Objective To investigate the effect of oral rehydration on hemedynamies and mierocirculatory perfusion in dogs with fatal hemorrhagic shock.Methods Twenty male Beagle dogs 16-20 months old weighing 8-12 ks were subjected to a loss of 40% of the total blood volume,then divided into 3 groups:no rehydration group (group NR,n=8),oral rehydration group(group OR,n=6)and intravenous rehydration group(group IR,n=6).Group NR received no treatment within 24 h after blood-letting.Group IR and OR were given glucose-electrolyte solution (GES) either by gastric tube or by intravenous infusion 3 times volume of the blood loss immediately after the establishment of the model.Then the lactated Ringer's solution,glucose saline and compound amino acid(2 times volume of the blood loss)were started to be given to supplement the physiological consumption from 24 h after blood-letting in each group.The MAP,cardiac index(CI),systemic vascular resistance (SVR),dp/dtmax,and intestinal mucoflal blood flow (IMBF) were determined before blood-letting(T0,baseline) and 2 h (T1),4 h(T2),8 h(T3),24 h(T4),48 h(T5) and 72 h(T6)after blood-letting.The fatality rate within 72 h after blood-letting and urinary output were calculated.Results The fatality rates were 63%,33%and O in group NR, OR and IR respectively, which showed significant difference between the groups (P < 0.05).Compared with the baseline values at To, MAP, CI and dp/dtmax were significantly decreased at T1-6, in group NR,at T1-5 in group OR and at T1-4 in group IR, and SVR was significantly increased, while IMBF decreased at each time point after blood-letting in the three groups ( P <0.05), but no significant change was found in MAP, CI and dp/dtmax at T6 in group IR and OR (P>0.05). MAP, CI, dp/dtmax , IMBF and urinary output were significantly higher, while SVR was significantly lower in group OR and IR than in group NR ( P < 0.05). MAP, CI,dp/dtmax, IMBF and urinary output were signiflcandy lower, while SVR was significantly higher in group OR than in group IR ( P < 0. 05). Conclusion Oral administration of GES 3 times volume of the blood loss within 24 h after fatal hemorrhagic shock can obviously improve the hemodynamics and microcirculatory perfusion, then improve the survival state and have obvious resuscitation efficacy.

Objective To investigate the effects of oral glucose-electrolyte solution (GES) on resuscitation of hemorrhagic shock induced by 40% blood volume loss in rats. Methods SD rats were randomly divided into three groups; oral GES without hemorrhagic shock (GES group, n = 16) , hemorrhage shock without fluid resuscitation (HS group, n = 20) and hemorrhagic shock resuscitated with oral GES (HS + GES group, n = 20). About 40% of total blood volume was bled from carotid artery of rats to produce a model of hemorrhagic shock. GES with a volume of three times of blood loss was given three times intragastrically at 0.5, 1 and 6 hours after hemorrhage. Mean arterial pressure (MAP) was measured constantly. Blood flow in liver, kidney, stomach and small intestines, and parameters like hemato-crit, plasma osmotic pressure, alanine aminotransferase (ALT) , creatinine (Cr) and diamine oxidase (DAO) were determined 24 hours after hemorrhage. Survival rates of the rats in three groups were calculated 24 hours after hemorrhage. Results MAPs of HS + GES group were 9. 7% and 10. 9% higher than those of HS group 4 and 24 hours after hemorrhage (P < 0. 05). The blood flow of liver, stomach and small intestines in HS + GES group were 18.6% , 88.4% and 22.0% respectively, higher than those in HS group(P <0.05 or P <0.01) 24 hours after hemorrhage. The hematocrit level of HS + GES group was significantly lower than that of HS group, while the levels of ALT, Cr and DAO in HS + GES group were significantly lower than those in HS group (P <0.01). The survival rate of rats in HS + GES group was 80% , which was significantly higher than 30% in HS group (P <0.01). Conclusions Oral rehydration can significantly improve MAP and tissue perfusion, maintain blood volume and plasma osmotic pressure, alleviate organ damage and hence promote the survival rates of rats with hemorrhagic shock.

Objective To investigate the effects of delayed fluid resuscitation on hemodynamics and visceral perfusion in dogs with hemorrhagic shock. Methods Fourteen Beagle dogs were prepared for cannulation of carotid artery and jugular vein, and 24 hours later they were subjected to hemorrhagic shock with about 42% of total blood volume exsanguinated. Animals were divided into delayed resuscitation group ( DR group, n = 8) and immediate resuscitation group ( IR group, n = 6) . In the first 24 hours after hemorrhage, dogs in Dr group were given no fluid resuscitation, while those in IR group were immediately given resuscitation with intra-venous glucose-electrolyte solution, of which the volume was three times that of blood loss. In the second 24 hours, all animals had intra-venous fluid resuscitation. The variables of hemodynamics and visceral perfusion were determined before hemorrhage and 2, 4, 8, 24, 48 and 72 hours after hemorrhage under conscious state of dogs. Results After hemorrhage, the mean arterial pressure,cardiac output index, max of left ventricular contractility, blood flow of intestinal mucosa and urinary output greatly decreased and systemic vascular resistance obviously increased in each group compared with those before hemorrhage ( P ＜ 0.05 ) . From 4 hours after hemorrhage, the above measurements of dogs in IR group gradually resumed and reach Oh levels in 72 hours after hemorrhage except systemic vascular resistance index and intestinal blood flow. Whereas those measurements in dogs of DR group kept on worsening, and the levels of mean arterial pressure, cardiac output index, intestinal blood flow and urinary output were significantly lower than those in dogs of IR group ( P ＜ 0. 05 ) . Over 72 hours, five of eight dogs died with anuria in DR, and no animals died in IR group. Conclusion The findings indicate that delayed fluid resuscitation deteriorates hemodynamics, handicapping the restoration of visceral perfusion and increasing mortality in dogs with hemorrhagic shock.

Since γH2 AX was firstly found in 1998 , it has been one of the most important scientific topics and research tools in the related scientific fields. At present, a series of advanced testing methods and analytical technologies have been developed, which exhibited a quite attractive application prospect in the area of life science and medical science. This paper reviewed the latest progress about γH2AX in terms of molecular mechanism of phosphorylation/dephosphorylation, development of testing technologies, and the related applications.

Objective:To evaluate the value of adenosine triphophate (ATP)stress/rest nuclide myocardial perfusion imaging (MPI)in the diagnosis of female patients with coronary heart disease (CHD).Methods:The clinical materials of 47 female suspected CHD patients were retrospectively analyzed,aged from 39 to 74 years,and the average age was (53.7±6.3)years old.All patients were hospitalized and underwent two-day ATP stress and rest nuclide MPI and coronary angiography (CAG)in two weeks. The results and images of MPI and CAG were evaluated by more than 2 attending physicians. Using CAG as the “gold standard”, the diagnostic efficiency (sensitivity, specificity and accuracy) of MPI for CHD was evaluated. Results:Compared with CAG, the sensitivity,specificity and accuracy of ATP stress MPI in diagnosing the female CHD patients were 81.3% (13/16),77.4% (24/31)and 78.7% (37/47)individually;the positive predictive value and negative predictive value were 65.0% (13/20)and 88.9% (24/27).There were no severe adverse effects in the ATP stress test and the incidence of adverse effects was 85.1%.Conclusion:There is a highly diagnostic efficiency of ATP stress MPI in the CHD patients.It can be the first choice of examination methods for screening without injury and diagnosing the myocardial ischemia in the female patients.

BACKGROUND: Previous study demonstrated that hypoxia preconditioning promoted mesenchymal stem cells survival and their therapeutic efficacy, and this effect was mediated by hypoxia induced factor-1α (HIF-1α). However, specific downstream mechanism remained unclear. OBJECTIVE: To observe the influence of hypoxia preconditioning on the survival and vascularization potential of bone marrow mesenchymal stem cells in vitro and explore the regulatory mechanism of HIF-1α/MALAT1/VEGFA pathway. METHODS: Bone marrow mesenchymal stem cells were obtained and cultured in vitro. Cells were divided into hypoxia (1% O2) and normoxia control groups (20% O2), and cultured for 24 hours. Cells proliferation, apoptosis and vascularization were evaluated. The expression of HIF-1α, MALAT1, and VEGFA was detected. HIF-1α and MALAT1 were inhibited by their siRNAs separately. HIF-1α siRNA scramble and MALAT1 siRNA scramble were used as negative controls before hypoxia preconditioning. Alterations of the molecules were examined and compared in different groups. RESULTS AND CONCLUSION: (1) Compared with the normoxia control group, cell viability was significantly enhanced; and cell apoptosis percentage was significantly declined in the hypoxia group; vascular lumen like structure was also increased significantly in the hypoxia group (P < 0.01); expression of HIF-1α, MALAT1, and VEGFA was significantly increased in the hypoxia group (P < 0.01). (2) After the inhibition of HIF-1α and hypoxia preconditioning, both MALAT1 and VEGFA expression levels were significantly reduced (P < 0.01). The expression of VEGFA was also significantly suppressed after the blockage of MALAT1 (P < 0.01). (3) This study suggested that hypoxia preconditioning effectively promoted bone marrow mesenchymal stem cell survival and vascularization through the activation of HIF-1α/MALAT1/VEGFA pathway.

Objective To investigate the causes of arterial reocclusion in diabetic feet patients after endovascular treatment and its remedial measures.Methods From January 2009 to October 2013,clinical data of 371 arterial reocclusion of diabetic feet patients after endovascular treatment in Tianjin First Central Hospital were reviewed retrospectively.We summarized the causes of reocclusion,treatment methods and the short term results.Results According to the Trans-Alantic Inter-Society Consensus (TASC) Ⅱ grading standards,the first time when the endovascular treatment started there were 37 cases of grade A,85 cases of grade B,143 cases of grade C,106 cases of grade D.Arterial re-occlusion developed from one day to 36 months,averaging at (21 ± 8) months.Causes of re-occlusion included intimal hyperplasia in 263 cases (70.9％),thrombosis in 65 cases (17.5％),dissection in 19 cases (5.1％),stent fracture in 17 cases (4.6％),vascular rupture in 7 cases (1.9％).Remedial therapy adopted for arterial reocclusion was repeated endovascular treatment in 327 cases (88.1％),arterial bypass surgery in 23 cases (6.2％),conservative treatment in 13 cases (3.5％),amputation (cut toe) in 4 cases (1.1％),4 cases (1.1％) died perioperatively.275 cases were followed up for 1 to 36 months,the average was (13 ± 8) months.patency rate was 82.9％,71.3％ and 63.0％ at 6 months,1 year and 2 years.Amputation rate was 1.1％,1.8％ and 2.5％ at 6 months,1 year and 2 years.Conclusions Intimal hyperplasia is to blame for arterial reocclusion after endovascular treatment of diabetic foot.In this case most patients still can benefit from second time endovascular treatment,with a satisfactory short term patency rate.

Objective To explore the clinical efficacy and satety of LFK-SLT30 semiconductor laser combined with polidocanol for the treatment of varicose veins of the lower extremities.Methods The clinical data of 105 patients treated by traditional surgery (surgery group) and 113 patients with endovascular laser treatment (EVLT) combined with polidocanol (combination group) were retrospectively analyzed from Apr 2013 to Apr 2015.Results The operative time [(50 ± 12) min vs.(70 ±10)min] and blood loss [(19 ± 6)ml vs.(41 ± 8)ml] between combination group and surgery group were significantly different (P ＜ 0.05).The rate of complications in surgery group was significantly higher than that in the combination group[15.2％ (16/105)vs.6.3％ (7/113),x2 =4.717,P =0.030].The overall 1',2' and 3 year follow-up rate was 85.3％ (186/218),76.6％ (167/218),and 60.6％ (132/218).The average follow up was (20 ± 13)months.No significant difference existed in the rate of recurrence [0 vs.3.5％(4/113),x2 =3.786,P=0.123] between the two groups.Conclusions EVLT combined with foam sclerotherapy is as effective as surgery,while resulting in less complications,less invasive,safer and more effective for the treatment of varicose veins of the lower extremities.

Objective To explore clinical effect of repairing soft tissue defect in forearm, hand and foot with free super-thin anterolateral thigh perforator flaps. Methods At first the site of perforator vessels were determined by Doppler, then the flaps were designed and harvested with the site as center; the fascia lata and subcutaneous fat were removed by sandhill-likely only the 4.0 cm × 3.0 cm - 3.0 cm×2.5 cm disc-like fascia lata and dermis layer were reserved. 15 traumatic soft tissue defects including forearm, hand and foot were repaired with the ree super-thin antemlateral thigh perforator flaps. Results No vascular crisis happened and all skin grafts survived in donor sites. 2.0 cm×1.2 cm of the distal of flap was necrosis in 1 case and it was healed by dress changing. 15 cases were followed up 3 months-2 years and the average is 6 months. The contour and texture of all flaps were good and two point discrimination (2-PD) was about 8-10 mm of. Conclusions The contour and texture of free super-thin anterolateral thigh perforator flap are good, the feeling of recipient site recovered well, it's less injury for donor site and there is no reshaping for flap. It is a fineness donor site for repairing soft tissue defects in hand and foot.

A new method for the comparison of the treatment efficacy for specific diseases or conditions between Chinese medicine and Western medicine, which serve the same medical aim but are based on substantially different theoretical systems, was identified. Abiding by the principle of parallel subgroup design of a randomized controlled trial (PSD-RCT), participants were recruited following identical inclusion and exclusion criteria and were randomly allocated into two groups to receive treatment using the respective approaches of Chinese medicine and Western medicine. The Chinese medicine group was divided into subgroups according to the theory of Chinese medicine and the Western medicine group was also divided into subgroups according to the theory of Western medicine. The treatment for each subgroup was well defined in the protocol, including major formulae and principles for individualized modifications. The primary outcome measure was ascertained to be directly related to the patients' status but independent from both theories of Chinese medicine and Western medicine, while the secondary outcomes were represented by the patient-reported outcomes and some laboratory tests commonly accepted by Chinese medicine and Western medicine. Then, taking functional dyspepsia as an example, the authors explain the framework of the PSD-RCT for efficacy comparisons between Chinese medicine and Western medicine, and recommend that the PSD-RCT can be used to compare treatment efficacy for a specific disease or condition between Chinese medicine and Western medicine, and the comparison among subgroups can provide valuable clues for further studies.
Dyspepsia ; therapy ; Humans ; Medicine, Chinese Traditional ; Randomized Controlled Trials as Topic ; Research Design ; Treatment Outcome ; Western World