Objective To explore the risk factors of peripartum cardiomyopathy (PPCM). Methods A total of 82 PPCM and 100 normal delivery females were randomly recruited in the current study. Echocardiographic, cTNI,high sensitive C-reaction protein(hs-CRP) ,NT-proBNP were measured. Fifty-two patients were followed up for a mean of 6 months. Results The PPCM patients (29. 5 ± 6. 4) yrs were older than the controls (25. 2 ± 5. 8) yrs (P<0.01) . Compared to the controls, the PPCM patients showed higher blood pressure (146.9/98. 8 mm Hg v. s. 130. 2/80. 1 mm Hg, P < 0. 01) , higher proportion of cesarean section (65. 9% v. s. 51. 0% , P < 0. 05) and complicated infection(75. 6% v. s. 10. 0% ,P <0. 01). The level of leucocyte(11.0 × 109/L) ,cTNI(0. 17 μg/L), hs-CRP(28. 2 mg/L)and NT-proBNP(650. 1 ng/L) were significantly higher in the PPCM patients compared with control(8. 8 × 109/L,0. 06μg/L,6. 2 mg/L and 110. 5 ng/L,P <0. 01). Hs-CRP was positively related with NT-proBNP(r = 0. 67, P < 0. 01). After average of 6 months of treatment, left ventricular ejection fraction enhanced from 32. 2% to 50. 6%. NT-proBNP significantly declined from 650. 1 ng/L to 225.6 ng/L(P <0. 01). Multiple linear regression analysis showed that diastolic pressure (P < 0. 05), LVED (P < 0. 05) and hs-CRP (P < 0. 05) were the independent predictors for declined NT-proBNP. Conclusions Inflammatory plays an important role in the development of peripartum cardiomyopathy.

Objective To explore the effect of inflammation and autoimmunity in peripartum cardiomyopathy(PPCM). MethodsA total of82 PPCM patients and 100 normal delivery patients were randomly selected and conducted epidemiological survey.High-sensitivity Creaction protein(hs-CRP),troponin I,human antimyocardial antibody IgG(AMA-IgG),Coxsackie B virus IgG(CBV-IgG)and adenovirus antibody IgG(ADV-IgG)were detected with ELISA. ResultsCompared with control group,PPCM patients had older age,higher pressure,higher proportion of cesarean section and infection.The levels of serum hs-CRP,cTNI,and leucocyte were markedly higher in PPCM patients compared with control.The positive proportion of AMA-IgG and CBV-IgG was significantly increased(P<0.01)in PPCM patients compared with the control.Logistic regression showed that infection(OR=2.87,95%CI 1.15-5.24),increased hs-CRP(OR=1.86,95%CI 1.08-4.02)and positive AMA-IgG(OR=2.68,95%CI 1.19-4.85)were independent risk factors for PPCM. ConclusionsInflammation and autoimmunity play an important role in peripartum cardiomyopathy.

Objective To evaluate the effects of remifentanil preconditioning on the renal injury induced by limb ischemia-reperfusion (I/R) in rats.Methods Twenty-seven healthy male Sprague-Dawley rats,weighing 200-250 g,were randomly assigned into 3 groups (n =9 each):sham operation group (Sham group),I/R group and remifentanil preconditioning group (RPC group).Limb ischemia was induced by clamping bilateral femoral arteries and veins for 2 h,followed by 24 h reperfusion in I/R and RPC groups.Remifentanil 1.0 μg· kg-1 · min-1 was infused via the caudal vein for 30 min before ischemia in RPC group,while the equal volume of normal saline was given in Sham and I/R groups.Blood sample was taken from the inferior vena cava at 24 h of reperfusion to measure blood urea nitrogen (BUN) and creatinine (Cr) concentrations in serum.The rats were sacrificed and the left kidney was removed for determination of tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) contents,cell apoptosis and microscopic examination of pathological changes.Apoptosis index was calculated.Results Apoptosis index and concentrations of BUN and Cr in serum,TNF-α and IL-6 contents,and apoptosis index were significantly higher,and the pathological changes were more severe in I/R and RPC groups than in Sham group.Compared with group I/R,concentrations of BUN and Cr in serum,TNF-α and IL-6 contents,and apoptosis index were significantly decreased,and the pathological changes were attenuated in RPC group.Conclusion Remifentanil preconditioning can attenuate renal injury induced by limb I/R in rats,and inhibition of inflammatory responses and cell apoptosis in kidney may be involved in the mechanism.

BACKGROUND: Studies have shown that hemiarthroplasty is suitable for single femoral head diseases with normal acetabulum. But indications for choosing bone cement or biological fixation types, short- and long-term efficacy as well as the complications have not yet reached agreement.OBJECTIVE: To discuss the efficacy of two kinds of femoral prosthesis for femoral neck fractures in hemiarthroplasty,and the application of three-dimensional CT reconstruction in displaced fractures.METHODS: Clinical data of 73 cases of femoral head fractures undergoing hemiarthroplasty were analyzed retrospectively, and divided into bone cement and biological groups. All patients were followed up for 1.5 years, and the operation indexes, hospitalization time and hip joint function were compared; the consistent degree with intraoperative findings was compared through hip three-dimensional CT and X-ray examination simultaneously.RESULTS AND CONCLUSION: (1) There was no significant difference in the effective rate between groups (P > 0.05).(2) The operation time in the biological group was significantly shorter than that in the bone cement group (P < 0.05); the intraoperative blood loss and hospitalization time in the bone cement group were significantly less than those in the biological group (P < 0.05). (3) The Harris scores in the bone cement group were significantly higher than those in the biological group at 1 month after replacement (P < 0.05); the Harris scores in the biological group were significantly higher than those in the bone cement group at 18 months after replacement (P < 0.05); while there were no significant differences between two groups at 3, 6 and 12 months after replacement. (4) The hip three-dimensional reconstruction and X-ray examination showed no error compared with the intraoperative findings, reaching 100%. (5) Our findings suggest that age, disease history and bone quality should be considered when choosing an appropriate type of hemiarthroplasty for the patients with femoral neck fractures, and bone cement prosthesis is suitable for the elder patients with severe osteoporosis; while those with good bone quality should receive biological prosthesis. Besides, the diagnosis accuracy of three-dimensional reconstruction is superior to X-ray examination, which is conductive to fully understand displaced fractures.

Objective To study the preparation method and analytical technique of hyperoside from Flos Abelmoschus manihot.Methods Hyperoside was isolated and purified by solvent extract and chromatography, whose structure was determined by 1H-NMR and 13C-NMR. The purity was analyzed by TLC and HPLC.Results The TLC showed that the hyperoside had no impurity spot. The HPLC indicated that the purity reached more than 98.5%.Conclusions The mothod of isolation and purification for hyperoside reported in this paper was simple and economical.

Objective To explore the relationship between the RunX2 expression and the clinicopathological features in bone giant cell tumor(GCT).Methods Fifty-eight specimens of GCT were selected and grouped according to the malignant degree,tumor pathological grade,whether having soft tissue invasion and complicating pathological fracture.Then the immunohistochemical staining technique was used to analyze and compare the difference of RunX2 expression levels among different groups.Results The RunX2 expression level in malignant GCT tissues was significantly higher than that in benign GCT tissue(P＜0.05).RunX2 expression level was increased with the GCT tissue histological grade increase(P＜0.05).The expression level RunX2 in GCT tissue with soft tissue invasion was significantly higher than that in the GCT tissue without invasion(P＜0.05);the RunX2 expression level in GCT tissue with complicating pathologic fractures was significantly higher than that in the GCT tissue without complicating pathologic fractures(P＜0.05).Conclusion The RunX2 expression level is related to the severity of GCT.

Objective To investigate the association between the osteogenic differentiation in the soft tissue lump and the clinicopathological characteristics of osteosarcoma patients. Methods We retrospectively reviewed the clinical data of conventional osteosarcoma patients with soft tissue lumps, including Enneking stages, chemotherapy sensitivity, overall survival and post-metastatic survival time. The ossification level in soft tissue lumps was assessed by imaging and the proportion of osteoid matrix was assessed by pathological examination. Results A total of 189 cases were included in this study. In patients with Enneking IIIB, non-osteoblastic, partially osteoblastic and osteoblastic types accounted for 30.2%, 9.6% and 6.3%, respectively. Non-osteoblastic osteosarcoma patients had a higher rate of initial metastasis (P < 0.05); Chemotherapy efficiency of non-osteoblastic, partially osteoblastic and osteoblastic types were 60.5%, 59.6% and 31.3%, respectively. The osteoblastic osteosarcoma held the worst rate of chemotherapy sensitivity (P < 0.05). The overall survival of non-osteoblastic osteosarcoma was shorter than those of partially osteoblastic and osteoblastic types (P < 0.05). Post-metastatic survival time of osteoblastic osteosarcoma was longer than that of non-osteoblastic osteosarcoma (P=0.078). Conclusion For conventional osteosarcoma, the osteogenesis level in soft tissue lumps is related to the surgical stage, chemotherapy sensitivity and prognosis of tumors, which may provide guidance for the individual decision regarding chemotherapy and surgery timing on patients.

Background:In the clinical setting, the effect of intra-abdominal hypertension on the human body is dependent on time, but its role is not yet clear.Objective:To investigate the effect of the duration of intra-abdominal hypertension (IAH) on the prognosis of critically ill patients.Methods:This prospective cohort study enrolled 256 IAH patients who were admitted to the Surgical ICU of 10 Grade A hospitals in Fujian Province from January 2018 to December 2020. The duration of IAH (DIAH) was obtained after monitoring IAP, and ICU length of stay, duration of mechanical ventilation, duration of continuous renal replacement therapy (CRRT) and average daily energy intake from enteral nutrition during ICU stay were observed and recorded. The correlation was analyzed by Spearman rank correlation. The patients were divided into the survival group and the death group according to their survival state at 60 days after enrollment. Thereafter, clinical characteristics between the two groups were compared. Multivariable logistic regression was used to study and validate the relationship between DIAH and 60-day mortality. The receiver operating characteristics (ROC) curve was established to evaluate the predictive abilities of DIAH on the mortality risk.Results:In critically ill patients, DIAH was positively correlated with duration of mechanical ventilation ( r=0.679, P<0.001), duration of CRRT ( r=0.541, P<0.001) and ICU length of stay ( r=0.794, P<0.001), respectively. In addition, there was a negative correlation between DIAH and average daily energy intake from enteral nutrition ( r=-0.669, P<0.001). After multivariable adjustment, DIAH was an independent risk factor for 60-day mortality in critically patients with IAH ( OR=1.05, 95% CI: 1.01-1.12; P = 0.012), and exhibited a linearity change trend relationship with mortality risk. The ROC curve analysis of DIAH showed that the area under ROC curve (AUC) was 0.825 (95% CI: 0.763~0.886, P<0.01). When the cut-off value was 16.5 days, the sensitivity was 78.4% and the specificity was 75.4%. Conclusions:DIAH is an important risk factor for prognosis in critically ill patients. Early identification and rapid intervention for the etiology of IAH should be performed to shorten DIAH.