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 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.

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.

砄bjective: To assess interexaminer errors in traditional cephalometric analysis so as to improve the accuracy . Methods : Ten cephalometric radiographs were selected randomly and 12 angular and 5 liner parameters were measured by 5 orthodontists in one week according to the original landmarks. The results were quantified with that of computer based. Results: The mean errors of some measurements were larger than 0.5, such as SL,GoGn SN, SE,FMA,FMIA,OP SN, 1 1 ,IMPA and SNA,while only those of SL and GoGn SN were larger than 1.0. Conclusion: Statistical significant differences are found in the The errors of measurements which need assisted line among the examiners but not found in the errors between angle measurements and liner measurements?

[Objective]To evaluate the results of treatment with arthroscope and high tibial osteotomy with fixation of staple made of retention alligation for osteoarthritis of the knee,and to discuss the indication for this technique.[Method]From March 1999 to May 2003,42 arthroscopic treatment and high tibial osteotomies were performed in 34 patients.There were 6 men(8 knees)and 28 women(34 knees,with a mean age of 54.2 years(ranged,42～67 years.The average postoperative follow-up was 36 months(ranged,16～44 months.The indications for high tibial osteteotomy were unicompartmental osteoarthritis and varus malalignment.After arthroscopic treatment,a lateral closing-wedge osteotomy was performed with fixation of staple made of retention alligation.The arthroscopic examination showed:plica synovialis in l0 knees,medial meniscus injuries in 12 knees,lateral meniscus injuries in 6 knees,articular cartilage injuries in 20 knees,body loose in joint in 7 knees,intercondylar fossa stenosis in 9 knees.Common peroneal nerve was not exposed and the periosteum opposite to the insicion position was left intact for sake of stability and acted as a hinge around which the wedge osteotomy was closed.The patients were reexamined to obtain a knee score,to make lateral andanteroposterior radiograph of the involved knee with the patient standing.[Result]During the follow-up,the patients showed satifying pain relief,improvement of joint function,correction of yams deformity.The average preoperative knee score was 53.714?6.7,The average postoperative knee score at the time of the latest follow-up was 91.02?7.7.Comparing preoperative with postoperative,there were significant differences(P

The patients with systemic inflammatory reaction syndrome had high possibility to get euthyroid sick syndrome, which happened more frequently and severely in patients with multiple organ dysfunction syndrome, reflecting that inflammation or cytokines may affect the hypothalamic- pituitary-thyroid axis.

Objective:To determine the differences of age, eruption sequence and gender of permanent teeth in children and adolescents in Xi'an, China. Methods:Cross-sectional data on permanent teeth eruption were collected from children aged 3~15 in pre-school, primary and secondary school. The subjects were drawn by multistage random sampling from the school registers. There were 6 712 subjects involved in present survey, including 3 604 boys and 3 108 girls. The data were subjected to probit regression analysis. Results:The median age of tooth eruption in girls was earlier than that in boys. Although the range of years during which the permanent teeth erupted was similar in both sexes, i.e. 6~12 years, the sequence of the tooth eruption was differed. All mandibular teeth, with the exception of first and second premolars in both males and females, tended to erupt earlier than their maxillary counterparts. Conclusion:The findings seem to be different from earlier studies done in the other parts of China.