OBJECTIVETo study the correlation between arachidonic acid (AA) and acute red blood cells damage in rats, and to build a model with hidden blood loss in vivo, and to explore the pathological mechenism of hidden blood loss.

METHODSA total of 50 male adult Sprague-Dawley rats weighing (200 ± 20) g were randomly divided into five groups (n = 10): control group and four experimental groups. The rats in the experimental groups were given 0.5 ml different concentrations of AA dilu- ents, 5, 10, 20, 40 mmol/L respectively. The blood samples were collected from orbital venous at the beginning and 24, 48, 72 hours after administration. Then the changes of hemoglobin (Hb) ,red blood cell count (RBC), glutathione peroxidase (GSH- PX) activity, total superoxide dismutase (T-SOD) activity and hydrogen peroxide (H202) in the blood samples were tested.

RESULTSSignificant hidden blood loss occurred when the concentration was 10 mmol/L in the experimental group, with the RBC and Hb sharply reduced in blood samples. The Hb and RBC were reduced in all the experimental groups and control group at 24 hours after administration, while in the experimental groups they changed more obviously. The GSH-PX activity, T-SOD activity and H₂O₂were also significantly reduced in all groups, and the changes showed significant differences. The Hb and RBC were relatively stable in the control group and the experimental groups at 48 hours after administration; while GSH-PX activity, T-SOD activity and H₂O₂were all significantly decreased, and the changes in the experimental groups were more notable.

CONCLUSIONElevated levels of AA in the blood causes oxidative stress in the red blood cells, leading to the damage of red blood cells and hemoglobin, which is responsible for hidden blood loss.

Animals ; Arachidonic Acid ; toxicity ; Erythrocytes ; drug effects ; metabolism ; Glutathione Peroxidase ; blood ; Hemoglobins ; analysis ; Male ; Rats ; Rats, Sprague-Dawley ; Superoxide Dismutase ; blood

Treatment based on syndrome differentiation is an essential feature of traditional Chinese medical diagnosis. The interventions based on changes of syndrome types in randomized controlled trials are complicated, leading to the difficulty of blind method enforcement. This article described a double-blind method. It could be used in randomized controlled trials under the condition of different syndrome types and different medications. It numbered drugs in two stages, and in two phases to achieve double-blind. This method not only guaranteed investigators and subjects to be in blinded conditions, but also achieved using different medications for patients of different syndromes. It also caused no drug waste. It was scientific and feasible.
Double-Blind Method ; Humans ; Medicine, Chinese Traditional ; Randomized Controlled Trials as Topic ; Single-Blind Method

Objective Not much information is available on the comparative analysis of G test on diagnosis of deep fungal in -fection by colormetric and turbidimetric measurements .The purpose of this paper was to explore the clinical value of fungal (1-3)-β-D-glucan detection kit ( colormetric measurement ) . Methods 89 clinical samples collected from Hainan Branch of PLA General Hos-pital were detected by fungal (1-3)-β-D-glucan detection kit (turbidimetric measurement) and fungal (1-3)-β-D-glucan detection kit ( colormetric measurement ) respectively , among which 32 cases were from disease group ( deep fungal infection in patients ) and 57 ca-ses were from control group ( healthy person ) .The comparison was made on the sensitivity , specificity and accuracy of these two meth-ods. Results The sensitivity, specificity and accuracy of colormetric measurement kit on the diagnosis of deep fungal infection were obviously higher than those of turbidimetry method kit (81.2%vs 53.1%, 91.2%vs 75.4%, 87.6%vs 67.4%, P<0.05), which was of significant difference .Detection result of colormetric method had a positive coincidence rate with other systems '( except respira-tory system) deep fungal infection, which was obviously higher than turbidimetry method (92.8%vs 57.1%, P<0.05).Positive co-incidence rate and total coincidence rate between colormetric method kit and clinical diagnosis result on differentiate samples were obviously higher than those of turbidimetric method kit (P=0.01). Conclusion Colormetric measurement kit has higher accuracy and higher coincidence rate with clinical diagnosis than turbidimetry meas-urement kit , which is better for clinical service .

Ginseng saponins are a type of important active substances in the ginseng genus plants. They have notable pharmacological activities of antineoplastic, neuroprotective, and hepatoprotective activities, which have been drawn more attention to obtain minor ginsenosides by all kinds of methods. In this review, we discussed the latest progress for enrichment of minor ginsenosides by biological transformation of major ginsenosides. At the same time, we have a brief outlook of the research at bioconversion of ginseng saponins.
Bacteria ; metabolism ; Biotransformation ; Drugs, Chinese Herbal ; chemistry ; metabolism ; Ginsenosides ; chemistry ; metabolism ; Panax ; chemistry ; metabolism

Objective To analyze the clinical techniques of renal artery control in laparoscopic donor nephrectomy.Methods 211 relative living renal transplantations were performed from June 2003 to June 2012,and 136 donors underwent laparoscopic donor living nephrectomy (LDN) since 2007.Forty donors were subjected to the Hem-o-lock clips for renal artery control by open surgery,87 donors to the Hem-o-lock clips for renal artery control by laparoscope,5 donors to the Endo GIA stapler for renal artery control by laparoscope,and 4 donors to the Hem-o-lock clips by laparoscope combined with hand-assisted suture transfixion for renal artery control.Results The warm ischemia time of renal artery control was shortest (1.1 ± 0.3 min) by Hem-o-lock clips in open surgery,and longest (3.2 ± 0.8) min by the Hem-o-lock clips with laparoscope.There was significant difference in the warm ischemia time of renal artery between open group and other groups,the differences (P＜0.05).The comparison of prognostic factors in the transplant renal outcome showed no significant difference among groups.The renal arterial stump-rrhexis-caused massive secondary bleeding occurred in 1 case subject to Hem-o-lock clips for renal artery control by laparoscope,with conversion to open surgery urgently,the operation was successful at last.Other renal artery control ways were all safe without any adverse reaction.Conclusion The warm ischemia time of renal artery control by Hem-o-lock clips in open surgery was shortest in laparoscopic donor nephrectomy.The renal artery control way by Endo GIA stapler in laparoscope or by Hem-o-lock clips with hand-assisted suture transfixion is safest.The utilization of Hem-o-lock clips should be careful in high risk population such as severe atherosclerosis etc.

Femoroacetabular impingement (FAI) is a common cause of hip pain and limited range of motion among young and middle-aged active adults and athletes. The acetabular labral tear and cartilage damage secondary to FAI may increase the risk of hip osteoarthritis. FAI is characterized by pathologic impact between the femoral headneck junction and the acetabular rim secondary to bony deformity. According to the pathological anatomy leading to impingement, the FAI can be divided into the femoral cam-type deformity (Cam), the acetabular over-coverage deformity (Pincer) and a combination of both. In recent years, arthroscopic osteoplasty of the femoral head-neck junction is the main way to treat the Cam deformity; However, there still remain some controversies about how to perform an adequate and effective arthroscopic femoroplasty. Based on this problem, the present article reviewed the preoperative diagnosis, intraoperative evaluation, surgical techniques and postoperative evaluation of Cam-type FAI to explore how to adequately correct Cam deformity under arthroscopy. In the present study, a total of 1928 related articles were obtained by searching PubMed, Web of Science, Cochrane library, China Knowledge Network, Wanfang Full-text Database and Weipu Science and Technology Journal Database. According to the inclusion and exclusion criteria, 43 papers were finally included. After summarizing the above literatures, it was found that anatomical structures such as Cam deformity, femoral neck anteversion, and acetabular coverage can be evaluated preoperatively by X-ray, three-dimensional CT and MRI. X-ray fluoroscopy and arthroscopic dynamic examination are performed during the femoroplasty to locate the Cam deformity and to determine whether the femoral neck offset radio and the spherical structure of femoral head are corrected, at the same time, it is necessary to consider the overall anatomy of the hip joint to achieve an adequate resection of the Cam deformity and restore the normal mobility of the hip joint.

The application of electronic informed consent has the advantages of speeding up the recruitment of subjects, helping the less educated to understand research and recruit groups, facilitating direct communication between subjects and researchers, minimizing human omissions and errors, and effectively improving the efficiency of clinical research. However, there are also some challenges, such as privacy, ethical censorship, hardware costs and so on. On the basis of the above discussion, this paper believed that electronic informed consent, as a new form, would provide a more powerful tool for clinical research in an era full of opportunities and challenges, with research value and potential.

OBJECTIVETo study correlation of brain hypoxia of different degrees with brain function and damage.

METHODSThe brain regional oxygen saturation (rSO2) was determined by using a non-invasive near infrared spectroscopy (NIRS) technique in 15 piglets; the piglets were subjected to inhale 3% - 11% oxygen-nitrogen mixed gas through mechanical ventilation for 30 min. The piglets were divided into groups according to the level of brain rSO2 (i.e. < 30%, 30% - 35%, 35% - 40%, and 40% - 50%), and the data were compared with those of the control group (rSO2 > 60%). Changes of brain function were detected through amplitude and frequency of EEG waves and signal complexity. The piglets were sacrificed via decapitation 72 h after brain damage, and then histopathological and ultrastructural examinations were performed on cerebral cortex and hippocampal CA1 area.

RESULTSIn the group with rSO2 > 40%, the mean arterial pressure (MAP) after hypoxia was (56 +/- 0.00) mm Hg (1 mm Hg = 0.133 kPa), the blood lactic acid (LA) was (2.3 +/- 1.2) mmol/L, the EEG findings were within normal range, and there was no change in brain tissue ultrastructure. In the group with brain rSO2 = 30% approximately 40%, the MAP was (73 +/- 8) mm Hg, the LA was (8.2 +/- 3.9) mmol/L, the EEG waves showed decreased amplitude, frequency and complexity, but restored to some extent after hypoxia. The brain tissue ultrastructure showed damages to the cerebral cortex and neuron mitochondria at hippocampal CA1 area. In the group with brain rSO2 < 30%, the MAP was (35 +/- 0) mm Hg, the LA was (12 +/- 2) mmol/L, the EEG showed decreased amplitude, frequency, and complexity of signals compared with those of the normal control group, and was difficult to restore after hypoxia in some of the piglets; the brain tissue ultrastructure appeared to be similar to the changes seen with high-degree swollen cerebral cortex and neuron mitochondria at hippocampal CA1 area.

CONCLUSIONDifferent degrees of hypoxia had different influence on brain function and brain damage. The lower the brain rSO2, the more severe the damages to the brain and its function. The rSO2 of brain tissues detected with noninvasive NIRS can reflect brain injury and its severity during cerebral anoxia.

Animals ; Blood Gas Analysis ; Brain Injuries ; complications ; Cerebral Cortex ; physiopathology ; Cerebrovascular Circulation ; physiology ; Electroencephalography ; Female ; Hypoxia ; metabolism ; pathology ; Hypoxia, Brain ; complications ; Hypoxia-Ischemia, Brain ; physiopathology ; Male ; Neurons ; pathology ; Oximetry ; instrumentation ; Oxygen ; metabolism ; Oxygen Consumption ; Spectroscopy, Near-Infrared ; methods ; Statistics as Topic ; Swine

Objective To analyze the risk factors for persistent corneal epithelial defects (PCED) after pars plana vitrectomy (PPV) in patients with proliferative diabetic retinopathy (PDR).Methods A total of 201 PDR patients (201 eyes) who received PPV were enrolled in this retrospective study.There were 86 males (86 eyes) and 115 females (115 eyes).The patients aged from 30 to 81 years,with the mean age of (57.94±9.65) years.Among them,159 patients were ≥50 years of age,and 42 patients were ＜50 years of age.There were 36 patients with HbA1c ＜7.0％,165 patients with HbA1c ≥7.0％.There were 93 right eyes and 108 left eyes.There were 93 right eyes and 108 left eyes.The diabetic retinopathy stages were as follows:stage Ⅳ in 24 eyes,stage Ⅴ in 78 eyes and stage Ⅵ in 99 eyes.The operation time was ranged from 1 to 4 hours,with an average of 2 hours.Among the 201 eyes,corneal epidermis were scraped on 25 eyes;70 eyes were combined with cataract surgery;a laser photocoagulation count ＜ 1000 points was performed in 78 eyes,and ＞ 1000 points were performed in 123 eyes.Sixty-one eyes involved intravitreal silicone oil tamponade,18 eyes involved intravitreal tamponade with C3F8,and 122 eyes were not involved with intraocular tamponade.Postoperative persistent intraocular hypertension was defined as an intraocular pressure (IOP) ≥21 mmHg (1 mmHg=0.133 kPa) after PPV with necessary treatment using IOP-lowering medications for ≥ 2 weeks.The diagnostic criteria for corneal epithelial defects were taken from the Expert Consensus on Clinical Diagnosis and Treatment of Corneal Epithelial Defect in China (2016).The corneal epithelial defect was diagnosed as PCED if it was treated with common methods such as a lacrimal substitute or corneal contact lens,but showed no improvement and no signs of healing for ≥2 weeks.The incidence of PCED after eye surgery was recorded and its related risk factors were analyzed.A multivariate logistic regression was used to analyze the risk factors for PCED,which were expressed as a odds ratio (OR) and a 95％ confidence interval (CI).Results Of 201 eyes,16 eyes (7.96％) presented with PCED after surgery and 185 eyes (92.04％) with no PCED.There was no significant difference in the age,sex,and eyes between the patients with or without PCED (x2=6.548,0.927,0.044;P=0.011,0.336,0.833).A multivariate logistic regression showed that intraoperative epithelial debridement (OR=1 3.239,95％CI 2.999-58.442,P=0.001),intraoperative treatment in combination with cataract surgery (OR=7.448,95％CI 1.975-28.091,P=0.003),intravitreal tamponade with C3F8 (OR=11.344,95％CI 2.169-59.324,P=0.004),and postoperative persistent intraocular hypertension (OR=10.462,95％CI 2.464-44.414,P=0.001) were risk factors for PCED after PPV.Conclusion Intraoperative epithelial debridement,intraoperative treatment in combination with cataract surgery,intravitreal tamponade with C3F8,and postoperative persistent intraocular hypertension are risk factors for PCED in patients with PDR after PPV.

Objective To comprehensively evaluate the risk factors of aplastic anemia, and provide scientific evidence for the primary prevention of aplastic anemia. Methods The published Papers were searched by"aplastic anemia" "case control study" and"risk factors" as key words collected from Chinese National Knowledge Infrastructure, Chinese VIP journal database, PubMed, Cochrane library and Clinical Trial and other databases, ranged from the creation date of each database to September 2017 .A meta-analysis of studies on risk factors was performed to calculate the pooled odd ratios (ORs) with 95％ confidence intervals (CIs) with Software Stata 14.0. Results The database search resulted in the identification of 1, 094 articles. After screening, 22 case-control studies were included in the study with 16 factors. Ten risk factors were showed statistically significant differences, including paint exposure (OR=3.82, 95％ CI: 1.68-8.66), chloramphenicol (OR=3.21, 95％ CI: 1.98-5.20), benzene exposure (OR=2.94, 95％ CI: 2.11-4.11), glue exposure (OR=2.56, 95％CI: 1.28-5.12), history of hepatitis (OR=2.54, 95％ CI: 1.94-3.34) , hair dye exposure (OR=2.37, 95％ CI: 1.08-5.22) , pesticides exposure (OR=1.98, 95％ CI: 1.60-2.45), β-lactam (OR=1.77, 95％ CI: 1.03-3.06), sulfonamides (OR=1.64, 95％ CI:1.03-2.61) and fuel/oil exposure (OR=1.53, 95％ CI: 1.25-1.87) , and high economic income (OR=0.52, 95％ CI:0.43-0.63) is the protective factor. Conclusion The meta-analysis of case-control studies suggests that the risk factors of aplastic anemia mainly including four aspects: drug use, past history, socioeconomic status and occupational or environmental exposure to chemical toxic substances.