Child ; Diarrhea ; diagnosis ; therapy ; Humans

Hypoxic preconditioning (HPC) refers to exposure of organisms, systems, organs, tissues or cells to moderate hypoxia/ischemia that is able to result in a resistance to subsequent severe hypoxia/ischemia in tissues and cells. The effects exerted by HPC are well documented. The original local in situ (LiHPC) is now broadened to remote ectopic organs-tissues (ReHPC) and extended crossly to cross pluripotential HPC(CpHPC) induced by a variety of stresses other than hypoxia/ischemia, including cancer, for example. We developed a unique animal model of repetitive autohypoxia in adult mice, and studied systematically on the effects and mechanisms of HPC on the model in our laboratory since the early 1960s. The tolerances to hypoxia and protection from injury increased significantly in this model. The adult mice behave like hypoxia-intolerant mammalian newborns and hypoxia-tolerant adult animals during their exposure to repetitive autohypoxia. The overall energy supply and demand decreased, the microorganization of the brain maintained and the spacial learning and memory ability improved but not impaired, the detrimental neurochemicals such as free radicals down-regulated and the beneficial neurochemicals such as adenosine(ADO) and antihypoxic gene(s)/factor(s) (AHGs/AHFs) up-regulated. Accordingly, we hypothesize that mechanisms for the tolerance/protective effects of HPC are fundamentally depending on energy saving and brain plasticity in particular. It is thought that these two major mechanisms are triggered by exposure to hypoxia/ischemia via oxygen sensing-transduction pathways and HIF-1 initiation cascades. We suggest that HPC is an intrinsic mechanism developed in biological evolution and is a novel potential strategy for fighting against hypoxia-ischemia and other stresses. Motivation of endogenous antihypoxic potential, activation of oxygen sensing--signal transduction systems and supplement of exogenous antihypoxic substances as well as development of HPC appliances and HPC medicines such as AHFs are encouraged based on our basic research on HPC. HPC may result in therapeutic augmentation of the endogenous cytoprotection in hypoxic-ischemic or suffering from other diseases' patients. Evolutionary consideration of HPC and clinical implications of HPC are both discussed to guide future research. The product of AHF is expected to be one of the most effective first aid medicines to rescue patients in critical condition. HPC is beginning to be used in surgery and is expected to be developed into a feasible adaptive medicine in the near future.
Animals ; Brain ; physiology ; Disease Models, Animal ; Hypoxia, Brain ; physiopathology ; Hypoxia-Inducible Factor 1 ; Ischemic Preconditioning ; Mice ; Signal Transduction

Objective To study the chemical constituents in the seeds of Euphorbia lathyris.MethodsCompounds were isolated by methods of column chromatography(silica gel,including reversed phase),Sephadex,and recrystallization.On the basis of spectroscopic methods including IR,MS,NMR,and X-ray,structures of compounds were confirmed.Results Twenty-two multi-type compounds were isolated from ethanol extract in the seeds of E.lathyris.Their structures were identified as 5,15-O-diacetyl-3-O-phenyl-6(17)-epoxylathyrol(1),5,15-O-diacetyl-3,7-O-dibenzoyl-7-hydroxylathyrol(2),5,15-O-diacetyl-3-O-benzoyl-lathyrol(3),20-O-hexadecanoyl-ingenol(4),3-O-hexadecanoyl-ingenol(5),15,17-O-diacetyl-3-O-cinnamoyl-17-hydroxyjolkinol(6),5,15,17-O-triacetyl-3-O-benzoyl-17-hydroxyisolathyrol(7),5,15-O-diacetyl-3-O-nicotinoyl-lathyrol(8),5,15-O-diacetyl-3-O-benzoyl-7-O-nicotinoyl-7-hydroxy-lathyrol(9),ingenol(10),lathyrol(11),esculetin(12),?-sitosterol(13),benzene-1,2,3-triol(14),palmiticacid(15),2,3-dihydroxypropyl icosanoate(16), 2,3-dihydroxypropyl oleate(17),2,3,4-trihydroxybutyl hexadec-3-enoate(18),aurantianide acetate(19),benzoic acid(20),p-hydroxybenzoic acid(21),oleic acid(22).Conclusion Among these,compounds 10,11,1419 are obtained from this plant for the first time and compounds 1-3 are the main diterpenes.

Objective To investigate the CT and MRI features of the autoimmune pancreatitis (ALP).Methods CT and MRI data of fourteen patients with AIP who were confirmed by histology and/or steroid therapy were retrospectively analyzed.Ten patients underwent CT examination, and seven patients underwent MRI, while three patients underwent both CT and MRI examinations.Results It was showed that diffuse (n =11 ) or local ( n = 3 ) enlargement of pancreas.CT features showed that the hypoattenuation pancreatic lesions on unenhanced CT (n = 10);segmental pancreatic duct could be seen in five patients;stenosis of common bile duct in the head of pancreas was observed in 5 patients;the capsule-like structure around lesions was seen in seven patients.Delayed homogeneous enhancement was showed on enhanced CT.MRI features included homogeneous ( n = 3) and heterogeneous ( n = 4) hyperintense on T1 WI with fat-suppression images and homogeneous ( n = 3 )and heterogeneous (n =4) hyperintense on T2WI with fat-suppression images.Pancreatic duct could be seen in four patients.MRCP showed pancreatic duct stenosis in the head of pancreas ( n = 1 ) and segmental pancreatic duct (n = 2).Stenosis of common bile duct in the head of pancreas was showed in 5 cases.The capsule-like structure around lesions was showed in seven patients.No pancreatic calcification was revealed, and no significant pancreatic duct dilation was detected ( ＞3 mm) in all 14 patients.Conclusions The CT and MRI manifestations of AIP had characteristic features such as sausage-like changes of the pancreas, capsule-like structure around the lesions, diffuse or local pancreatic duct stricture, and stenosis of common bile duct in the bead of pancreas.

Objective To investigate the clinical results and prognosis between proximal and total gastrectomy in proximal advanced gastric cancer.Methods The clinicopathological data of 221 patients with proximal advanced gastric cancer who undcrwent radical gastrectomy were retrospectively analyzed.82 patients and 139 patients underwent proximal and total gastrectomy respectively.The number of dessected lymph nodes,postoperative complications and mortality were compared.Kaplan-Meier survival rate curves and Log-rank test were drawn and compared.Results A total of 1 411 (11-34) and 3 345 (14-35) lymph nodes were harvested from the surgical specimens of 82 and 139 patients with proximal and total gastrectomy respectively,the average number of harvested lymph nodes was 17 ± 11 and 24 ± 10 (t =2.586,P ＜0.05).The overall complications in proximal gastrectomy were higher than total gastrectomy (73.2％ vs.30.2％,x2 =38.291,P ＜0.01).The ratio of functional delayed gastric emptying,anastomotic leakage and stenosis,reflux esophagitis in proximal gastrectomy patients was higher than total gastrectomy.The survival rate in proximal gastrectomy were lower than total gastrectomy in proximal advanced gastric cancer (P ＜0.01).Conclusion Total gastrectomy is recommended for proximal advanced gastric cancer.

Objective To explore related influencing factors for postoperative delirium in elderly patients, to provide a reference for the prevention and treatment. Methods Fifty-four patients with delirium after surgery were used as observa?tion group, and a total of 150 subjects with no delirium after surgery during the same period were selected as the control group. Data of age, gender, malnutrition, disorders of water and electrolyte metabolism, postoperative mechanical ventilation, postoperative hypoxemia, severe infection and postoperative pain degree, and the combination of basic diseases were com?pared and analysed between two groups. The binary logistic regression analysis was used to analyse the influencing factors of postoperative delirium. The outcome and prognosis were observed and analyzed in observation group. Results The average age was significantly higher in observation group than that of control group (P<0.05). The percentages of postoperative hy?poxemia and severe infection were significantly higher in observation group than those of control group ( P<0.05). Patients with higher age, postoperative hypoxemia and severe infection were risk factors for postoperative delirium. In observation group,1 case died of lung infection, 1 case died of multiple organ failure, the remaining 52 patients were improved and dis?charged from hospital after three months. Conclusion For patients with higher age, postoperative hypoxemia and severe in?fection are the risk factors for occurrence of postoperative delirium. More attention should be paid to clinical preoperative and postoperative periods.

AIM: To assay the pattern of thyroid hormone alternations in systemic inflammatory response syndrome (SIRS) patients. METHODS: 50 SIRS patients were enrolled, divided into two groups as to whether they got MODS. Thyroid hormone measurements were taken, including total T_3 (TT_3), total T_4 (TT_4), free T_3 (FT_3), free T_4 (FT_4) and TSH. The acute physiology and chronic health evaluationⅡ (APACHEⅡ) score was calculated according to clinical data. Outcome (recovery or deterioration) was recorded, as well as the length of time from the onset of SIRS to the day when thyroid hormones were measured (the duration of SIRS). RESULTS: Euthyroid sick syndrome (ESS) was presented in 45 cases. TT_3 level was negatively correlated with APACHEⅡscore (r=-0.330, P0.05). CONCLUSION: SIRS patients has high possibility to get ESS, which happens more frequently and severely in MODS patients. With the persistence and aggravation of SIRS, there is a progression of thyroid hormone reduction.

Objective To study the effects of resin absorptive devices combined with hemodialyzer in series treatment for patients with uremia.Methods Sixty maintenance hemodialysis patients with uremia were randomly divided into two groups: the experimental group and control group. The patients in experimental group were given the treatment for traditional hemodialysis two or three times a week,combined with the treatment for resin absorption twice a month.The patients in the control group were only given the treatment for traditional hemodialysis two or three times a week.The middle molecular substance(MMS),beta(2) microglobulin(?_2-MG),blood urea nitrogen,creatinine,albumin,globulin,the counts of red blood,hemoglobin,the change of blood pressure and clinical manifestation of the patients were observed before and three months after the treatment respectively.Results The rates of clearance of MMS and ?_2-MG were significantly higher in the experimental group than those of the control group(P

Dyspnea ; diagnosis ; Humans ; Inhalation

Adolescent ; Antibodies, Antinuclear ; blood ; Child ; Female ; Humans ; Sjogren's Syndrome ; diagnosis ; immunology ; therapy