Extracorporeal Membrane Oxygenation ; Female ; Heart Failure ; therapy ; Humans ; Infant ; Postoperative Period ; Respiratory Insufficiency ; therapy ; Twins, Conjoined

Objective To study the therapeutic and protective effect of low tidal volume(LTV) ventilation in children with acute respiratory failure.Methods Forty-eight patients with respiratory failure were enrolled in our study.The patients were suffered from severe infection,trauma or after major operation.Besides general treatments,they were all given ventilation with LTV.Blood gas,ventilation parameters and complications related to ventilation were also measured.Results No significant difference was found between the patients with high tidal volume(HTV) and those with LTV in the results of improving respiratory acidosis.But the incidence of(ventilated-)induced lung injury(VILI) was lower in LTV patients.Conclusion LTV ventilation is preferable for children with acute respiratory failure and beneficial for alleviation of VILI.

Child ; Evidence-Based Medicine ; Guidelines as Topic ; Humans ; Nephrotic Syndrome ; diagnosis ; therapy ; Steroids ; therapeutic use

Chorionic Gonadotropin, beta Subunit, Human ; blood ; Down Syndrome ; blood ; diagnosis ; Female ; Humans ; Pregnancy ; Pregnancy, Twin ; Prenatal Diagnosis ; alpha-Fetoproteins ; metabolism

Objective To explore value of quantitative tissue velocity imaging(QTVI) in the regional systolic and diastolic myocardial function of hypertrophic cardiomyopathy(HCM) patients and healthy persons. Methods By Doppler myocardial imaging 20 HCM patients and 18 healthy subjects were collected,then the regional velocity were measured in the mid and basal segment in systolic,early diastolic and later diastolic period respectively. Results The parameters as systolic velocity(Vs),early diastolic velocity(Ve) and early systolic velocity/later diastolic velocity (Ve/Va) of the HCM group were significantly lower than those of the normal group,while later diastolic velocity(Va) showed no statistic difference between two groups. Conclusions The systolic and diastolic myocardial functions of hypertrophic cardiomyopathy patients are reduced. The abnormality of heart function in HCM patients could be accurately detected by QTVI.

Objective To investigate the efficacy of monotherapy or combination of ACEI and ARB in treating diabetic nephropathy(DN). Methods 183 patients with DN were randomly allocated into three treatment groups: benazepril,losartan or the combination of these two drugs for 12 weeks.The changes of blood pressure, proteinuria, serum potassium and creatinine, creatinine clearance(Ccr)were observed before and after treatment. Results Both of benazepril and losartan reduced blood pressure and proteinuria efficiently.And their effects were similar.In contrast, the reduction in proteinuria was greater in the combination therapy than in treatments of either drug alone(P<0.05), but their reductions in blood pressure were achieved to the same level(P>0.05).There were not significant differences in serum levels of potassium, creatinine and Ccr before and after treatment(P>0.05). Conclusion A combination of ACEI and ARB in patients with DN produces a better anti-proteinuric effect than either of the monotherapies.This protection is not dependent on changes in blood pressure.

Objective To study the effects of esmolol on fluid responsiveness and hemodynamic parameters in patients with septic shock.Methods A prospective self-control study was conducted.Fifteen septic shock patients undergoing mechanical ventilation admitted to Department of Critical Care Medicine of Yijishan Hospital from January 2015 to August 2015 were enrolled.All patients enrolled in this study were given the treatment based on American College of Chest Physicians/Society of Critical Care Medicine (ACCP/SCCM) Consensus 2012.Esmolol was intravenously injected at a beginning rate of 6 mg·kg-1·h-1, and then the dose was adjusted to reduce heart rate by 10％ from baseline.The changes in hemodynamic and systemic oxygen metabolism indexes were monitored by pulse indicator continuous cardiac output (PiCCO) before and 2 hours after the esmolol administration, and the fluid responsiveness was evaluated by stroke volume variation (SVV).SVV ≥ 10％ was considered to be a positive fluid responsiveness.Results In 15 patients, 9 were male and 6 female, with an age of 65 ± 16.Among them 10 patients suffered from pulmonary infection, and 5 patients with abdominal infection.Acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score was 21 ±9;sequential organ failure score (SOFA) was 8 ±4.28-day mortality was 40.0％.SVV was significantly decreased after esmolol infusion as compared with baseline [(14 ± 5)％ vs.(17 ±7)％, t =2.400, P =0.031].Heart rate [HR (bpm): 100±4 vs.112±8, t =8.161, P =0.000], cardiac output [CO (L/min):6.13 ± 1.45 vs.7.88 ± 1.82, t =4.046, P =0.001], cardiac index [CI (mL·s-1·m-2): 51.51 ± 11.00 vs.66.18 ± 11.48, t =4.131, P =0.001], stroke volume index [SVI (mL/m2): 31.0 ± 6.4 vs.35.4 ± 6.5, t =2.577, P =0.020], the maximum rate of left ventricular pressure rise [dp/dt max (mmHg/s): 927±231 vs.1 194±294, t =3.775, P =0.002], global ejection fraction (GEF: 0.21 ±0.05 vs.0.24±0.06, t =3.091, P =0.008), cardiac function index (CFI: 5.03 ± 1.37 vs.6.59 ± 1.92, t =4.769, P =0.000) showed significant decrease during esmolol infusion.On the other hand, central venous pressure [CVP (mmHg, 1 mmHg =0.133 kPa): 9±3 vs.8±3, t =-3.617, P =0.003], diastolic blood pressure (DBP, mmHg: 69± 15 vs.66± 13, t =-2.656, P =0.019), systemic vascular resistance index (SVRI, kPa·s·L-1·m-2:206.8±69.8 vs.206.8±69.8, t =-3.255, P =0.006) were significantly increased during esmolol infusion.No significant difference was found in systolic blood pressure [SBP (mmHg): 120 ± 25 vs.123 ± 18, t =0.678, P =0.509],mean arterial pressure [MAP (mmHg): 86 ± 18 vs.85 ± 14, t =-0.693, P =0.500], global end diastolic volume index [GEDVI (mL/m2): 614 ± 84 vs.618 ± 64, t =0.218, P =0.830], extravascular lung water index [EVLWI (mL/kg):5.99±1.50 vs.5.73±1.14, t =-1.329, P =0.205], central venous oxygen saturation (ScvO2: 0.711±0.035 vs.0.704 ± 0.048, t =-0.298, P =0.773), arterial blood lactate [Lac (mmol/L): 3.1± 0.3 vs.3.0 ± 0.4, t =-0.997, P =0.345],and difference of central venous-arterial carbon dioxide partial pressure [Pcv-aCO2 (mmHg): 4.1 ± 0.9 vs.4.7 ± 0.5,t =1.445, P =0.182] as compared with those before esmolol treatment.Conclusion Heart rate control with esmolol infusion may reduce fluid responsiveness, cardiac function, heart rate and cardiac output without adverse effect on systemic perfusion in septic shock patients.

AIM: To study the effect of genistein on c-myc mRNA expression induced by oxidized low density lipoprotein (ox-LDL) in human vascular endothelial cells (ECV304). METHODS: LDL were isolated from healthy human plasma by gradient ultracentrifugation and oxidized by CuSO4. ECV304 cells were exposed to ox-LDL 200 mg*L-1 in the presence or absence of genistein 100 μmol*L-1 for 1, 2, and 4 h in vitro. Northern blot was employed to measure c-myc mRNA levels of ECV304. RESULTS: In response to ox-LDL 200 mg*L-1, c-myc mRNA expression in ECV304 increased by 3 fold for 1h and 3.3 fold for 2 h and decreased below the control level at 4 h. Expressions of c-myc stimulated by ox-LDL in the presence of genistein 100 μmol*L-1 for 1 h and 2 h were separately 80 percent and 60 percent of that in the absence of genistein 100 μmol*L-1. CONCLUSION: Genistein can effectively inhibit c-myc mRNA expression in ECV304 induced by ox-LDL.

BACKGROUND: Reports regarding adipose-derived stern cells (ADSCs) differentiation into dopaminergic (DN) neurons are few in addition, there is not experimental evidence of the effect of ADSCs on maintaining the survival of DN neurons.OBJECTIVE: To investigate the effect of glial cell-derived neurokophic factor (GDNF)-modified adipose-derived stem cells on survival of DN neurons under co-cultured condition.DESIGN, TIME AND SETrlNG: The in vitro cytology experiment was conducted at the Institute of Otolaryngology-Head and Neck Surgery and Key Laboratory of Zoonoses of Ministry of Education between March and December 2007.MATERIALS: Wistar rats with 3-weeks-old, or 14 days of pregnancy were provided by Norman Bethune College of Medicine, Jilin University.METHODS: The GDNF recombinant adenovirus was constructed by using pAdTrackCMV and pAdEasy-1 system. DN neurons were obtained from the rostral mesencaphalic tegmentum of Wistar rat embryos by using trypsin and collagenase method. ADSCs isolated from rat inguinal fat pads were digested with collagenase Ⅱ, cultured and passaged in vitro. When the cells reached 60% cenfluency at the 3rd passage, cells were transfectad with 1×109vp/mL of Ad-GDNF for 1 hour and then transferred into growth medium for another 24 hours, and GDNF level in cell supematant was detected by ELISA assay. Meanwhile, the co-cultured of ADSCs and DN neurons were carried out for following 7 days. With GFP-modified ADSCs was served as a control group.MAIN OUTCOME MEASURES: The effect of co-cultured condition on the survival of DN neurons, as well as the differentiation of GDNF-modified ADSCs was detected by immunofluorescence staining.RESULTS: GDNF appeared in ADSCs supematant at 24 hours after Ad-GDNF transfection and reached a peak at 72 hours.There was approximately 80% GFP-positive labeled in ADSCs. The tyrosinase hydroxylase staining results demonstrated that the rate of survival DN neurons were significantly increased than in DA neurons cultured alone, co-cultured group of GFP-modified ADSCs and GDNF-modified ADSCs groups (55%, 15%, 25%, P < 0.01). However, there were no co-expressing TH and GFP positive cells appeared at 7 days of co-culture, which indicated that the co-cultured condition was not available to ADSCs differentiation.CONCLUSION: The co-cultured of GDNF modified ADSCs and DN neurons can promote the survival and growth of cultured DN neurons, however, it can not induce ADSCs differentiate into DN neurons.

Objective To study the cause of death and mechanism after(TACE)in China during the past 14 years.Methods Related repots in Chinese Medical Current Content(CBM)and National Knowledge lnfrastruc ture(CNKI)from January 1994 to June 2008 were retrieved.The cause of death and mechainsm after TACE wer e analyzed.Results A total of 150 patients who died after TACE were reposed in China during the past 14 ye ar s.84%eases were caused by liver lunction failure,upper gastrointestinal bleeding and rupture of liver cancer. 78.7%cases died one month postoperation.Conclusion Liver function failure.upper gastrointestinal bleeding and rupture of liver cancer are the main complications which Can cause death and the majority cases died early.