Objective To explore the blood-saving and conservation effect and clinical prognosis of extracorporeal circulation circuits designed individually by using medical polymeric materials for adults and infants in cardiac surgical procedures.Methods A total of 41 new extracorporeal circulation circuits designed based on the operation requirements,including 20 for adults and 21 for infants,were applied on adults and infants (body weight less than 10 kg),and the results were compared with that of the conventional circuits on adults (20) and infants (19)respectively.Total priming volume,priming and intraoperative blood products consumption,pump pressure,intraoperative blood hemoglobin (Hb) level,free Hb (f-Hb),platelet (Plt) count,mixed venous oxygen saturation (SvO2),colloid osmotic pressure (COP),lactate (Lac) level,Hb level after modified ultrafiltration,endotracheal intubation time and ICU time were all collected in two groups.Results Priming volume,priming and intraoperative blood consumption and f-Hb level in the blood-saving and conservation circuits group were significantly lower than that of conventional circuits group (P＜0.05).There were no significant differences (P＞0.05) between the two groups in pump pressure,intraoperative blood Hb level,Plt,SvO2,COP,Lac level,Hb level after modified ultrafiltration,endotracheal intubation time and ICU time.Conclusions The minimized blood conservation extracorporeal circulation circuit plays an important role in reducing priming volume and blood transfusion.It maintains a normal level of hemodynamics,oxygenation and tissue perfusion level during cardiopulmonary bypass in cardiac surgery for adults and infants.Red blood cell destruction can be reduced by improving blood compatibility,and physical data are all stabilized intra and post operation.This new circuit is secure,with its better outcome,expected in application.

ObjectiveTo compare the levels of sFas in the sera among Kawasaki disease (KD),incomplete Kawasaki disease (IKD),and normal control groups,and to analyze the relationship of sFas with IKD children.MethodsA total of 32 cases of acute KD and acute IKD children,and 20 cases of the control children were selected,respectively.The levels of serum sFas among three groups were measured using ELISA kits.Each child among the three groups was examined by echocardiography.Results(1)The levels of serum sFas among the three groups were[ (0.54±0.20)ng/L in KD,(0.55±0.16)ng/L in IKD,and (0.24 ± 0.04) ng/L] in control group,respectively.The overall means of sFas in the KD and IKD groups were higher than the control group,and the differences were statistically significant( F=29.276,P＜0.05 ).(2)The levels of serum sFas among echocardiography abnormal and normal groups were[ (0.65±0.19) ng/L and (0.49±0.10)ng/L],respectively; and the difference between two groups were statistically significant ( t=3.139,P ＜ 0.05 ).ConclusionsThe expression levels of sFas in the peripheral serum of IKD children were increased,and there was a close association of overexpression of sFas with the cardiovascular damage in IKD children.

Actinobacillus succinogenes A3 was mutagenized by ultra high hydrostatic pressure for improving the production ability of succinic acid.The effects of pressure,rate of pressure changes and growth periods on the lethality rate of the strain were investigated.The strain in stationary phase was mutagenized at 200 MPa with the pressure changes at the rate of 50 MPa/min.As a result,a mutation strain Actinobacillus succinogenes B19 was obtained,and the concentration of succinic acid could reach 32.2 g/L,which was 17.9%higher than that of the original strain,and in the meanwhile the concentration of acetic acid was decreased by 11.5%.After six generation,the mutant also has good stability of descendiblity for succinic acid production.

In the cardiovascular surgery of infants,especially in complex congenital heart surgery,the advantages and disadvantages of blood supply and demand have gradually attracted clinical attention.Besides,allogeneic blood transfusion may lead to the infection of infectious diseases. As a result, how to minimize postoperative bleeding, reduce the usage of allogeneic blood products,and avoid the damage of blood has become a hot issue for urgent consideration and solution.The blood coagulation system of infants is not mature compared with adults, and the operation of congenital heart disease is becoming more and more complex, which makes the issue of maintaining the blood coagulation system of infants become increasingly prominent.This paper provides a reference for perfecting blood conservation strategy of infants with congenital heart disease, which systematically reviews the application progress of minimized extracorporeal circulation circuits, combined ultrafiltration technology,vacuum assist venous drainage,blood dilution and priming,utilization of antifibrinolytic drugs,and application of autotransfusion.

Objective To evaluate the feasibility of CEUS in Crohn discasc (CD) activity.Methods Thirty-nine patients with CD were analyzed.The clinical disease activity index of 18 cases were less than 150 (inactivity),and 21 cases were between 150 and 450 (activity).The thickness of intestinal walls were measured and Limberg classification were determined by power-Doppler results.The CEUS was performed,and the parameters including rise time,peak intensity,mean transit time,time from peak to one half,wash in slope and time to peak were statistical analyzed.Results The thickness of the lesions,peak intensity and wash in slope of activity CD were greater than those of inactivity CD,which had significant difference (all P＜0.05).The Limberg classification of type Ⅰ was 1 case,type Ⅱ was 4 cases,type Ⅲ was 10 cases and type Ⅳ was 6 cases in activity CD.The Limberg classification of type Ⅰ was 10 cases,type Ⅱ was 7 cases and type Ⅲ was 1 case.The Limberg classification were mainly type Ⅲ and type Ⅳ in activity CD,and type Ⅰ and type Ⅱ in inactivity CD,which had significant difference (P＜0.001).Conclusion CEUS can provide quantitative parameters in CD activity and has great clinical value.

Objective To investigate the state of endemic fluorosis, running status of water improvement project to reduce fluoride in Jiangsu province, and to provide a scientific basis for prevention and control of endemic fluorosis. Methods In 2008, in the ten key counties of endemic fluorosis (zone), in Xuzhou,Lianyungang and Suqian, a stratified sampling method was employed to select 40 diseased villages according to their past water fluoride survey data. All children aged 8 to 12 were examined dental fluorosis, and all adults over 16 years were examined clinical skeletal fluorosis. Thirty per cent of the 40 diseased villages were selected, and 20 adults over the age of 16 in each selected village were examined by X-ray, respectively;50% of the 40 diseased villages were selected, and 30 any time urine samples of children aged 8 to 12 in each diseased village were tested urine fluoride. In each city, select a county, the status of water improvement project to reduce fluoride, water supply capacity and coverage in the county were investigated. Results A total of 3560 children aged 8 to 12 were examined, the detection rate of dental fluorosis was 38.51% (1371/3560), tooth defect rate was 5.34% (190/3560), and dental fluorosis index was 0.8. Seven hundred and eight urine samples were tested, the median urinary fluoride was 1.47 mg/L and the range was 0.08 ~ 10.08 mg/L. Clinical detection of skeletal fluorosis was 21.3% among adults over the age of 16, and X-ray detection rate of skeletal fluorosis was 39.2% (123/314).Investigated a total of 248 facilities of centralized water improvement projects, no funds to run or damaged 49, the water fluoride > 1.0 mg/L was 18. Conclusions Endemic fluorosis in Northern Jiangsu province has not been controlled completely, but has a rising trend, we should further strengthen the supervision of water fluoride reduction.

Objective To study the sources and the relationship between the management and the outcome of hemorrhage after cephalic pancreatoduodenectomy.Methods The clinical data of 370 patients who underwent pancreatic resection at the Lihuili Hospital and the Second Affiliated Hospital of Zhejiang University were retrospectively analyzed.Results Postoperative bleeding occurred in 35 patients with 11 deaths.Among those intraabominal bleeding occurred in 14 cases and gastrointestinal hemorrhage occurred in 22,with one case suffering from both.Bleediug developing within 72 hours after operation in 12 cases (early-stage group),which was caused by improper intraoperative homeostasis.In other 23 cases,bleeding 72 hours after operation(later stage group)was caused by the erosion following pancreatic and/or bile leakage.Relaparotomy was performed in 13 cases and endoscopic homeostasis was performed in 3. Relaparotomy or endoscopic homeostasis was superior to that of conservative therapy in the early-stage group (P0.05).Pancreatic or bile leakage was identified as the significant risk factors for the postoperative bleeding.Conclusions In order to prevent the postoperative hemorrhage and to reduce the mortality of pancreatic resection,skillful techniques,expeditious homeostasis,proper management of stump pancreas and the prevention of pancreatic and bile leakage are essential.

OBJECTIVETo observe the synergistic effect of beta-elemene Injection (betaI) combined Paclitaxel Injection (PI) on breast cancer MB-468 cells and to study possible mechanisms.

METHODSBreast cancer MB-468 cells were treated with betaI (2.5, 5.0, 10.0, 20.0, 40.0, 80.0, 160.0, 320.0, and 640.0 microg/mL), PI (0.00100, 0.00200, 0.00400, 0.00800, 0.01600, 0.03125, 0.06250, 0.12500, and 0.25000 microg/mL), and betaI combined PI for 24 h and 48 h respectively. Cell proliferation was determined using SRB assay. Cell apoptosis and cell cycle phase distribution were detected using flow cytometry. The post-intervention expressions of cell cycle proteins [cyclin-dependent kinase (CDK1), cyclin-B1, P21(cip1), and P27(kip1)] were detected by Western blot.

RESULTSBeta-elemene or paclitaxel inhibited the growth of MB-468 cell line. The IC50 and IC20 values treated with beta-elemene for 24 h were 34.20 and 52.59 microg/mL and for 48 h were 10.15 and 17.81 microg/mL respectively, while the IC50 values treated with paclitaxel for 24 h and 48 h were 2.449 and 1.698 microg/mL respectively. Beta-elemene (20 and 40 microg/mL respectively) and Paclitaxel (0.016 and 0.008 microg/mL respectively) synergistically inhibited cell proliferation of MB-468 cells, with Q value > 1.15. Beta-elemene alone (52.59 microg/mL) apparently decreased the expression of cyclin-B1 protein. The expression of cyclin-B1 protein in the combined group was also lower than that in the PI group (1.698 microg/mL). The expression of P27(kip1) was up-regulated when compared with that in the betaI group or the PI group.

CONCLUSIONBeta-elemene had synergistic effect with Paclitaxel, and its possible mechanism might be correlated with down-regulating the cell cycle protein cyclin-B1 expression and up-regulating the P27(kip1) expression.

Antineoplastic Agents, Phytogenic ; administration & dosage ; pharmacology ; Breast Neoplasms ; drug therapy ; Cell Cycle ; drug effects ; Cell Cycle Proteins ; metabolism ; Cell Line, Tumor ; Drug Synergism ; Female ; Humans ; Paclitaxel ; administration & dosage ; pharmacology ; Sesquiterpenes ; administration & dosage ; pharmacology

OBJECTIVETo compare the efficacy of second-line EGFR-TKIs followed by third-line pemetrexed with second-line pemetrexed followed by third-line EGFR-TKIs in patients with advanced lung adenocarcinoma.

METHODSFrom March 2007 to August 2008, 83 patients with advanced lung adenocarcinoma who failed standard first-line chemotherapy were included in this study. The patients who received EGFR-TKIs as second-line therapy followed by third-line pemetrexed were designated as group A (n = 45). The patients who received pemetrexed as second-line therapy followed by third-line EGFR-TKIs were designated as group B (n = 38). PFS and MST were estimated with Kaplan-Meier analysis and the difference between groups were compared with Log-rank test.

RESULTSThe progression-free survival (PFS) after second-line therapy in the groups A and B was 8.05 months (95% CI, 5.90 to 10.20) and 4.20 months (95% CI, 3.33 to 5.06), respectively (P = 0.001). The PFS after second-line therapy in smokers and non-smokers was 3.69 months (95% CI, 5.00 to 7.59) and 7.12 months (95% CI, 5.51 to 8.38), respectively (P = 0.007). The PFS of male and female patients was 5.56 months (95% CI, 4.02 to 7.10) and 6.85 months (95% CI, 4.98 to 7.58), respectively (P = 0.279). The PFS after third-line therapy in groups A and B was 6.88 months (95% CI, 5.07 to 8.69) and 7.60 months (95% CI, 5.59 to 9.12) respectively, (P = 0.899). The PFS after third-line therapy in smokers and non-smokers was 4.95 months (95% CI, 2.83 to 7.05) and 8.49 months (95% CI, 6.27 to 10.76), respectively (P = 0.050). The PFS after third-line therapy in male and female patients was 5. 96 months (95% CI, 4.02 to 7.91) amd 8.38 months (95% CI, 5.68 to 11.07), respectively (P = 0.176). The MST in groups A and B was 23.60 months (95% CI, 19.23 to 28.00) and 15.58 months (95% CI, 11.85 to 19.32), respectively (P = 0.021). The MST in smokers and non-smokers was 11.99 months (95% CI, 8.55 to 15.49) and 23.18 months (95% CI, 19.33 to 27.02), respectively (P = 0.001). The MST in male and female patients was 17.40 months (95% CI, 13. 19 to 21.61) and 22.74 months (95% CI, 18.29 to 27.19), respectively (P = 0.111).

CONCLUSIONSSecond line EGFR TKIs followed by third line pemetrexed regimen improves the PFS and MST compared with the regimen second line pemetrexed followed by third line EGFR TKIs in patients with advanced lung adenocarcinoma. Smoking status is an independent prognostic factor. Survival is not influenced by gender. Prospective clinical trials are needed to confirm these findings.

Adenocarcinoma ; drug therapy ; pathology ; Adult ; Aged ; Antineoplastic Agents ; therapeutic use ; Disease-Free Survival ; Erlotinib Hydrochloride ; Female ; Glutamates ; therapeutic use ; Guanine ; analogs & derivatives ; therapeutic use ; Humans ; Lung Neoplasms ; drug therapy ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Pemetrexed ; Protein Kinase Inhibitors ; therapeutic use ; Quinazolines ; therapeutic use ; Receptor, Epidermal Growth Factor ; antagonists & inhibitors ; Retrospective Studies ; Smoking ; Survival Rate

Objective To explore the incidence rate of mild cognitive impairment (MCI) among the elderly which transferred to Alzheimer disease (AD) and to analyze the related influencing factors. Methods 10 urban communities were selected through stratified cluster sampling as the research sites where 361 patients with MCI were screened from 1 942 residents aged over 60 years old. Questionnaires and laboratory assays were used to collect data from subjects, including characteristics of demographic, life style, medical history, Alzheimer-associated neuronal thread protein,(AD7C-(NTP)), amyloid β-protein 42(Aβ42) and amyloid β-protein 40(Aβ40), etc. Patients with MCI were followed up for three years to determine whether they progressed to AD. Results 121 of 361 patients of MCI converted to AD, and the incidence rate of MCI to AD was 9.49% person-years. According to the results of Logistic regression analysis model, elder (80-89 years) (OR=3.651,95% CI:1.295-10.297, P<0.001),female (OR=2.603,95% CI:1.136-5.966, P<0.001), heavy drinking(OR=1.479,95% CI:1.343-1.627, P<0.001), increased ADL score (OR=1.790, 95% CI:1.443-2.220, P=0.031) and smoking (OR=1.157,95% CI:1.091-1.224, P<0.001) were the risky factors of the transition of MCI to AD. The increase of Moca score (OR=0.766,95% CI:0.681-0.861, P<0.001) was the protective factor of the transition. Conclusions We should strengthen our monitor on elder female MCI patients, and promote healthy lifestyles among the elders, encouraging them to actively participate in physical exercises and reading, in order to delay patients' transition of MCI to AD.