A lot of children with congenital heart disease have an abnormal development of nervous system. A variety of biochemical and physical examination indices can be used to predict adverse outcome of neurodevelopment caused by congenital heart disease and they contribute to early intervention and improvement of neurodevelopmental disorders. In recent years, new progresses in the laboratory tests, neurological physiccal examination and perioperative management of the neurodevelopmental abnormalities caused by congenital heart disease have been made. The predictive factors of abnormal neurodevelopment caused by congenital heart disease were reviewed in this article.

Objective To explore the role of clinical pharmacists in nutrition support therapy in the patients with hyperemesis gravidarum. Methods The clinical pharmacist played a positive role in nutrition support care of a patient with hyperemesis gravidarum by analysising disease characteristics and adverse drug reactions, providing suggestion on the selection of fat emulsion and offering an individualized pharmaceutical care. Results The clinical pharmacist recognized the potential risk in nutrition support plan, took modifications timely, and prevented the occurrence of unfavorable clinical outcomes. Conclusion The participation of clinical pharmacists in nutrition support therapy of the patients with hyperemesis gravidarum is beneficial to improve the efficacy and safety of nutrition support and promote the rational use of drugs.

Bacterial Infections ; microbiology ; therapy ; Humans ; Integrative Medicine ; Male ; Microbial Sensitivity Tests ; Middle Aged ; beta-Lactamases ; isolation & purification

Adolescent ; Adult ; Female ; Health Care Surveys ; Health Status ; Humans ; Male ; Medical Waste Disposal ; Middle Aged ; Occupational Health ; Personnel, Hospital ; Young Adult

ObjectiveTo investigate the extracorporeal clearance rate of imipenem in severe infection patients in the mode of continuous vena-venous hemofiltration (CVVH) during continuous renal replacement therapy (CRRT), in order to approach if the concentration of imipenem in plasma could achieve effective levels of anti-infection, and to explore the effect of time and anticoagulation measure on imipenem clearance during CRRT treatment.Methods A prospective observational study was conducted. All adult severe infection patients complicating acute kidney injury (AKI) in the Department of Critical Care Medicine of the Fourth Hospital of Hebei Medical University from March 2013 to September 2014, who were prescribed imipenem as part of their required medical care, and CRRT for treatment of AKI were enrolled. 0.5 g doses of imipenem was administered intravenously every 6 hours or 8 hours according to random number table, and infused over 0.5 hour. The unfractionated heparin was used for anticoagulation in the patients without contraindications, and no anticoagulation strategy was used in the patients with high risk of bleeding. At 24 hours after first time of administration, postfilter venous blood and ultrafiltrate samples were collected at 0, 0.25, 0.5, 0.75, 1, 2, 5, 6, and 8 hours after imipenem administration. The concentration of imipenem in above samples was determined with liquid chromatography-mass spectrometer/mass spectrometer (LC-MS/MS).Results A total of 25 patients were enrolled. Thirteen patients received imipenem intravenously every 6 hours, and 12 patients, every 8 hours. The anticoagulation was conducted with heparin in 13 cases, and 12 cases without anticoagulation. The intra-day precision, inter-day precision, matrix effect, and recovery rate in low, medium, and high concentration of plasma and ultrafiltrate, and the stability of samples under different conditions showed a good result, the error of accuracy was controlled in the range of±15%. With the application of Prismaflex blood filtration system and AN69-M100 filter, under the mode with CVVH, the total clearance rate of imipenem was (8.874±2.828) L/h when the actual dose of replacement fluid was (31.63±1.48) mL·kg-1·h-1, the total CRRT clearance rate of imipenem in vitro was (2.211±0.539) L/h, which accounting for (30.1±15.7)% of the total drug clearance. In 6 hours interval dosage regimen, the percentages of the time> 4×minimum inhibitory concentration (MIC) at specific 4×MIC of 2, 4, 6, and 8μg/mL of imipenem were more than 40% of the dosing interval. But in the 8 hours interval dosage regimen, when the level was above the 4×MIC of 4μg/mL, maintaining time would drop below 40% of the dosing interval, with significant differences compared with that in 6 hours interval dosage regimen [4×MIC = 2μg/mL: (60.84±20.25)%vs. (94.01±12.46)%,t = 4.977,P = 0.001; 4×MIC = 4μg/mL: (39.85±15.88)% vs. (68.74±9.57)%,t = 5.562, P = 0.000; 4×MIC = 6μg/mL: (27.58±13.70)% vs. (53.97±8.36)%,t = 5.867,P = 0.000; 4×MIC = 8μg/mL:(18.87±12.43)% vs. (43.48±7.83)%,t = 5.976,P = 0.000]. No significant change in sieving coefficient of imipenem was found within a short time (6 hours), which indicated that there was no effect of anticoagulation on clearance of imipenem by AN69-M100 filter, and no statistical significance was found with repeated measure analysis (F = 0.186, P> 0.05).ConclusionsThe clearance rate of imipenem is increased significantly in vitro under the mode of CVVH with the actual dose of replacement fluid was (31.63±1.48) mL·kg-1·h-1 in severe infective patients with severe sepsis complicating AKI, affecting the level of plasma drug concentration, need to adjust the dosage regimen. When the time of the dosing interval was shortened, the concentration of imipenem in patients' plasma could be increased significantly. In a short period of time, the sieving coefficient of imipenem through AN69 filter is not affected by anticoagulation measures and time cleaning efficiency will not decline.

Aim To investigate the hippocampal neuronal injury induced by ?-amyloid peptide ( A?) in rats and the candidate contribution of JNK signal transduction pathway to A? toxicity. Methods Rats were bilaterally injected with A?1 -40 into hippocampi CA1 area. The pathological changes,survival and apoptosis,and ultrastructure of hippocampal neurons,as well as p-JNK positive cells were observed by HE staining,Nissl staining,TUNEL staining,immunohistochemistry and transmission electron microscopy,respectively. Results Thepyramidal cells in hippocampus arranged loosely with decreased cell number. The gliacytes significantly proliferated. Significant apoptotic features were observed in CA1 ultrastructure. TUNEL-positive cells and p-JNK-positive cells significantly increased ( P

BACKGROUND: Titanium alloy implant has been widely used in the clinic. But there are few reports addressing on corrosion performance of medical titanium alloy dental implant, in particular in different physiological electrolytes. OBJECTIVE: To investigate the corrosion behaviors of medical titanium alloys in physiological saline, simulated saliva, and simulated body fluid. DESIGN, TIME AND SETTING: A randomized grouping, controlled observation was performed at the School of Stomatology, Lanzhou University and State Key Laboratory of Solid Lubdcation, Lanzhou Institute of Chemical Physics, Chinese Academy of Sciences between November 2008 and March 2009. MATERIALS: Medical titanium alloys (Ti-6Al-4V) were cut into 10 mm×10 min×1 mm sheets and were randomly divided into 3 groups, with 10 sheets in each group. METHODS: Corrosion performance of titanium alloys in physiological saline, simulated saliva, and simulated body fluid was investigated using electrochemical measurements. Following electrochemical corrosion, surface morphologies and wettability of samples were also observed using scanning electron microscope and CA-A type contact angle tester. MAIN OUTCOME MEASURES: Tafel curve, surface morphology, and contact angle of medical titanium alloys in three physiological electrolytes after 4 days of electrochemical corrosion. RESULTS: The corrosion of titanium alloys was most severe in simulated saliva, followed by simulated body fluid, and mildest in physiological saline. Scanning electron microscope results demonstrated that medical titanium alloy surface exhibited many holes after corrosion by physiological saline, showed rough surface with a slightly changed number of holes after corrosion by simulated body fluid, and presented with an increased number of holes, with aperture greatly increased in some holes after corrosion by simulated saliva. The contact angles of titanium alloys were all reduced after corrosion of three electrolytes. CONCLUSION: The corrosion of titanium alloy was most serious in simulated saliva. Thus, corresponding protection measures should be given in clinical application.

Objective To investigate the clinical and prognosis characteristics of SLE patients whose initial clinical presentations were Sj(o)gren's syndrome (SS).Methods Medical charts of 41 consecutive SS/SLE inpatients admitted to Peking Union Medical College Hospital (PUMCH) from February 1998 to February 2008 were systematically reviewed,including demographic data,clinical features,laboratory findings,treatment as well as prognosis.Two hundred and fourteen cases were randomly selected as controls from 2331 non SS-onset lupus (NSs/SLE) inpatients weated in PUMCH at the same time period.Results There were significant differences between SS/SLE and NSS/SLE patients in the following aspects (P＜0.05):①gender composition:(F/M) (41/0 vs 184/30),age at the diagnosis of SLE [(43±41) yrs vs (32±31) yrs)],disease duration L(114±84) mollths vs (45±18) months];②clinical features:xerostomia (85.3% vs 6.1%),xerophthalmia (75.6% vs 2.3%),faeial rash (9.8% vs 46.3%),renal tubular acidosis (21.9% vs 0),nephrotic syndrome (7.3% vs 31.3%),central nervous system invoivement (4.9% vs 19.6%),interstitial lung disease (12.2% vs 2.8%);③labratory findings:ESR[(65±75) mm/1 h vs (46±34) mm/1 h)],patients with elevated IgG level (56.4% vs 29.9%) and IgA level (38.5% vs 20.4%),RF,prevalence of anti-SSA and anti-SSB antibodies (70.8% vs 20.3%,82.9% vs 43.4% and 39.0% vs 7.9%);④SLEDAI score (8±8 vs 10±10),glucocorticosteroid treatment (methylprednisolone bolus/1～2 mg·kg-1·d-1 prednisone/1 mg·kg-1·d-1 prednisone)(8/26/7 vs 91/102/21),and rate of death and/or severe irreversible organ failure (2.4% vs 14.9%).SS/SLE patients were followed up for (33±34) months,40 cases remained stable and only one patient died of acute pulmonary embolism.Conclusion Compared to NSS/SLE,SS/SLE patients ale older and have more insidious disease course.They have higher prevalence rate of anti-SSA and anti-SSB antibodies,renal tubular acidosis and interstitial lung disease,but less severe neuropsychiatric and renal involvements and much better prognosis.

BACKGROUND: Acellular vascular matrix as vascular scaffold has following advantages: acellular vascular matrix possesses complicated three-dimensional structure of natural blood vessels. Growth factor and structural domain on the surface of acellular matrix helps for cell adhesion and infiltration.OBJECTIVE: To prepare acellular vascular matrix material and to evaluate its biocompatibility in vivo and in vitro.METHODS: Trypsin and Triton X-100 were used to gradually dispose pig carotid artery and to prepare acellular vascular matrix. The biocompstibility of the material was evaluated by implantation in muscle, acute toxicity experiment and cytotoxicity test in vitro.RESULTS AND CONCLUSION: The acallular vascular matrix material possessed good chemical stability and did not release harmful factors that produced destruction and dissolution in erythrocytes, without acute hemolytic reaction or toxic effects on cell growth. The acellular vascular matrix material showed lots of inflammatory cell infiltration in eady stage of implantation, and no significant inflammatory cell infiltration in late stage of observation. Fibroblasts were visible in the acellular matrix. In addition, the acellular matrix material did not exhibit toxic effects on surrounding tissues, showing wound stage I healing. Simultaneously,histological sections demonstrated that there were good compatibility of scaffold material and surrounding tissues, without rejection. These indicated that acellular matrix material presented good biocompatibility in animals.

Due to the characteristics and environmental factors, electrocardiogram (ECG) signals are usually interfered by noises in the course of signal acquisition, so it is crucial for ECG intelligent analysis to eliminate noises in ECG signals. On the basis of wavelet transform, threshold parameters were improved and a more appropriate threshold expression was proposed. The discrete wavelet coefficients were processed using the improved threshold parameters, the accurate wavelet coefficients without noises were gained through inverse discrete wavelet transform, and then more original signal coefficients could be preserved. MIT-BIH arrythmia database was used to validate the method. Simulation results showed that the improved method could achieve better denoising effect than the traditional ones.
Algorithms ; Arrhythmias, Cardiac ; Databases, Factual ; Electrocardiography ; Humans ; Signal Processing, Computer-Assisted ; Wavelet Analysis