ObjectiveTo investigate the therapeutic effect of Xiaoqinglong decoction for supplementary treatment of patients with ventilator-associated pneumonia (VAP).Methods Thirty-three VAP patients with syndrome of traditional Chinese medicine (TCM) as interior retention of phlegm and exopathic cold admitted to Affiliated Hospital of Tianjin Academy of Traditional Chinese Medicine (TCM) from July 2011 to December 2014 were enrolled, and their historical data were retrospectively analyzed. According to the difference in treatment methods, the patients were divided into TCM treatment Xiaoqinglong decoction group (observation group, 18 cases) and general treatment group (control group, 15 cases). The patients in both groups were given conventional western medicine treatment, including anti-infection, phlegm elimination and cough relieve, protection of gastric mucosa and organ function, nutritional support, prevention of bedsore and thrombosis, etc. Additionally, the patients in TCM treatment group were given Xiaoqinglong decoction (drug composition: herba ephedrae 15 g, ramulus cinnamomi 15 g, herba asari 15 g, rhizoma zingiberis 15 g, chinese peony 15 g, rhizoma pinelliae 15 g, fructus schisandrae 15 g, radix glycyrrhizae preparata 10 g) for nasal feeding, once 150 mL, twice a day, once every 7 days. The changes in body temperature were observed before and 3 days and 7 days after treatment, and peripheral blood was collected for determination of white blood cell count (WBC) and C-reactive protein (CRP) level in the two groups. Comprehensive therapeutic effects of the patients in both groups were recorded.Results There were no significant differences in body temperature, WBC and CRP before treatment between the two groups. After treatment, the above parameters in both groups were significantly lower than those before treatment, and they showed a decrease tendency with time prolongation. The decrease in body temperature and WBC in observation group was more obvious than those of control group, and the comparisons showed statistical significant differences on 7 days after treatment [body temperature (℃): 36.5±0.6 vs. 37.0±0.8, WBC (×109/L):6.7±3.0 vs. 8.9±2.5, bothP < 0.05], but there was no significant difference in CRP between the observation group and control group (mg/L: 3 d was 73.7±20.5 vs. 61.5±18.4; 7 d was 27.2±10.5 vs. 23.5±9.1, bothP > 0.05). The total effective rate on the 7th day after treatment in observation group was higher than that of control group [83.3% (15/18) vs. 80.0% (12/15)], but no statistical significant difference was seen (P > 0.05).Conclusions The Xiaoqinglong decoction can reduce the inflammatory reaction of patients with VAP, and improve their symptoms.

Objective: To explore the comprehensive effects of folic acid (FA), riboflavin (RF) and MTHFR C677T polymorphism on genomic stability. Method: Cytokinesis-block micronucleus assay was used to detect the effects of different concentration combination of FA (20 and 200nmol/L, i.e. LF and HF) , RF (1 and 500 nmol/L, i.e. LR and HR) and MTHFR C677T polymorphism on genomic stability of 9 d cultured human lymphocytes. Results: The genetic damage was significantly higher in LFHR group regardless the genotype (P

FGF21 (fibroblast growth factor 21) is a recently described member of the FGF family. It has been previously demonstrated that FGF21 is a potent regulator of glucose homeostasis. To improve stability of FGF21 for better efficacy, a new form of recombinant FGF21 was generated by fusion of a full length FGF21 gene and the Fc fragment of human IgG4 with flexible linker sequence. To examine the glucose regulation activity of FGF21-L-Fc, 3T3-L1 pre-adipocytes were differentiated into adipocytes, and glucose uptake activity of FGF21-L-Fc was examined by glucose oxidase and peroxidase (GOD-POD) assay. The results showed that in comparison with wild type FGF21, FGF21-L-Fc was more potent in stimulation of glucose uptake by 3T3-L1. In vivo studies on the modified protein demonstrated that FGF-L-Fc had a better efficacy in lowering blood glucose of the STZ-induced diabetic animals and controlled glucose level for a longer time. The results provided a sound basis for further studies.

This article introduces the clinical requests of indigenous diagnostic imaging ultrasound devices in first-time registration application and the clinical trial requests in Technical Review Guidance of Ultrasound Imaging Diagnostic Devices (category III) Registration and puts forward some questions of the guidance's implementation. It is hoped to help concerned people.
China ; Clinical Trials as Topic ; standards ; Device Approval ; legislation & jurisprudence ; standards ; Guidelines as Topic ; Ultrasonography ; instrumentation

Objective To investigate the relationship of pathological response of breast cancer after neoadjuvant chemotherapy with the imaging findings in dynamic contrast-enhanced MRI.Methods Forty- five patients with pathologically confirmed breast carcinoma who finished courses of neoadjuvant chemotherapy had breast MRI prior to operation.Dynamic contrast-enhanced MRI scans were performed on a 1.5 T scanner using 3D SPGR sequence before and repeated 6 times after administration of Gd-DTPA. Pathological response was assessed by a pathologist according to Miller & Payne five points classification blinded to breast MRI results.Grade 5 was defined as pCR(pathological complete response).Grade 4 and 5 were defined as major histopathological response(MHR).The type of time signal intensity curve(TIC) (three types),pattern of residual enhancement of each breast cancer were recorded and correlated with pathological findings.Fisher exact test was used for statistical analysis.Results Grade 5 responses were achieved in seven patients;grade 4 in sixteen patients;grade 3 in sixteen patients and grade 1—2 in six patients.70.0%(14/20)of type Ⅰ time signal intensity curve correlated with MHR,while all 6 type Ⅲ curves showed non-MHR response.The type of time signal intensity curve and pathological response grades had statistically significant correlation(P=0.001).18 of the 23 cases with MHR exhibited residual enhancement,while the remaining 5 cases showed no enhancement.Of the 18 MHR cases with residual enhancement,11 showed non-mass-like enhancement and 7 showed mass-like enhancement.The mass(non- mass)morphological pattern in dynamic contrast enhanced-MRI had statistically significant differences in pathological response(P=0.012).Conclusions Pathological response of breast carcinoma after neoadjuvant chemotherapy could be characterized using dynamic contrast-enhanced MRI by identifying patterns of residual contrast enhancement and kinetic curve.Favorable pathological responses correlated with Type Ⅰ TIC,non-enhancement,and non-mass-like residual enhancement.

OBJECTIVE: To study the feasibility, safety, effectiveness of linear ablation and circumferential isolation of pulmonary veins for atrial fibrillation (AF) guided by 3-dimensional mapping system. METHODS: Twenty-eight consecutive patients with drug refractory paroxysmal and persistent AF were included in this study. Real-time 3-dimensional left atrial (LA) and pulmonary veins (PVs) maps were constructed through 3-dimensional mapping system (Ensite NavX) in all patients. Pulmonary vein isolation was performed by encircling the left and right sides of PVs at 1 to 2 cm away from the ostium of PVs. The endpoint of ablation included: All circum PVs ablation lines finished; all PVs were isolated; and non-inducibility of AF was observed. RESULTS: All 28 patients reached the endpoint of ablation completely. The mean procedure time and fluoroscopy time was (161.3+/-23.2) min and (38.0+/-6.8) min, respectively. During the 6 approximately 17 month follow-up, 20 patients (71%) were free of AF without any antiarrhythmic drugs. Recurrence of AF was found in the other 8 patients (29%): Two were treated with amiodarone and 6 repeated ablation. After the second ablation, 4 were free of AF and 2 recurrence were treated with amiodarone. No complications occurred during the procedure and the follow-up. CONCLUSION Linear ablation and circumferential isolation of pulmonary veins for atrial fibrillation (AF) guided by 3-dimensional mapping system is effective and safe. But the long-term outcome remains to be investigated.
Adult ; Aged ; Atrial Fibrillation ; surgery ; Catheter Ablation ; methods ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Pulmonary Veins ; surgery ; Treatment Outcome

OBJECTIVE: To monitor the changes of plasma asymmetric dimethylarginine (ADMA), nitric oxide (NO), and von Willebrand factor (vWF) levels in patients with stable angina pectoris (SAP) or acute coronary syndrome (ACS) and to evaluate the correlation between ADMA and different types of coronary heart disease. METHODS: A total of 143 subjects were divided into a non-CHD group, a SAP group and an ACS group. Plasma levels of ADMA, NO and vWF were examined and their correlation with SAP or ACS was analyzed. RESULTS: Compared with the non-CHO or the SAP group, ADMA level was elevated in the ACS group (P<0.05). The ADMA level tended to increase in the SAP group compared with the non-CHD group, but had no significant difference (P>0.05). Compared with the non-CHD group, NO level was decreased in both the SAP and ACS group (P<0.05), and it decreased more in ACS group than that in the SAP group (P<0.05); vWF levels were increased in both the SAP and ACS group compared with the non-CHD group (P<0.05). There was no significant difference in the plasma levels of vWF in the SAP and the ACS group (P>0.05). CONCLUSION The change of plasma ADMA level is closely correlated with acute coronary syndrome. ADMA might be a clinical marker for acute coronary syndrome.
Acute Coronary Syndrome ; blood ; Aged ; Angina Pectoris ; blood ; Arginine ; analogs & derivatives ; blood ; Biomarkers ; blood ; Coronary Disease ; blood ; classification ; Female ; Humans ; Male ; Middle Aged ; Nitric Oxide ; blood ; von Willebrand Factor ; metabolism

Purpose: RIOK1 has been proved to play an important role in cancer cell proliferation and migration in various types of cancers—such as colorectal and gastric cancers. However, the expression of RIOK1 in breast cancer (BC) and the relationship between RIOK1 expression and the development of BC are not well characterized. In this study, we assessed the expression of RIOK1 in BC and evaluated the mechanisms underlying its biological function in this disease context. Materials and Methods: We used immunohistochemistry, western blot and quantitative real-time polymerase chain reaction to evaluate the expression of RIOK1 in BC patients. Then, knockdown or overexpression of RIOK1 were used to evaluate the effect on BC cells in vitro and in vivo. Finally, we predicted miR-204-5p could be a potential regulator of RIOK1. Results: We found that the expression levels of RIOK1 were significantly higher in hormone receptor (HR)–negative BC patients and was associated with tumor grades (p=0.010) and p53 expression (p=0.008) and survival duration (p=0.011). Kaplan-Meier analysis suggested a tendency for the poor prognosis. In vitro, knockdown of RIOK1 could inhibit proliferation, invasion, and induced apoptosis in HR-negative BC cells and inhibited tumorigenesis in vivo, while overexpression of RIOK1 promoted HR-positive tumor progression. MiR-204-5p could regulate RIOK1 expression and be involved in BC progression. Conclusion These findings indicate that RIOK1 expression could be a biomarker of HR-negative BC, and it may serve as an effective prognostic indicator and promote BC progression.

OBJECTIVETo study the biomechanical characteristics of Ni-Ti shape-memory alloy-enclosed interlocking intramedular nail Ni-Ti En for clinical application.

METHODSSix transverse fractures were induced in 6 fresh humeral shafts and fixed with Ni-Ti En, plate, interlocking intramedullary nail, and Ender nail, respectively. The specimens then underwent stress analysis for comparison of the bending strength, twisting force, and flexibility.

RESULTSThe bending strength of Ni-Ti En was not significantly different from that of the plate and better than ender's nail; the twisting force of the interlocking intramedullary nail was comparable with the plate, but better than Ender nail.

CONCLUSIONNi-Ti Enpossess good biomechanical property to meet the demand of osteosynthesis, and its less stress protection, freedom of distant nail locking, flexibility and stable fixation may accelerate fracture healing.

Biomechanical Phenomena ; Bone Nails ; Fracture Fixation, Intramedullary ; instrumentation ; methods ; Humans ; Humeral Fractures ; physiopathology ; surgery ; Nickel ; Titanium

BACKGROUNDNominal atrioventricular (AV) interval in dual chamber pacemaker (DDD) is not the best AV delay in the majority of patients with atrioventricular block. To find a simple method for optimizing AV delay adjustment, we assessed surface electrocardiography (ECG) for optimizing AV delay during dual chamber pacing.

METHODSDDD pacemakers were implanted in 46 patients with complete, or almost complete, AV block. Optimal AV delay was achieved by programming an additional delay of 100 ms, to the width of intrinsic P wave or to the interval between pacing spike to the end of P wave on surface ECG. Left ventricular (LV) end diastolic and end systolic volumes, ejection fraction and diastolic parameters were measured by Doppler echocardiography during both nominal and optimal AV delay pacing.

RESULTSCompared to nominal AV delay setting, LV end diastolic volume increased [to (53.2 +/- 11.3) ml from (50.2 +/- 10.2) ml, P < 0.05], end systolic volume decreased [to (26.1 +/- 9.0) ml from (27.9 +/- 8.2) ml, P < 0.05] during adjusted AV delay pacing, resulting in an increase in LV ejection fraction [to (68.2 +/- 5.3)% from (64.5 +/- 4.3)%, P < 0.05]. LV diastolic filling and isovolumic relaxation time were not significantly changed.

CONCLUSIONOptimization of AV delay by surface ECG is a simple method to improve LV systolic function during dual chamber pacing.

Adult ; Aged ; Aged, 80 and over ; Atrioventricular Node ; physiopathology ; Cardiac Pacing, Artificial ; methods ; Electrocardiography ; methods ; Female ; Heart Block ; physiopathology ; therapy ; Humans ; Male ; Middle Aged ; Time Factors