Eisenmenger syndrome (ES) was considered as a surgical contraindication in the past time. Only a few patients got lung transplantations or heart-lung transplantations due to lack of donors. Most of the patients had to choose conservative treatment to prolong their survival time. Recently, some clinical trials indicated targeted therapies in pulmonary arterial hypertension (PAH) were effective for the treatment of ES. This article reviewed the recent advances in this area.

Accidents, Occupational ; Acetic Anhydrides ; Adult ; Blast Injuries ; complications ; therapy ; Burns, Inhalation ; etiology ; therapy ; Humans ; Lung Injury ; etiology ; therapy ; Male ; Middle Aged

Objective To understand the incidence of renal involvement of children with non Hodgkin′s lymphoma and to recognize its different CT findings. Methods The thoracic and abdominal plain and contrast enhanced CT of 30 cases of NHL in children were reviewed and all cases were confirmed by pathology. The changes in both pre and post chemotherapy were analysed in the 10 selected cases with renal involvement. Results CT demonstrated 6 cases of multiple masses and 1 case of multiple patchy lesions in bilateral kidneys. Two cases of single mass and 1 case of multiple masses were detected in single kidney. Conclusion The incidence of renal involvement of children with non Hodgkin′s lymphoma is relatively high. CT can clearly demonstrate the renal involvement of NHL, which is helpful for clinical stage, especially in the evaluation of the therapeutic effects. Hence, abdominal plain and contrast enhanced CT scan should be done in children with NHL.

Objective To invetigate the effect and safety of sufentanil mixed levobupivacaine on postoperative analgesia in pediatric caudal block anesthesia.Method Sixty pediatric patients (2 ～ 6 years old) who were undergoing elective abdominal surgery,such as repair hernia of high ligation,were randomly divided into three groups with 20 cases each.after intravenous induction,0.25％ levobupivacaine was injected in sacrum tube in group Ⅰ,0.5 μg/ml sufentanil mixed 0.25％ levobupivacaine and 1.0 μg/ml sufentanil mixed 0.25％ levobupivacaine were injected in sacrum tube in group Ⅱ and group Ⅲ respectively.The analgesia effect,the analgesia time,recover time and adverse reaction were observed and recorded 2,4,8,12,16,24 hours after the surgery.Results The analgesia effect in group Ⅱ、Ⅲ were significantly better than the group Ⅰ when 4、8、12 hours after the operation(P ＜0.05),and the analgesia effect in groupⅢ were significantly better than the group Ⅱ when 8 hours after the operation (P ＜ 0.05).There were no significant differences in three groups when 2、16、24 hours after the operation(P ＞0.05),the analgesia time in group Ⅱ、Ⅲ were significantly longer than the group Ⅰ (P ＜ 0.05),and the analgesia time in group Ⅲ were significantly longer than the group Ⅱ (P ＜ 0.05).There were no differences in the recovery time of three groups (P ＞ 0.05).There were no adverse reactions in three groups.Conclusions 0.5 μg/ml and 1.0 μg/ml sufentanil mixed 0.25％ levobupivacaine may be used on postoperative analgesia in pediatric caudal block anesthesia safely and analgesia effect and time were more better and longer than 0.25％ levobupivacaine singly.The analgesia effect in group with 1.0μg/ml sufentanil mixed 0.25％ levobupivacaine was the best in three groups with the fewest side effects.

WHO proposed the concept of intrinsic capacity in the World Report on Aging and Health in 2015.As the basis of functional ability in the elderly, intrinsic capacity plays an important role in maintaining the quality of life and promoting healthy aging.However, research on intrinsic capacity is still in its infancy.This article reviews research progress on intrinsic capacity, including the concept, domains, screening methods and its impact on the health of the elderly, in order to provide a reference for further research on this subject.

Objective: Our aim was to observe the protective effect of propofol in clinical relevant concentration on the peroxidative injured erythrocyte. Methods: Intravenous blood samples taken from 20 healthy adults were prepared for red blood cell (RBC) suspensions and divided equally into 5 groups: groupⅠfor control, group Ⅱ with hydrogen peroxide (H2O2, 100 mmol/L) -induced injury, and group Ⅲ, Ⅳ, Ⅴ with the same injury as the group Ⅱ but being pretreated with 3 different concentrations of propofol (25, 50, 75 μmol/L), respectively. The concentrations of potassium and malondialdehyde (MDA) in RBC suspensions and hemolytic degree after incubation were measured. Results: After 60-minute incubation, the extracellular potassium concentrations (0.16, 0.14, 0.14 mmol/L), MDA concentrations (5.66, 5.57, 6.20 nmol/L), and hemolytic degree (76.89%, 59.84%, 64.22%) decreased significantly in the groups that were pretreated with propofol as compared with the group Ⅱ (0.26 mmol/L, 9.19 nmol/L, and 100%), but no difference has been seen within the groups pretreated with 3 different concentrations of propofol and between the propofol-treated groups and the group Ⅰ(0.10 mmol/L, 4.13 nmol/L, 52.73%). Conclusion: Propofol in clinical relevant concentrations may decrease MDA production, hemolytic degree, and potassium exflux from erythrocyte in response to in vitro oxidative challenge with hydrogen peroxide and enhance erythrocyte antioxidant capacity. The protective effect is not related with concentrations.

Objective To detect stunned myocardium using low-dose dobutamine stress (DBS)combined with two-dimensional speckle tracking imaging (2D-STI),and to evaluate the difference and characteristics of mechanical parameters in different conditions between stunned myocardium and adjacent normal myocardium.Methods The acute myocardium ischemia/reperfusion (I/R) of anterior wall of left ventricle(LV) was induced with 60 minutes ligation of left anterior descending coronary artery (LAD),and with reperfusion of 120 minutes in 10 open-chest beagle dogs.Dobutamine was administered continuously via vein with two different dose of 5 μg · kg-1 · min-1 and 10 μg · kg-1 · min-1.At baseline,post ischemia/reperfusion,after the first DBS and the second,the gray-scale dynamic images of three cardiac cycle of left ventricular short axis at the levels of mitral annulus,papillary muscle and apex were acquired.The systolic peak of circumferential strain (CS),radial displacement (RD) of eighteen segments of subendocardium and subepicardium were analyzed by Speckle tracking workstation.LV end-systolic dimension(LVIDS),LV end-diastolic dimension (LVIDD),LV eject fraction (LVEF),heart rate (HR),aortic valve forward flow velocity time integral(AV-VTI) were also measured.Results ①There was no statistical significance (P ＞0.05) under the conditions of baseline,post I/R,the first DBS and the second for LVIDD,LVIDS,LVEF,HR and AV-VTI.②Compared with baseline,the peak systolic subendocardium and subepicardium CS,RD decreased significantly at the apex and middle of short-axis anterior wall of LV under the conditions of post I/R;The parameters of the first DBS was significantly increased compared with the I/R (P ＜ 0.05) ; There was no difference between the two DBS and baseline(P ＞0.05).The peak systolic subendocardium and subepicardium CS,RD at the bottom segment of LV were no statistical significance under the four conditions.③There was no difference for anterolateral wall and anterior septum of LV at the level of papillary muscle under the four conditions.Conclusions ①Low-dose DBS combined with two-dimensional speckle tracking imaging can detect stunned myocardium accurately.② After the occurrence stunning myoeardium,the peak systolic subendocardium RD decreased slightly,subepicardium RD was normal,the subendocardium CS of the surrounding myocardium was still normal,and the peak systolic subepicardium CS decreased to some degree.

Objective To investigate the effect of second generation antipsychotics (SGAs) on adiponectin (APN) and metabolic indicators and to explore the role of APN in the antipsychotic-induced weight gain (AIWG). Methods A total of 86 drug na?ve first episode schizophrenia patients and 88 sex-and age-matched healthy controls were collected. All patients received a single SGAs treatment for 8 weeks. In patient group, the level of weight, body mass index (BMI), waist-to-hip ratio (WHR), fasting plasma glucose (FPG), triglyceride (TG), total cholesterol (TC), APN and fasting insulin (FINS) were measured before and after 8-week treatment. While as the control group was only measured once after enroll?ment. Results The serum APN [(9.32 ± 0.76) μg/mL vs. (10.9 ± 0.66) μg/mL] was lower and FINS was higher [(20.27 ± 15.02)μIU/mL vs. (12.68±11.70)μIU/mL] in drug na?ve patients compared with healthy controls (P<0.05). After 8-weekSGAs treatment, patients showed significant increases in weight [(59.01 ± 10.56) kg vs. (63.80 ± 9.78) kg], BMI [(21.74 ± 3.57) kg/m2 vs.(23.49±3.44) kg/m2], WHR [(0.88±0.07) vs. (0.92±0.05)], TG [(0.94±0.92) mmol/L vs. (1.63±1.08) mmol/L] and FINS [(12.68 ± 11.70)μIU/mL vs. (20.27 ± 15.02)μIU/mL], and significant decreases in APN [(9.32 ± 0.76)μg/mL vs. (8.03±0.68)μg/mL] and FPG [(5.04±1.01) mmol/L vs. (4.46±0.57) mmol/L] (all P<0.05). In male patients, baseline APN levels were positively correlated with AIWG (r=0.548,P=0.005). Conclusion The serum APN levels in drug na?ve first episode schizophrenic patients are significantly lower than normal and are further decreased after SGAs treatment. Base?line APN may predict the AIWG in male patients.

Type 2 diabetes is a metabolic disease with increasing prevalence,which causes great socioeconomic burden.Intestinal flora is the microbiota located in the human intestines,which are participating in human growth and development,physiological procedures,or even pathogenesis as a closely connected environmental factor.There have recently been rapid progresses in the research on the relationship between intestinal flora and type 2 diabetes in the field of endocrinology and metabolism.In this article,we reviewed the overall framework and research progress in the relationship between intestinal flora and type 2 diabetes,aiming to shed some light on the future research about this topic.

Objective To investigate the interactive mechanism of dopamine and α-synuclein in SH-SY5Y cells,and to explore their effects on Parkinson's disease (PD).Methods The concentration of exogenous dopamine was definited by MTT method.The effect of exogenous dopamine on the expressions of α-synuclein and caspase-3 active fragments and malondialdehyde (MDA) content were detected by Western blot and commercial kit.Recombinant plasmid of wild-type α-synuclein was transfected into SH-SY5Y cells.Level changes in dopamine concentration,MDA content and expression of caspase-3 active fragment were observed.Furthermore,the effect of GBR12935,an inhibitor of dopamine transporter,on these outcomes were detected.Results Intracellular dopamine concentration was increased by 16 folds in SH-SY5Y cells which were added 300 umol/L exogenous dopamine for 24 hours as compared with blank controls (t=7.32,P＜0.01).Expressions of α-synuclein and caspase-3 active fragments and MDA content were increased in exogenous dopamine treated group as compared with blank controls (t=4.92,17.14,6.55,all P＜0.01).Intracellular dopamine concentration,MDA content and expression of caspase-3 active fragment were increased in SH-SY5Y cells transfected with recombinant plasmid of wild-type α-synuclein as compared with SH-SY5Y cells transfected with empty plasmid (F =32.97.107.80,55.54,all P＜0.01),whlie these increases could be partially inhibited by GBR12935.Conclusions Dopamine promotes the expression of α-synuclein,while over-expressed α-synuclein increases intracellular dopamine concentration,which forms a vicious cycle of cytotoxicity in SH-SY5Y cells.