Objective To evaluate the feasibility of using stroke volume variation (SVV) as the left ventricular preload to draw the cardiac function curve.Methods Twenty-seven patients of both sexes,aged 18-64 yr,with body mass index of 18-30 kg/m2,of American Society of Anesthesiologists physical status Ⅱ (New York Heart Association Ⅱ),with abnormal cardiac function,scheduled for elective offpany coronary artery byp grafting,were enrolled in this study.Twenty-five patients,aged 18-64 yr,with body mass index of 18-30 kg/m2,of American Society of Anesthesiologists physical status Ⅰ (New York Heart Association Ⅰ),with normal cardiac function,scheduled for elective non-cardiac surgery,were also enrolled in this study.SVV and SV were monitored by using a FloTrac/VigileoTM system.The patients were in the supine position from the end of anesthesia induction to the beginning of surgery.After the hemodynamics was kept stable for 5 min,SVV and SV were recorded.6％ hydroxyethyl starch 130/0.4 500 ml was intravenously infused over 20 min.SVV and SV were recorded after volume expansion.Spearman rank-order correlation was used to analyze the relationship between SVV and SV.The quadratic regression analysis was used to draw the SVV-SV curve,and the SVV-SV curve was compared with the Frank-Starling curve.Results Compared with the value before volume expansion,SVV and HR were significantly decreased,and SV was increased after volume expansion in the patients with normal cardiac function,and SVV was decreased after volume expansion in the patients with abnormal cardiac function (P＜0.01).SVV was negatively correlated with SV in the patients with normal cardiac function,and r=-0.467 (P＜0.05).SVV was negatively correlated with SV in the patients with abnormal cardiac function,and r=-0.378 (P＜0.05).The mirror symmetry was found between the SVV-SV curve in the patients with normal cardiac function and the normal Frank-Starling curve,and the general trend was close.The symmetry was not detected between the SVV-SV curve in the patients with abnormal cardiac function and the Frank-Starling curve in the patients with decreased myocardial contractility,and the general trend was not close.Conclusion For the patients with normal cardiac function,SVV can be used as the left ventricular preload to draw the cardiac function curve.

To control the quality of Humulus scandens, the quality standard was established in this study. According to the method recorded in the Appendix of Chinese Pharmacopoeia (2010 Edition) , the water and ash inspections were carried out. The component luteoloside and cosmosiin in Humulus scandens were identified and assayed by TLC and HPLC. The results showed a strong characteristics microscopic of Humulus scandens, and trichoromethane-methanol-formic acid (10: 3: 0. 3) as the mobile phase of TLC, the spots at 365 nm with a UV lamp was clear. The 16 batches of samples were analyzed by HPLC with a gradient elution of acetonitrile and phosphate solution (0.2%) at a flow rate of 1.0 mL · min(-1) and detected at 350 nm. The content of luteoloside was 0.015%- 0.651% (average 0.148%); the content of cosmosiin was 0.003%-0.118% (average 0.036%). The linear calibration curve of luteoloside and cosmosiin was acquired in the ranges of 0.011-0.364 g · L(-1) (r = 1.000 0) and 0.003-0.096 g · L(-1) (r = 1.000 0), respectively. The average recovery was 100.5% and 98.5%, respectively. The methods are convenient and reliable, which can be ap- plied for quality assessment of Humulus scandens.
China ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; analysis ; standards ; Humulus ; anatomy & histology ; chemistry ; Quality Control

Evaluation of the permeability mainly focuses on intestinal absorption in biopharmaceutics classification system (BCS). It is more complicated that the absorption and metabolism under multicomponent environment in biopharmaceutics classification system of Chinese materia medica (CMMBCS) compared with single component environment, which needs suitable mathematical models to be described. Therefore, with full consideration of existing single component mathematical algorithm combining with the characteristics of intestinal absorption and metabolism, we explored and designed a new mathematical algorithm of intestinal absorption and metabolism of multicomponent drug. Then we put forward a new coefficient, P (influence), the relative change rate of the single component's intestinal absorption and metabolism under multicomponent environment compared with single component environment, which described the influences of intestinal absorption and metabolism of the component under multicomponent environment. Moreover, P (influence) highlights the distinctive characteristics of multicomponent drug's intestinal absorption and metabolism, and lays the foundation for the construction of CMMBCS.
Algorithms ; Drugs, Chinese Herbal ; chemistry ; pharmacokinetics ; Humans ; Intestinal Absorption ; Intestines ; chemistry ; metabolism ; Models, Theoretical ; Solubility

Objective To explore the possible mechanism and protective effect of Xuebijing injection (血必净注射液)and dexamethasone on rats with paraquat-induced chronic pulmonary injury.Methods Thirty male Wistar rats were randomly divided into six groups:normal group(n=5),model group(n=5), treatment groups(n=20).In the normal group,normal saline was used,while in the other groups,20% paraquat 80 mg/kg was injected peritoneally for poisoning.After 2 hours of intoxication,low dose Xuebijing injection(1.25 g/kg),high dose Xuebijing injection(2.50 g/kg),dexamethasone(25 mg/kg),high dose Xuebijing injection combined with dexamethasone(combined group)respectively were administered into the four different treatment groups,equal amount of normal saline was given to the normal and model groups,and the treatment continued for 4 days.At 28 days after paraquat injection,5 rats in each group were killed respectively,serum transforming growth factor-?1(TGF-?1)and hydroxyproline(HYP)level in the lung homogenate were measured,and pulmonary coefficient and histological changes were observed.Results In the treatment groups,the levels of serum TGF-?1 and lung tissue HYP,pulmonary coefficient were leas than those of model group,and among the treatment groups,combined group had the best results(all P

Objective: To investigate the correlation between FIB-4 and the clinicopathological characteristics and prognosis of patients with hepatocellular carcinoma (HCC) after curative resection. Methods: From January 2009 to December 2012, the clinicopathological and follow-up data of 245 patients with HCC after curative resection were retrospectively studied. Their survival was calculated using the Kaplan-Meier method. The Cox proportional hazard regression model was used for the multivariate analysis. Results: According to FIB-4 index, patients were divided into two subgroups: FIB-4Ⅰ(≤3.25) and FIB-4Ⅱ(>3.25). FIB-4 could predict liver cirrhosis severity (Ishak grade, Grade 1-5 vs. Grad 6, r=0.681, P<0.001). It was associated with liver function such as:aspartate transaminase (P<0.001)、total bilirubin (P=0.009)、albumin (P=0.001) and platelet count (P<0.001) other than tumor clinicopathologic features. Both univariate and multivariate analysis showed FIB-4 could predict the prognosis of HCC patients (Overall survival: P=0.037 and 0.011; Recurrencefree survival: P=0.027 and P=0.043, respectively). Conclusion: The preoperative FIB-4 index could be used as a prognostic marker for the prognosis of HCC after curative hepatectomy.

Objective To describe a new kind of Y-shaped metallic stent delivery system and evaluate its feasibility and preliminary effect for managing multiple airway stenoses involving the lower trachea and the tracheal carina.Methods The Y-shaped metallic stent delivery system consisted of three- tier structure.The inner-tier was composed of four parallel guiding tubes,which was used for two guidewires and two threads passing through,the middle-tier was delivery catheter,which contained the four guiding tubes,and the outer-tier was introducer sheath.Under the fluoroscopic guidance,15 patients with multiple stenoses involving the lower trachea and the tracheal carina were treated with the new covered self-expandable Y-shaped metallic stents.Results Stent placement in the tracheo-bronchial tree was technically successful in all patients with obliteration of the dyspnea immediately after stent placement,and SaO_2 was increased form preoperative 75%—89% to postoperative 96%—99%.During follow-up a period of 3—58 weeks (M 22 weeks),all stenosis were resolved without stent-related complications,and the general physical of all 15 patents was improved with no occurrence of obviously dyspnea and bleeding.Karnofsky performance status(KPS)was improved from preoperative 26%—45% to postoperative 72%—95%.Five patients died of the following causes unrelated to stent insertion:multiple organ failure(n=3),cachexia(n=1)and pulmonary infection caused by gastrobronchial fistula(n=1),and the remaining 10 patients were alive with no evidence.of dyspnea at the time of this report.Conclusion Deployment of the covered Y-shaped metallic stent with the use of Y metallic stent delivery system in the management of airway stenoses involving the lower trachea and the tracheal earina was a simple and safe procedure and with a good short-term clinical efficacy.

OBJECTIVETo investigate root canal curvatures of human maxillary first premolars in buccolingual directions.

METHODSOne hundred extracted permanent maxillary first premolars were used. After access preparation, a K-file was inserted into the canals and gently advanced until it reached the apical foramen. Then standardized periapical radiovisiography (RVG) images were taken from mesiodistal direction. The angle of curvature was determined according to the method described by Schneider. The radiu of curvature and length of the curved part of the root canal were calculated.

RESULTS1) The total 50.00% (88/176) of root canal curves were in buccolingual directions, and 53 curves were showed in apical 1/3 of root region. 11.93% (21/176) of S-shaped canals were detected, and the first curves were mostly showed in middle 1/3 of root region, the secondary curves were totally showed in apical 1/3 of root region. 2) There was no difference of curvatures between buccal and lingual root canals, but the secondary curves of S-shaped canals were more complicated than other root canals. 3) There was no correlation between the angle of curvature and the radius of curvature (r=0.002, P>0.05), but significantly correlation between the angle of curvature and length of the curved part of the root canal (r=0.489, P<0.01).

CONCLUSIONThe occurrence of curved root canals in buccolingual directions may be high in human maxillary first premolars, and the curvatures of S-shaped canals were more complicated than others.

Bicuspid ; Dental Pulp Cavity ; Humans ; Root Canal Therapy ; Tooth Root

OBJECTIVETo investigate the efficiency and safety of different regimens by intravesical instillation of epirubicin, a derivative of adriamycin, for the prevention of primary superficial bladder carcinoma from recurrence.

METHODSNinety patients supplemented with intravesical epirubicin instillation after operation were randomly divided into three groups: Group A--80 mg in one dose; Group B--repeated epirubicin 40 mg q wk x 4-8 sessions followed by q month to the end of the second year; or Group C--50 mg q month to the same duration. All patients were followed up for two years by observing the recurrence rates and side effects.

RESULTSThe recurrence rate of groups A, B and C at one year was 16.7%, 13.3% and 16.7%, respectively, without any significant difference observed. However, it was 50.0%, 36.7% and 36.7% at two years, at which time the recurrence rate of group A was significantly higher than those of groups B and C. The side effects rate was 23.3%, 40.0% and 33.3% for groups A, B and C, respectively. The more instillations the patients had, the more severe side effects were.

CONCLUSIONEarly postoperative single high dose intravesical instillation of epirubicin combined with repeated lower doses of the same drug every month may be an efficient and safe regimen to prevent the primary superficial bladder carcinoma from recurrence.

Administration, Intravesical ; Adult ; Aged ; Antibiotics, Antineoplastic ; administration & dosage ; adverse effects ; Combined Modality Therapy ; Epirubicin ; administration & dosage ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; prevention & control ; Postoperative Period ; Prospective Studies ; Urinary Bladder Neoplasms ; prevention & control ; surgery

Objective To summarize the adverse reactions of blepharospasm (BSP) and hemifacial spasm (HFS) after botulinum toxin A (BoNT-A) injection and offer corresponding responses.Methods Clinical data of 163 BSP patients and 221 HFS patients,admitted to and subjected to BoNT-A injection in our hospital from September 2017 to October 2019,were analyzed retrospectively.Albert and Cohen evaluation scale was used to evaluate the therapeutic efficacy after injection.All adverse reactions were recorded and corresponding responses were proposed.Results The effective rates of BoNT-A injection for BSP and HFS were 97.5％ and 100％,respectively.The most common early-onset adverse reactions were local pain (BSP:13.5％;HFS:17.2％) and hematoma (BSP:3.7％;HFS:4.5％);the late-onset adverse reactions included dry eyes/epiphora (BSP:9.8％;HFS:11.3％),incomplete closure of eyelid (BSP:20.2％;HFS:20.4％),facial stiffness (HFS:39.4％) and asymmetry (HFS:11.8％),and eyelid edema could be noted in a few patients (BSP:1.2％;HFS:1.4％).The main measures on reducing or avoiding adverse reactions after injection included appropriate injection apparatus,accurate injection sites,exact drug doses,and consideration of the individual differences of patients.Conclusion BoNT-A is effective in the treatment of BSP and HFS,but it is necessary to avoid early-onset and late-onset adverse reactions to maximize the benefits of patients.

OBJECTIVETo estimate the diagnostic potential of the dental operating microscope used for locating the second mesiobuccal canal (MB2) orifice in maxillary first molars.

METHODS120 extracted maxillary first molars were used, all the access cavities were prepared and fixed on the dental study model. MB2 orifices were examined with naked eye and under a dental operating microscope (DOM). The examination was repeated by another dentist with the same methods. Then Indian ink was injected into the pulp chamber and all the teeth were treated to be transparent to determine if it had a real MB2.

RESULTSThe sensitivity and accuracy of the DOM group were 0.78 and 0.76, higher than 0.61 and 0.65 of the naked eye group (P<0.05). The correspondency of Kappa index between observers by naked eye and DOM was 0.701 and 0.819, respectively.

CONCLUSIONThe use of DOM can increase the detection rate of MB2.

Dental Pulp Cavity ; Diagnostic Tests, Routine ; Humans ; Maxilla ; Microscopy ; Molar