ultrasonography