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.

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.

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

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.

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.

Objective To explore the methods of the nutritional support of children with severe sepsis.Methods The biochemical index,nutrition index,blood gas,blood routine and 24 hours urinary urea nitrogen of 198 children with severe sepsis were detected after hospitalization.Enteral nutrition,parenteral nutrition,or enteral and parenteral nutrition at the same time were selected for every children according to patients status.Children with parenteral nutrition were divided into glutamine (Gln) group and non-Gln group.Nutrition and metabolism indexes of survival and dead children were detected,including blood glucose,C-reactive protein,hemoglobin (Hb),pH,blood sodium,blood potassium,alanine transaminase,blood urea nitrogen,creatinine,blood lacticacid,lactate clearance rate,blood triglycerides,blood total cholesterol,serum pre-albumin (PA),retinal-binding protein (RBP),serum albumin (ALB) and 24 hours urinary urea nitrogen.The intake of calories were compared between survival and dead children before nutrition support (0 d),3 d and 7 d after nutrition support.Immunoglobulins of Gln group and non-Gln group were compared.Results The nutrition indexes of the survival group were higher than those of dead group [PA (130.0 ± 30.0) mg/L vs (50.8 ±20.5) mg/L,RBP(22.3 ±10.3) mg/L vs (15.7 ±6.7) mg/L,ALB(35.3 ±8.1) g/L vs (28.7 ±6.2) g/L,Hb(113.2 ±27.7) g/L vs (95.3 ±10.6) g/L,IgA(0.40 ±0.03) g/L vs (0.40 ±0.03) g/L,IgM(0.52 ±0.18) g/L vs (0.49 ±0.03) g/L] (P ＜0.05).The intake calories of survival group in 3 d and 7 d after nutrition support were (50.32 ±2.76) kcal/(kg·d) and (65.70 ±3.25) kcal/(kg·d),which were significantly higher than those of dead group [(32.54 ± 1.72) kcal/(kg·d) and (46.12 ± 1.08) kcal/(kg·d)).Among the survival children with parenteral nutrition,the levels of immunoglobulin in Gln group were higher than non-Gln group [IgG(4.93 ± 2.1) g/L vs (4.01 ± 1.03) g/L,IgA (0.31 ± 0.07) g/L vs (0.19 ±0.03) g/L,IgM(0.52 ±0.08) g/L vs (0.32 ±0.10) g/L] (P ＜0.05).Negative nitrogen balance was better in Gln group as(-2.5 ± 1.4) g/d than non-Gln group as (-5.3 ± 1.3) g/d(P ＜0.05).Conclusion Children with severe sepsis manifeste significantly increased metabolic rate and energy consumption,the protein decomposition utilization is greater than the synthetic with negative nitrogen balance.Children with more severe sepsis have lower metabolic indexes,nutrition indexes,and immunoglobulin.It is necessary for children with severe sepsis to use glutamine while having parenteral nutrition.

Objective To explore the relationship between life events and depression of patients with primary sjgren's syndrome (PSS).Methods 80 patients with PSS complicating depressive disorder were tested by self-rating depression scale(SDS) and life event scale (LES),and compared with the control group including 80 PSS patients with non-depressive disorder matched with age and sex.Then the correlation between SDS and LES were analyzed.Results The total score of life events (32.72 ± 13.93),the score of negative life events (24.36 ±11.24),the score of SDS(58.60 ± 16.78) and the frequency of life events(91.3％) in the research group were higher than those in control group(P ＜ 0.05),but the positive life events score (7.15 ± 5.84) was lower than that in control group (9.76 ± 7.29),and there was statistically significant difference between the two groups (P ＜ 0.05),there were more negative life events,especially on the aspects of family,work and study in the research group.There was positive correlation among the negative life events score,total score of life events and SDS score in the research group(P＜ 0.01),meanwhile,negative correlation was revealed between the score of positive life events and SDS score in the research group(P ＜ 0.05).Conclusion Patients with PSS complicating depressive disorder experienced more negative life events which play an important role in depression of patients with PSS.

Objective To survey the prevalence and the related factors of depression in patients with primary Sj(o)gren's syndrome (pSS),and provide references for early mental intervention.Methods The depression state of 217 patients with pSS was screened with self-rating depression scale (SDS) first and then assessed by Hamilton depression scale (HAMD,17 index).The prevalence of depression was determined based on the diagnosis of psychiatrist based on the 3rd edition of Chinese classification of mental disorders (CCMD Ⅲ).The personality was evaluated by Eysenck personality questionnaire (EPQ),and the life events were questionnaired by life events scale (LES).The general condition was analyzed by self-designed questionnaire.Finally,step-wise multiple factor regression analysis was carried out to determine the risk factors that best accounted for the depression.Results The prevalence rate of depression in patients with pSS was 39.2％ (85/217).There were 5 factors entered the regression equation by multifactor regression analysis.They were severe pain,concerns of doctor and nurse,known of the fact by patients,adverse life events,and neuroticism of EPQ,and the concern of doctor and nurse was negatively correlated.Conclusion More attention from clinicians should be paid to the depression of pSS.Patients with severe pain,lack of attention from doctors and nurses,known of the disease itself,adverse life events and neurotic personality traits are factors related with depression.Recognizing the risk factors early can provide guidance for early psychological intervention.

Objective To characterize the features of Nasopharyngeal non-Hodgkin's lymphoma (NHL) on MR imaging and find the main points to differentiate it from the other nasopharyngeal tumors.Methods The MR images of 41 patients with pathologically and immunohistochemically proven nasopharyngeal NHLs were reviewed retrospectively. Images were assessed by the size, invasive extent,signal intensity of primary nasopharyngeal tumor, and the distribution of cervical lymphadenopethy. The difference of regional tissues invasion and cervical lymphadenopathy distribution between the patients with B-cell NHLs and the patients with T-cell or NK/T-cell NHLs were analyzed by Pearson's Chi-Square test or Fisher's exact test Results Of the 41 patients, 26 patients had mature B-cell lymphoma, two patients with mature T-cell Iymphoma, and thirteen patients showed Nature killer/T-cell lymphoma in nasopharynx. MRI revealed that NHLs of nasopharynx can be showed as thickening of nasopharyngeal mucosa and (or) lumps in nasopharynx, which were slightly hyper-intensity on T2-weighted images, and intermediate signal intensity (similar to muscle) on T1 -weighted images, with mild or moderated enhancement following contrast medium administration. Twenty four cases had symmetrical disease of all walls of nasopharynx, and 17 cases had unsymmetrical tumor. Of all cases, 5 cases had superficial ulcerations, 9 cases had exceed nasoharynx invasion spreads superficially along the mucosa, 23 cases had invasion of lingual and (or) palatine tonsils,20 cases showed invasion of parapharygeal muscles, 12 cases suffered from skull base bone infiltration,25 cases had retropaharyngeal lymphadenopathy, and 27 cases had cervical lymhadenopathy. Patient with nasopharyngeal Nature killer/T-cell lymphoma had a higher incidence of exceed nasopharynx invasion,parapharyngeal structures invasion, and superficial ulcerations (the cases were 8, 11, 4 in patient with T-cell or N K/T-cell lymphoma, and 4, 10, 1 in patients with B-cell lymphoma, respectively). Patients with nasopharyngeal B-cell lymphoma had a higher incidence of inasion of lingual and (or) palatine tonsils.Conclusions Nasopharyngeal NHL is a homogeneous tumor that tends to diffusely involve all walls of the nasopharynx and spread in an exophytic fashion to fill the airway, rather than infiltrating into the deep tissues. Different pathological types of nasopharyngeal NHLs have some different appearance on MRI between each other. A large tumor in nasopharynx that fills the nasopharynx cavity, with no or minimal invasion into deep structures, but with invasion extend down into the lingual and(or)palatine tonsils, may suggest the diagnosis of nasopharyneal NHL.