Adult ; Anthropometry ; Enteral Nutrition ; Female ; Humans ; Liver Cirrhosis ; physiopathology ; therapy ; Liver Function Tests ; Male ; Middle Aged

Objective To investigate the effects of acute hypervolemie hemodilution(AHH)combinedwith bypotension(CH)on hemodynamies and tissue perfusion and to evaluate the safety of the technique.MethodsForty-eight ASA Ⅰ-Ⅱ patients of both sexes(28 male,20 female)aged 41-63 yr weighing 47-85kg undergoingelective orthopedic operations were randomly divided into 4 group with 12 patients in each group:A control group;B CH group;C AHH group and D CH+AHH group.The patients were premedicated with oral diazepam 10 mgand intramuscular atropine 0.5 mg.Anesthesia was induced with midazolam 0.04 mg?kg~(-1),fentanyl 4?g?kg~(-1),propefol 1.5-2.0 mg?kg~(-1) and vecuronium 0.1 mg?kg~(-1) and maintained with inhalation of 1%-3 % isoflurane and50% N_2O in O_2 supplemented with intermittent i.v.boluses of vecaronium.The patients were mechanicallyventilated after tracheal intubation(V_T=8-10 ml?kg~(-1),RR 12 bpm).Radial artery and right internal jugular veinwere cannulated.The CVP catheter was inserted into right atrium and the blood obtained from right atrium was usedto replace mixed venous blood.ECG,MAP,HR,CVP,SpO_2 and urine output were continuously monitored duringoperation.Controlled hypotension was induced with sodium nitroprusside(NTP)at 0.1-2 ?g?kg~(-1)?min~(-1) andMAP was maintained at 70% of the baseline MAP during operation.NTP infusion was terminated 30 min beforethe end of surgery.AHH was induced with 6% HES 15 ml?kg~(-1) at 50 ml?min~(-1) after induction of anesthesia andbefore skin incision.Blood samples were taken from radial artery and right atrium before AHH(T_0,baseline),immediately after AHH or before CH(T_1),1h after AHH or 40 min after start of CH(T_2),at the end of surgeryor 30 rain after termination of NTG infusion(T_3)and 24h after surgery(T_4)for blood gas analysis and calculationof oxygen extraction ratio(ERO_2).Blood volume was maintained with infusion of colloid and lactated Ringer'ssolution.The amount of blood loss and blood transfusion were recorded.Hb was maintained above 70 g?L~(-1)Results CVP increassd significantly after AHH in group C and D as compared to baseline(P0.05).Conclusion AHH combined with CH can maintain stable hemodynamics,decrease blood loss andblood transfusion during operation and maintain the balance between oxygen delivery and oxygen consumption.

ObjectiveTo evaluate the effects on serum homocysteine(Hcy) level,vascular function and carotid intima-media thickness(IMT) in metformin-treated diabetic patients with or without supplementation with folate and Vitamin B12.MethodsA total of 100 newly diagnosed diabetic type 2patients were divided into two groups by random digits table with 50 cases each,90 patients completed study.Forty-seven participants (control group) received a 6-month course of metformin treatment,43 patients (treatment group) received mefformin,folate and Vitamin B12 treatment.The levels of serum Hcy,endothelin-1 (ET-1),carotid IMT,large or small arterial elasticity index (C1,C2),flow-mediated dilatation (FMD) of the brachial artery were evaluated before and after treatment.ResultsThe level of serum Hcy in control group significantly increased compared with before treatment[ (13.4 ± 2.7)μ mol/L vs.(11.1 ± 1.9)μ mol/L],hut the level of serum Hcy in treatment group significantly decreased compared with before treatment [ (9.2 ± 1.8 ) μ mol/L vs. ( 11.3 ± 2.0) μ mol/L ],there was significant difference(P ＜ 0.05 ).A beneficial effect was observed in the serum ET-1,FMD,carotid IMT and C2 in treatment group[ (20.0 ± 6.2)ng/L,( 15.8 ± 7.6)％,(0.8 ± 0.2) mm,(4.1 ± 2.1 ) ml/mm Hg ( 1 mm Hg =0.133 kPa) × 100 vs. (31.3 ±10.1 ) ng/L,(9.7 ± 4.5)％,( 1.1 ± 0.4) mm,(2.3 ± 1.0) ml/mm Hg × 100 ] (P ＜ 0.05).The levels of ET-1,FMD,carotid IMT and C2 after treatment in control group [ (24.8 ± 6.8) ng/L,( 12.9 ± 6.3 )％,(0.9 ± 0.3)mm,(3.0 ± 1.4) ml/mm Hg × 100] had significant difference compared with before treatment [ (30.6 ± 8.7)ng/L,(9.8 ± 4.6)％,( 1.0 ± 0.3) mm,(2.2 ± 0.9) ml/mm Hg × 100](P＜ 0.05).However,the results were improved significantly in treatment group than those in control group (P ＜0.05).In treatment group,significant correlation were detected between changes of Hcy and ET- 1 (r =0.43,P ＜ 0.05 ),carotid IMT(r =0.56,P ＜ 0.05),FMD (r =-0.54,P ＜ 0.05 ),C2 (r =-0.37,P ＜ 0.05 ).ConclusionsAdministration of folate and Vitamin B12 can reduce the levels of serum Hcy and ET-1 in metformin-treated type 2 diabetic patients,which exert beneficial effect on carotid IMT,FMD and C2.

Objective To investigate the technique and effect of tunneled cuffed catheter as long-term hemodialysis access and the prevention of its related complications.Methods Permcath cuffed dual lumen catheter wag implanted in patients by the standard Seldinger technique,that a guidewire wss inserted into deep central vein, following by the insertion of the cuffed catheter through a peel-away sheath.The catheter related complications were observed.Urea reduce rate(URR),the Kt/V,the normalized protein catabolic rate(nPCR)and the time-averaged BUN concentration(TACurea)were measured as the index of the effect of hemodislysis.The effects were compared to those of arteriovenous fistula(AVF)within the same period(in 20 cases).Results In the total of 25 patients, 23 catheters were implanted in the internal jugular vein (21 cases at right,two at left side),one in the subclavian vein and one in the external jugular vein.Except for that one case died of cerebral infarction,all patients were using the catheter in well condition.Catheter related thrombosis or underfed occurred in 4 cases for 9 times, which became fluent after thrombolytic therapy or the adjustment of catheters.Catheter related infections occurred in 2 cases,and were successfully treated with anti-inflammation therapy.The average URR was 71.03%,Kt/V was 1.29,TAC urea was 12.74 mmol/L,and nPCR was 0.93 g/(kg·d)in all 25 patients,which was not significant different compared to patients with AVF((URR 72.46%,Kt/V 1.31,TACurea 12.86 mmol/L,nPCR 0.94 g/(kg·d)).Conclusions Cuffed dual lumen catheter for long-term aecegs in persistent hemodialysis has good effect on hemodialysis. Good catheter implanting technique and prevention of complications may improve the application of the catheter.

Objective To observe the expression of matrix metalloproteinases(MMP)-1,MMP-3 and iNOS in cartilage of experimental rabbit osteoarthritis at different time intervals after anterior cruciate ligament transection(ACLT)operation.The aim of this study is to provide the theoritical evidence for using ACLT rabbit model in Osteoarthritis(OA)research.Methods Unilateral ACLT was performed on 27 randomly selected while rabbits and underwent unilateral arthrotomy was performed on the other 9 white rabbits as the control group.Nine randomly selected white rabbits in experimental group were killed and 3 white rabbits in the control group at 4th,8th and 12th week respectively.Cartilage degradation of femoral condyles was evaluated macr-oscopically,mRNA expression level and protein expression level of MMP-1,MMP-3 and iNOS was measured by reverse transcription-polymerase chain reaction(RT-PCR)and immunohistochemistry respectively.Results Forepart OA cartilage degradation was observed at the 4th week and became more severe at the 8th week after ACLF.Afterpart cartilage degradation was evident at the 12th week after ACLT while cartilage still remained normal in the control group,mRNA expression level and protein expression level of MMP-1.MMP-3 and iNOS were increased at the 4th week and became higher gradually at the 8th,12th week after ACLT compared with the control group.Expression distribution of MMP-1,MMP-3 and iNOS bad different patterns respectively.Conclusion It is suggested that the process of OA cartilage degradation can be simulated by ACLT model and MMP-1,MMP-3 and iNOS may be good markers in therapeutical research of OA.

The mechanism of biological actions of quercetin was studied by using metabolomic method and biomolecular network. HPLC-MS was used to analyze the serum metabolome in rats of blank group and quercetin administration group rats, and MS data were processed by MATLAB software. With multivariate statistical analysis of serum metabolite profiles, a clear separation among blank group and quercetin administration group was achieved, potential biomarkers were selected according to the parameters of variable importance in the projection (VIP) and identified according to MS information and database retrieval. Four compounds, related enzymes, action targets and metabolic pathways had been confirmed, namely retinoic acid and RARbeta, arachidonate and COX-2, 3, 5-diodotyrosine and TPO, uridine diphosphate glucose and PDEs. The mechanism of quercetin enhancing ability of retinoic acid on the induction of RARbeta, activating TPO, using as COX-2 and PDEs inhibitor was approved by biomolecular network and related literatures. In this study, a mechanism of multiple biological actions of quercetin was evaluated at the level of the biomolecular network, metabolomics and biomolecular network can be used to investigate the biological effects mechanism of quercetin, which provided a new method to further revealing mechanism of drug action.
Animals ; Antioxidants ; pharmacology ; Biomarkers ; blood ; Chromatography, Liquid ; Mass Spectrometry ; Metabolic Networks and Pathways ; Metabolome ; Metabolomics ; Multivariate Analysis ; Quercetin ; pharmacology ; Rats

According to the records in ancient Chinese literatures such as Lingshu (Miraculous Pivot), Nanjing (The Yellow Emperor's Canon of 81 Difficult Issues), Jinzhen fu (Odes to Golden Needles) and Zhenjiu Dacheng (Compendium of Acupuncture and Moxibustion), the importance of pressing hand has been always stressed. The role of the pressing hand can irreplaceable by the puncturing hand. The touching and pressing with the pressing hand assist on the accurate location of acupoint. The plucking technique may invigorate meridian qi and promote the arrival of qi. Inserting the needle against the finger nail of the pressing hand avoids or alleviates pain to the largest extent. Detecting along meridian and pressing technique main induce qi getting to the affected area. This paper introduces the importance of pressing hand, aiming to suggest the clinical physicians pay more attentions to the effect of the pressing hand in acupuncture practice.
Acupuncture Therapy ; history ; instrumentation ; methods ; China ; History, Ancient ; Humans ; Medicine in Literature ; Moxibustion ; history ; instrumentation ; methods

In 2013, the World Health Organization reported the first case of human infection with a new influenza A (H7N9) virus in China. This has caused damage and panic within certain areas in China. Therefore, analysis of this virus with bioinformatics technology is very necessary. Neuraminidase (NA) is one of the most important antigens of the influenza virus and an important target for anti-flu drugs. In this study, the nucleotide and protein sequences of NA gene of A/H7N9 influenza viruses were retrieved from the NCBI database, and MEGA 5.0 software was employed to construct a phylogenetic tree based on the nucleotide coding sequence; BioEdit software was used to align the nucleotide and protein sequences of NA and calculate the homologies of nucleotides and amino acids and then to analyze the important mutation sites of NA gene. The results demonstrated that the spread of influenza virus H7N9 showed certain geographical and temporal relations. The H7N9 virus isolated from China in 2013 belonged to Euroasiatic serotype, and its NA stalk region hadobvious variation, which may be one of the reasons that this virus infects human. These analyses may be very helpful for understanding the evolutionary relationship and mutation trend of A/H7N9 influenza viruses.
Databases, Genetic ; Evolution, Molecular ; Humans ; Influenza A Virus, H7N9 Subtype ; enzymology ; genetics ; Mutation ; Neuraminidase ; chemistry ; genetics ; Phylogeny ; Sequence Analysis

Based on the advantages and disadvantages of the esteemed acupuncturists' experiences, after analyzing the collection work on inheriting the esteemed acupuncturists' experiences, this paper proposes to apply the information technology to build a multimedia platform for the esteemed acupuncturists. Therefore, the precious clinical experiences of the esteemed acupuncturists are preserved. This paper states the potential future of the coming multimedia platform.
Acupuncture ; education ; Humans ; Learning ; Multimedia ; Professional Practice ; Thinking

Objective To investigate the effects of cognitive interventions (CIs) in the context of communi- ty based rehabilitation (CBR) on cognitive deficits (CDs) in stroke patients.Methods Ninety-two stoke patients with CDs were randomly divided into a CI group and a control group.All patients were treated with conventional CBR.In addition,the patients in the CI group were also treated with special intervention therapy.The patients in both groups were assessed with the neurological and cognitive status examination (NCSE) for cognitive functioning, the FCA for motor function and the BI for their ability in the activities of daily living.Results The NCSE,FCA and BI scores in the cognitive intervention group after treatment were significantly higher than those before treatment and also significantly higher than those in the control group after treatment.Conclusion CIs can not only improve CDs,but also enhance recovery of motor function and ADL.