Objective To observe the change of gastric mucosal-arterial partial pressure of carbon dioxide gap [p(g-a)(CO2)] in septic shock rabbit.Methods Sixteen anesthetized and mechanically ventilated rabbit were randomly assigned to 2 groups:shock group(n=8) and control group(n=8).The rabbit in shock group were challenged with intravenous injection of 2 mg/kg Lipopolysaccharides from Escherichia coli.The rabbit in control group were intravenous injection of normal saline solution.Mean arterial pressure(MAP) and heart rate were continuously recorded by multichannel physiologic recorder.Cardiac index(CI) and superior mesenteric blood flow index(SMBFI) were continuously monitored by doppler flowmeter.Gastric mucosal partial pressure of carbon dioxide [pg(CO2)] was evaluated by gas tonometry every 10 min.Arterial and venous blood gas analysis,hemoglobin,and lactate levels were measured every 1 hour.Results The parameters remained stable in control group,but the parameters changed significantly in shock group.Compared with baseline levels,2 hours after Lipopolysaccharides infusion in shock group,MAP decreased from(78?5) mmHg to(50?2) mmHg(1 mmHg=0.133 kPa)(F=145.3 P

Objective To investigate the feasibility and clinical effectiveness of interventional ventricular septal defect(VSD) occlusion using asymmetric occluders in patients whose VSD are adjacent to aortic valves.Methods One hundred and fifty-two patients from our hospital whose VSD were occluded with asymmetric occluders were examined by echocardiography.Dimensions,shapes and shunts of VSD,structures around defects were observed and aortic valve prolapse(AVP) degrees were accessed before the interventions.The patients were followed up periodically after the procedures.The longest follow-up was 6 years.Results Sizes of VSD measured from left ventricular side were larger than those measured from right ventricular side.Twenty-seven cases with VSD had mild AVP.Right sides of defects had adhesions with variable morphological patterns in 85% patients with perimembranous VSD.After occlusion,there were 7 cases showed residual shunt,2 cases with the third degree atrio-ventricular blockages,3 cases appeared aortic-valve regurgitations (AR) and 1 case with slightly increased AR.Conclusions Immediate and medium-term effects of interventional occlusion with asymmetric occluders were satisfactory in the patients with VSD and mild AVP whose aortic valve margin were insufficient to symmetric occluders.Surgical operation should be preferred to patients with VSD and moderate to severe AVP and to very young children.Pre-closure echocardiographic evaluation is critical to the success of interventional closure with asymmetric occluder and the long-term out coming.

AIM: To study the chemical components from the bioactive extract of Chuanminshen violaceum Sheh et Shan in Sichuan province. METHODS: The isolation and purification of this extract were conducted by means of silica gels column chromatography.The structures of the compounds were elucidated based on their physical,chemical features and spectrum data. RESULTS: 8 compounds were isolated from the extract.They were elucidated as hexadecanoic Acid(A),2,6-dimethoxybenzoic acid(B),succinic acid (C),combination of sigmasterol and sitosterol(1(∶)1)(D),chrysophanol(E),8-hydroxy-5-methoxypsoralen(F),4-hydroxy-3-methoxybenzoic acid(G) and stigmasteryl 3-O-?-D-glucopyranoside(H). CONCLUSION: Compounds B,C,E,G were isolated from Chuanminshen violaceum for the first time.

Objective To evaluate the efficacy and safety of a new drug,human urinary kallidinogenase,against acute brain infarction.Method A 15-center,randomized,double-blinded and 3:1 placebo-controlled study was carried out.Acute brain infarction within 48 hours of onset in the territory of the middle cerebral artery were indicated as subjects;kallidinogenase or placebo which was dissolved in 50 ml saline,was slowly injected intraveousely within 30 minutes daily for 3 weeks.The European Stroke Scale and Barthel Index were used to evaluate the neurological deficit and the activities of daily living(ADL),followed by a follow-up at the end of the third month.Results 446 patients were enrolled,who completed ITT analysis,including 330 in kallidinogenase group and 116 in placebo group,meanwhile 421 proceeded with PP analysis(311 and 110 respectively).There were no significant differences of the baseline data between the 2 groups.At the end of treatment,the ESS scores increased by 55.1%?33.0% and 44.7%?32.8% respectively in kallidinogenase group(KG)and placebo group(PG,P=0.0022),the difference being significant.PP analysis had similar results.As for ADL,follow-up 90 days after the treatment showed 374 cases followed,280 in KG and 94 in PG;1 died in PG,while none in KG.In KG,the cases whose BI≥50 were significantly more than those in PG(P=0.0228).Adverse events possibly or definitely attributable to the drug were observed in 27 cases(7.74%),mostly were mild,such as palpitation,flush,dizziness, nausea etc,without special management needed.Only 2 died which was confirmed not correlated to kallidinogenase,and another 2 cases of sudden blood pressure drop were observed.The blood pressure drop, quickly restoring soon after the withdrawal of kallidinogenase and use of hemopiesic drugs,was considered to be caused by the combination use of anti-hypertensive drug ACEI and quick infusion speed.Conclusion Kallidinogenase is efficacious for acute brain infarction in improving the neurological deficits,which is safe in clinical use.

Adolescent ; Adult ; Anemia, Aplastic ; etiology ; therapy ; Benzene ; poisoning ; Bone Marrow Cells ; drug effects ; pathology ; Female ; Humans ; Male ; Occupational Diseases ; etiology ; therapy ; Occupational Exposure ; adverse effects

Objective To study the national surveillance results and learn the current situation of iodized salt consumption at household level in 2008, and to find out the remaining problems and to provide scientific basis for developing control strategies against iedine deficiency disorders. Methods In 2008, in accordance with the requirements of the "National Iodine Deficiency Disorders Surveillance Program (Trial)", the surveillance was conducted at county level in 31 provinces and at division level in Xinjiang Production and Construction Corps. In each county 9 townships were randomly selected according to their sub-area positions of east, west, south, north and center;4 villages were randomly sampled in each chosen township;8 households were randomly selected in each chosen village. In every county with 9 or less townships, 1 township was randomly selected respectively in the east, west, south,north and center sub-areas;4 villages were randomly sampled in each chosen township;15 households were randomly selected in each chosen village. Edible salt from these households was collected. Iodized salt coverage rate, proportion of qualified iodized salt and consumption rate of the qualified iodized salt of the households in each province were counted and analyzed. Iodized salt was determined by direct titration;the salt samples from Sichuan and other enhanced salt were detected by arbitration. Results Totally 2817 counties (districts, cities, banners) and 14 divisions of the Xinjiang Production and Construction Corps reported the monitoring results, monitoring coverage reached 99.96%(2831/2832). Mean of iodine content was 31.51 mg/kg.Sixteen provinces had a variation coefficient of iodine content for more than 20%. A total of 826 968 households were tested of their edible salt, in which iodized salt 798 725 copies, non-iodized salt 28 243 copies, and unqualified iodized salt 20 270 copies. Weighted by population,at national level, the coverage rate of iodized salt was 97.48%, qualified rate of iodized salt 97.16%, and consumption rate of qualified iodized salt was 94.79%.Twenty seven provinces (autonomous regions and municipalities) and Xinjiang Production and Construction Corps had a qualified iodized salt coverage rate of above or equal 90.00%. Tibet, Hainan, Xinjiang and Tianjin provinces (regions) had a qualified iodized salt coverage rate lower than 90.00%. Further, 2487 counties had the rate high or equal 90.00% accounting for 87.82% (2487/2831) of complementing monitoring counties. One hundred and four counties and 1 division of the Xinjiang Production and Construction Corps had the coverage rate of iodized salt below 80.00%. Conclusions Sixteen provinces(autonomous regions and municipalities) have relatively a high degree of variation coefficient in salt iodine content. The quality of iodized salt needs to be improved. The coverage rate of iodized salt and the qualified iodized salt at national level are both above or equal 90.00%. However, the non-iodized salt problem is still serious and have a relatively lower coverage of iodized salt in Tibet, Hainan and Xinjiang.

Objective To understand the current level of iodized salt coverage in areas with intensified monitoring measure in China in 2008. Methods In accordance with the "National Iodine Deficiency Disorders Surveillance Program (Trial)" of Ministry of Health issued in 2007, the selected key counties (cities, districts and banner) were divided into 5 sub-areas, 1 non-iodine townships(towns, street offices) was sampled randomly in each sub-area, 4 administrative villages (neighborhood committees) were sampled from each selected township;15households salt samples in each selected village were randomly collected. All salt samples were detected by semiquantitative kit at first. The salt samples that can not be determined by the kit were tested by direct titration and the arbitration act (GB/T 13025.7-1999) detection. Iodized salt determination criteria: reagent color change in semiquantitative test kit or iodine content ≥ 5 mg/kg were identified as iodized salt. Otherwise, the salt samples were identified as non-iodized salt. Results All the provinces(autonomous regions, municipalities) except Tibet in China had conducted a specific survey on iodized salt coverage in non-iodized salt high-risk areas, which revealed that the national coverage rate of iodized salt was 93.01%(130 928/140 770). At the provincial level, twenty provinces and the Xinjiang Production and Construction Corp had a iodized salt coverage over 90%, while the other six provinces (Beijing, Xinjiang, Zhejiang, Fujian, Tianjin and Jiangxi) between 80% - ＜ 90% and the rest four provinces,such as Guangxi, Qinghai, Guangdong and Hainan, lower than 80%. At the county level, 64.57%(277/429) of all the surveillance counties had a iodized salt coverage over 95% while 10.02%(43/429) lower than 80%. Among all the six types of areas where specific survey were conducted, areas with incomplete iodized salt distribution network and areas with crude salt production had a iodized salt coverage lower than 90%, 81.74%(4978/6090) and 86.53%(17 098/19 759), respectively. In raw salt production area, there were 10 out of 21 provinces with iodized salt coverage rate below 90%, it consisted of 47.6%(10/21) of the total monitoring provinces in the same type areas.There were 8 out of 16 provinces with iodized salt coverage rate lower than 90% in the areas with faultiness iodized salt network, it consisted of 50.0%(8/16) of the sampling provinces in the same type area. Conclusions Most provinces(21) in China have a relatively high iodized salt coverage at household level during this specific survey.Areas with incomplete iodized salt distribution network and crude salt production are the most affected areas by noniodized salt. Aiming at the high-risk non-iodized salt areas discovered during this survey, corresponding intervention measures should be implemented with joint efforts from sectors concerned.

OBJECTIVETo explore the effect of the treatment for long-term disease-free survival (DFS) of post-remission patients with acute myeloid leukemia (AML).

METHODSTwenty-nine AML patients with completely remission (CR) and 17 with partial remission (PR) were treated with Chinese medicine, Longchan Cigu Decoction 1 dose per day and Lingxiong Piaoling Powder 7 doses per month, and combined with DA or HA regimen of chemotherapy one course per year. Patients peripheral blood picture, bone marrow smear, biopsy and human leukocyte antigen DR (HLA-DR) cells were examined before and after treatment, and their disease-free survival (DFS) was followed up.

RESULTSAfter treated with above mentioned treatment for 2 months, percentage of patients with normal peripheral blood count increased, including patients with WBC > or = 4.0 x 10(9)/L raised from 46% to 70%, with Hb > or = 120 g/L from 17% to 46% and with PLT > or = 100 x 10(9)/L from 63% to 85%; nucleated cell volume in bone marrow increased from 35.83 +/- 28.42% to 60.46 +/- 17.73% (P < 0.01); HLA-DR cell was also increased significantly from 10.55 +/- 4.95% to 14.84 +/- 4.94%, (P < 0.01); while the residual leukemia cells were not increased in one year, from 5.90 +/- 5.09% before and 5.82 +/- 2.42% after treatment (P > 0.05). The maximal DFS in patients was 123 months. The 3-year survival rate was 64.15 +/- 1.96% and 5-year survival rate was 51.19 +/- 16.25%.

CONCLUSIONThe integrative Chinese and western medicine treating program used in this study is beneficial for the long-term treatment of AML patients after complete remission.

Adolescent ; Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Child ; Child, Preschool ; Disease-Free Survival ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Leukemia, Myeloid, Acute ; drug therapy ; Male ; Mercaptopurine ; administration & dosage ; Methotrexate ; administration & dosage ; Middle Aged ; Phytotherapy ; Remission Induction ; Survival Rate

OBJECTIVETo investigate the clinical manifestations, pathological characteristics, and treatments of urothelial-type mucinous adenocarcinoma of the prostate (UMAP).

METHODSWe reported a case of UMAP, reviewed relevant literature, and analyzed the clinicopaothological features, diagnosis, treatment, and prognosis of the disease.

RESULTSThe patient was a 60-year-old male and underwent transurethral resection of the prostate for dysuria. Postoperative pathology indicated mucinous adenocarcinoma and sigmoidoscopy revealed no primary colon cancer. Immunohistochemical staining showed the negative expressions of PSA and P504s and positive expressions of CK7, CK34 β E12, CK20, and CDX2. Thus UMAP was confirmed and treated by intensity-modulated radiotherapy. Then the patient was followed up for 30 months, which showed desirable therapeutic result, with neither local progression nor distant metastasis.

CONCLUSIONUMAP has a bad prognosis and its diagnosis depends on pathological and immunohistocchemical examinations. It responds well to radical prostatectomy but is not sensitive to endocrine therapy. Radiotherapy can be considered for those who are not fit to receive radical prostatectomy.

Adenocarcinoma, Mucinous ; metabolism ; pathology ; therapy ; Humans ; Keratins ; metabolism ; Male ; Middle Aged ; Neoplasm Proteins ; metabolism ; Prognosis ; Prostatectomy ; Prostatic Neoplasms ; metabolism ; pathology ; therapy ; Racemases and Epimerases ; metabolism

OBJECTIVETo investigate the neurodevelopmental outcome of preterm infants who were discharged from neonatal intensive care unit (NICU) at 1 year of age and the impact factors contributing to the neurodevelopmental outcome and to study whether early intervention can improve the neurodevelopmental outcome in preterm infants.

METHODSEarly intervention guidance and follow-up visits were performed after the preterm infants discharged from NICU. The infants received the infant development test of Child Development Centre of China (CDCC) for neurological development at 1 year of age. The neurodevelopmental outcome was evaluated based on mental development index (MDI) and physical development index (PDI). MDI and PDI > 85 was defined as normal, MDI or PDI between 70 and 85 as critical and MDI or PDI < 70 as abnormal. Social-domestic and clinical factors related to neurological development were analyzed by ANOVA or chi-square test. Potential high risk factors were analyzed with logistic regression. To investigate the effects of intervention compliance on neurological development, the infants were classified into two groups according to different intervention compliances. The good compliance group included infants who received a through familial intervention for more than 4 days weekly (30 minutes daily) and consulted with physicians more than 5 times in 1 year. The infants who did not receive the interventions as the good compliance group served as the bad compliance group.

RESULTSThis study consisted of 210 infants, with a mean gestational age of 33.2 +/- 2.6 weeks and a mean birth weight of 1923.3 +/- 558.8 g. Normal, critical and abnormal neurological development occurred in 123 cases (58.6%), 61 cases (29.0%) and 26 cases (12.4%) respectively. Eighteen infants (8.6%) had mental lag and 9 (4.3%) had cerebral palsy (CP). The MDI and PDI scores of the good compliance group (111 cases) were 97.15 +/- 17.38 and 94.23 +/- 18.55 respectively, which were markedly higher than those of the bad compliance group (89.87 +/-18.92 and 87.20 +/-19.12; P < 0.05). The incidence of CP (3/111, 2.7%) in the good compliance group was lower than that of the bad compliance group (5/99, 6.1%) although there were no statistical differences. Parents' education level, multiple birth, serious intracranial hemorrhage and apnea were risk factors for adverse neurodevelopmental outcome.

CONCLUSIONSPreterm infants discharged from NICU are a high risk group of neurodevelopmental disablement. Early intervention can improve the neurodevelopmental outcome of perterm infants at high risk.

Child Development ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Intensive Care Units, Neonatal ; Logistic Models ; Nervous System ; growth & development ; Patient Compliance ; Prognosis ; Risk Factors