Objective To investigate the effect of sevoflurane postconditioning on the myocardial oxidative stress injury in patients undergoing heart valve replacement with cardiopulmonary bypass (CPB) . Methods Thirty ASA Ⅱ or Ⅲ and NYHA class Ⅱ or ID patients, aged 30-59 yr, weighing 42-62 kg, scheduled for cardiac valve replacement with CPB, were randomly divided into 2 groups ( n = 15 each) : control group (group C) and sevoflurane postconditioning group (group S) . Anesthesia was induced with iv injection of midazolam 0.05-0.08 mg/kg, fentanyl 3-6 μg/kg, vecuronium 0.10-0.15 mg/kg and etomidate 0.1-0.2 mg/kg. The patients were tracheal intu- bated and mechanically ventilated. Anesthesia was maintained with intermittent iv boluses of fentanyl and midazolam and continuous infusion of atracurium and propofol. In group S, 2% sevoflurane was given over 15 min via the cardiopulmonary bypass machine immediately after aortic unclamping. Blood samples from the internal jugular vein were collected immediately before skin incision (T1 ) and at 30 min, 3 h and 24 h after aortic unclamping (T2-4 ) for measurement of the plasma malondialdehyde level. Myocardial tissues were taken from the left auricle before operation and after termination of CPB for determination of α-glutathione-S-transferase expression by Western blot. Results The plasma malondialdehyde concentration was significantly lower at T2, 3, while a-glutathione-S-transferase expression in myocardial tissues higher after termination of CPB in group S than in group C ( P ＜ 0.05) . Conclusion Sevoflurane postconditioning can enhance the antioxidant capacity and attenuate the myocardial oxidative stress injury in patients undergoing cardiac valve replacement with CPB, which may be helpful to reduce myocardial ischemia-reperfusion injury.

Objective To quantitatively analyze the early warning value of laboratory indexes for death risk in children with criti ‐cal hand foot and mouth disease (HFMD) .Methods The univariate and multivariate Logistic regression analysis were conducted to explore the independent risk factors of death in critical HFMD children .Then the area under receiver operating characteristic curve (AUC) was applied to give the comprehensive assessment of the test model ,as well as the early warning capacity and the optimal cut‐off level of laboratory indexes in critical HFMD children .Results The AUC of the Logistic regression model (Y ) established based on white blood cell ,neutrophil ,myoglobin ,creatinine for early predicting the death risk in critical HFMD children patients was 0 .847 (95% CI :0 .783 - 0 .911) ,which indicating that its diagnostic value was superior to single index .Conclusion The diag‐nostic value of the Y model established based on four indexes of white blood cell count ,neutrophile granulocytes count ,myohemo‐globin and creatinine is superior to any single index ,which has the better early warning value for the death risk in children with crit‐ical HFMD .

This study aimed to evaluate the vasorelaxant effect and mechanisms of compound reserpine and triamterene tablets (CRTTs) and its component triamterene on isolated rat thoracic aorta rings. Isolated rat thoracic aorta rings pre-contracted by high potassium or norepinephrine (NE) were used to evaluate the vasodilatory effect of CRTTs and its component triamterene. The mechanisms concerning endothelium, potassium channels and calcium channels were studied through the interventions of several tool drugs. Animal welfare and experimental procedures followed the requirements of the Laboratory Animal Management and Animal Welfare Ethics Committee of the Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College. The results showed that both CRTTs and triamterene had potent relaxant effect on KCl and NE pre-contracted vessels. Triamterene showed partial endothelium dependency, and N-nitro-L-argininemethyl ester hydrochloride (L-NAME) could influence the relaxant effect, which may be related to the opening of calcium-activated potassium channels. Meanwhile, CRTTs could inhibit intracellular Ca²⁺ release and extracellular Ca²⁺ influx. Overall, CRTTs and its component triamterene have vasorelaxant effects on vessels in vitro, and the vasorelaxant effect of CRTTs may be related to intracellular Ca²⁺ release and extracellular Ca²⁺ influx, while this effect of triamterene may depend on vascular endothelial function and may also be related to the opening of calcium-activated potassium channels.

OBJECTIVETo explore the role of survivin and PI3K/AKT pathway in the pathogenesis of psoriasis vulgaris (PV).

METHODSPlaque-like lesions collected from 22 patients with PV in progressive stage and 18 normal control skin specimens were examined using immunohistochemical staining, Western blotting and real-time quantitative PCR for expressions of survivin, PI3K and AKT in the keratinocytes, and their correlation was analyzed. A small interfering RNA (siRNA) was used to knock down AKT in cultured HaCaT cells, and Western blotting was used to detect the changes in the expression of survivin. RESULTS Compared with normal skin, PV lesions showed obviously up-regulated expressions of survivin, PI3K and AKT in the keratinocytes. Survivin expression was positively correlated with PI3K (r=0.4510, P=0.0351) and AKT (r=0.4423, P=0.0393) in the keratinocytes in PV lesions. In cultured HaCaT cells, siRNA-mediated knockdown of AKT caused down-regulation of survivin expression.

CONCLUSIONSurvivin and PI3K/AKT signaling pathway may participate in the occurrence and progression of PV.

OBJECTIVE: To develop the visual uroflow scale (VUS), analyze the relationship of VUS score and index of free uroflowmetry, assess urination function preliminarily and improve the work efficiency in the clinic. METHODS: Male lower urinary tract symptoms (LUTS) patients, who attended the Department of Urology in Peking University People's Hospital from March 2016 to March 2017, were assessed for their urination function according to the Visual Uroflow Scale without help from clinicians before undertaking a free uroflowmetry test. And afterwards, a free uroflowmetry was undertaken, and variables including maximal flow rate (Qmax), the average flow rate (Qave) and voiding volume (VV) was obtained. During the study, 124 cases were collected and 53 cases met the inclusion and exclusion criteria and were included in the study cohort. The Spearman correlation analysis was used for analyzing the correlation of VUS scores with free uroflowmetry variables and age. The validity of VUS was evaluated. RESULTS: Most of the patients could choose the very figure matched with self-condition by first instinct without any help from the clinician. The data were analyzed by Spearman correlation analysis. In the present study, voiding time was positively correlated with the VUS score (correlation coefficient, 0.62, P < 0.05). In the present cohort, the patients chose the third and fourth figures to take longer time to urinate, implying worse LUTS situation. Flow time and VUS scores were positively correlated (correlation coefficient, 0.61, P < 0.05). The patients with higher VUS scores would spend more time on urinate, no matter how long urinary hesitation was. Both Qmax and Qave were negatively correlated with the VUS score (correlation coefficient －0.54, －0.62, P < 0.05). The study illustrated that the VUS score suggested that the Qmax basically and further reflected the urination function. And its relationship to age revealed the decreased urination function of aging male, which had reached a consensus. CONCLUSION Development of VUS has helped the clinician assess the urination function preliminarily at the first time. Patients are assessed for a VUS score before getting surgery or receiving the drug for treatment, and can be re-assessed after. The VUS score can provide an objective quantitative basis to evaluate the treatment efficacy. In addition, considering that it is convenient, timesaving and easy to understand, the VUS is available for follow-up.
Cohort Studies ; Humans ; Lower Urinary Tract Symptoms ; Male ; Urination ; Urodynamics

OBJECTIVETo explore the influence of smoking on chronic diseases among people with various income levels in China.

METHODSCross-sectional study on smoking behavior, chronic disease and income level was performed using database of the Second National Health Service Study (1998) provided by the Ministry of Health in China.

RESULTSCompared to never-smokers, smokers (including current smokers and former smokers) had a higher rate of having chronic diseases, after adjusted in age, income, educational level, employment status and type of jobs with corresponding countryside (OR = 1.185, 95% CI: 1.121 - 1.253 and town OR = 1.083, 95% CI: 1.010 - 1.161). Smoking had a more serious effect on having chronic illness in males from the countryside (former-smoker OR = 2.764, 95% CI: 2.471 - 3.092) than in town (former-smoker OR = 2.112, 95% CI: 1.844 - 2.419). Smokers at the lowest income level had a higher possibility of having chronic illness (town OR = 2.076, 95% CI: 1.551 - 2.780; countryside OR = 2.903, 95% CI: 2.248 - 3.749) than those at the highest income level (town OR = 1.785, 95% CI: 1.285 - 2.479 in the countryside OR = 2.466, 95% CI: 1.941 - 3.134).

CONCLUSIONSmoking might cause more serious health problems to people at lower income level in China.

China ; epidemiology ; Chronic Disease ; epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Income ; Male ; Smoking ; adverse effects ; Social Class

The objective of this study is to evaluate the correlation between the absolute ventricular fibrillation voltage (AVFV) computed from electrocardiogram (ECG) and the outcome of defibrillation shocks. Orthogonal ECG (sagittal, x; transverse, y; and longitudinal, z) was recorded from 11 dogs during 10 seconds of electrically induced ventricular fibrillation followed by defibrillation shocks with 50% probability of success. The transvenous two-leads defibrillation system was used to deliver defibrillation shocks. The envelope voltage was estimated by using the Hilbert transform. The comparison of the envelope voltages between 236 successful trials and 249 unsuccessful trials did not show any consistent and statistically significant differences. In contrast with the previously reported correlation, the moving average of AVFV was not higher in the successful trials. In the Z direction, the successful trials had lower voltage than did the unsuccessful trials (P < 0.05). These results suggest that the absolute voltage of ECG during ventricular fibrillation is not robustly correlated with the outcome of defibrillation shocks.
Animals ; Dogs ; Electric Countershock ; Electrocardiography ; methods ; Female ; Male ; Models, Theoretical ; Signal Processing, Computer-Assisted ; Ventricular Fibrillation ; physiopathology ; therapy

OBJECTIVETo investigate the role of p38MAPK pathway in the protective effect of glycyrrhiznatis against myocardial ischemia-reperfusion in rabbits.

METHODSThirty rabbits were randomly divided into control group, I/R group, and glycyrrhiznatis group. In the latter two groups, the left anterior descending branch of the coronary artery was ligated for 40 min followed by 120 min of reperfusion, and in glycyrrhiznatis group, glycyrrhiznatis was given intravenously at 2.5 mg/kg before the occlusion. Blood samples were taken to measure the plasma levels of TNF-alpha, IL-6, and IL-8 at 20 min before (T(0)) and 20 min (T(1)) and 40 min (T(2)) after the occlusion, and at 1 h (T(3)) and 2 h (T(4)) after the reperfusion. At the end of the reperfusion, the infarct size and the area at risk were defined by Evams and TTC staining. The heart was harvested and the levels of the p38 MAPK measured by Western blotting. The ultrastructures of the cardiac myocytes were observed under electron microscope.

RESULTSThe p38MAPK activity and the plasma levels of the inflammatory factors were significantly lower in gtycyrrhiznatis group than in I/R group (P<0.05). Glycgrrhiznatis significantly reduced the infarct size as compared with that in I/R group.

CONCLUSIONSlycyrrhiznatis can reduce myocardial ischemia-reperfusion injury by inhibiting p38MAPK activity and modulating the cytokine expression.

Animals ; Anti-Inflammatory Agents ; therapeutic use ; Cytokines ; metabolism ; Female ; Glycyrrhizic Acid ; therapeutic use ; Male ; Myocardial Reperfusion Injury ; prevention & control ; Myocardium ; metabolism ; Rabbits ; Random Allocation ; Signal Transduction ; drug effects ; p38 Mitogen-Activated Protein Kinases ; metabolism

ObjectiveTo investigate the influencing factors for chronic kidney disease (CKD) in patients with hepatitis B cirrhosis within 3 years. MethodsA total of 376 patients with hepatitis B cirrhosis who attended Beijing Ditan Hospital, Capital Medical University, from January 2014 to July 2017 were enrolled and followed up for 3 years, and according to the presence or absence of CKD, they were divided into CKD group with 23 patients and non-CKD group with 353 patients. Related general information and laboratory markers were collected. The t-test or the Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups; a stepwise forward Cox regression analysis was used to screen out the independent influencing factors for CKD within 3 years in patients with hepatitis B cirrhosis. The area under the receiver operating characteristic curve (AUC) was used to investigate the value of the influencing factors in predicting CKD in patients with hepatitis B cirrhosis; the Kaplan-Meier method was used for survival analysis, and the log-rank test was used for comparison of the cumulative incidence rate of CKD between the patients with different risks. ResultsThe multivariate Cox regression analysis showed that age (hazard ratio ［HR］=1.078, 95% confidence interval ［CI］: 1.007-1.114, P=0.026), albumin (Alb) (HR=0.923, 95% CI: 0.860-0.989, P=0.024), and estimated glomerular filtration rate (eGFR) (HR=0.977, 95% CI: 0.955-0.999, P=0.037) were independent influencing factors for CKD within 3 years in patients with hepatitis B cirrhosis. Age, Alb, and eGFR had a relatively good value in predicting CKD, with AUCs of 0.701, 0.710, and 0.706, respectively. The Kaplan-Meier survival curve showed that the patients with baseline age ≥55 years, Alb ＜32 g/L, and eGFR ≥60 ml·min-1·1.73 m-2 and ＜76 ml·min-1·1.73 m-2 had a higher risk of CKD (χ2=9647, 13621, and 30.940, all P＜0.05). ConclusionRenal function should be closely monitored for patients with old age and low Alb and eGFR levels.

This article aims to analyze LI Fei's academic thinking and experience in treating facial paralysis.LI Fei proposes that the diagnosis and treatment of facial paralysis should follow the principle of"identify the cause of the disease when it is occured at first time,followed by exploring the pathogenesis of the disease,then differentiating the syndrome and treating the disease,and recognizing the syndrome and treating the disease",and that the basic treatment principle should be"dispelling wind and unblocking the collaterals,regulating the tendons and meridians".In clinical treatment,"put emphasis on anatomy,treat the disease according to symptoms"is the basic policy;meanwhile,integrating Chinese and western theories,combining the anatomical structure of the expression muscle,dynamically judging the recovery of nerves and muscles,and selecting the corresponding empirical acupoints according to the symptoms.LI Fei emphasizes the integration of theories and summarizes the"triple"methods of differentiation by reasoning,staging and symptoms,and the"triple"theory of treatment by regulating menstruation,tendon and spirit,which is worthy of reference in the clinic.