In order to evaluate appropriately the role of lipid metabolism by the refined konjac meal (RKM), a new source of dietary fiber, the effects of RKM on the level of serum and liver lipids, hepatic histopathology and on the composition and output of fecal bile acids in comparison with pectin, algin and agar were studied.The RKM contained about 75-80% of glucomannan. All four kinds of dietary fiber "were given at a level of 5% in the diet to the young male Wistar rats fed on a lipid-rich diet containing 5% lard, 1% cholesterol and 0.25% chplate. The control group was fed on a lipid-rich diet alone withput fiber. The normal group was fed on a basal diet without extra lipid added. Feeding period was 9 weeks.The results obtained were as follows;1)All the dietary fibers tested have the similar effects on serum lipid composition. At the end of 2-week of the experiment, the serum total cholesterol levels of the four experimental groups were only 62% to 75% of that of the control group, and at the end of 7-week they were lowered to the same level of the normal group. The level of the triglyceride in serum did not change in all groups during the experiment.2)Relative liver weights were lower in four experimental groups than in control group. Hepatic hisiopathological examinations showed lipotropic effect in RKM, pectin and algin groups. Both of the above effects appeared most significantly in RKM group. The concentrations of total cholesterol and triglyceride in liver in RKM group were lower than those in control group as well as other three experimental groups.3)No harmful effects on the intake of food and growing of rats were found when feeding these four kinds of dietary fiber at the level of 5%.4)The daily output of fecal bile acids (CDCA + GDCA) was significantly increased in four experimental groups.The increase of fecal output of bile acids, especially CDCA, may be one of the mechanisms of hypocholesterola-emic effect of dietary fibers.It could be concluded that RKM has the same significant hypocholestero-lemic effect as the pectin, algin and agar, but its lipotropic effect is more potent.

Objective:To establish mice models of Staphylococcus aureus bloodstream infections so as to investigate the inflammatory responses and histopathological changes in bloodstream infections (BSIs) mice.Methods:C57BL/6 mice were inoculated with S.aureus intravenously or intraperitoneally to induce BSIs.Survival rate , weight loss and murine sepsis scores ( MSS ) were ob-served.Blood samples and tissue homogenates were plated on agar to determine bacterial burden .Inflammatory proteins ( CRP,PCT) and cytokines ( IL-1β, IL-6 and TNF-α) were determined by ELISA kits.Histopathologic changes were also assessed by pathological inflammation scores(PIS),macroscopic and microscopic examination.Results: About 70% survival rate was observed in 4.5×108 CFU/ml S.aureus induced BSIs mice.Body weight decreased and sepsis scores increased significantly since 24 h post-infection in BSIs mice,and more prominent in IV group.The counts of WBC began to significantly increase at 3 h post-infection,while CRP and PCT levels peaked at 48 hours in IV and IP groups ( 60.80 ±5.63 vs 40.58 ±7.54 for CRP;6.796 ±1.16 vs 2.740 ±0.36 for PCT ) . Moreover,the levels of IL-1β,IL-6 and TNF-αin serum and tissue homogenates ( liver,lungs,and kidneys ) were significantly elevated in BSIs mice.Pathological changes in tissues (liver,lungs and kidneys) and higher pathological inflammation scores (PIS) were also observed in BSIs mice.Conclusion:Our study represents an effective approach for S.aureus BSIs model to mimic human sepsis.Our results demonstrated that inflammation protein (PCT,CRP) and cytokines(IL-6,IL-1βand TNF-α) play an important role in the in-flammatory response and histopathological changes during BSIs caused by S .aureus.

Objective To study the diagnostic accuracy of bedside lung ultrasound examination in chronic obstructive pulmonary disease (COPD) and cardiac pulmonary edema.Methods A prospective pilot and single-blind trial was conducted.A total of 89 patients with respiratory failure admitted to the Department of Critical Care Medicine of Anhui Provincial Hospital from September 2012 to September 2013 were enrolled.There were 32 patients with COPD,31 patients with cardiac pulmonary edema,8 patients with interstitial lung disease,12 with lung infection,and 6 patients with other diseases.Another group of 30 patients without respiratory disease were enrolled as the control group.Bedside lung ultrasound examinations were performed in all patients within 24 hours,and chest radiograph was performed at the same time.The signs to be revealed were the A lines or horizontal lines arising from the pleural line,and the comet-tail artifact (B lines) arising from the lung wall interface.Results Of 89 patients,33 patients were shown a mean of 2.94 ± 1.87 A lines per case with the bedside lung ultrasound,and 38 patients with a mean of 3.27 ± 1.72 B lines per patient.1.94 ± 0.96 A lines a case and 1.74 ± 0.82 B lines a case in control group.There were significant difference between the test group and control group (Aline:t=3.835,P=0.000; B line:t=6.540,P=0.000).Among 32 cases with COPD,28 patients had a positive result of A line with a coincidence rate of 81.2％.In the 31 patients with cardiac pulmonary edema,25 patients presented B line,with a coincidence rate of 80.6％.The A lines or horizontal lines arising from the pleural line showed a sensitivity of 81.30％ and a specificity of 87.70％ with a positive predictive value (PPV) 78.80％ and a negative predictive value (NPV) 89.30％ of in the diagnosis of COPD,and the B lines showed a sensitivity of 80.60％ and a specificity of 77.60％ with a PPV of 65.80％ and a NPV of 88.20％ in the diagnosis of cardiac pulmonary edema.However,X-ray examination showed a sensitivity of 65.50％,a specificity of 86.00％,a PPV of 72.40％ and a NPV of 81.70％ in the diagnosis of COPD,and it showed a sensitivity of 74.20％,a specificity of 69.00％,a PPV of 56.10％ and a NPV of 83.30％ in the diagnosis of cardiac pulmonary edema.Bedside ultrasound was highly consistent with X-ray in diagnosis of COPD [area under receiver operating characteristic curve (AUC):0.833 vs.0.816,P＞0.05],but Kappa value of ultrasound technology A line in the diagnosis of COPD was greater than the value of X-ray imaging techniques (0.685 vs.0.527).There was little diagnostic value of ultrasound A line in cardiac pulmonary edema (AUC was 0.305),while the B line was superior to X-ray (AUC:0.888 vs.0.747,P＜0.001),and had a higher Kappa value than the value of X-ray imaging techniques (0.553 vs.0.481) in cardiac pulmonary edema.Conclusions We conclude that bedside ultrasound is cost-effective,easy for repeated examination,and suitable for differential diagnosis of lung diseases.It might be useful in screening for COPD and cardiac pulmonary edema.

Objective Konno-Rastan procedure is one option to cope with complex multilevel left ventricular outflow tract obstruction (LVOTO),which continues to pose a serious challenge to cardiac surgeons.The aim of this study is to retrospectively analyse indications for Konno-Rastan procedure,and to review the safeguards and pitfalls.Methods Between January 1996 and August 2012,totally 13 children with multilevel LVOTO underwent Konno-Rastan procedure.There were 8 boys and 5 girls.Age at surgeries ranged from 5 to 13 years,and weight from 12 to 51 kg with median of 21 kg.The pathology of this cohort includes:8 cases of congenital aortic valvular stenosis,3 cases of congenital aortic valvular stenosis combined with supravalvular stenosis,1 case of congenital aortic stenosis combined with VSD,coarctation and RVOT obstruction,1 case of aortic stenosis s/p percutaneous balloon aortic valvuloplasty.All patients have secondary diffuse tunnel LVOTO.Diameter of aortic ring ranges from 12.0 to 16.4 mm,and pressure gradient across the stenotic region ranges from 90-151 mm Hg.8 cases were implanted with St.Jude AG19 while 5 cases implanted with St.Jude AG17.Results All 13 cases survived.The 4th patient was implanted permanent epicardial pacemaker for transient Ⅲ AVB.The 4th and 5th patients were found residual ventricular septal repture at the nadir of ventricular incision,one underwent redo procedure while another is being followed up.All cases take cumadine to sustain INR at 1.8-2.5.No death emerges during follow-up period.The motality is 0％,the incidence rate of B is 7.7％,residual VSD 15.4％ and endocarditis 7.7％.Conclusion Konno-Rastan procedure is a promising techi.to relieve LVOTO.However,this complex procedure may lead to several fetal complications.Success of the surgery demands perfect operations.

Objective The study aimed to explore the development direction of congenital heart disease surgery through comparing Europe with Guangdong General Hospital(GDGH) in data of ECHSA Congenital Database.Methods The data between 2009 to 2015 of Europe and GDGH were extracted from ECHSA Congenital Database.The data of Europe and GDGH were compared by basic information,operating difficulty and mortality.Results The results of Europe and GDGH were patient number(71 763 vs 13 119),procedure/patient ratio(126.2％ vs 104.1％),age[(75.91 ± 146.18) months VS(105.80 ± 172.18) months],the proportion of neonate (18.2％ vs 4.4％),Aristotle mean score (7.00 vs 6.67),30 days mortality (2.98％ vs 1.73 ％).The proportion of neonate palliative operation of Europe was more than that of GDGH.In adult group,Europe was more of reoperation and of GDGH was more of primary surgery.Conclusion The surgical treatment of congenital heart disease of GDGH is developing and is close to the mean average of Europe.The proportion of neonate,complex surgery and reoperation is lower than Europe.

Objective To investigate the imaging changeof cerebral ischemireperfusion injury (CIRI) afteinterventional therapy in acute middle cerebral artery occlusion .Method32 patientwith acute middle cerebral artery occlusion in ouhospital from January 2013 to Novembe2014 were selected .16 casewere performed the recanalization therapy aftearterial thrombolysiand/omechanical thrombectomy(recanalization group) and 16 casewere notreated by thrombolytitherapy (non-recanalization group) .The differenceof brain imaging changes(onse,on 3 ,7 d afteonset) were analyzed and compared between the two group. ResultThe proportion of lateral ventricle compression degree and the shifdegree of brain midline on 3 d afteonsein the reca-nalization group were greatethan those in the non-recanalization group ,the differencebetween the two groupwere statistically significant[0 .50 ± 0 .11 v.0 .58 ± 0 .10 ,0 .57(0 .18 ,0 .83)cm v.0 .22(0 ,0 .57)cm ,P＜0 .05] ,while which on 7 d of onsein the recanalization group were lesthan those in the non-recanalization group[0 .80 ± 0 .11 v.0 .55 ± 0 .12 ,0(0 ,0 .13) v.0 .46(0 , 0 .88)cm ,P＜0 .055] .Conclusion Although the interventional therapy ian importanmeasure foearly treatmenof ischemistroke ,buiaggravatethe early brain edem,therefore CIRI induced by the interventional therapy should be paid more attention to.

OBJECTIVETo examine the prevalence and the sequence of the genes of new genotypes of hepatitis G virus (HGV) in Guangxi, China.

METHODSSerum samples were collected from 85 intravenous drug abusers (IVDAs), 80 patients with liver diseases (PLDs) and 50 blood donors (BDs). All sera (n=215) were tested by using EIA for HBsAg, anti-HCV and anti-HIV, and by using nested PCR for HGV RNA. In 62 subjects positive for HGV, HGV RNA was sequenced, and a phylogenetic tree was constructed for analyzing genotypes of HGV.

RESULTSHGV RNA was detected in 85 of 215 serum samples (39.53%). The positivity rates for HBsAg, anti-HCV and anti-HIV were 39.07%, 42.79% and 0, respectively. First, 11 nucleotide sequences were determined and the isolates were grouped into three clusters with HGV. 5 of 11 HGV isolates clustered in a distinct phylogenetic branch (genotype Asia) which was different from the described GBV-C and HGV sequences, suggesting the presence of a new genotype of HGV in this locality. Second, 51 nucleotide sequences were determined and analyzed for their genotypes of HGV, and showed genotype GBV-C (3.23%), genotype HGV 30-65% and new genotype (genotype Asia) 64.51%, respectively.

CONCLUSIONSThere were subgenotypes in 3 genotypes of HGV; The predominant genotypes of HGV were genotype Asia and genotype HGV among IVDAs, PLDs, and BDs patients in Guangxi, China.

Adult ; Blood Donors ; China ; epidemiology ; Female ; GB virus C ; genetics ; isolation & purification ; Genotype ; Hepatitis C ; epidemiology ; Humans ; Liver Diseases ; virology ; Male ; Polymerase Chain Reaction ; RNA, Viral ; genetics ; Sequence Analysis, RNA ; Substance Abuse, Intravenous ; virology

OBJECTIVE: To investigate culturing neural stem cells (NSCs) from rat embryos in vitro and to observe their growth and differentiation. METHOD: NSCs were isolated from hippocampus of SD rat embryos (P16-P18) and cultured in DMEM/F12 medium containing EGF, bFGF, B27. To observe process of cell proliferation by microscope and identify cell types by immunocytochemical analyses after differentiation. RESULT: NSCs grew well in serum-free conditional medium and their cell bodies present transparent with good refraction at about eighth day. After differentiation, the cells demonstrated NSE and GFAP immunoreactive. CONCLUSION NSCs were cultured well in serum-free conditional medium and they could be induced to differentiate into neurons and astrocytes in serum conditional medium.
Animals ; Cell Differentiation ; Cell Proliferation ; Cells, Cultured ; Culture Media, Serum-Free ; Embryo, Mammalian ; Female ; Hippocampus ; cytology ; embryology ; Multipotent Stem Cells ; cytology ; Neural Stem Cells ; cytology ; Pregnancy ; Rats ; Rats, Sprague-Dawley

Objective Evaluation of the efficacy of high-frequency repetitive transcranial magnetic stimulation for chronic disturbance of consciousness after severe craniocerebral injury based on magnetic resonance spectroscopy.Methods The clinical data of 106 patients with chronic disturbance of consciousness after severe craniocerebral injury from January 2018 to December 2022 were retrospectively analyzed,and they were divided into control group(conventional rehabilitation treatment)and observation group(high frequency repetitive transcranial magnetic stimulation treatment)by propensity score matching method(1∶1),with 53 cases in each group.Both groups were examined by magnetic resonance spectroscopy(MRS)before and after treatment.The brain metabolic indexes[N-acetyl aspartate(NAA)/creatine(Cr)value,choline complex(Cho)/Cr value],Glasgow coma scale(GCS)score,electroencephalogram(EEG)grading,coma recovery scale(CRS-R)score,brainstem auditory evoked potential(BAEP)grading,upper limb sensory evoked potential(SSEP)grading and Cerebral blood flow perfusion index[cerebral blood volume(CBV),mean transit time(MTT),cerebral blood flow(CBF)]were compared between the two groups.Results After treatment,the NAA/Cr values of the thalamus and brainstem in the two groups increased,while the Cho/Cr values decreased,and the levels of brain metabolic indexes in the observation group were signifi-cantly better than those in the control group(P<0.05).The two groups'GCS score and CRS-R score increased,and the improvement of the observation group was better than that of the control group(P<0.05).The BAEP grading,EEG grading,and SSEP grading of the two groups improved,and those of the observation group were better than the control group(P<0.05).The CBF and CBV of the two groups increased,and MTT decreased,and the level of cere-bral blood perfusion index in the observation group was better than that in the control group(P<0.05).Conclusion High frequency repetitive transcranial magnetic stimulation has a significant effect on the recovery of patients with chronic consciousness disorders after severe craniocerebral injury.The mechanism may be related to improving the blood flow velocity of brain tissue and metabolism in the brain.

Novel coronavirus Omicron variant infection can cause severe illness and even death in certain populations. Omicron variant infection may lead to systemic inflammatory response, coagulation disorder, multi-organ dysfunction and other pathophysiological changes, which are different from other Novel coronavirus variants to a certain extent, so therapeutic strategies should not be the same. The National Medical Center for Major Public Health Events invited experts in fields of infectious diseases, respiratory medicine, intensive care, pediatrics and fever clinic to develop this quick guideline based on the current best evidence and extensive clinical practices. This quick guideline aims to standardize the diagnosis and treatment of novel coronavirus Omicron infection, and to improve the disease management abilities of clinicians.