Objective To investigate the effects of high flow hemodialysis (HFHD) on cardiac function in uremia patients. Methods A prospective randomized controlled study was conducted. Sixty patients who were diagnosed with uremia, taken maintenance hemodialysis (MHD) and 30 healthy controls admitted to the Second People's Hospital of Guiyang from December 2014 to June 2015 were enrolled. They were randomly divided into two groups:HFHD group (HFHD three times a week) and the routine hemodialysis group (HD group, HD three times a week), with 30 in each group. Patients in each group were received hemoperfusion and hemofiltration once a month. Before the treatment and 6 months after the treatment, venous blood from all the patients were collected for testing the brain natriuretic peptide (BNP), cardiac troponin T (cTnT) and the ultrasound cardiograph were done at the same period by a special person, the left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD), the left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), left ventricular posterior wall thickness (LVPWT), interventricular septum thickness (IVST), early and late diastolic blood flow to the largest ratio (E/A), left ventricular ejection fraction (LVEF), left ventricular mass index (LVMI) were recorded. Results Compared with the health control group, BNP, cTnT, LVEDD, LVESD, LVESV, LVPWT, IVST were significantly increased, LVEDV were significantly lowered before treatment in the HD group and HFHD group. But no significant differences in the above indexes and E/A, LVEF, LVMI between two groups were found. Compared with the data before treatment, the BNP, LVPWT were significantly lowered after treatment in HD group [BNP (ng/L): 641.50±60.09 vs. 2676.20±454.30, LVPWT (mm): 10.57±1.16 vs. 12.57±1.41, both P < 0.05]. The BNP, LVPWT were significantly lowered in HFHD group as compared with HD group [BNP (ng/L): 253.10±48.77 vs. 641.50±60.09, LVPWT (mm): 9.29±1.08 vs. 10.57±1.16, both P < 0.05]; in addition, the cTnT, IVST, LVMI were significantly lowered after the treatment in HFHD group compared with those before treatment [cTnT (μg/L): 0.014±0.005 vs. 0.028±0.011, IVST (mm): 7.81±1.69 vs. 11.04±2.23, LVMI (g/m2): 149.10±15.77 vs. 158.70±17.25, all P < 0.05], and the LVEF were significantly increased in HFHD group as compared with those before treatment (0.574±0.068 vs. 0.528±0.082, P < 0.05). Conclusion HFHD has obvious advantages than the routine HD in improving cardiac function of uremia patients.

OBJECTIVETo compare therapeutic effects of locking plates for the treatment of Neer 3-and 4-part proximal humerus fractures.

METHODSFrom January 2009 to June 2011, 64 patients with Neer 3-and 4-part proximal humerus fractures were treated with locked plate fixation. There were 39 patients in the 3-part group including 16 males and 23 females, with an average age of (55.12 +/- 12.52) years old; and 25 patients in the 4-part fractures group including 9 males and 16 females,with an average age of (57.92 +/- 13.14) years old. The American Shoulder and Elbow Surgeons score (ASES), visual analogue scale (VAS) and complications were documented for analysis before and after treatment.

RESULTSAll the patients had incision healing at the first stage. All the patients were followed up, and the duration ranged from 12 to 30 months, with a mean of 16.5 months. Comparably better shoulder function recovery was achieved in the 3-part fractures group with regard to the ASES (76.14 +/- 14.10 in the 3-part fractures group vs. 65.93 +/- 11.82 in the 4-part fractures group, P < 0.05). Moreover,a statistical difference (P < 0.05) was observed regarding the VAS pain score (2.12 +/- 1.63 in the 3-part fractures group vs. 3.90 +/- 2.21 in the 4-part fractures group). For the complications rate,no statistical difference was noted between 3-part fractures group and 4-part fractures group (20.51% vs. 36.00%).

CONCLUSIONThe clinical outcomes of the 3-part proximal humerus fractures is better than the 4-part fractures proximal humerus fractures treated with locking plate. Complex proximal humeral fractures treated with locking plates can be achieved a satisfactory outcome when attention is paid to anatomic reduction, stable fixation, proper screws and plate placement, and reasonable functional exercise postoperative.

Adult ; Aged ; Aged, 80 and over ; Bone Plates ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Shoulder Fractures ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed ; Treatment Outcome

Objective To investigate the association between serum homocysteine (Hcy) level and oxidative stress in elderly patients with obstructive sleep apnea/hypopnea syndrome (OSAHS). Methods The 123 patients from January 2007 to June 2010 were recruited and divided into the elderly OSAHS group (n=55) and the non-elderly OSAHS group (n=68). One hundred healthy subjects were selected and divided into the elderly control group (n=52) and the non-elderly control group (n=48). The PSG variables were recorded and the levels of Hcy, malondialdehyde (MDA) and glutathione (GSH) were detected after sleep in all subjects. Serum Hcy level was measured by cyclophorase, MDA and GSH levels were measured by spectrophotometer. Results There were statistical differences in Hcy concentration between four groups (F=28.26, P=0.000). The Hcy concentration was higher in elderly OSAHS group than in other groups, and was higher in elderly control group than in non-elderly control group, and was higher in non-elderly OSAHS group than in non-elderly control group. There were statistical differences in MDA and GSH concentrations between the four groups (F=5.56, P=0.002;F=4.79, P=0.004). The concentrations of MDA and GSH were higher in elderly OSAHS group than in other groups. Multiple regression analysis indicated a statistically significant relationship of Hcy concentration with age, MDA, GSH and AHI (β=0.07, 0.50, 0.23 and 2.00). Conclusions The concentration of Hcy increases and oxidative stress enhances with aging, especially in the elderly patients with OSAHS. The mechanism of high level of serum Hcy in elderly patients with OSAHS may be the high oxidative stress.

Objective To determine the utility of diffusion-weighted magnetic resonance imaging ( MR DWI ) in detecting tumor necrosis with histological correlation after neoacljuvant chemotherapy. Methods Conventional MRI and DWI were obtained from 36 patients with histological proven esteosarcoma. Magnetic resonance examinations were performed in all patients before and after 4 cycles of preoperative neoadjuvant chemotherapy. Apparent diffusion coefficients (ADC) were calculated. The degree of tumor necrosis was assessed using the histological Huvos classification after chemotherapy. T-test was performed for testing changes in ADC value between the 2 groups. P value less than 0. 05 were considered as a statistically significant difference. Results The differences in ADC between viable [ (1.06±0. 30) ×10-3mm2/s ] and necrotic [ (2. 39±0. 44 )×10-3mm2/s] tumor were significant (t= 3. 515,P<0. 05). Changes in ADC value was greater in good responses to neoadjuvant chemotherapy than in poor responses, the ADC value in good responses was increased from (1.18±0. 19)×10-3mm2/s to (2. 27±0. 20)×10-3mm2/s, the corresponding value in poor responses was increased from (1.45± 0.11)×10-3mm2/s to (1.83±0. 16)×10-3mm2/s, There was significant difference in changes of ADC values between good responses and poor responses ( t = 4. 981, P < 0. 01 ). Conclusion Diffusion-weighted MRI permits recognition of tumor necrosis induced by chemotherapy in osteosarcoma. DWI is correlated directly with tumor necrosis. They have potential utility in evaluating the preoperative chemotherapy response in patients with primary osteosarcoma.

Objective To explore the operative methods and clinical outcomes in emergency or sube- mergency repair for the complicated tissue defects in hand in first stage applying microsurgical technique. Methods From Jan.,2000 to Aug.,2005,49 emergency cases of complicated hand tissue defects were re- paired in the first stage with replantation,reconstruction,free flaps,combined finger reconstruction and flap transplantation,including 21 cases in mini tissue mass replantation or reconstruction,15 cases in replantation combined with free flap transplantation,8 cases in replantation and reconstruction combined with free flap transplantation,5 cases in combined multiple digits reconstruction with free flap transplantation.The free flap transplantation included the anterolateral femoral flap,the latissimus dorsi myocutaneous flap,the dorsalis pe- dis flap,the media pedis flap and the instep flap.Results All the flaps,the replanted and reconstruceted finger survived uneventfully except for one replanted finger necrosis.45 cases healed in the first stage and the other 4 cases healed in the second stage.During a follow-up from 6 months to 3 years postoperatively,a satis- factory appearance and function of the reconstructed hand was achieved.The excellent and good rate was 85.7% assessed with provisional functional assessment criterion for upper limbs issued by Chinese Society of Hand Surgery.Conclusion The emergency or subemergency repair for the complicated tissue defects in hand has the advantage of short-term treatment and desirable functional outcome.The emergency replantation and reconstruction combined with various flaps or tissue mass can be applied to repair tissue defect in hand in the first stage according to the position and area of the defect along with the technique level of the surgeon, having been proved to achieve desirable clinical outcomes.And the key points leading to a successful operation is the correct treatment for the raw surface of the defects,suitable choice for various flaps,logical design of combination pattern and prevention and timely treatment for vessel crisis.

Objective To study the recovery of the peripheral lymphocyte subsets in patients underwent allogeneic peripheral blood stem cell transplantation (allo-PBSCT) and guide the prevention and treatment of infection. Methods Indirect immunofluorescence assay was used to detect the lymphocyte subsets, such as T cell subsets (CD3, CD4, CD8). B cell (CD19) and natural killer cell(CD56) at 1, 3, 6, 12, 18months post transplantation, in the meantime, lymphocyte subsets of 32 samples from healthy blood donors were tested as normal control values. Results CD+3, CD+4 and CD+8 ceils significantly decreased than that of normal control at 1 month post transplantation, the recovery of CD+3 T cells was within 3-12 months, CD+4 and CD+8 T cells recovered to normal at 6 months and 3 months post transplantation respectively, CD+4/CD+8 ratio were not significantly lower than that of normal control at different stages, CD+4/CD+8 ratio reversed only at 6 months post transplantation. CD+19 and CD +56 T cells recovered quickly and they were more than normal proportion at 3 months post transplantation. The CD+3, CD+8 T cells and CD+4/CD+8 ratio were statistically higher in HLA haploidentical allo-PBSCT patients than that in HLA identical allo-PBSCT at 3 months post transplantation. There were no difference between the two groups at 1, 6, 12, 18 months post transplantation.The patients with cGVHD had significantly higher CD+4 cells than those without cGVHD at 1 month after transplantation. There was no significant difference in all of the lymphocyte subsets at 3, 6, 12, 18 months after transplantation between them. Conclusion Allo-PBSCT has a hastened immune reconstitution, which was not delayed by the incompatibility of HLA and the development of cGVHD.

Objective To evaluate preventive effect of semireclining and alternately lateral recumbent position on ventilator associated pneumonia.Method Fifty-fiv patients requiring mechanical ventilation for more than 48 hours were randomly divided into two groups 28 in semireclining with ahemately lateral recumbent position group and 27 in only semireclining group.Chest physiotherapy was carried out simultaneously in two groups.The secretion in lower respiratory tract was regularly cullected for quantitative cultures of microbiology.Results There were no significant differences between groups on gender,age,Acute Physiology and Chronic Health EvaluationⅡscore,risk factors for VAP.VAP occurred in 6 of 28 patients in the semireclining and alternately lateral recumbent position group and in 11 of 27 in the semireclining group (P0.05).Conclusions Semi-reclining with alternately lateral recumbent position can reduce aspiration and postural drainage that can decrease VAP rate and shorten duration of mechanical ventilation and ICU stay.

Animals ; Behavior, Animal ; drug effects ; Biogenic Monoamines ; metabolism ; Brain ; drug effects ; metabolism ; Dose-Response Relationship, Drug ; Female ; Formaldehyde ; toxicity ; Maze Learning ; drug effects ; Mice ; Mice, Inbred BALB C

To study the condensation mechanism of sodium new houttuyfonate, and determinate the chemical structure of condensation products, dimer was prepared, and LC-DAD-MS/MS multiple techniques were employed to investigate the ultraviolet absorption feature and mass spectrum of transformation solution of dimer, and the transformation kinetics and half-life were studied by ultraviolet spectrophotometry. The pure substance of stable condensation product was obtained by extracting with organic solvent and purifying with column chromatography, the chemical structure of this substance was identified by assaying of IR, HR-ESI-MS and NMR, and the data of LC-MS/MS were compared with that of transformation products of dimer. The results indicated that the dimer is unstable, it will be rapidly dissociated in aqueous solution to form free new houttuyfonate and then cycloaddition reaction will occur and followed by an in situ dehydration to generate 1, 3, 5-tri (dodecanoyl) benzene (trimer) with a six-ring which is stable in aqueous solution. The transformation process may fit second-order kinetics, and the half-times were found to be 3.17 hours at 25 degrees C (298 K) and 6.39 min at 100 degrees C (373 K), separately. It suggests that dimer is an intermediate in condensation reaction, and the end condensation product of sodium new houttuyfonate injection may exist as trimer.
Alkanes ; chemistry ; pharmacology ; Chromatography, Liquid ; Molecular Structure ; Pharmaceutical Preparations ; analysis ; Sulfites ; chemistry ; pharmacology ; Tandem Mass Spectrometry

A cross-sectional survey with multiple-stage and random sampling was performed among middle and elderly aged permanent inhabitants in Wuhan area.The prevalences of metabolic syndrome,diabetes mellitus, impaired glucose tolerance,hypertension and obesity were 12.2%,11.8%,10.3%,31.9% and 48.0% respectively.