Diabetic cardiomyopathy ( DC) is an independent complication of diabetes mellitus accompanied with cardiac metabolic imbalances ( increase of fatty acids and reduction of glucose) ,which would impair cardiac function and structure seriously. Peroxisome proliferator-activated receptors ( PPARs) are ligand-activated transcription factors belonging to the nuclear hormone receptor superfamily,and they could transcriptionally regulate energy metabolism and function. PPARs also play an important role in regulating metabolism in DC heart,and directly or indirectly affect cardiac function and structure.

Objective:To investigate the curative effect and safety of slow continuous ultrafiltration(SCUF) treatment on congestive refractory heart failure with renal failure, and to investigate the correlation between fluid balance and the postoperative complications.Methods:Thirty patients with congestive refractory heart failure with renal failure were chosen to receive slow continuous ultrafiltration treatment after deep vein catheterization, blood flow volume being 100-150 ml/min and therapy time being 24h. PiCCO was used to monitor the hemodynamic parameters, along with the change of blood pressure, blood oxygen saturation, heart beat and electrolyte.Results: After the slow continuous ultrafiltration treatment, the hemodynamic parameters of all patients showed obvious improvements, with better results on cardiac function and electrolyte balance. All the patients patients developed cardiopulmonary complications postoperatively have a larger total fluid balance of the first two days postoperatively than those without complications.Conclusion:SCUF have therapeutic effect and safety for treating congestive refractory heart failure with renal failure, and the status of the fluid balance can be a predictor of the postoperative morbidity and mortality.

OBJECTIVE:To observe the efficacy and safety of aerosol inhalation recombinant human interferon α1b in the treat-ment of bronchiolitis in children. METHODS:60 children with bronchiolitis were randomly divided into low-dose group,high-dose group and control group. All children were given tracheal suctioning,phlegm dispersing and other symptomatic treatment. Based on it,low-dose group was given recombinant human interferon α1b 1-2 μg/(kg·times),adding into 3 ml 0.9% Sodium chloride injec-tion,compression aerosol inhalation,twice a day;high-dose group was given recombinant human interferon α1b 3-4 μg/(kg·times), adding into 3 ml 0.9% Sodium chloride injection,compression aerosol inhalation,twice a day;control group was given ribavirin 10-15 mg/(kg·d),adding into 5% Glucose injection at ratio of 1∶1 by intravenous infusion,once a day. The treatment course for all groups was 5-7 d. Clinical efficacy,disappearance time of cough,respite,rale and three depressions,hospitalization time and incidence of adverse reactions in all groups were observed. RESULTS:Disappearance time of cough,respite,rale and three depres-sions and hospitalization time in high-dose group were significantly shorter than low-dose group and low-dose group shorter than control group,the differences were statistically significant(P<0.05). Total effective rate in high-dose group was significantly high-er than low-dose group and low-dose group higher than control group,the differences were statistically significant (P<0.05). There were no obvious adverse reactions during treatment. CONCLUSIONS:Based on conventional treatment,both efficacy and safety of aerosol inhalation recombinant human interferonα1b in the treatment of bronchiolitis in children are good.

Humans ; Inflammation ; Medicine, Chinese Traditional ; Pneumonia ; diagnosis ; therapy ; Pulmonary Disease, Chronic Obstructive ; Qi ; Syndrome

Adolescent ; Adult ; Athletic Injuries ; Clinical Clerkship ; Female ; Humans ; Nurses ; Occupational Injuries ; Young Adult

Objective To evaluate the clinical features and key points in treatment of ovarian torsion in children. Methods The clinical data of 64 children with ovarian torsion, hospitalized in our hospital from January 2005 to October 2012, were analyzed retrospectively. The clinical manifestations in children of all ages were summarized. The anal examina-tion, B ultrasound examination, CT examination were used for the early diagnosis of ovarian torsion. All children were per-formed laparoscopic surgical exploration. All children were found the typical lower abdominal cramps. The B ultrasound and CT examination showed non-homogeneous mass in pelvic, which suggested the early diagnosis of ovarian torsion. The detec-tion rate of anal examination reached 70.3%(45/64). Results All patients were performed laparoscopic surgical explora-tion. Five patients were treated with ovariectomy. The rest were treated conservatively. The postoperative follow-up was good. Conclusion Ovarian torsion in children was likely to be misdiagnosed. Doppler, CT, anal examination and laparo-scopic operation were important for the early diagnosis and treatment of ovarian torsion.

ObjectiveTo assess the energy expenditure status in critically ill children on mechanical ventilation.MethodsFifty critically ill children on mechanical ventilation were enrolled in this study.Resting energy expenditure (REE) on days 1,3,5,and 7 were measured.The predictive REE was calculated for each subject using age-appropriate equations (Schofield-HTWT).ResultsREE on day 1 and Schofield-HTWT equation predictive REE were (96.80 ± 42.63 ) and ( 110.67 ± 38.35 ) kJ/d,respectively.REE on days 1,3,5,and 7 were (100.53 ±50.24),(113.80 ±49.19),(117.99 ±50.57),and (115.05±50.18) kJ/d,respectively (F =1.267,P =0.292).The REE of day 1 in children with congenital heart disease (CHD) and without CHD was (75.66 ± 31.23 ) and ( 113.40 ± 28.40) kJ/d,respectively ( F =10.423,P =0.002).ConclusionsThe hypometabolic response is apparent in critically ill children with mechanical ventilation,and the energy expenditure shows no time-specific change within the first week.The energy expenditure in children with CHD is lower than those without CHD.

Background The effectiveness of medical tissue adhesive for the reparation of operative incision has been recognized,but its influence to ocular surface microenvironment is not quite clear.Objective This study was to appraise the safety and efficacy of α-cyanoacrylate,a medical issue adhesive,for the reparation of the conjunctival and skin laceration.Methods Twenty healthy New Zealand rabbits were randomly divided into suturing group and medical glue group.Routine ophthalmic examination,the level of tear secretion and breakup time of tear film (BUT) were tested before operation.The upper bulbar conjunctiva of each right eye was cut apart about 1.0 cm after surface anesthesia and the skin of back was incised about 2.5 cm length after local anesthesia.The conjunctival and skin lacerations were adhered with compound medical adhesive in the medical glue group,and continuous suture was done to repair the conjunctival laceration and interrupted suture to the skin laceration with 5-0 chorda serica chirurgicalis in the suture group.The routine ophthalmic examination,level of tear secretion,BUT and the states of wound healing were examined 1 day,2 days and 7 days postoperatively.Pathologic examination of the corresponding tissues was also carried out 1 week after the animals were sacrificed.The data were analyzed by SPSS 13.0 statistical software.This experiment followed the Administration of the Care and Use of Experimental Animals of Shanghai City.Results The conjunctival and skin lacerations healed well both in the suture group and the medical glue group.The levels of tear secretion 1 day and 2 days postoperatively in the medical glue group were (12.70±2.21)mm and (12.70±2.00)mm respectively,showing a significant lowness in comparison with (14.90±2.38)mm and (14.90±2.33)mm of the suture group (q =-4.02,P =0.03;q =-4.02,P =0.03).Compared with the baseline,the difference of the levels of tear secretion in the medical glue group was not statistically significant in various time points after operation (P=1.00,1.00,0.51).The BUT values at 2 days and 7 days postoperatively in the medical glue group were (4.50 ± 1.18) seconds and (4.10±0.88) seconds respectively,being significantly longer than (3.30 ± 1.06) seconds and (3.00±1.25) seconds in the suture group (q=4.37,P=0.02;q=4.19,P=0.03).Compared with the baseline,there was not statistically significant difference at each time point postoperatively in the medical glue group (P =0.28,0.59,0.21).However,BUT at each time point after operation in the suture group was significantly shorter than that of the baseline (P=0.01,0.01,0.00).Pathological examination showed that all the conjunctival and skin lacerations healed well.Trivial collagen hyperplasy was seen in the eyes of the suture group and infiltration of a few of inflammatory cells was found in the medical glue group.In the pathological result of the skin test,there was conspicuous scar and severe collagen hyperplasy in the suture group,but in the medical glue group,the skin structure was almost normal.Conclusions α-Cyanoacrylate is safe and effective for the repair of the conjunctival incision with little affection to ocular surface microenvironment.

This study was aimed to compare and investigate protective effects of metformin and rosiglitazone on cardiac dysfunction in experimental diabetic cardiomyopathy (DC) model rats. The experimental DC rat model was induced by feeding high calorie diet plus single intraperitoneal injection of small dosage of streptozotocin (STZ). Then, intragastric administration of metformin (140 mg·kg-1) or rosiglitazone(2 mg·kg-1) was given to DC rats for consecutive 6 weeks. Parameters of general signs, eating amount, blood sugar, blood lipids, heart function, heart structure and lipometabolism of myocardial tissues were measured. The results showed that both metformin and rosiglitazone can obviously improve the myocardial injury of DC model rats and reduce the CK value (P < 0.01). Metformin can obviously increase the cardiac output of DC model rats (P < 0.01). Rosiglitazone can improve the maximum rate of myocardial contraction and diastole of the model rat's left ventricle (P < 0.05). Both metformin and rosiglitazone can decrease interventricular septal thickness (IST) value (P < 0.01). Metformin can obviously im-prove general signs of DC rats, inhibit body weight loss and reduce water intake (P < 0.05). Metformin can obvi-ously reduce the blood sugar level (FBG, GSP, HbA1c and FMN) of DC rats (P < 0.05, or P < 0.01) as well as the concentration of TG (P < 0.01). Rosiglitazone can reduce the concentration of FBG and HbA1c (P < 0.05). Meanwhile, rosiglitazone can significantly reduce the concentration of TG and LDL as well as obviously increase the myocardial FA-β-oxidase (P < 0.05). It was concluded that both metformin and rosiglitazone can recover the cardiac dysfunction and myocardial injury of DC rats on certain level. Metformin showed more effects on eating amount and body weight improvements of DC rats.

Objective To study inflammatory cytokines changes in brain tissue of neonatal rats with periventricular leukomalacia (PVL).Method A total of 80 neonatal SD rats (P3) were randomly assigned into 2 equal groups,sham-operated group and PVL group.Rats in each group were further assigned into four subgroups (12,24,48,72 h),with 10 rats in each subgroup.The hypoxic-ischemic PVL modal were established following the procedure:first,isolation and ligation of left common carotid artery,and then exposed to 8％ O2 and 92％ N2 for 2.5 h.The sham-operated rats were processed with isolation of left common carotid artery only.Rats of the four subgroups were sacrificed at 12,24,48 h and 72 h respectively,then the brains were rapidly removed in corresponding time.Pathological changes of brain tissues were observed using HE stain.The mRNA expression levels of tumor necrosis factor α(TNF-α)and inter leukin-1β (IL-1β) were assessed using real-time quantitative PCR assays,the protein levels of TNF-α and IL-1β were detected using enzyme linked immunosorbent assay method.Result The brains tissues of rats in PVL group showed remarkably hyperemia and edema,with left ventricle enlargement.Periventricular white matter structure was disintegrated comparing with sham-operated group.The expression of TNF-α and IL-1 β mRNA in PVL group increased significantly,reaching peak by 24 h and then gradually decreased 72 h after the procedure.The mRNA levels of TNF-c and IL-1 β were significantly different between each two time points of 12,24 h and 48 h in PVL group (P ＜0.05).However,there was no differences between 72 h and 48 h within PVL and sham-operated group group(P ＞0.05).In PVL group,the protein expression trends of TNF-α and IL-1 β were similar to mRNA expression trends.Moreover,the protein levels were significantly different between each two time points of TNF-α and IL-1 β,respectively (P ＜ 0.01).The protein expression levels of TNF-α were different at each time point between PVL group and sham-operated group[(189.2 ± 20.4) pg/ml vs.(131.4 ±5.2) pg/ml at 12 h,(213.8 ± 16.7) pg/ml vs.(127.7 ±7.4) pg/ml at 24 h,(181.7 ± 15.0) pg/ml vs.(126.3 ± 6.0) pg/ml at 48 h,(159.6 ± 25.3) pg/ml vs.(131.4 ± 6.0) pg/ml at 72 h;P ＜0.01].The protein levels of IL-1β were different between the two groups only at 24 h and 48 h.[(121.8 ±30.0) pg/ml vs.(67.4 ± 13.7) pg/ml,(83.3 ± 15.7) pg/ml vs.(65.3 ± 14.9) pg/ml;P ＜0.05].In sham-operated group,no differences of TNF-α and IL-1 β protein levels were found between any different time points (P ＞ 0.05).Conclusion Inflammatory cytokines such as TNF-α and IL-1β are involved in ischemic-hypoxia induced PVL.Dynamic detection of inflammatory factors is expected to be an important method of early diagnosis,assessment of treatment efficacy and prognosis of PVL.