Obgective To observe the effect of Milrinone combined with Esmolol in the treatment of severe hand-foot-and-mouth disease (HFMD) so as to improve the prognosis.Methods Eighty-two cases of children with critically severe HFMD,who were hospitalized in the Intensive Care Unit of Xuzhou Children's Hospital,were enrolled in the study from may of 2013 to June of 2014,and were randomly divided into a control group and an observation group.The control group was given intravenous Milrinone,and the observation group was given Milrinone combined with Esmolol.The heart rate (HR),systolic blood pressure (SBP),cardiac output (CO),left ventricular ejection fraction (LVEF) and brain natriuretic peptide (BNP),norepinephrine (NE) were detected on admission and checked again 1 hour and 48 hours again after treatment.The changes in the above indicators were compared before and after therapy to evaluate the clinical curative effect.Results (1) There was no significant difference in the HR,SBP,CO,LVEF,BNP and NE between the 2 groups before treatment(all P ＞ 0.05).(2) The HR,SBP,CO and LVEF of 2 groups were significantly improved after 1 hour treatment compared with those before treatment (all P ＜ 0.05),and the BNP and NE of the control group were not obviously improved compared with those before therapy (all P ＞ 0.05),but the significant changes were seen in the observation group (all P ＜ 0.05).Forty-eight hours after the treatment,all the observed indicators in 2 groups were significantly improved compared with those before treatment(all P ＜ 0.01).(3)Compared with control group,the HR,SBP,CO,LVEF and BNP of the observation group were significantly improved after 1 hour treatment (t =2.08,2.12,-2.11,-2.37,2.07,all P ＜ 0.05),but the NE of the observation group had no obvious improvement (t =0.83,P ＞ 0.05).All the observed indicators of the observation group were significantly improved compared with the control group after 48 hours treatment(t =3.76,2.48,-2.70,-2.27,5.37,2.74,all P ＜ 0.05).Conclusions Milrinone combined with Esmolol can significantly improve the cardiac function and the vital signs of the children with critically severe HFMD,which can be recommended clinically.

ObjectiveTo evaluate the value of modified early warning score (MEWS) in predicting mortality of critically ill patients admitted to emergency department.Methods A prospective cohort study was conducted. Clinical data of emergency patients admitted to resuscitation room of Peking Union Medical College Hospital from Feburary 13rd, 2014 to April 20th, 2014 were collected, and their MEWS were calculated based on medical records and their clinical outcomes was followed. Incidence of primary outcome (3-day mortality) and secondary outcome [all deaths and composite outcome of intensive care unit (ICU) transfer, cardio-pulmonary resuscitation, and death] were compared between MEWS positive (MEWS≥5) or negative (MEWS 0-4) patients, and multi-regression logistic analysis was done to look for the impact factors of primary outcome in these patients.Results 176 patients, among them 98 (55.68%) were male, were enrolled in the study. Their mean age was (56.86±21.46) years old. Mean MEWS was 4.30±2.74. There was 74 cases in MEWS positive group, and 102 in negative group. Primary endpoint occurred in 41 patients, and the 3-days mortality in MEWS positive group was significantly higher than that in MEWS negative group [37.84 (28/74) vs. 12.74% (13/102), odds ratio (OR) = 4.167, 95% confidence interval (95%CI) = 1.973-8.804,P< 0.001]. At the meantime, incidence of all death [54.05% (40/74) vs. 17.65% (18/102),OR = 5.490, 95%CI = 2.770-10.883,P< 0.001] and the incidence of ICU transfer, cardio-pulmonary resuscitation and death [64.86% (48/74) vs. 25.49% (26/102),OR = 5.396, 95%CI = 2.809-10.366,P< 0.001] were also significantly higher in MEWS positive group as compared with negative group. Multi-regression logistic showed abnormal mental status (OR = 3.606, 95%CI = 1.541-8.436,P = 0.003) but not MEWS≥5 (OR = 1.672, 95%CI = 0.622-4.494,P = 0.308)was the predictor of 3-day mortality in emergency admitted critically ill patients.Conclusions Although the incidence of severe adverse events is significantly increased in patients with MEWS≥5 compared with those with MEWS 0-4, MEWS≥5 cannot be an efficient predictor for 3-day mortality. Abnormal mental status shows some predictive value for early mortality in critically ill patients seen in emergency department.

Objective To analyze the influential factors of healthy children′s heart rate turbulence (HRT). Methods One hundred and six healthy children with ventricular premature beat (VPB) were selected in this study and the correlation among HTR parameters as turbulence onset (TO) and turbulence lope (TS) and age, gender, basic heart rate, the number of VPBs were analyzed. Results It was observed that among three age groups, TO decreased with the age, and the difference was statistically significant (P < 0.05), but there was no significant gender difference (all P > 0.05). TS increased with the age, and intergroup difference was statistically significant (P < 0.05). In the group of children aged over seven, significantly higher TS was observed among boys (P < 0.05), while in the group of children aged 1 to 3 and the group aged 3 to 7 , there was no significant gender difference (P > 0.05). TO and TS decreased with the decline of heart rate (r = 0.494, P < 0.00; r = -0.569,P < 0.00 respectively), and the correlation between TO and HR, TS and HR was found.The number of VPBs had no significant correlation with TO or TS (r = 0.104,P = 0.290; r = 0.122,P =0.212). Conclusions The results demonstrate that influenced by age and basic heart rate, healthy children′s HRT increases with the age and the decline of heart rate. Therefore, the reference index of children′s HRT should differ from that of adults, which requires further evaluation.

This study is to establish a method for simultaneously determination of five nucleosides and nucleobases, including hypoxanthine, uridine, adenine, guanosine and adenosine in Rehmannia glutinosa Libosch. which was collected from different regions in China. A Diamonsil C18 column (250 mm x 4.6 mm, 5 microm) was used. Acetonitrile and 0.04 mol L(-1) potassium dihydrogen phosphate solution were adopted as mobile phase with gradient elution. The flow rate was 1 mL min(-1) and column temperature was 30 degrees C. The detection wavelength was at 254 nm. The method had good linearity over the range of 1.0 - 16.0 microg mL(-1) (r2 = 0.999 8), 5.0 - 80.0 microg mL(-1) (r2 = 0.999 8), 1.0 - 16.0 microg mL(-1) (r2 = 0.999 5), 1.25 - 20.0 microg mL(-1) (r2 = 0.999 8) and 1.0 - 16.0 microg mL(-1) (r2 = 0.999 8) for hypoxanthine, uridine, adenine, guanosine and adenosine, respectively. The average recoveries were between 98.8% and 100.7%. The content of hypoxanthine, uridine, adenine, guanosine and adenosine in Rehmannia glutinosa Libosch. from different regions was significantly different. This established method was sensitive and reliable for the quantification of five chemical constituents in Rehmannia glutinosa Libosch.

Objective:To analyze the relationship between free androgen index and insulin function in obese young men aged from 20 to 35.Methods:A total of 82 young obese men in Obesity Clinic from February to October 2019 were enrolled in the study. The subjects were divided into 3 subgroups according to free androgen index level tertiles. The blood glucose and insulin levels were tested after oral glucose tolerance test. Homeostasis model assessment for insulin resistance (HOMA-IR), homeostasis model assessment for β cell function (HOMA-β), insulin secretion index, and insulin sensitivity index (Matsuda index) were used to evaluate β cell function in oder to analyze the relationship between free androgen index and insulin function.Results:In young obese men, participants with higher free androgen index levels exhibited less waist circumference, lower body mass index, 1 h postprandial insulin, 2 h postprandial insulin, HOMA-IR level but with a higher total testosterone, sex hormone binding globulin, and Matsuda index level (all P<0.05). There was a negative correlation between the free androgen index and the HOMA-IR ( r=-0.386, P=0.016), and the correlation tended to a linear trend after adjustment for age, sex, body mass index, and waist circumference ( Ptrend=0.034). Free testosterone was positively correlated with Matsuda index ( r=0.280, P=0.004), but the correlation disappeared after adjustment ( Ptrend=0.623). The results of further regression analysis showed that the level of free testosterone index decreased by 14.1% ( OR=0.869, 95% CI0.767-0.984, P=0.028) for each increase of HOMA-IR after adjustment. Conclusion:The level of free testosterone index is a predictor of insulin resistance in obese young men, but the association between this parameter and insulin sensitivity may be caused by obesity.

Predicting the protein binding rate of drugs in plasma is helpful to us in understanding the pharmacokinetic characteristics of drugs, with much value of reference for early research on drug discovery. In this study, plasma protein binding rate information of 2 452 clinical drugs were collected.Two pieces of software, Molecular Operating Environment (MOE) and Mordred, were used to calculate molecular descriptors, which were used as input features of the model.Extreme gradient boosting (XGBoost) algorithm and random forest (RF) algorithm were then used to build a machine learning model.The results showed that, compared with MOE, the prediction performance of the constructed model was better using the molecular descriptor calculated by Mordred as the input of the model.The prediction performance results of the model constructed using the XGBoost algorithm and the RF algorithm were similar, and the R2 of the optimal model were both 0.715.According to the research results, it can be concluded that the drug plasma protein binding rate is closely related to some physical and chemical properties of the drug molecule, such as water solubility, octanol/water partition coefficient and conjugated double bonds.Using these parameters to predict the plasma protein binding rate of drugs has the advantages of convenience and efficiency, which can provide reference for related pharmacokinetic studies.

OBJECTIVETo express solute carrier 26A proteins in HEK-293 cells and explore their functions.

METHODSSLC26A-eGFP plasmids were transiently transfected into HEK-293 cells, and the nonlinear capacitance of the cells expressing SLC26A proteins was measured by whole-cell patch recording.

RESULTSAll the SLC26A transporters were expressed on the membrane of HEK-293 cells. Each member of the SLC26A transporter family showed robust nonlinear capacitance, which represented their binding capability with anions.

CONCLUSIONThe SLC26A transporters expressed on HEK cells show similar functions as expected in tissue environment. The plasmids we constructed facilitate structural and functional study of SLC26A transporters.

Anion Transport Proteins ; metabolism ; HEK293 Cells ; Humans ; Patch-Clamp Techniques ; Transfection

OBJECTIVETo investigate the development of the electrophysiological property of bushy cells in the anterior ventral cochlear nucleus (AVCN) of neonatal Sprague Dawley (SD) rats.

METHODSThe development of action potential and spontaneous miniature excitatory postsynaptic currents (mEPSCs) in AVCN bushy cells were investigated by whole-cell patch-clamp technique in SD rats during the postnatal days 5-21 (P5-21). The half band width of the action potential (AP), 10%-90% risetime and decay tau of the mEPSCs were analyzed.

RESULTSThe AP of the bushy cells became faster with age from P5 to P21 and stopped changing around the period of hearing onset, as evidenced by the alteration of half band width of the AP. The time accuracy of mEPSCs of the bushy cells also increased with age and stabilized around hearing onset as shown by briefer 10%-90% rise time and decay tau of mEPSCs in P14/P21 than in P7.

CONCLUSIONThe functional refinement of the bushy cells in the AVCN precedes hearing onset in neonatal rats.

Action Potentials ; Animals ; Cochlear Nucleus ; cytology ; Excitatory Postsynaptic Potentials ; Hearing ; Neurons ; cytology ; Patch-Clamp Techniques ; Rats ; Rats, Sprague-Dawley ; Synapses

OBJECTIVETo explore the effects of astragalus (AST) , total flavone of astragalus (TFA), total saponins of astragalus (TSA) and astragalus polysaccharides (APS) on ischemia/reperfusion (40 min/60 min) injury in isolated guinea-pig heart.

METHODSIsolated guinea-pig hearts underwent ischemia, then followed by K-H perfusion (I/R group), AST (60 mg/L),AST (60 mg/L), TFA (60 mg/L), TSA (60 mg/L) and APS (60 mg/L) perfusion (n = 6 each).Isolated hearts without ischemia serve as control group (n = 6). Activity of lactate dehydrogenas (LDH) and creatine kinase (CK) in effluent were measured.Infarct size, myocardial superoxide dismutase (SOD) activity and malondiadehyde (MDA) contents were also determined.

RESULTSCompared to control hearts, heart rate, coronary flow and myocardial superoxide dismutase (SOD) activity were significantly reduced, while LDH and CK in effluent as well as myocardial MDA were significantly increased in the I/R hearts during reperfusion (all P < 0.05), these changes could be partly reversed by AST and TFA perfusion.Infarct size was also significantly reduced in AST (11.9 ± 2.03) % and TFA (13.31 ± 1.17) % treated hearts compared to that in I/R group (18.9 ± 2.27) % (all P < 0.01).

CONCLUSIONSThe findings indicate that AST and TFA could attenuate I/R injury in isolated guinea-pig heart possibly through enhancing the activity of SOD and reducing lipid peroxidation.

Animals ; Astragalus Plant ; Guinea Pigs ; Heart ; Heart Rate ; Myocardial Ischemia ; Myocardial Reperfusion Injury ; drug therapy ; Myocardium ; Plant Extracts ; pharmacology ; Reperfusion Injury ; Superoxide Dismutase

OBJECTIVE: To investigate the diagnostic value of transcranial Doppler ultrasound in early stage cerebral arteriosclerosis. METHODS: We selected 50 patients with early cerebral arteriosclerosis as the disease group. At the same time we selected another 50 patients as a control group with no significant symptoms in the nervous system. By 2 MHz pulse Doppler probe through double-temporal windows and pillow windows Basilar artery (BA), the bilateral middle cerebral artery (MCA) was detected. In the TCD spectrum, we selected the spectrum of a single-family cardiac cycle, identified the starting point (ts), pulse-incisure point (ti), end point (te), and the peak velocity (tp), measured the time of the spectrum starting point to the peak velocity (Tp) and calculated the time required for the peak velocity in the share of ventricular systolic (Tp/Ti), the time required for the peak velocity in the share of the whole cardiac cycle (Tp/T). Tp, Tp/Ti and Tp/T were respectively named as time to peak velocity (TPV), peak-time index-1 (PTI-1) and peak-time index-2 (PTI-2). All data were analyzed by SPSS13.0. RESULTS: There was no significant difference in blood vessel velocity, PI, RI and S/D of BA and RMCA (P>0.05) between the control group and the disease group. Compared with the control group, TPV of the BA, LMCA and RMCA significantly extended, PTI-1 and PTI-2 of BA, LMCA and RMCA increased significantly in the disease group (P<0.01). In the disease group, there was no significant correlation between peak time index and PI, S/D (P>0.05). CONCLUSION TPV, PTI-1 and PTI-2 are sensitive indicators of early stage cerebral arteriosclerosis.
Adult ; Basilar Artery ; diagnostic imaging ; Blood Flow Velocity ; physiology ; Case-Control Studies ; Female ; Humans ; Intracranial Arteriosclerosis ; diagnostic imaging ; Male ; Middle Aged ; Middle Cerebral Artery ; diagnostic imaging ; Ultrasonography, Doppler, Transcranial