Objective To investigate the fluid resuscitation strategies to craniocerebral injury patients combined with multiple trauma.Methods This retrospective review was made on 124 patients with combined craniocerebal injury (GCS 3-12 points) plus multiple trauma.Based on the fluid resuscitation strategies,63 patients were treated with aggressive fluid resuscitation (AFR),and 61 with limited fluid resuscitation (LFR).A restrictive rehydration principle was performed with intensive hemodynamic monitoring:mean arterial pressure was kept between 70-80 mmHg for 48 hours and central venous pressure between 6-8 cmH2O for 48 hours in LFR group; mean arterial pressure was kept in basic level and central venous pressure between 8-12 cmH2O in AFR group.No significant differences were shown in the rest of treatments.Parameters were compared between groups such as blood pressure,shock index,coagulation function,imaging data,GCS,and GOS at 6 months postinjury.Results Between-group differences were insignificant with regard to mean arterial pressure (MAP),shock indices,ISS,trauma severity indices (TSI),and GCS (P ＞0.05).Blood pressure fluctuation in LFR group was (18.5 ±9.9) mmHg vs (29.4 ± 11.1) mmHg in AFR group (P ＜ 0.01).Eight patients developed intracranial hemorrhage progression in LFR group,with 3 being treated with craniotomy.In comparison,19 patients developed intracranial hemmorrhage progression in AFR group,with 10 being treated with craniotomy (P ＜ 0.01).Improvement in coagulation disorders was better in LFR group than in AFR group.On days 7 after admission,GCS in LFR groups was (9.1 ± 3.6) points vs (7.2 ± 2.3) points in AFR group (P ＜0.05).At 6-month follow-up,results were 34 good and 27 poor in LFR group,better than 23 good and 40 poor in AFR group.Conclusion For moderate to severe craniocerebral injury combined with multiple trauma,LFR is effective to treat coagulation disorders and hemorrhagic shock,reduce the probability of delayed intracranial hemorrhage,and further improve the outcome.

Objective To explore and conclude the influence factors of long-term outcomes of mitral valve repair for moderate and severe mitral regurgitation due to myxomatous degeneration.Methods To review the in-patient data and followup outcomes of 261 patients after mitral valve repair for moderate and severe mitral regurgitation due to myxomatous degeneration from Jan 1993 to Jan 2008 in Changhai Hospital of Second Military Medical University.Results There were 7 perioperative deaths and 254 survivors who obtained satisfactory perioperative outcomes.During the follow-up,24 patients were lost and 230 patients were followed up from 36 months to 174 months (77.3 ±30.3) months and follow-up rate was 90.6％.Multivariate Cox regression shows age ≥ 60 years old,left ventricular ejection fraction ＜ 0.50,undergoing combined coronary artery bypass grafting were the independent risk factors for long-term death after operations and left ventricular ejection fraction ＜ 0.50,New York Heart Association functional classification Ⅲ-Ⅳ,anterior leaflet prolapse were the independent risk factors for long-term recurrent moderate or severe mitral regurgitation after operations and prosthetic ring or band annulopasty was a protective factor.Conclusion The age ≥60 years old,left ventricular ejection fraction ＜ 0.50,undergoing combined coronary artery bypass grafting,New York Heart Association functional classification Ⅲ - Ⅳ,anterior leaflet prolapse,and prosthetic ring or band annulopasty were closely related with long-term adverse events after operations.

Objective To investigate the effect of plasma fibrinogen (Fib) level on stroke recurrence within one year of first-ever ischemic stroke.Methods The patients with first-ever acute ischemic stroke were enrolled prospectively and were followed up for at least one year.They were divided into either a recurrent group or a non-recurrent group.Multivariate logistic regression analysis was used to explore the risk factors for stroke recurrence within one year of first-ever ischemic stroke.According to the plasma Fib levels of the early onset,the patients were divided into a high Fib group and a normal Fib group.Kaplan-Meier survival analysis was used to compare the recurrence between the two groups.Results A total of 121 patients with first-ever acute ischemic stroke were enrolled,111 completed one year follow up,and 30 of them (27.027％) had recurrent stroke.Multivariatelogistic regression analysis showed that the increased plasma Fib level (odds ratio [OR] 13.238,95％ confidence interval [CI] 1.152-152.077; P=0.038),older at the first onset (OR 1.321,95％ CI1.064-1.641;P=0.012),high body mass index(OR 1.351,95％ CI 1.001-1.823; P=0.049),and poor compliance of antiplatelet drugs (OR 36.819,95％ CI 1.890-717.143; P=0.017) and antihypertensive drugs (OR 50.765,95％ CI 3.198-805.878; P =0.005) were the dependent the risk factors for stroke recurrence within one year of first-ever ischemic stroke.Kaplan-Meier survival function curves showed that the recurrence rate of stroke in the high Fib group was significantly higher than that in the normalFib group (Log-rank test,P =0.000).Conclusions The increased high plasma Fib level,advanced age,obesity,as well as poor compliance of antiplatelet drugs and antihypertensive drugs were the independent risk factors for stroke recurrence within one year of first-ever ischemic stroke.

Aim To investigate the effect of fibrinogenlike protein 1 (FGL1)) silencing on docetaxel sensitivity in human lung adenocarcinoma PC-9 cells. Methods Western blot was used to detect the expression of FGL1 protein in human normal bronchial epithelial cell line BEAS-2B and human lung adenocarcinoma cell line PC-9. The FGL1 gene in PC-9 cell line was silenced by siRNA. CCK-8 assay was used to detect the inhibitory effect of silencing FGL1 on PC-9 cell proliferation and its effect on docetaxel sensitivity. Results Compared with BEAS-2B cell line, FGL1 was highly expressed in PC-9 cell line, and the relative expression of FGL1 protein was 6. 5 times that of BEAS-2B cell line with statistically significant difference (P <0. 01). Silencing FGL1 by transfection with FGLlsiRNA could enhance the inhibitory effect of docetaxel on PC-9 cells. Compared with FGLlsiNC group, the IC50value of PC-9 cells in FGL1siRNA group was significantly reduced with statistically significant difference (P < 0. 01). Conclusions Specific silencing of FGL1 gene could inhibit the expression of FGL1 in human lung adenocarcinoma cell PC-9, inhibit the proliferation of PC-9 cells and increase the sensitivity to docetaxel.

By scattered-sampling testing the disposable sterilized syringe according to legal inspection and explorative research methods of vitro cytotoxicity and easy oxide etc. testing, this article comprehensively evaluated and analyzed the product quality and found the potential risk. The results will help to improve the work process and product quality.
Disposable Equipment ; Product Surveillance, Postmarketing ; Quality Control ; Syringes

OBJECTIVETo establish discriminant functions of diarrhea-predominant irritable bowel syndrome (IBS-D) by studying it from quantitative diagnosis angle, hoping to reduce interference of subjective factors in diagnosing and differentially diagnosing Chinese medical syndromes of IBS-D.

METHODSA Chinese medical clinical epidemiological survey was carried out in 439 IBS-D patients using Clinical Information Collection Table of IBS. Initial syndromes were obtained by cluster analysis. They were analyzed using step-by-step discrimination by taking information of four Chinese medical diagnostic methods and serum brain-gut peptides (BGP) as variables.

RESULTSClustering results were Gan stagnation Pi deficiency syndrome (GSPDS), Pi-Wei weakness syndrome (PWWS), Gan stagnation qi stasis syndrome (GSQSS), Pi-Shen yang deficiency syndrome (PSYDS), Pi-Wei damp-heat syndrome (PWDHS), cold-damp disturbing Pi syndrome (CDDPS). Of them, GSPDS was mostly often seen with effective percentage of 34. 2%, while CDDPS was the least often seen with effective percentage of 5.5%. A total of 5 discriminant functions for GSPDS, PWWS, GSQSS, PSYDS, and PWDHS were obtained by step-by-step dis- crimination method. The retrospective misjudgment rate was 4.1% (16/390), while the cross-validation misjudgment rate was 15.4% (60/390).

CONCLUSIONThe establishment of discriminant functions is of value in objectively diagnosing and differentially diagnosing Chinese medical syndromes of IBS-D.

Alarmins ; Brain ; Cluster Analysis ; Diarrhea ; classification ; diagnosis ; Hot Temperature ; Humans ; Irritable Bowel Syndrome ; classification ; diagnosis ; Medicine, Chinese Traditional ; Qi ; Retrospective Studies ; Surveys and Questionnaires ; Yang Deficiency

Osteoarthritis (Osteoarthritis, OA) is a common clinical degenerative joint disease with increased incidence rate in recent years. Animal experiment is one of the important ways to explore pathogenesis and treatment of OA, while induced animal model is the most important part in animal experiment. Intra-articular injection of drugs is a classical method for establishing animal model of OA. Choose of animal should follows the principle of correlation, appropriateness and practicability, injections should perform in accordance with experimental purposes and subject, detections means and evaluation methods also should corresponding to experimental reality. The gold standard of OA animal model and intra-articular injections has not build, need further study.
Animals ; Cytokines ; analysis ; Disease Models, Animal ; Injections, Intra-Articular ; Mice ; Osteoarthritis ; diagnosis ; etiology ; immunology ; Rabbits ; Rats

OBJECTIVETo study soft tissue changes observed through musculoskeletal ultrasound (MSUS) in the treatment of knee osteoarthritis with needle-knife, so as to provide MSUS basis for needle-knife in the treatment of knee osteoarthritis.

METHODSForty patients with knee osteoarthritis treated in the Third Affiliated Hospital of Beijing University of Chinese Medicine from December 2011 to December 2012 were selected according to inclusion and exclusion criteria. All the patients were treated with needle-knife release method. The VAS scores and knee joint circumference were recorded before treatment and 2 weeks after treatment. The changes of knee joint hydrops articuli and joint synovial thickness were measured through MSUS.

RESULTSThe knee pain index was 6.850 +/- 1.417 before treatment and 2.790 +/- 1.299 after treatment;the index after treatment was lower than that of before treatment. The knee joint circumference was 407.320 +/- 45.151 mm before treatment and 391.240 +/- 41.129 mm after treatment; the knee joint circumference decreased after treatment. The amount of hydrops articuli observed by musculoskeletal ultrasound showed that 47 knees were cured, 19 knees improved and 2 knees failed. The synovial membrane thickness: 43 knees cured, 17 knees improved and 8 knees failed.

CONCLUSIONThe hydrops articuli and synovial thickness of knee joint of patients with knee osteoarthritis observed under the MSUS is consistent with the main symptoms and signs, which suggests that MSUS observation on soft tissue changes before and after needle knife in the treatment of knee osteoarthritis with high reliability.

Adult ; Aged ; Female ; Humans ; Knee Joint ; diagnostic imaging ; pathology ; Male ; Middle Aged ; Needles ; Osteoarthritis, Knee ; complications ; diagnostic imaging ; pathology ; surgery ; Pain ; complications ; Synovial Membrane ; pathology ; Treatment Outcome ; Ultrasonography

To produce membrane-permeable human epidermal growth factor (hEGF), a pPTD-hEGF prokaryocyte expression vector was constructed and transformed into E. coli BL 21 (DE3). The PTD-hEGF fusion protein was induced by 0.3 mmol/L of IPTG expressed in the form of inclusion body with an yield of 40% of the total protein in the cells, and then purified by Ni2+ -NTA affinity chromatography. The SDS-PAGE analysis showed a single fusion protein band with a molecular weight of 16 kD. The amino acid sequence was checked by MALDI-TOF-MS analysis. The genetic engineering PTD-hEGF fusion protein obviously promoted the proliferation and growth of the HEK-293 cells in vitro.
Amino Acid Sequence ; Cell Line ; Cell Proliferation ; drug effects ; Epidermal Growth Factor ; biosynthesis ; genetics ; Escherichia coli ; genetics ; metabolism ; Humans ; Molecular Sequence Data ; Recombinant Fusion Proteins ; biosynthesis ; genetics ; pharmacology ; Transduction, Genetic

OBJECTIVETo evaluate the safety and efficacy of Xiongshao Capsule (XS), consisting of Chuangxiongol and paeoniflorin, in preventing restenosis after percutaneous coronary intervention (PCI) in senile coronary heart disease (CHD) patients.

METHODSA multi-center, randomized, double-blind, placebo-controlled trial was conducted. A total of 335 CHD patients were randomly assigned to treatment with oral administration of XS, or a placebo for 6 months after successful PCI. A clinical follow-up was performed at 1, 3 and 6 months after PCI and an angiographic follow-up was scheduled at 6 months. The primary endpoint was angiographic restenosis defined as a luminal stenosis ≥ 50% in follow-up. The secondary endpoints were combined incidence of death, target lesion nonfatal myocardial infarction, repeat target-vessel angioplasty, and coronary artery bypass graft surgery (CABG). The follow-up for the above clinical endpoint events was continued to 1 year after PCI.

RESULTSThe subgroup analysis of 152 senile patients (68 cases angiographic follow-up) showed that the restenosis rates tended to reduce in the XS group as compared with that in the placebo group (24.32% vs. 38.71%, P > 0.05), and the minimum lumen diameter (MLD) significantly increased in the follow-up (2.15 ± 0.84 for XS vs. 1.73 ± 0.91 for placebo, P < 0.05). The incidence of recurrent angina at 3 and 6 months after PCI was also significantly reduced in the XS group (4.11% and 12.33%) as compared with those in the placebo group (17.72% and 43.04%), but there was no significant difference in the combined incidence of clinical outcomes (6.85% in the XS group vs. 11.39% in the placebo group, P > 0.05). No significant adverse reactions occurred within the 6-month follow-up period in the XS group.

CONCLUSIONAdministration of XS in addition to standardized Western medication for 6 months is demonstrated to be safe and effective in reducing post-PCI recurrent angina and inhibiting luminal restenosis after PCI in senile CHD patients.

Aged ; Angina Pectoris ; complications ; diagnostic imaging ; epidemiology ; Angioplasty, Balloon, Coronary ; adverse effects ; Capsules ; China ; epidemiology ; Coronary Angiography ; Coronary Restenosis ; diagnostic imaging ; drug therapy ; etiology ; prevention & control ; Double-Blind Method ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Endpoint Determination ; Female ; Humans ; Male ; Placebos ; Recurrence