Objective To learn about electrolytes imbalance and water intoxication in children treated with high-dose cyclophosphamide(HD-CTX)as well as the renal function and the relative clinical symptoms,and study the mechanisms of hyponatremia.Methods Patients' clinical manifestations during and after HD-CTX therapy were summarized.Serum electrolytes and creatinine(Cr)were detected before and 6 or 8 hours after therapy with HD-CTX,antidiuretic hormone(ADH) in some patients were measured.Results Of 108 therapeutic cases 24 accompanied with vomits and 22 with a decreased urine output,in which 4 developed eyelid or ankle edema.Seven cases had neural-sarcous symptoms and 5 cases had abdominal pain or diarrhea.Serum sodium decreased significantly after HD-CTX[(139.12?3.30) mmol/L vs(134.06?8.23) mmol/L] in whom rechecked after 6 h,(141.77?3.59) mmol/L vs(133.26?6.41) mmol/L in those rechecked after 8 h(Pa0.05].Serum Cr increased 8 h after therapy[(29.95?13.61) ?mol/L vs(43.33 ? 17.25) ?mol/L P

OBJECTIVETo explore combination rules of Chinese herbal prescriptions from effective cases for treatment of unstable angina (UA).

METHODSPrescription data from 156 UA patients effectively treated at Cardiovascular Diseases Centre of Xiyuan Hospital were analyzed using complex network method.

RESULTSAccording to multi-scale analysis of backbone network and pointwise mutual information analysis, core prescriptions from the 156 UA patients were presented as follows: Rhizoma Ligustici wallichii, Radix Paeoniae rubra, Radix Codonopsis, Rhizoma Pinelliae, poria, and Angelica sinensis. Meanwhile, core couplet medicines for these patients covered Rhizoma Ligustici wallichii and Radix paeoniaerubra, Angelica sinensis and Rhizoma Ligustici wallichii, Radix Codonopsis and Rhizoma Ligustici wallichii, Rhizoma Ligustici wallichii and Rhizoma Pinelliae, Rhizoma Atractylodis Macrocephalae and poriacocos, Bulbus Alli Macrostemi and Rhizoma Pinelliae. Among different primary symptoms, there was slightly difference in core prescriptions.

CONCLUSIONThe core prescriptions for the treatment of UA include blood-activating drug, phlem-resolving drugs. As an exploration of combination rules of Chinese herbal prescriptions in treating UA based on complex network, it can be used as a reference for further researches.

Angelica sinensis ; Angina, Unstable ; drug therapy ; Drugs, Chinese Herbal ; standards ; therapeutic use ; Humans ; Pinellia ; Plant Roots ; Practice Guidelines as Topic ; Prescriptions ; standards

0.05)],which less than in control group [(4.614?1.683) IU/cm,(0.119?0.068) IU/cm,(564.2?53.8) ?m Pa

Objective To study the association of Hp infection and insulin resistance (IR) with vascular dementia (VaD).Methods Eighty-six elderly VaD patients admitted to our hospital from April 2015 to April 2016 served as a VaD group and 52 healthy subjects undergoing physical examination served as a control group in this study.The patients in VaD group were further divided into Hp-positive group (n =50) and Hp-negative group (n =36).Their fasting blood glucose (FBG) and fasting insulin (FINS) levels were measured with positive C13 urea breath test as the diagnostic index of Hp infection.HOMA-IR=FINS× FBG/22.5 was calculated according to the self balance model analysis.Results The positive Hp rate,serum FBG and FINS levels,and HOMA-IR were significantly higher in VaD group than in control group (58.14％ vs 28.58％,x2=10.273,P=0.002;5.53±0.60 mmol/L vs 5.19±0.38 mmol/L,P=0.0004;10.29±4.95 μIU/L vs 8.77±4.02 μIU/L,P=0.0317;2.57±1.34 vs 2.06±0.96,P=0.0179).The serum FBG and FINS levels and HOMA-IR were significantly higher in Hp-positive group than in Hp-negative group (P＜0.05,P＜0.01).Conclusion Hp infection and IR are closely associated with VaD,and can thus lead to the occurrence or progression of VaD by inducing or aggravating IR.

Objective To study hemodynamics of cerebral blood flow in newborns with asphyxia.Method Bilateral cerebral electrical admittance plethysmogram(BCEAP) was used to explore characteristics of cerebral blood flow in 20 healthy newborns and 20 newborns with asphyxia respectively from first to fourth day after birth.Results Both the ratio of Hs to b-S(Hs/ b-S) and index of admittance differential loop(ADL) Ⅰ+Ⅱ decreased significantly in newborns with asphyxia compared to normal control from first to fourth day after birth(P

OBJECTIVETo explore the effects of different liquid therapies on the intracranial pressure, brain water content, and expressions of aquaporin-4 and N-methyl-D-aspartate-1 in the brain tissue.

METHODSTwo intervention factors including the colloids (two levels: 4% gelofusine; 6% hydroxyethyl starch and sodium chloride injection) and the crystal/gel ratios (two levels: 0:1; 1:1) were set based on the results of the analysis of variance of factorial design. Thirty-two patient who had undergone epilepsy surgery were equally and randomly divided into four groups: group A (4% gelofusine, crystal/gel ratio 0:1); group B (6% hydroxyethyl starch and sodium chloride injection, crystal/gel ratio 0:1); group C (4% gelofusine, crystal/gel ratio 1:1); and group D (6% hydroxyethyl starch and sodium chloride injection, crystal/gel ratio 1:1). The intracranial pressure during operation was recorded. After the operation, the intracranial pressure and brain water content were measured and the expressions of aquaporin-4 and N-methyl-D-aspartate-1 in the brain tissue were determined with Western blot. Glasgow coma scores were obtained 2 hours after operation.

RESULTSThe intracranial pressure (F=55.714, P=0.000; F=142.432, P=0.000) and the brain water content (F=31.477, P=0.000; F=84.896, P=0.000) significantly increased after the application of the 6% hydroxyethyl starch and sodium chloride injection and crystal/gel ratio 1:1, and the expressions of aquaporin-4 (F=37.205, P=0.000; F=149.652, P=0.014) and N-methyl-D-aspartate-1(F=29.664, P=0.000; F=65.951, P=0.000) in the brain tissue significantly increased. There were additive effects between two of them (the intracranial pressure: F=11.056, P=0.002; the brain water content: F=8.007, P=0.008; the expression of aquaporin-4: F=9.845, P=0.004; and the expression of N-methyl-D-aspartate-1: F=5.020, P=0.033). However, the Glasgow coma score showed no significant difference after the administration (P>0.05).

CONCLUSIONThe liquid therapy with 4% gelofusine and crystal/gel ratio 0:1 can result in better control on the intracranial pressure, brain water content and expressions of aquaporin-4 and N-methyl-D-aspartate-1 in the brain tissue better than the liquid therapy with 6% hydroxyethyl starch and crystal/gel ratio 1:1 during neurosurgery, although it may not improve the coma status.

Adolescent ; Adult ; Aquaporin 4 ; metabolism ; Brain ; drug effects ; metabolism ; Female ; Fluid Therapy ; methods ; Humans ; Intracranial Pressure ; drug effects ; Male ; Middle Aged ; N-Methylaspartate ; metabolism ; Water ; metabolism ; Young Adult

Objective To evaluate the effect of ventilation with different positive end-expiratory pressures (PEEPs) on intracranial pressure in the patients undergoing gynecological laparoscopic surgery.Methods Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients,aged 25-55 yr,with body mass index of 18-27 kg/m2,scheduled for elective gynecological endoscopic surgery,were divided into 3 groups (n=20 each) using a random number table method:routine ventilation group (group A),4 cmH2O PEEP group (group B) and 8 cmH2O PEEP group (group C).The patients were mechanically ventilated with PEEP 4 or 8 cmH2O at 5 min of head-down tilt after start of pneumoperitoneum in group B and group C.The patients were mechanically ventilated in volume-controlled mode,with tidal volume 7 ml/kg,inspired oxygen concentration 50％ and inspiratory/expiratory ratio 1 ∶ 2.Blood samples were collected from the radial artery for measurement of PaCO2 and PaO2 at 5 min after tracheal intubation (T0),5,15 and 30 min of head-down tilt (T1-3),and 5 min of the supine position after the end of pneumoperitoneum (T4).The peak airway pressure (Ppeak) was recorded,dynamic pulmonary compliance (Cdyn)was calculated,and optic nerve sheath diameter was measured using an ultrasonic apparatus at T0-4.Cognitive function was assessed at 1 day before surgery and 7 days after surgery using Mini-Mental State Examination.Results Compared with group A,Ppeak was significantly increased at T1-4,and PaO2 was increased at T2 in group B,and Ppeak and PaO2 were increased at T1-4,and Cdyn was increased at T1,2 in group C (P＜0.05).Compared with group B,Ppeak was significantly increased at T4,and Cdyn was increased at T2 in group C (P＜0.05).There was no significant difference in optic nerve sheath diameter or Mini-Mental State Examination score at each time point among three groups (P＞0.05).No patients developed cognitive dysfunction at 7 days after surgery in three groups.Conclusion Ventilation with different PEEPs causes no increase in intracranial pressure of the patients undergoing gynecological laparoscopic surgery.

Acute kidney injury (AKI) is a common complication following orthotopic liver transplantation (OLT) and is associated with increased morbidity and mortality.The aim of the current study was to determine the risk factors for AKI in patients undergoing OLT.A total of 103 patients who received OLT between January 2015 and May 2016 in Tongji Hospital,China,were retrospectively analyzed.Their demographic characteristics and perioperative parameters were collected,and AKI was diagnosed using 2012 Kidney Disease:Improving Global Outcomes (KDIGO) staging criteria.It was found that the incidence of AKI was 40.8％ in this cohort and AKI was significantly associated with body mass index,urine volume,operation duration (especially ＞ 480 min),and the postoperative use of vasopressors.It was concluded that relative low urine output,long operation duration,and the postoperative use of vasopressors are risk factors for AKI following OLT.

Objective To study the effects of tetrahydrobiopterin (BH4) on left ventricular diastolic function and expression of phosphorylated protein kinase B (p-Akt) in hypertensive mice.Methods Male C57BL/6 mouse were selected to construct hypertensive models,the mouse modeled successfully were randomly divided into two groups according to their weight:Experimental group (lavage with BH4 solution 10 pL · g-1 · d-1) and model group (lavage with normal saline),20 healthy mouse were selected as sham operation group (lavage with normal saline),at dose of 10 μL · g-I in three groups,all were continuously fed for 7 days.The effect of BH4 intervention on left ventricular function in mice were detected by echocardiography.The expression of Akt and p-Akt proteins in the myocardium were detected by Western blot.Results After BH4 intervention,ratio of left ventricular early diastolic fillig velocity/left ventricular early diastolic mitral annual velocity (E/E')in sham operation group,model group and experimental group were 25.74 ± 5.23,38.45 ± 3.68,32.15 ± 5.24,respectively;the left ventricular end diastolic pressure (LVEDP,mmHg) in the three groups were 84.0 ± 5.2,104.3 ±12.5,100.2±7.5 respectively;the Tau(ms) in the three groups were 10.6 ±0.5,14.3 ±0.8,12.1 ± 0.6,respectively;the end-diastolic pressure-volume relation (EDPVR,mmHg · μL-1) in the three groups were 0.15 ±0.02,0.22 ±0.05,0.16 ±0.05,respectively.The factors in the model group were higher than the sham operation group;while the factors in the experimental group were lower than the model group;the differnce had significantly (P ＜ 0.05 or P ＜ 0.01).There was no significant difference in the expression of Akt protein in each group (P ＞ 0.05).The expression of p-Akt protein in myocardium of experimental group was higher than that of the model group with significantly(P ＜ 0.05).Compared with the model group,the levels of nitric oxide(NO) and superoxide dismutase (SOD) in the myocardial tissue of the experimental group increased and the malonaldehyde (MDA) level decreased with significantly (P ＜ 0.05 or P ＜ 0.01).Conclusion BH4 can decrease the level of myocardial oxidative stress and improve the left ventricular diastolic function by increasing the expression of p-Akt in myocardium of hypertensive mice.

Objective To investigate the value of serum microRNA(miRNA)-184 and miR-451a expression in predicting recurrent metastasis after radical resection of stage Ⅰ to Ⅱ A non-small cell lung cancer(NSCLC).Methods A total of 203 patients with radical resection of stage Ⅰ to Ⅱ A NSCLC in the hospital from January 2020 to October 2021 were selected as NSCLC group.According to the recurrence and metastasis status during the 2-year follow-up,they were divided into recurrence and metastasis group with 30 cases and non-recurrence and metastasis group with 173 cases.Addition-ally,87 healthy volunteers with physical examinations in the same period were selected as control group.Real-time quantitative polymerase chain reaction was used to detect serum expression of miR-184 and miR-451a.Multivariate Logistic regression model was used to analyze the factors affecting recurrence and metastasis after radical resection of stage Ⅰ to Ⅱ A NSCLC.Receiver operating characteristic(ROC)curve was used to analyze the value of serum miR-184 and miR-451 a expression in predicting recurrence and metastasis.Results Compared with the control group,the expression of serum miR-184 and miR-451a in the NSCLC group decreased significantly(P＜0.05).After 2 years of follow-up,the recurrence and metastasis rate of 203 patients with stage Ⅰ to ⅡA NSCLC was 14.78％(30/203).Compared with the non-recurrence and metastasis group,the expression of serum miR-184 and miR-451a in the recurrence and metastasis group decreased significantly(P＜0.05).The independent risk factors for recurrence and metastasis after radical resection of stage Ⅰ to Ⅱ A NSCLC were stage Ⅱ A,poor differentiation and postoperative adjuvant chemotherapy,while the independent protective factors were increased miR-184 and miR-451a expression(P＜0.05).The area under the curve(AUC)of the combined prediction of serum miR-184 and miR-45 1 a expression for recurrence and metastasis after radical resection of stage Ⅰ to Ⅱ A NSCLC was 0.868,which was greater than 0.784 and 0.781 of serum miR-184 and miR-451 a expression alone(P＜0.05).Conclusion The serum miR-184 and miR-451a expression in patients with stage Ⅰ to ⅡA NSCLC is low and closely re-lated to recurrence and metastasis after radical resection.The combined detection of serum miR-184 and miR-451a has a high predictive value for recurrence and metastasis after radical resection of stage Ⅰ to ⅡA NSCLC.