Objective To investigate the clinical features,treatment,prognosis,and occurrence of neurogenic pulmonary edema(NPE) in children with severe hand-foot-mouth disease (HFMD) complicated with brain stem encephalitis and abnormal cranial magnetic resonance imaging (MRI).Methods 386 cases of severe HFMD were hospitalized in our Intensive Care Unit (ICU) from May to October 2010,of which 24 cases had abnormal cranial MRI.Their clinical symptoms,MRI features,treatment,and prognosis were analyzed.Results The clinical symptoms of severe HFMD with brainstem encephalitis included fever,startle,lethargy,vomiting,difficulty swallowing,drooling,and so on.The patients with abnormal cranial MRI were prone to have a neurogenic pulmonary edema (NPE) (5％ vs 6.5％,x2 =34.55,P ＜0.01).Conclusions The nervous system-affected parts of severe HFMD is the brain stem,thalamus,and spinal cord.Brain stem inflammation can be found early by the cranial MRI to be highly vigilant of NPE.During course of 1 ～ 5 day,special attention should be paid to the symptoms of the nervous system.The early detection,timely intervention,and prevention from NPE would result in the good prognosis.

Objective To investigate the role of glucagon peptide-1(GLP-1) in blood pressure variability (BPV) in diabetic hypertensive patients. Methods A total of 120 diabetic hypertensive patients were included in this study. GLP-1 was used for the treatment. The values of body mass index (BMI), fasting blood glucose, glycosylated hemoglobin, creatine and 24-hour ambulatory blood pressure (BP) monitoring were detected before and after treatment with GLP-1 for six months. The clinical indices were compared before and after treatment. Results The values of fasting blood glucose (mmol/L:7.12± 0.64 vs 9.19±2.78), glycosylated hemoglobin (%:7.00±0.14 vs 8.28±1.32) and BMI (kg/m2:19.30±3.24 vs 24.5±4.53 ) were de-creased to the normal level after GLP-1 treatment for six months (P<0.05). There were significant decrease in the 24-h sys-tolic BP (mmHg:135.02 ± 16.57 vs 139.52 ± 15.60), daytime systolic BP (mmHg:132.5 ± 14.6 vs 136.44 ± 14.24), 24-h systolic BP variability (mmHg:12.20 ± 1.44 vs 12.73 ± 1.66), daytime systolic BP variability (mmHg:11.11 ± 1.48 vs 11.74 ± 1.52 ), and daytime diastolic BP variability (mmHg:7.03±1.42 vs 7.43±1.45) after GLP-1 treatment for six months (P<0.05). Conclu-sion GLP-1 can decrease BPV in diabetic hypertensive patients.

Objective To explore the psychological stressors of pregnant women with chronic HBV infection.Methods Using phenomenological method of qualitative study,there were 9 pregnant women with chronic HBV infection participated in the study and their mental stress was investigated by deep interview.Results Five main psychological stressors of pregnant women with chronic HBV infection emerged:fear of children being infected; anxious about giving birth in the hospital for infectious diseases; having no idea of selecting the mode of delivery and feeding pattern; worrying about their own health; to feel nervous about playing the role of mothers.Conclusions Healthcare workers should make appropriate health guidance and psychological supports to alleviate the psychological distress combined with features of pregnant women with HBV infection.At the same time,it is necessary to make change of public misunderstanding of hepatitis B,so as to create a fair and friendly social atmosphere for all the hepatitis B patients.

BACKGROUND: People have concerned with the effect of fibroblast growth factor biological protein sponge on the repairing effect of traumatic ulcer.OBJECTIVE: To observe the repairing effect of fibroblast growth factor biological protein sponge on the repairing effect of traumatic ulcer and its possible adverse reactionDESIGN: Grouping comparison observation.SETTING: Staff Room of Physiology, Medical College of Jinan University PARTICIPANTS: Totally 40 cases of traumatic ulcer accepted the treatment in the First Hospital of Jinan Univerity between March 2004 and May 2005 were recruited. Patients with diabetes mellitus and infection on the whole body were excluded. Traumatic ulcer lay in the shank. Patients were randomly divided into experimental group and control group with 20 in each group.INTERVENTIONS: In the experimental group (n=20), sterilized fibroblast growth factor biological protein sponge was used and in the control group (n=20), sterilized petrolatum gauze dressing was used on the wound.Change the gauze dressing once per day until the wound healed. Drugs,which affected wound growth, were not used on the whole body and at the local part. Wound healing status was evaluated 1, 2 and 3 weeks after changing the drugs (The secretion of a wound was divided into: nothing, a little, middling, a great deal. frontier reaction of wound was divided into:nothing, slight, middling, severe.). Pigment deposition and scar was recorded after wound healing.MAIN OUTCOME MEASURES: Healing time of ulcer, healing course of the wound and adverse reaction of the patients in the two groupsRESULTS: Totally 40 patients of the two groups entered result analysis.Wound healing status after treatment of the patients in the two groups: The rate of wound healing in 3 weeks in the experimental group was significantly higher than that in the control group [95% (19/20),55% (11/20),χ2=8.533,P ＜ 0.05]. Wound secretion and peripheral inflammatory reaction of the wound in the experimental group was obviously milder than that of the control group; there was no obvious adverse reaction and scar of the wound found in the two groups.CONCLUSION:FGF biological protein sponge can promote the healing of traumatic ulcer; shorten the healing time without scar and adverse reaction.This dressing is convenient, safe, and non-irritative.

Objective To investigate the clinical status of 1242 patients with diabetic kidney diseases (DKD) during their first hospitalization,and to analyze the risk factors of prognosis,so as to provide reference for clinical practice. Methods Retrospective case-control study was performed.Clinical data of 1242 patients diagnosed as DKD in first hospitalizaton from January 2003 to December 2008 were reviewed,and patients were followed up to realize the prognosis.Multiple regression analysis was carried out to screen the risk factors. Results Most of the patients were Mogensen stage Ⅳ or Ⅴ in their first hospitalization,accounting for 77.2％.24.8％ of cases was complicated with cardiocerebrovascular diseases.Scr of 36.6％ patients was higher than 176.8 μmol/L.One way ANOVA indicated that diabetes course,hemoglobin,serum albumin,Scr and Charlson index were significantly different among Mogensen stage Ⅲ, Ⅳ,Ⅴ patients.Logistic regression showed that age,albumin,Scr,cardiocerebrovascular diseases and Chalson index were risk factors for death in DKD patients (OR =1.057,0.908,1.002,2.006,1.371),but sex,diabetes course and hemoglobin were not risk factors,which was in accord with the resuh from 416 non-dialysis patients.Multiple linear regression analysis revealed serum albumin level was positively correlated with survival in non-dialysis DKD patients (P=0.003).The mean survival time was only 1.2145 year in 162 non-dialysis dead patients. Conclusions DKD patients in our hospital refer quite late,usually with poor conditions and complications.Most of DKD patients are Mogensen stage Ⅳ or Ⅴ in the first hospitalization.Age,serum albumin,Scr,cardiocerebrovascular diseases and Charlson index are risk factors of death,while gender,diabetes course and hemoglobin are not significantly correlated with death.In addition,serum albumin is positively correlated with survival time.Early diagnosis and management of risk factors are crucial for improving the prognosis of DKD patients.

Objective To analyze the manifestation,reason,the processing method of the steel wire implantation with the sereotactic mammography to improve the accuracy of the preoperative positioning.Methods Seventy-nine cases which got the stereotactic steel wire implantation.In 96 lesions, 13 had steel wire displacement.Among them,5 cases got steel wire displacement during the sereotactic process,5 cases got steel wire displacement after the stereotactic process,2 cases got steel wire displacement during the operation,one case did not show the calcification on the postoperative radiography.Results The steel wire displacement occurred in 5 cases during the stereotactic process came from the patients and doctors respectively and the repositioning was needed.The steel wire displacement after the stereoscopic positioning was attributed to the overdose injection of local anesthesia,which led to the mismatch between the depth of Z axis of the mammary gland and the actual depth the computer given,the incorrect method for needle placement,and,neglecting whether the steel wire have got the lesion anchored when pulling out the needle set of steel wire hood,besides,these three kinds of instances above were all exaggerated by the accordion effect.For the displacement within 2 cm,the lesion can be excised toward the pathological change direction according to the position that steel wire prompted and re-place the second steel wire,putting the J-shaped steel wire into the needle hood and taking it out of the body.After repositioning,2 cases had the steel wire prolapse during operation,which resulted from the over-lifting of the steel wire.After placing the steel wire, the radiologist should give an accurate description on the depth and direction to the surgeon and the notch should be taken for incision from the steel wire head end which is proximate to skin.The postoperative specimen from one case had no calcification,which might be related to the condition that the calcification was located in the gland body,which got destruction from the surgical electrical electrotome.The excisionscope should be extended and the short term reexamination is recommended to make sure the complete excision of the calcification.Conclusion It is the gold standard method that implanting the steel wire with the stereotactic mammography to guide the surgical dissecting technique to diagnose non-palpable breast lesion(NPBL).Thorough understanding of the displacement manifestation of implanting steel wire with stereotactic technique and the treatment methods will be helpful in the surgical dissecting guidance.

Objective:To investigate the prognosis and outcome of patients with chronic hepatitis C (CHC) related cirrhosis after achieved sustained virologic response (SVR) treated with direct-acting antiviral agent (DAA).Methods:Ninety-five patients diagnosed with CHC related cirrhosis who had complete data in Tianjin Second People′s Hospital from January 2014 to June 2017 were retrospectively followed up. Among them, 72 patients were treated with DAA and all of them achieved SVR, and the other 23 patients did not receive any antiviral therapy. The differences of mortality and incidence of hepatocellular carcinoma (HCC) between DAA treatment group and non-antiviral treatment group were compared. Statistical analysis was performed by independent sample t test, Mann-Whitney U test and chi-square test. Results:At the end of follow-up for three to 71 months, patients in DAA treatment group had a significant improvements in alanine aminotransferase, aspartate aminotransferase, albumin and liver stiffness measurement compared with those before treatment (42(23, 61) U/L vs 18(13, 28) U/L, 54(37, 75) U/L vs 23(18, 28) U/L, 39(33, 42) g/L vs 45(41, 48) g/L, 26(18, 37) kPa vs 15(11, 26) kPa, respectively, Z=-6.005, -7.008, -6.057 and -3.162, respectively, all P<0.01). However, there were no significant differences in incidence of HCC (12%(9/72) vs 17%(4/23)) and mortality (3%(2/72) vs 13%(3/23)) between the DAA treatment group and non-antiviral treatment group (both P>0.05). There was no significant difference of cumulative incidence of HCC in DAA treatment group compared with non-antiviral treatment group ( P=0.609). The age of patients progressed to HCC was older than those without HCC ((60.3±3.6) years vs (54.4±9.9) years, t=-3.948, P<0.01). In subgroup analysis, among the six patients with HCC, four had diabetes, the prevalence of diabetes in the patients without HCC was 17%(7/42); the level of fasting blood glucose (FBG) ((7.3±1.9) mmol/L vs (5.9±1.1) mmol/L) were higher in patients progressed to HCC than those without HCC in DAA treatment group with compensated cirrhosis ( χ2=7.430 and t=-2.442, respectively, both P=0.019). Conclusions:DAA treatment could notably improve liver function and alleviate liver fibrosis, but could not reduce the mortality and incidence of HCC in patients with CHC related cirrhosis significantly. Diabetes and high level FBG may be the risk factors for occurrence of HCC in patients with CHC related compensated cirrhosis.

The purpose of this study was to investigate the different effects of ACh on the action potential and force contraction in guinea pig atrial and ventricular myocardium by using standard microelectrodes and force transducer. The results showed that the duration of the action potential (APD) of atrial myocardium was shortened from 208.57+/-36.05 to 101.78+/-14.41 ms (n=6, P<0.01), and the APD of the ventricular myocardium was shortened from 286.73+/-36.11 to 265.16+/-30.06 ms (n=6, P<0.01).The amplitude of the action potential (APA) of the atrial myocardium was decreased from 88.00+/-9.35 to 62.62+/-20.50 mV (n=6, P<0.01), while the APA of the ventricular myocardium did not change significantly.The force contraction of atrial myocardium was inhibited completely (n=6, P<0.01), while the force contraction of ventricular myocardium was inhibited by 37.57+/-2.58% (n=6, P<0.01). The ACh effects correlated with its concentration. The K(D) of the APD shortening effects in the atrial and ventricular myocardium were 0.275 and 0.575 micromol/L. The K(D) of the negative inotropic in the atrial and ventricular myocardium were 0.135 and 0.676 micromol/L, respectively. The corresponding data points were compared using t test between the atrial and ventricular myocardium, and the differences were significant when the ACh concentration was above 10 nmol/L. Furthermore, atropine (10 micromol/L) and CsCl (20 mmol/L) blocked the effects of 10 micromol/L ACh on the APD of ventricular myocardium, while CdCl2 (0.1 mmol/L) had no influence on these effects. In conclusion, ACh could shorten the action potential duration and inhibit the force contraction of atrial and ventricular myocardium in a concentration-dependent manner. There are differences in the effects of ACh on the atrial and ventricular myocardium. The atrial myocardium is more sensitive to ACh than the ventricular myocardium. It is probable that the muscarinic receptor and the potassium channel, but not the calcium channel, are involved in the ACh-induced shortening of the ventricular APD.
Acetylcholine ; pharmacology ; Action Potentials ; drug effects ; Animals ; Calcium Channels ; metabolism ; Guinea Pigs ; Heart Atria ; drug effects ; Heart Ventricles ; drug effects ; Microelectrodes ; Potassium Channels ; metabolism ; Receptors, Muscarinic ; metabolism

AIMTo observe the regulatory volume decrease (RVD) process of human intestine cells and investigate its ion channel mechanism.

METHODSCultured human intestine cells were exposed to hypotonic solution and the cell volume was measured using Coulter Counter System. RT-PCR was explored to detect the mRNA expression of Ca(2+) -activated K+ channel.

RESULTSHuman intestine cells showed a RVD process and this process could be blocked by Cl- channel blocker NPPB and K+ channel blocker TEA. Further results demonstrated the subtype of K+ channel involved in RVD was an intermediate-conductance, Ca(2+) -activated K+ channel (IK) because of its high sensitivity to clotrimazole. RT-PCR results also showed the expression of IK in this cell line.

CONCLUSIONThe RVD process of intestine cell was dependent on the parallel activation of Cl- channel and K+ channel. The subtype of K+ channel in volved in the RVD process was IK channel.

Cell Line ; Cell Size ; drug effects ; Chloride Channels ; antagonists & inhibitors ; metabolism ; Epithelial Cells ; cytology ; Humans ; Hypotonic Solutions ; Intestine, Small ; cytology ; Potassium Channel Blockers ; pharmacology ; Potassium Channels ; metabolism ; Potassium Channels, Calcium-Activated ; metabolism

This study is to establish an HPLC-DAD-ELSD method for simultaneous determination of 5 flavones and saponins in Rhizoma Anemarrhenae including neo-mangiferin, mangiferin, timosaponin B II, timosaponin B III and timosaponin A III. Samples were analyzed on a Merck Purospher STAR column(4.6 mm x 250 mm, 5 μm). The mobile phase consisted of acetonitrile( A) and 0. 1% formic acid (B) with gradient elution at a flow rate of 1.0 mL · min(-1). The column temperature was set at 40 °C. The DAD detector wavelength was set at 254 nm. The ELSD conditions were as follows: the nebulizing gas flow rate was 2.0 L · min(-1) and temperature of drift tube was 105 °C. The volume was 10 μL. The five compounds were well separated with good linear correlations. The mean recoveries were between 102.0%-104.0%. This method was quick and reliable which provides a foundation for quality control of R. Anemarrhenae.
Anemarrhena ; chemistry ; Chromatography, High Pressure Liquid ; instrumentation ; methods ; Drugs, Chinese Herbal ; analysis ; Flavones ; analysis ; Rhizome ; chemistry ; Saponins ; analysis