Based on chaos theory,chaological connotations of pulse tracings and sphygmology were expounded and explained.Main contents included embodiments of four characteristics(inner randomness,sensitivity to initial value,chaos order and unpredictability of long-term behavior)of chaos in pulse tracings and sphygmology.

Objective To explore acute toxicity of succimer on mice.Methods Twenty Kunming mice(10 males and 10 females) weighting approximately (21.2?2.3)g were acclimatized for 3 days prior to dosing,then were divided into control group and experiment group with 10 mice in each group according to body weight.Fasted for 12 hours,the mice in experiment group received intragastric administration of 160mg DMSA in deionized water in 24 hours,and the control group received the same volume of deionized water,and then they were observed for 7 days.Blood was collected into heparinized-tubes by removal of eyeball.All mice were sacrificed and brain,heart,liver and kidney were removed and washed with normal saline.The activity or amount of BUN,Scr,AST,ALT,SOD, GSH-PX and MDA were analyzed.Results (1)Given 160rag DMSA in 24 hours,gastrointestinal symptoms were main side effects.During the observation,experiment group lost weight due to the decrease of food-intake ,and some mice had slight hydroabdomen.(2)High dose of DMSA caused a significant inhibition of GSH-PX(P0.05).The hepatic cell was damaged accord- ing to the significant raise of MDA in liver(P0.05),which was related to acute toxicity on liver.Conclusion Succimer could inhibit the antioxidarrt systems and could do damage to liver and kidney.

OBJECTIVETo study the epidemiology of human metapneumovirus (hMPV) infection in children and its relations with meteorological conditions in Suzhou.

METHODSamples obtained from 6655 children hospitalized with acute respiratory tract infections (ARIs) during the period from 2006 to 2009, were tested for virus pathogens. Nasopharyngeal aspirates were obtained from the children according to a standard protocol and were tested for respiratory syncytial virus (RSV), influenza viruses (IFV) A and B, parainfluenza virus (PIV) types 1, 2, and 3 and adenovirus (ADV) with direct immunofluorescence assay. Samples were tested for hMPV with reverse transcription polymerase chain reaction (RT-PCR). Meteorological conditions including mean temperature, relative humidity, rainfall amount, sum of sunshine and mean wind velocity were collected monthly. The relationship between activity of the virus and meteorological conditions was analyzed by linear regression and stepwise regression analysis.

RESULTViral pathogens were identified in 32.2% of 6655 specimens. The positive rate of hMPV was 8.9%, RSV was 15.7%, IFV, PIV and ADV detection rates were less than that of hMPV. The annual positive rate of hMPV from 2006 to 2009 was 8.2%, 8.1%, 12.7%, 7.4% respectively (χ(2) = 33.23, P < 0.05). The hMPV positive rate of the four seasons was 11.6%, 7.6%, 4.7% and 11.7%, respectively, detection rate in winter and spring was significantly higher than those in summer and autumn (χ(2) = 74.67, P < 0.001). The positive rate of hMPV and the monthly mean temperature was moderately correlated (r = -0.43), and the monthly average rainfall (r = -0.29), monthly mean relative humidity (r = -0.27), monthly average sunshine duration (r = -0.11), the monthly average wind speed (r = -0.13) had low correlations.

CONCLUSIONhMPV was the second most common viral pathogen of acute respiratory tract infection in children in Suzhou, which prevailed predominantly in the winter and spring. Climatic factors, especially temperature and rainfall may affect the prevalence of hMPV.

Child ; Child, Preschool ; China ; epidemiology ; Climate ; Female ; Humans ; Infant ; Male ; Metapneumovirus ; Respiratory Tract Infections ; epidemiology ; virology ; Seasons

BACKGROUNDThe equations for estimating glomerular filtration rate (GFR) based on creatinine have been found to have limitations and have not been generalizable across all populations. Equations based on cystatin C provide an alternative method to estimate GFR. Whether the equation based on cystatin C alone or combined creatinine would improve GFR estimates has not been validated among Chinese patients with chronic kidney disease (CKD) and diabetes. The aim of this study was to compare the performance of the modification of diet in renal disease (MDRD) equation based on creatinine with the five cystatin C-based formulae for estimation of GFR in patients with CKD and diabetes.

METHODSA total of 166 patients with CKD and 91 patients with type 2 diabetes were enrolled in this study. Cystatin C was measured by using the particle-enhanced immunonephelometric method and estimated formulae proposed by five different investigator teams (Stevens, Ma, Rule, Macisaac and Perkins). The plasma clearance of (99m)Tc-DTPA was determined as measured GFR (mGFR).

RESULTSFor CKD patients, the bias and accuracy for the Ma and Macisaac equations were superior compared with the MDRD, and the mean results for the Ma formula were closer to mGFR than the other equations in CKD stages 2 - 5. The differences between Macisaac and mGFR in CKD stages 2 - 4 were significantly less than those in CKD stage 1 or 5. Stevens and Rule's formulae revealed a similar bias and accuracy compared with the MDRD equation. The MDRD formula had a higher accuracy in CKD stages 3 - 5 as compared with the results in other stages. For diabetic patients, the mean results between Macisaac and mGFR were closer than those of other equations in mGFR >or= 90 mlxmin(-1)x1.73 m(-2) stage. In GFR 60 - 89 mlxmin(-1)x1.73 m(-2) stage, the MDRD formula showed the smallest difference compared with other equations. All equations overestimated GFR in the cases with GFR < 60 mlxmin(-1)x1.73 m(-2) stages. The MDRD formula had a greater accuracy within 50% of mGFR than the equations based on cystatin C in diabetic patients. Perkins formula showed a large positive bias and low accuracy, therefore it may not be suitable for assessing GFR in patients with CKD and diabetes.

CONCLUSIONSThe formulae for estimating GFR based on cystatin C or creatinine have different trends and accuracies in patients with CKD and diabetes, especially in patients with various GFR levels. The equations based on cystatin C provide less accurate results than MDRD formulae, at least in the diabetic patients. Therefore, whether the formulae based on cystatin C are superior to MDRD formula requires further investigation in large diverse populations.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Chronic Disease ; Creatinine ; blood ; Cystatin C ; blood ; Diabetes Mellitus ; physiopathology ; Female ; Glomerular Filtration Rate ; Humans ; Kidney Diseases ; physiopathology ; Male ; Middle Aged

OBJECTIVETo analyze the characteristics of atrial tachycardia originating from the atrioventricular cingulum.

METHODThe electrophysiological mechanism, ablation site graph and nerve distribution of 16 cases of atrial tachycardia originating from the atrioventricular cingulum or adjacent atrial muscle which were proved by electrophysiological monitoring and radiofrequency ablation.

RESULTSAtrial tachycardia from peri-cingulum represented 23.2% of atrial tachycardia treated by radiofrequency ablation during the same period. The ratio of left to right atrioventricular cingulum was 3:16. There was no difference of the surface ECG characteristics and electrophysiological mechanism between the atrial tachycardia originating from atrioventricular cingulum and that from other positions. Both A and V components were recorded at all the successful ablation sites. The ratio of amplitude of A to V was between 2:3 and 6:1. Atrial potential in the target site was 20-46 (38.6 +/- 6.7) ms earlier than P'wave in surface ECG. The success rate of ablation was 87.5% and the recurrent rate 7.1%.

CONCLUSIONSPeri-cingulum atrial tachycardia accounts for a certain proportion in all atrial tachycardia. The exciting sites originating from right cingulum are more common than those from left cingulum. Its electrophysiological mechanism has no difference from other positions. Cingulum mapping and ablation have important practical meanings.

Adolescent ; Adult ; Aged ; Catheter Ablation ; Child ; Electrophysiologic Techniques, Cardiac ; Female ; Humans ; Male ; Middle Aged ; Tachycardia, Ectopic Atrial ; physiopathology ; surgery ; Young Adult

BACKGROUND: High-volume hemofiltration (HVHF) is technically possible in severe acute pancreatitis (SAP) patients complicated with multiple organ dysfunction syndrome (MODS). Continuous HVHF is expected to become a beneficial adjunct therapy for SAP complicated with MODS. In this study, we aimed to explore the effects of fluid resuscitation and HVHF on alveolar-arterial oxygen exchange, the Acute Physiology and Chronic Health Evaluation II (APACHE II) score in patients with refractory septic shock. METHODS: A total of 89 refractory septic shock patients, who were admitted to ICU, the Provincial Hospital affiliated to Shandong University from August 2006 to December 2009, were enrolled in this retrospective study. The patients were randomly divided into two groups: fluid resuscitation (group A, n=41), and fluid resuscitation plus high-volume hemofiltration (group B, n=48). The levels of O2 content of central venous blood (CcvO2), arterial oxygen content (CaO2), alveolar-arterial oxygen pressure difference P(A-a)DO2, ratio of arterial oxygen pressure/alveolar oxygen pressure (PaO2/PAO2), respiratory index (RI) and oxygenation index (OI) were determined. The oxygen exchange levels of the two groups were examined based on the arterial blood gas analysis at different times (0, 24, 72 hours and 7 days of treatment) in the two groups. The APACHE II score was calculated before and after 7-day treatment in the two groups. RESULTS: The levels of CcvO2, CaO2 on day 7 in group A were significantly lower than those in group B (CcvO2: 0.60±0.24 vs. 0.72±0.28, P<0.05; CaO2: 0.84±0.43 vs. 0.94±0.46, P<0.05). The level of oxygen extraction rate (O2ER) in group A on the 7th day was significantly higher than that in group B ( 28.7±2.4 vs. 21.7±3.4, P<0.01). The levels of P(A-a)DO2 and RI in group B on the 7th day were significantly lower than those in group A. The levels of PaO2/PAO2 and OI in group B on 7th day were significantly higher than those in group A (P<0.05 or P<0.01). The APACHE II score in the two groups reduced gradually after 7-day treatment, and the APACHE II score on the 7th day in group B was significantly lower than that in group A (8.2±3.8 vs. 17.2±6.8, P<0.01). CONCLUSION: HVHF combined with fluid resuscitation can improve alveolar- arterial-oxygen exchange, decrease the APACHE II score in patients with refractory septic shock, and thus it increases the survival rate of patients.

Objective To analyze the status quo of patients with severe mental illness in Jinshan district, Shanghai, and provide sci-entific evidence for strengthening the prevention and treatment of them. Methods The data of severe mental illness until March 1st, 2016 were derived from the national database and analysis system, and were used for statistical analysis. Results A total of 4778 patients with severe mental illness were registered. Among them, 54.40% suffered from schizo-phrenia, patients aged 18 to 59 years old (67.73%) accounted for the vast majority, 86.44% only got junior high school education or below, 40.46% were unmarried or divorced, 76.50% patients choose outpatient department as a way to see doctor, and 15.11% patients did not take any treatment. Conclusion The prevention of severe mental illness has become the important gambit for this district. The proportion of patients choosing appropriate way to visit doctor is relatively low. The management of patients with severe men-tal diseases needs to be strengthened to promote the recovery of patients and social stability.

Objective:To discuss the topical action characteristics of the biological transmission of moxibustion heat via temperature collection and numerical modeling.Methods:Temperature of moxibustion was measured at multiple points at a distance of 3 cm to obtain the moxibustion temperature field nephograms by the high-accuracy temperature measure array.Finite element analysis was used to imitate the three-dimensional dynamic distribution of temperature in acupoint tissues.Results:Through numerical analysis,the one-dimensional,two-dimensional and three-dimensional distributions of temperature in human acupoint tissues at 5 min of moxibustion were established.The result showed that moxibustion heat mainly transmitted from the surface of the tissue to the internal,and the influence of moxibustion heat decreased with the depth of the tissue.The analysis of the nephograms of acupoint tissue temperature at 5,10,15 and 20 min of moxibustion showed that with the increase of the moxibustion time,the temperature in acupoint tissues constantly rose,and the transmission depth of moxibustion heat also further expanded inside acupoint.Conclusion:By establishing the three-dimensional dynamic model of heat transmission inside acupoint tissues with the biological parameters of human tissues and the temperature values obtained,this study used finite element analysis software ANSYS 14.0 and discovered the rules in the transmission of heat in body tissues during moxibustion,and the features in moxibustion heat transmission (from the proximal to the distant) and heat penetration (from the surface to the internal).This study provides theoretical and experimental support for the application of moxibustion in clinical practice.

OBJECTIVETo investigate the cyto-genotoxicity of cigarette smoke condensates (CSCs) in human peripheral blood lymphocytes with different assays in vitro.

METHODSHuman lymphocytes were exposed to particle matter of cigarette smoke combined with or without S9 mixtures at doses of 25, 50, 75, 100 and 125 microg/ml for 3 h. The cytotoxicity induced by CSCs was detected by CCK-8 assay. The DNA damage, DNA repair (repair time: 30, 60, 90, 120 and 240 min, respectively) and the somatic cell mutations induced by 75 microg/ml CSCs were measured by comet assay, hprt gene and TCR gene mutation tests, respectively.

RESULTSCCK-8 assay indicated that the cell viability decreased with CSCs doses. At the doses of 100, 125 microg/ml, the cell viability of CSCs +S9 group was significantly higher than that of CSCs -S9 group (P < 0.05, P < 0.01). In comet assay, DNA damage significantly increased in a dose-dependent manner, as compared with controls (P < 0.01). Moreover, there was significant difference between -S9 group and +S9 group (P < 0.05, P < 0.01). The Mf-TCR at each dose group was significantly higher than that of controls (P < 0.05, P < 0.01). The Mf-hprt at high-dose groups were significantly higher than that of controls (P < 0.01), and significant difference of Mf-TCR and Mf-hprt at high doses of CSCs between -S9 group and +S9 group (P < 0.05, P < 0.01). The DNA damage induced by CSCs +S9 or CSCs -S9 could be repaired, but DNA repair speed was different between -S9 group and +S9 group (P < 0.05, P < 0.01).

CONCLUSIONCSCs may induce cyto-genotoxicity in human peripheral blood lymphocytes in vitro, but S9 mix could reduce the toxicity of CSCs and impact DNA repair speed.

Cells, Cultured ; Comet Assay ; DNA Damage ; drug effects ; DNA Repair ; drug effects ; Humans ; Lymphocytes ; drug effects ; Male ; Mutation ; Tobacco Smoke Pollution ; adverse effects ; Young Adult

BACKGROUNDCardiac resynchronization therapy (CRT) device and coronary sinus (CS) lead extraction are required due to the occurrence of systemic infection, malfunction, or upgrade. Relevant research of CS lead extraction is rare, especially in developing countries because of the high cost and lack of specialized tools. We aimed to evaluate percutaneous extraction of CS leads by modified conventional techniques.

METHODSOf 200 patients referred for lead extraction from January 2007 to June 2011, 24 (12.0%) involved CS leads (24 CS leads). We prospectively analyzed clinical characteristics, optimized extraction techniques and feasibility of extraction.

RESULTSComplete procedural success was achieved in 23 patients (95.8%), and the clinical success in 24 patients (100.0%). The leading indication for CS lead extraction was infection (66.7%). Mean implant duration was (29.5 ± 20.2) months (range, 3 - 78 months). Sixteen CS leads (66.6%) were removed with locking stylets plus manual traction by superior transvenous approach. Mechanical dilatation and counter-traction was required to free fibrotic adhesions and extract 4 CS leads (16.7%), which had longer implant duration than other leads ((62.5 ± 12.3) vs. (22.9 ± 14.1) months, P < 0.05). Another 4 CS (16.7%) leads were removed by modified and innovative snare techniques from femoral vein approach. Median extraction time was 11 minutes (range, 3 - 61 minutes) per CS lead, which had significant correlation with implant duration (r = 0.8, P < 0.001). Sixteen patients (66.6%) were reimplanted with new devices at a median of 7.5 days after extraction. Median followed-up was 23.5 months (range, 8 - 61 months), three patients died due to sudden cardiac death (26 months), heart failure (45 and 57 months, respectively).

CONCLUSIONThe modified procedure was proved to be practical for percutaneous extraction of CS leads, especially in developing countries lacking expensive powered sheaths.

Aged ; Cardiac Resynchronization Therapy Devices ; adverse effects ; Coronary Sinus ; surgery ; Device Removal ; methods ; Electrodes, Implanted ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies