Objective To evaluate the feasibility of using stroke volume variation (SVV) as the left ventricular preload to draw the cardiac function curve.Methods Twenty-seven patients of both sexes,aged 18-64 yr,with body mass index of 18-30 kg/m2,of American Society of Anesthesiologists physical status Ⅱ (New York Heart Association Ⅱ),with abnormal cardiac function,scheduled for elective offpany coronary artery byp grafting,were enrolled in this study.Twenty-five patients,aged 18-64 yr,with body mass index of 18-30 kg/m2,of American Society of Anesthesiologists physical status Ⅰ (New York Heart Association Ⅰ),with normal cardiac function,scheduled for elective non-cardiac surgery,were also enrolled in this study.SVV and SV were monitored by using a FloTrac/VigileoTM system.The patients were in the supine position from the end of anesthesia induction to the beginning of surgery.After the hemodynamics was kept stable for 5 min,SVV and SV were recorded.6％ hydroxyethyl starch 130/0.4 500 ml was intravenously infused over 20 min.SVV and SV were recorded after volume expansion.Spearman rank-order correlation was used to analyze the relationship between SVV and SV.The quadratic regression analysis was used to draw the SVV-SV curve,and the SVV-SV curve was compared with the Frank-Starling curve.Results Compared with the value before volume expansion,SVV and HR were significantly decreased,and SV was increased after volume expansion in the patients with normal cardiac function,and SVV was decreased after volume expansion in the patients with abnormal cardiac function (P＜0.01).SVV was negatively correlated with SV in the patients with normal cardiac function,and r=-0.467 (P＜0.05).SVV was negatively correlated with SV in the patients with abnormal cardiac function,and r=-0.378 (P＜0.05).The mirror symmetry was found between the SVV-SV curve in the patients with normal cardiac function and the normal Frank-Starling curve,and the general trend was close.The symmetry was not detected between the SVV-SV curve in the patients with abnormal cardiac function and the Frank-Starling curve in the patients with decreased myocardial contractility,and the general trend was not close.Conclusion For the patients with normal cardiac function,SVV can be used as the left ventricular preload to draw the cardiac function curve.

AIM:To explore the changes of the subsets and HLA-DR expression of dendritic cells and their concerning cytokine levels in peripheral blood of patients with breast cancer.METHODS:The subsets of the precussors of dendritic cells(pDC)in the peripheral blood of 57 cases of patients with breast cancer before operation and a week or six months after operation and 20 cases of healthy controls were analyzed by four-color FCM.The levels of IL-12p40,IL-10,IFN-? and IL-4 in the plasmas were tested by ELISA.RESULTS:Among 57 cases of patients with breast cancer,2 cases in Ⅲ phase and 4 cases in Ⅳphase expressed deficiency of pDC,the ratios of pDC1/pDC2 in the other cases inⅠ,Ⅱ,Ⅲ,Ⅳ phase were respectively 1.62?0.59,1.41?0.63,0.91?0.32,0.81?0.29 before operation,which were markedly lower than those in controls(1.94?0.44).The ratios of pDC1/pDC2 in the cases inⅠ,Ⅱ,Ⅲ phase were 1.71?0.47,1.52?0.54,1.04?0.36 a week after operation,which were the same as those in pre-operation,but markedly lower than those in controls.The ratios of pDC1/pDC2 in the cases inⅠ,Ⅱ,Ⅲ phase were 1.92?0.72,1.63?0.65,1.28?0.34 six months after operation,which were markedly higher than those in pre-operation,meanwhile,to compare with controls,those were still lower for patients in Ⅱ,Ⅲ phase except in Ⅰphase.No difference between patients and controls in the expression of HLA-DR of pDCs and the levels of IL-12p40,IL-10,IFN-?,IL-4 in plasmas and the ratios of IL-12p40/IL-10,IFN-?/IL-4 was observed.CONCLUSION:The ratios of pDC1/pDC2 in peripheral blood of patients with breast cancer inⅠ-Ⅳ phase are decreased.Parts of patients in Ⅲ,Ⅳ phase are deficiency of pDCs.HLA-DR expression of DCs and the ability of DCs which secret the concerning cytokines do not change as pDC subsets change.pDC subsets improve markedly inⅡ,Ⅲ phase patients and recover to the normal level inⅠphase patients after operation.

Objective To investigate the left ventricular (LV) performance in patients with essential hypertension(EH) by global performance index (GPI) based on three-dimensional speckle tracking imaging (3D-STI).Methods A total of 164 EH patients were enrolled and divided into four subgroups according to LV configuration:LV normal group (LVN,n =67),concentric cardiac remodeling group (CCR,n =49),concentric cardiac hypertrophy group (CCH,n =28) and eccentric cardiac hypertrophy group (ECH,n =20).Thirty age and sex matched healthy volunteers were enrolled as controls.3D-STI was performed to assess LV 3D global strain and LV torsion,then LV systolic dyssynchrony index (SDI) and global performance index (GPI) were calculated.Global strain parameters were investigated among the groups,and correlations with GPI were studied.Results GPI,global longitudinal strain(GLS),global area strain(GAS),global radial strain(GRS) and global 3D strain(G3DS) in EH groups were respectively lower than those in the normal controls,and there were statistical differences among the respective parameters (P ＜0.05,respectively).SDI in group CCH and ECH were significantly higher than that in normal controls (P ＜ 0.05,respectively).In multivariate stepwise regression analysis,GAS was the most influential to GPI.Conclusions GPI based on 3D-STI may accurately reflect LV performance in patients with EH,and has potential applications in clinical practice.

Objective To evaluate the feasibility of using comprehensive geriatric assessment (CGA) in estimating if standard dose treatment is fit for the elderly patients with diffuse large B cell lymphoma.Methods.Comprehensive geriatric assessments including three assessments of activity of daily living,instrumental activity of daily living and comorbidity scoring according to Cumulative Illness Rating Score for Geriatrics were adopted to assess if standard dose treatment is fit for the elderly patients in our prospective study.Thirty seven patients with diffuse large B cell lymphoma,aged ＞70 years were enrolled in the study,and grouped into fit,unfit and frail groups according to comprehensive geriatric assessment scoring and their age.The treatment protocolswere not determined by comprehensive geriatric assessment scores,but by clinical judgments made by clinicians based on their clinical experience and disease features.The clinically effective response and overall survival (OS) were analyzed in the three groups.Results According to CGA scores,patients were grouped into fit [21 cases (56.8％)],unfit [7 (18.9％)] and frail [9 (24.3％)].37 cases received 213 courses of treatment at average 5.76 courses per case.The overall response (complete / partial remission) rates were [85.7％(18/21) vs.28.6％ (2/7) vs.44.4％ (4/9),x2=9.69,P=0.008] and median survival times were (44 months vs.10 months vs.9 months;x2 =7.03,P=0.03) among fit,unfit and frail groups with statistically significant differences.Total effective rate (achieving all clinical targets) in fit group of 21 cases were 100 ％ (12/12)with receiving standard dose therapy,and 66.7％ of(6/9)with low dose therapy(P=0.06).Overall response rate(total/partial remission) [85.7％(18/21) vs.28.6％(2/7) vs.44.4％(4/9),x2=9.69,P=0.008] and median survival (44 months vs.10 months vs.9 months;x2 =7.03,P=0.03) amongfit,unfit and frail groups.In fit group,the two-year overall survival was higher in patients receiving standard dose treatment than receivingpalliativetreatment,with statistical significance [83.3 ％ (10/12) vs.33.3 ％ (3/9),P =0.032],without significant hematologic toxicity observed between the subgroups.Conclusions Comprehensive geriatric assessment can identify if elderly patients diffuse large B cell lymphoma can acquire a satisfactory curative effect from a standard dose treatment ofimmunochemotherapy.

Objective To evaluate the efficacy of anesthesia with etomidate administered by TCI in combination with continuous iv remifentanil infusion titrated to maintain BIS values at 40-60 for non-cardiac surgery in a prospective randomized single-blinded multicenter controlled clinical study.Methods Two hundred and forty-four ASA Ⅰ or Ⅱ patients of both sexes aged 20-60 yr undergoing non-cardiac surgery lasting less than 3 h were randomly allocated into 2 groups:etomidate group (group E,n =123) and propofol group (group P,n =121 ).The patients were unpremedicated.A bolus of midazolam 0.03 mg/kg was injected iv immediately before induction of anesthesia.Anesthesia was induced with sufentanil 0.3-0.4 μg/kg and TCI of etomidate (effect-site concentration (Ce) =0.5-1.0 μg/ml) or propofol (Ce =3-4 μg/ml).Tracheal intubation was facilitated with rocuronium 0.9 mg/kg.The patients were mechanically ventilated (VT 8-10 ml/kg,RR 10-12 bpm,FiO2 =1 ).PETCO2 was maintained at 35-40 mm Hg.Anesthesia was maintained with TCI of etomidate ( Ce =0.3-0.8 μg/ml ) or propofol ( Ce =3-4 μg/ml) in combination with continuous iv infusion of remifentanil at 0.1-1.0 μg· kg-1 ·min-1 and intermittent iv boluses of rocuronium.BIS values were maintained at 40-60 during operation.Sufentanil 0.1 μg/kg was administered iv before skin closure.Ce at loss of consciousness,during maintenance of anesthesia and at emergence,the consumption of remifentanil and vasoactive agents,the emergence time and extubation time were recorded.The incidences of injecton pain,post-operative nausea and vomiting (PONV) and emergence agitation were measured.Results Ce of etomidate at loss of consciousness,at emergence and during maintenance of anesthesia was (0.50 ± 0.22),(0.16 ± 0.09) and 0.22-0.39 μg/ml respectively.The incidence of injection pain and the consumption of vasoactive agents were significantly lower but more remifentanil was needed in group E than in group P (P ＜0.05 or 0.01).There was no significant difference in emergence time and extubation time between the 2 groups (P ＞ 0.05).The incidence of PONV and emergence agitation were significantly higher during recovery in group E than in group P ( P ＜ 0.05 ).Conclusion The hemodynamics is stabler during operation,but the incidence of PONV and emergence agitation are significantly higher during recovery in group E than in group P.Etomidate induces little injection pain.

Objective To explore a new 18F multifunctional synthesis module with two vessels to synthesize various kinds of 18F labeled radiopharmaceuticals for clinical utilities. Methods The module with two vessels contained five systems, capture of F ion, the first reaction vessel, the second reaction vessel, high performance liquid chromatography (HPLC) purification, and solid extraction. The two vessels were made of transparent glass and were used to prepare complex products by nucleophilic reaction or hydrolyzation. Results The complex compounds of 18F-ethyl-choline, 18F-N-succinimidyl-4-18 F-fluorobenzoate (SFB), and common compounds of 18F-fluorodeoxyglucose (FDG), 18F-3'-deoxy-3'-18 F-fluorothymidine (FLT) were synthesized by the new module. The uncorrected synthesis yield (EOS) of 18F-SFB, 18F-ethylcholine, and 18F-FDG were (28.2±1.9)% (n=5), (22.5±3.8)%(n=6), and (58.2±5.4)% (n=32), respectively. The corrected synthesis yield of 18F-FLT was (30.1 ±6.2)% ( n = 10). In addition,11C-N-methyl-N-( 1-methylpropyl )-1-( 2-corophenyl )-isoquinoline-3 -carboxamide ( PK11195 ) was also prepared by the module with the yield of (31.2 ± 2.5) % ( n = 3 ). Conclusions The new module with two vessels has been used for synthesis of many 18F compounds and it may have the potential to be used for other more 18F radiopharmaceuticals.

Objective To determine the concentration ofβ-D-gluco-pyranosy1-3-(0-β-D-glucopyranosyloxy)-oleanolate (AA-2) in rat plasma by ultra performance liquid chromatography and tandem mass spectrometry (UPLC-MS/MS) method.Methods Plasmas were separated from the heparinized whole blood by centrifugation.After addition of chlorzoxazone as an internal standard (IS),protein precipitation by acetonitrile-methanol (9∶1) was used to prepare samples.Chromatographic separation was achieved on a UPLC BEH C18column (2.1 mm × 100 mm,1.7 μm) with 0.1％ formic acid and acetonitrile as the mobile phase with gradient elution.An electrospray ionization source was applied and operated in negative ion mode.Multiple reactions monitoring (MRM) mode was used for quantification using target fragment ions m/z 793.5→631.4 for AA-2,and m/z 168.1→132.1 for IS.Results Calibration plots were linear throughout the range of 10-5000 ng · mL-1 for AA-2 in rat plasma.Mean recoveries of AA-2 in rat plasma ranged from 70.4％ to 87.8％.RSD of intra-day and inter-day precision were both less than 10％.The accuracy of the method was between 91.1％ and 104.1％.After intravenous administration of AA-2(1,3,5 mg · kg-1),the mean residence time(MRT0-t) were (0.32 ±0.13),(0.48 ±0.15),(0.44±0.08) h.The i1/2 were (1.15±0.72),(1.32 ± 0.90),(1.02 ± 0.22) h.The CL were (4.53±1.66),(4.44 ±0.94),(4.86±0.49) L · h-1 · kg-1 The Cmax were (681.67 ±246.78),(1809.45 ±479.11),(4953.21 ± 722.72) ng· mL-1.Conclusion The method was simple,rapid and sensitive,which was suitable for pharmacokinetics study of AA-2 after intravenous administration in rats.

Haploinsuffieiency of the runt-related transcription factor 2 (Runx2) gene is widely known to be responsible for cleidocranial dysplasia (CCD).To date,more than 190 mutations in Runx2 gene have been reported to be related to CCD.In this study,a novel mutation of Runx2 gene was observed in a female with CCD.Genomic DNA was extracted from peripheral venous blood of the proband and eleven members of her family.Genetic testing on these twelve people identified a novel missense mutation (c.895T＞C,Y299H) in exon 5 of the RUNX2 gene in the proband.This mutation results in an amino acid change at codon 895 (P.Tyr 299 His.) from a tryptophan codon (TAT) to a histidine codon (CAT).Our finding may further extend the known mutation spectrum of the RUNX2 gene,and facilitate prenatal genetic diagnosis of CCD in the future.

OBJECTIVETo study the chemical constituents of Excoecaria agallocha L.

METHODThe constituents were isolated and purified by repeated column chromatography and their structures were elucidated by spectroscopic analysis.

RESULTSix triterpenoids including taraxerone (1), beta-amyrin acetate (2), 3beta-[(2E,4E)-6-oxo-decadienoyloxy]-olean-12-ene (3), taraxerol (4), acetylaleuritolic acid (5), and cycloart-22-ene-3beta, 25-diol (6), and three steroids including beta-sitostenone (7), (24R)-24-ethylcholesta-4,22-dien-3-one (8), and beta-sitosterol (9) were isolated and identified from the stems and twigs of the mangrove plant E. agallocha.

CONCLUSIONCompounds 5-8 were isolated from E. agallocha for the first time.

Euphorbiaceae ; chemistry ; Magnetic Resonance Spectroscopy ; Oleanolic Acid ; analogs & derivatives ; chemistry ; isolation & purification ; Sitosterols ; chemistry ; isolation & purification ; Steroids ; chemistry ; isolation & purification ; Triterpenes ; chemistry ; isolation & purification

OBJECTIVEHypertension is one of the most common disorders in adults. Although it may be already present in children and adolescents, it does not often have clinical pictures. There is a lack of data on the blood pressure in children in Beijing area. This study was conducted to investigate the present situation of blood pressure of children and adolescents in Beijing area.

METHODSChildren and adolescents aged 3 to 18 years in 4 urban and 3 rural areas of Beijing were involved in the study at random. Blood pressure (BP) was measured three times with the use of mercury sphygmomanometery, and the means of the last two BP value were recorded. Systolic BP (SBP) was determined by the first Korotkoff sound, and diastolic BP (DBP) by the fourth Korotkoff sound.

RESULTSAltogether, 20 780 (99.6%) individuals with complete records were studied, including 10 582 from urban and 10 198 from rural areas; 10 398 were males and 10 382 were females. BP of boys was higher than that of girls [SBP: (106 +/- 12) mm Hg vs. (101 +/- 11) mm Hg, u = 27.14, P < 0.01; DBP: (67 +/- 9) mm Hg vs. (65 +/- 8) mm Hg, u = 14.14, P < 0.01]. BP of both boys and girls increased with age. However, SBP had a larger magnitude of increase than that of DBP. Both SBP and DBP of urban children were lower than those of rural children [SBP: (103 +/- 12) mm Hg vs. (104 +/- 12) mm Hg, u = 2.55, P < 0.05; DBP: (66 +/- 8) mm Hg vs. (67 +/- 9) mm Hg, u = 6.73, P < 0.01]. There was a positive correlation between BP and age, height, weight and BMI. SBP had a stronger relationship with each variable than DBP did. Among children aged 6 - 18 years, about 8.1% were found to have hypertension according to the criteria of blood pressure of children and adolescents by age and by gender of 1987 in Beijing.

CONCLUSIONSThe present study provided with the current information and characteristics of blood pressure of children and adolescents in Beijing area. The blood pressure was correlated with sex, age, body height, body weight and BMI of children and adolescents.

Adolescent ; Blood Pressure ; physiology ; Body Height ; Body Mass Index ; Body Weight ; Child ; Diastole ; Female ; Humans ; Hypertension ; physiopathology ; Hypotension ; physiopathology ; Male ; Rural Population