OBJECTIVE:To observe clinical efficacy and safety of rhBNP combined with levosimendan in the treatment of acute heart failure,and to investigated the effects of drug combination on serum UA and BNP levels. METHODS:68 patients with acute heart failure were randomly divided into observation group and control group,with 34 cases in each group. Both groups re-ceived routine treatment;control group was additionally given Levosimendan injection 5 ml added into 0.9% Sodium chloride in-jection 45 ml with persistent micropump injection:at pump rate of 12 μg/(kg·min)within first 1 h,and then at pump rate of 0.5μg/(kg·min)for consecutive 23 h;observation group was additionally given rhBNP 1.5 μg/kg for intravenous shock,and then giv-en consecutive intravenous injection of rhBNP at rate of 7.5 ng/(kg·min)continuous 3-7 days on the basis of control group. Clini-cal efficacy of 2 groups were observed,and serum levels of UA and BNP,heart function index,the safety of drug use were ob-served before and after treatment. RESULTS:After treatment,total effective rate of observation group(94.11%)was significantly higher than that of control group (70.59%),with statistical significance (P<0.05). The improvement of serum levels of UA and BNP in observation group was more significant than in control group,with statistical significance (P<0.05). The stroke volume and left ventricular ejection fraction of observation group were significantly better than those of control group,with statistical signif-icance (P<0.05). There was no statistical significance in the incidence of ADR between observation group (2.94%) and control group(5.88%)(P>0.05). CONCLUSIONS:rhBNP combined with levosimendan have significant clinical efficacy and high safety in the treatment of acute heart failure.

[Objective] To discuss the effect of intestine-dredging and Qi-benefiting method and its corresponding prescription in managing systemic inflammatory response and preventing multiple organ dysfunction syndrome (MODS). [Methods] Eighty. SD rats were randomized to control, model, low-dosage (LD) and high-dosage (HD) groups. One day before modeling, HD and LD groups were administered the preparation based on intestine-dredging and Qi-benefiting method by 60g/kg and 30 g/kg for 2 times, and control and model groups were given equal amounts of normal saline. On the 2nd day after the administration, 3 groups except the control group were modeled on the given reference. Twelve hours after modeling, the content of TNF-? and NO in serum was examined and histopathological examination of the main organs was conducted. [Results] Compared with the control group, the level of TNF-? and NO significantly increased (P

Objective To investigate the infection status of human parvovirus B19(HPV B19) in voluntary blood donors of Fos‐han City .Methods The HPV B19 IgG and IgM antibodies of voluntary blood donors were detectd by using ELISA .Real‐time PCR assay was applied to detect HPV B19 DNA on HPV B19 IgG and/or IgM antibody positive specimens .Results There were 92 HPV B19 IgG positive cases in 368 specimens ,positive rate was 25 .00% ;and the HPV B19 IgM positive cases were 2 ,positive rate was 0 .54% .4 positive cases were detected in 94 antibody positive specimens ,positive rate was 4 .26% .Conclusion HPV B19 in‐fection of blood donation person in Foshan is high ,new infections and chronic infection rate are low .HPV B19 viral loads are low in people with chronic infection .

Objective To evaluate the feasibility of the three-dimensional brain artery vessel wall imaging technology reverse rotation angle of fast spin echo (T1 W-SPACE)in the diagnosis of ischemic cerebrovascular disease by comparing it with TOF vascular imaging in magnetic resonance. Methods Patients undergoing stroke but stable condition,including 50,patients with transient cerebral ischemia (TIA)or a history of stroke,examined by TOF-MRA and routine MRI sequence first,then followed by T1 W-SPACE.Results In 43 of 50 cases,conventional MRI sequences detectiog was positive,TOF-MRA found the vascular stenosis in 76 branches,T1 W-SPACE found the vascular stenosis in 73 branches,there was no difference between the two groups(χ2 =0.625,P >0.05);Conventional TOF-MRA cannot detect the vascular wall, T1 W-SPACE found that arterial wall thickening,plaque in 48 branches.Conclusion Compared with the TOF-MRA,T1 W-SPACE can not only detect the vessel stenosis,but also the vessel wall and plaque,and can also type on plaque from pathology angle,has im-portant clinical significance for early prevention and treatment of stroke.

Objective To investigate the effect of propofol combined with butorphanol on hemodynamics and anesthesia complications in patients with endoscopic retrograde cholangiopancreatography (ERCP),and to provide a reference for the selection of ERCP.Methods A total of 120 patients with ERCP were selected,aged 31-59 years,ASA grade Ⅰ-Ⅱ,BMI 17.9-25.4kg/m2,no general anesthesia contraindications before surgery,no opioid allergy history,no liver and kidney dysfunction.The patients were randomly divided into two groups with computer software:propofol + butorphanol group (B group) and propofol + remifentanil group (R group).The systolic blood pressure (SBP),diastolic blood pressure (DBP),heart rate (HR),oxygen saturation (SpO2) were recorded at the time of anesthesia induction (T0),immediately after injection of propofol (T1),10 min (T2) after propofol injection,before ending (T3) and immediate after recovery (T4).At the same time,the propofol induced dose,propofol maintenance dose and awakening time were recorded.Regarding the adverse reactions,the intraoperative hypotension,PONV,lethargy,intraoperative physical movement,skin itching were recorded.Results The levels of SBP in R group were significantly lower than those in B group at T1,T2,T3 and T4 (t =3.952,4.876,5.190,4.391,all P ＜0.05).The levels of DBP in R group were significantly lower than those in B group at T1,T2,T3 and T4 (t =4.295,5.722,2.952,2.475,all P ＜0.05).HR in R group was significantly higher than those in B group (t =2.096,3.012,3.253,2.257,all P ＜ 0.05).There were no statistically significant differences in propofol induced dose,propofol maintenance dose and awakening time between the two groups (t =0.214,0.753,0.436,all P ＞0.05).The incidence rates of hypotension and hypoxia in B group were significantly lower than those in R group (14 cases vs.5 cases,10 cases vs.3 cases,x2 =5.065,4.227,all P ＜ 0.05).Conclusion Butorphanol can provide good analgesic effect to patients undergoing ERCP,while maintaining hemodynamics stability,the patients' respiratory depression is also mild and does not increase the incidence of other anesthesia-related complications risk,with good effect and safety.It is worth to promote in clinical.

Objective:To investigate the risk factors for futile recanalization in patients with acute anterior circulation large vessel occlusion after endovascular mechanical thrombectomy (EMT), and establish a nomogram model predicting futile recanalization in these patients.Methods:One hundred and eighty-eight patients with acute anterior circulation large vessel occlusion after EMT were enrolled from Department of Neurology, Zhongshan Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine from January 2018 to December 2021. Patients were divided into futile recanalization group and effective recanalization group according to whether futile recanalization occurred; futile recanalization was defined as successful recanalization showed by immediate postoperative DSA (modified thrombolysis in cerebral infarction [mTICI] ≥2b), but poor functional outcome (modified Rankin Scale [mRS] scores>2 90 d after surgery). The clinical data were compared between futile recanalization group and effective recanalization group. Multivariate Logistic regression analysis was used to screen the risk factors for futile recanalization. R software was used to establish a nomogram model for futile recanalization. C-index was used to evaluate the differentiation of the model, and correction curve was used to evaluate the accuracy of the line graph model prediction. Receiver operating characteristic (ROC) curve was used to evaluate the predictive efficiency of the nomogram model.Results:Ninety-two patients had futile recanalization. Compared with the effective recanalization group, futile recanalization group had significantly older age, significantly higher hemoglobin A1c on admission, significantly longer time from puncture to vascular recanalization, significantly higher proportions of patients with hypertension history and poor collateral circulation, and significantly different severities of stroke and white matter hyperintensities (WMHs) and distribution of occlusive sites ( P<0.05). Multivariate Logistic regression analysis showed that age, history of hypertension, time from puncture to vascular recanalization, poor collateral circulation, severe WMHs, and moderate-severe stroke were independent risk factors for futile recanalization after EMT in patients with acute anterior circulation large vessel occlusion ( P<0.05). A nomogram model of futile recanalization was established according to the above 6 factors, with C-index of 0.862 ( 95%CI: 0.809-0.914); the calibration curve of the model was highly coordinated to the ideal model curve; area under the ROC curve of futile recanalization was 0.862 ( 95%CI: 0.809-0.914, P<0.001). Conclusions:Acute anterior circulation large vessel occlusion patients with older age, history of hypertension, longer time from puncture to vascular recanalization, poor collateral circulation, severe WMHs, and moderate-severe stroke trend to have futile recanalization after EMT. This nomogram can predict futile recanalization after EMT.

A novel delayed anaphylactic reaction to red meat, associated with tick bites and IgE antibodies against galactose-alpha-1, 3-galactose (alpha-gal), was reported in 2009 in the US, Australia and Europe. In this case, serum specific IgE to galactose-alpha-1, 3-galactose (>100 kU/L) and IgE to multiple non-primate mammalian proteins were positive. However, the pathogenesis of this disease remains unclear. We report the first case in Asia of delayed anaphylactic reaction to red meat, which was induced by bites from the hard tick, Hematophagous ixodidae. We confirmed the increased concentration of IgE reactive epitopes in non-primate mammalian organs, which may be rich in alpha-gal proteins in lymphatic and endothelial tissues. All confirmed ticks associated with this disorder in the literature and in our case belonged to the hard tick family. We hypothesize that hard tick saliva is enriched with blood-type substances, such as oligosaccharides, from the non-primate mammal victim's blood after days to weeks of blood sucking, which sensitizes humans through the injection route while blood sucking.
Anaphylaxis* ; Antibodies* ; Asia ; Australia ; Epitopes ; Europe ; Food Hypersensitivity ; Galactose* ; Humans ; Immunoglobulin E* ; Ixodidae ; Mammals ; Meat* ; Oligosaccharides ; Saliva ; Tick Bites ; Ticks

OBJECTIVETo investigate the cytochrome P450 2E1 (CYP2E1) RsaI/PstI and DraI polymorphisms in workers exposed to benzene.

METHODSA cross-sectional survey was carried out. A total of 71 workers exposed to benzene were included in observation group and the same number of people without occupational benzene exposure were included in control group. Blood samples from the two groups were collected and genotyping for CYP2E1 RsaI/PstI and DraI were conducted using the polymerase chain reaction-restriction fragment length polymorphism.

RESULTSThere were no significant differences in CYP2E1 DraI genotype and allele distributions between the observation group and the control group (χ² = 2.374, P > 0.05; χ² = 2.113, P > 0.05). Significant differences in CYP2E1 RsaI/PstI genotype and allele distributions between the two groups were observed (χ² = 9.129, P < 0.01; χ² = 6.028, P < 0.05).

CONCLUSIONMutations at CYP2E1 RsaI/PstI can enhance the expression of CYP2E1 and this suggests individuals with the mutated gene have increased susceptibility to chronic benzene poisoning.

Alleles ; Benzene ; poisoning ; Cross-Sectional Studies ; Cytochrome P-450 CYP2E1 ; genetics ; metabolism ; Genetic Predisposition to Disease ; Genotype ; Humans ; Poisoning ; genetics ; Polymerase Chain Reaction ; Polymorphism, Genetic ; genetics ; Polymorphism, Restriction Fragment Length

Objective: To analyze the clinical features of perianal condyloma acuminatum in HIV infected men who have sex with men (MSM) and assess the effects of combined treatment of microwave and photodynamic therapy. Methods: Clinical and laboratory data of 260 male patients with perianal condyloma acuminatum were collected and microwave combined with photodynamic therapy was applied on them. Results: The majority of the patients with perianal condyloma acuminatum were young people (243/260). Warts were mainly located in the anus or from the outside to inside of the anus (245/260). Among them, the proportion of warts position of extraanal in HIV-infected group (8/220) was lower than that of non-HIV-infected group (7/40). HPV types 11 (70/118), 6 (44/118) and 16 (40/118) were the most common types of HPV infection. People with HIV infection were more likely to develop high-risk, mixed types HPV infection and multiple HPV infection than those without HIV infection. More than half of the patients (146/260) needed only 1-3 sessions of photodynamic treatments. There was no significant difference in the times of photodynamic treatments and the numbers of photosensitizers required between the HIV-infected and non-HIV-infected groups. The recurrence rate of HIV-infected group (13.6%, 30/220) was also similar to that of non-HIV-infected group (15.0%, 6/40), but far lower than those who underwent microwave therapy alone (45%, 18/40). Conclusions The combination therapy significantly reduced the recurrence rate of perianal condyloma acuminatum in HIV infected MSM.

Objective To investigate the prediction model of hypotension in patients with hepato-cellular carcinoma resection using controlled low central venous pressure technique(CLCVP).Methods A total of 144 patients with liver cancer admitted from January 2020 to June 2023 were retrospectively ana-lyzed,including 81 males and 63 females,aged 45-64 years,BMI 22-26 kg/m2,ASA physical status Ⅰ or Ⅱ.144 patients were randomly divided into trial set(n=96)and verification set(n=48)according to 2:1.The trial set and verification set were divided into hypotensive group and non-hypotensive group ac-cording to whether hypotension occurred after operation.Preoperative albumin,preoperative hemoglobin,op-eration method,operation time,tumor site,tumor size,hilar block time,number of hilar block times,hilar block interval time,blood loss,mean intraoperative CVP,intraoperative fluid volume,and intraoperative u-rine volume were collected.Univariate and multivariate Logistic analysis were used to analyze the risk factors of hypotension in the experimental group,and a risk prediction model was established.The risk prediction model was verified in the validation group.Results There were 29 patients(30.2％)of postoperative hy-potension in the test group and 15 patients(31.3％)of postoperative hypotension in the validation group.Compared with the non-hypotensive group,the preoperative albumin in the hypotensive group was signifi-cantly decreased(P<0.05),the operation time was significantly prolonged,the ratio of tumor diameter≥5 cm,and the amount of blood loss were significantly increased(P<0.05).Multivariate analysis showed that preoperative albumin elevation(OR=0.216,95％CI 0.164-0.665,P<0.05)was an independent protective factor for postoperative hypotension.Prolonged operative time(OR=2.649,95％CI 1.802-7.553,P<0.05),tumor diameter≥5 cm(OR=3.789,95％CI 2.011-12.458,P<0.05),in-creased blood loss(OR=8.873,95％CI 2.750-17.553,P<0.05)was an independent risk factor for postoperative hypotension.According to the results of multi-factor analysis,the risk factors of postoperative hypotension in patients with controlled low central venous pressure hepatocellular carcinoma resection were established:F=-408.64-(1.534×preoperative albumin)+(0.974×operation time)+(1.332×tumor diameter≥5 cm)+(2.183×blood loss).The risk model was validated in the validation set,and the area under the ROC curve(AUC)was0.821(0.695-0.943),the sensitivity was71.7％,and the speci-ficity was 86.5％.The Hosmer-Lemeshow goodness of fit test showed that χ2=10.654,P=0.222.Conclusion Prolonged operative time,tumor diameter≥5 cm and increased blood loss are risk factors for hypotension after hepatocellular carcinoma resection using CLCVP technique,and higher preoperative albumin is protective factor.The establishment of risk prediction model through multi-factor analysis has good forecasting value.