Objective To evaluate the effectiveness and safety of acute normovolemic hemodilution(ANH) in the elderly patients undergoing knee arthroplasty.Methods Thirty ASA Ⅰ～Ⅱ patients of both sexes,aged between 65～75 years undergoing elective knee arthroplasty were enrolled in this study.The hemodynamic status,hemostasis,arterial blood gas and hematocrit were monitored at before anesthesia(T1),after anesthesia(T2),after hemodilution(T3),the start of operation(T4),the end of operation(T5),24 hours after operation(T6),48 hours after operation(T7).Results The vital signs were fairly stable during preoperative in both groups.In both groups compared with time point T1 CVP was significantly elevated at point T3 and point T4.The increase in CVP was significantly higher in group Ⅱ than that in group Ⅰ(P

Double aortic arch is a congenital heart defects,which is related to vascular rings.It accounts for about 0.5％ of the incidence of congenital heart disease and will result in varying degrees of airway compression of the esophagus,such as wheezing breathing,swallowing difficulties,severe respiratory distress or chronic respiratory symptoms.Spiral CT,echocardiography and cardiovascular imaging can diagnose double aortic arch.Double aortic arch is divided into three types,the treatment of which is different and surgery is effective.In recent years,with the improvement of thoracoscopic technique,thoracoscopic surgery has become an effective means of treatment to double aortic arch.This review focuses on the surgical treatment of double aortic arch progress.

Animals ; Drugs, Chinese Herbal ; pharmacology ; Female ; Heart Failure ; drug therapy ; physiopathology ; Hemodynamics ; Male ; Myocardial Ischemia ; drug therapy ; physiopathology ; Phytotherapy ; Rats ; Rats, Wistar ; Rhodiola

Objective To identify the nutritional risks of the hospitalized children with congenital heart disease (CHD) during perioperative period and the relationship between nutrition risks and the clinical outcomes.Methods Totally 780 CHD children (522 cases of ventricular septal defect,133 cases of atrial septal defect,70 cases of tetralogy of fallot,and 55 of patent ductus arteriosus) were recruited.The STRONGkids (Screening Tool for Risk on Nutritional Status and Growth) was used to analyze the nutritional risks of CHD children and to identify the nutritional risks of these children at different ages.Also,the potential effect of pulmonary hypertension on malnutrition and effects of the possible nutritional risks on the clinical outcomes were analyzed.Results Of these 780 CHD children,260 (33.3％) were found to be with high and moderate nutritional risks.The incidences of these risks were 49.2％ (187/380) in the 0-1-year-old group,which was significantly higher than that in the 1-3-year-old group (26.2％,60/229) (x2 =25.174,P ＜0.001) and the ＞ 3-year-old group (7.6％,13/171) (x2 =36.029,P ＜ 0.001).Both pulmonary hypertension and malnutrition showed synergic effects on the clinical nutritional risk,and higher nutrition risks were associated with poorer clinical outcomes.Conclusions STRONGkids can effective evaluate the nutritional risks of CHD children during the perioperative period and thus can inform the standardized nutrition support.

Changes in behaviour relevant to the vestibular system were studied in Long-Evans rats which were fertilized, born and housed in 2 acceleration of gravity for 4 months and thereafter exposed to 1 acceleration of gravity, and expression of Fos protein in the brain stem was examined. Data from the hypergravity rats were compared respectively with those from the rotation group and the labyrinthectomized group. Static and locomotion modes of the hypergravity rats were changed, tension of extensor was enhanced and the abilities in locomotion equalization and orientation in swimming and air-righting response were reduced. The adaptation process varied with different behaviours. The time for recovery of the ability of orientating in swimming was the longest, taking more than 1 month. The Fos protein expression provides a useful tool for mapping brain functional activities after sensory stimulation, showing a low basal level in normal and labyrinthectomized groups. The hypergravity rats, on the other hand, exhibited more Fos-positive cells in the superior colliculus, inferior colliculus, periaqueductal gray, raphe dorsal nucleus and solitary nucleus. In contrast, the inferior olivary nuclei, locus coeruleus and vestibular nuclei were not strongly labeled. These spatial patterns of Fos expression suggest that a decrease in gravity-inertial force may activate a neural pathway different from the vestibulo-olivar pathways activated by an increase in gravity-inertial force.

Abstract: The coronavirus disease 2019 (COVID-19) has become a global public health problem due to its highly contagious nature. This article aims to discuss the current situation of traditional Chinese medicine in the prevention and treatment of COVID-19, and to provide a basis for traditional Chinese medicine research and scientific and standardized treatment of COVID-19.In this article, the etiology, pathogenesis, treatment plan and research progress were summarized, analyzed and concluded by retrieving and reviewing the literature and clinical reports related to the prevention and treatment of COVID-19 with traditional Chinese medicine. Traditional Chinese medicine has obvious effects in the prevention and treatment of COVID-19, improvement of clinical symptoms, and control of disease progression, which had the unique advantages of mild curative efficacy and safety. It has important practical significance in relieving patients' early symptoms and reducing the incidence of progression from mild to severe, and had great potential for development in the treatment of COVID-19. The traditional Chinese medicine intervention and the formulation of diagnosis and treatment plans for the COVID-19 need to be continuously optimized and improved. Scientific and rational application of traditional Chinese medicine to prevent and treat COVID-19, optimization diagnosis and treatment programs, and in-depth exploration of pharmacological mechanisms, especially the provide reference for early intervention of new coronavirus pneumonia by traditional Chinese medicine, the control of disease progression in the middle stage, and improve prognosis in the late stage with Western medicine.

Arthritis, Rheumatoid ; metabolism ; Cells, Cultured ; HSP72 Heat-Shock Proteins ; pharmacology ; Humans ; Interleukin-10 ; metabolism ; Synovial Membrane ; cytology ; drug effects ; metabolism ; Toll-Like Receptor 2 ; metabolism ; Toll-Like Receptor 4 ; metabolism

AIM: To study the role of nitric oxide ( NO ) and γ-aminobutyric acid ( GABA) in the formation of amblyopia by establishing 2 different types of amblyopic models.METHODS:A total of 18 aged 3-week kittens were randomly divided into monocular deprivation, strabismus and normal groups. All types of amblyopia were developed in the experimental eyes that were detected by P-VEP 12wk later. The cats were killed and the immunocytochemistry staining method were applied to observe under the light microscope the changes of distribution and positive cells areas of NO and GABA across the amblyopic retinal, compared to that from the normal cats of identical age.
RESULTS: The P-VEP showed that the amplitude of wave P1 was lower (P<0. 05) and the P1 latent time was longer ( P<0. 05 ) in two types of amblyopic cats than those in the normal cats. Compared to the normal cats, the NO and GABA positive cells areas were obviously reduced ( P<0. 05 ) across the retina in the amblyopic cats. But no significant difference was found between two kinds of amblyopic cats.
CONCLUSION:The NO and GABA play an important role in the formation of amblyopia in the level of retinal.

Obgective To explore the antimicrobial resistance genotypes and molecular epidemic features of Klebsiella pneumoniae (K.pneumoniae) producing extended spectrum 3-lactamases (ESBLs) in the Pediatric Intensive Care Unit (PICU) of Guiyang Children' s Hospital.Methods Disc diffusion technique (Kirby-Bauer method) and automatic microbiology analysis system were employed to determine the antimicrobial resistance,and Double-disk Diffusion was adopted in the phenotype confirmatory test of ESBLs,and PCR was used to determine the antimicrobial resistance genotypes.Results Among 44 straits of non-repetitive-K.pneumoniae,isolated from the children during hospitalization since April to December of 2013,29 straits (65.9％) were detected.The findings of sensitivity tests showed that 29 strains of ESBLs-producing K.pneumoniae presented a higher rate of sensitivity to carbapenems,cephamycin and quinolones,100％ resistance to penicillin and cephalosporins of the first and the second generations.Fifteen non-ESBLs-producing K.pneumoniae presented 100％ resistance to penicillin.The rate of resistance to 9 kinds of antibiotics (Ampicillin/Sulbactam,Cefazolin,Cefuroxime,Cefamandole,Cefiriaxone,Ceftazidime,Cefepime,Gentamicin,Aztreonam) in ESBLs-producing K.pneumoniae strains(79.3％,100.0％,100.0％,100.0％,100.0％,79.3％,65.5％,41.4％,79.3％) was significantly higher than that of non-ESBLs-producing K.pneumoniae trains (13.3％,6.7％,20.0％,20.0％,0,0,0,6.7％,0) (x2 =17.54,35.51,28.00,28.00,44.00,24.93,17.30,4.18,24.93,all P ＜ 0.05).In 29 strains of ESBLs-producing K.pneumoniae,3 genotypes were detected respectively:93.1％ of SHV (27/29 strains),51.7 ％ of TEM (15/29 strains) and 37.9 ％ of CTX-M (11/29 strains).Five forms of genotype distribution were presented:14 (43.8％) strains carrying single ESBLs gene,5 (17.2％) strains carrying 2 types,19 (31.0％) strains carrying 3 types,and 1 strain had not been genotyped.Conclusions ESBLs-producing K.pneumoniae had been epidemic in PICU of Guiyang Children's Hospital,with multiple antimicrobial resistances and diversification of antimicrobial resistance genotypes.

Objective To investigate the impact of optimal respiratory system dynamic compliance (Cdyn) strategy for titrating positive end-expiratory pressure (PEEP)on the prognosis of acute respiratory distress syndrome (ARDS) in infants.Methods A total of 30 patients with ARDS admitted in Pediatric Intensive Care Unit (PICU) of Guangxi Maternity and Child Health Hospital were divided into 2 groups randomly (n =15).PEEP was set in the control group according to PEEP/FiO2 in American ARDS collaboration while optimal Cdyn was for the treatment group.Pressure control ventilation(PCV) mode and small tidal volume(7 mL/kg)strategy were taken.Respiratory mechanics,hemodynamics and inflammatory cytokines were monitored in each group before and after experiment.The time of assisted ventilation,and the hospital stay in PICU and 28-day mortality were compared.Results (1) There was no significant differences in gender,age and severity of disease between the 2 groups (all P ＞ 0.05).(2) The optimal PEEP of the control group was significant lower than that of the treatment group[(6.4 ± 1.4) cmH2O vs (9.9-± 1.6) cmH2O,P ＜ 0.01].(3) Cdyn and oxygenation index(OI) in 2 groups were all improved,and the degree of improvement in the treatment group was significantly better than that of the control group [Cdyn after the experiment at 2 h:(0.39 ± 0.03) mL/(cmH2O·kg) vs (0.36 ±0.03) mL/(cmH2O · kg),P＜0.05; 24 h:(0.40±0.03) mL/(cmH2O · kg) vs (0.38±0.03) mL/(cmH2O · kg),P ＜0.05; 48 h:(0.43 ±0.02) mL/(cmH2O · kg) vs (0.40 ± 0.02) mL/(cmH2 O · kg),P ＜ 0.01 ; OI after the experiment at 24 h:(20.07 ± 2.12) cmH2O/mmHg vs (21.94 ± 2.05),P ＜0.05 ; 48 h:(17.51 ± 1.64) cmH2O/mmHgvs (19.82 ± 2.07) cmH2O/mmHg,P ＜ 0.01] ; There were no significant differences in heart rate(HR),mean aerial pressure(MAP),cardiac index (CI) before and after the experiment (all P ＞ 0.05).(4) Interleukin-6 (IL-6) in two groups all decreased gradually,and the decrease in treatment group was more obvious than that of control group after the experiment at 24 h:(84.58-± 9.11) ng/L vs (93.18 ± 9.27) ng/L,P ＜ 0.05 ; 48 h:(76.67 ± 9.23) ng/L vs (90.10-± 9.42) ng/L,P ＜ 0.01.(5) The lengths of assisted ventilation and the hospital stay in PICU of the treatment group were significantly less than that of the control group [length of assisted ventilation:(6.62 ± 1.26) d vs (8.06-± 1.44) d ; the hospital stay in PICU:(8.12 ± 1.31) d vs (9.53 ±1.42) d,all P ＜0.05].There had no barotrauma and the mortality was not distinct between the two groups(P ＞ 0.05).Conclusions Optimal Cdyn method for titrating PEEP improves respiratory mechanics of ARDS obviously,shortens the time of assisted ventilation,and has no serious adverse effect on hemodynamics.