OBJECTIVE:To observe the effects of hemofiltration combined with Jisheng shenqi pill on protein and energy re-serves of uremia patients. METHODS:124 uremia patients were randomly divided into control group(n=60) and test group (n=64). Control group was given 250-300 ml/min hemofiltration,4 h for every times,3 times a week;test group was additionally giv-en 9 g Jisheng shenqi pill,twice a day. The treatment course for both groups was 12 months. Hemoglobin(Hb),blood urea nitro-gen (BUN),glutamate aminotransferase (ALT),albumin (ALB),serum transferrin (TF),plasma fibronectin (FN),systolic blood pressure,diastolic blood pressure,mean arterial pressure;body mass index(BMI),subcutaneous fat thickness and arm mus-cle circumference in 2 groups before and after treatment were observed. RESULTS:After treatment,Hb,TF and FN levels in 2 groups were significantly higher than before,test group was higher than control group;ALT,ALB,BUN levels,systolic blood pressure,diastolic blood pressure and mean arterial pressure were significantly lower than before,test group was lower than control group;there were significant differences in the BMI,subcutaneous fat thickness and arm muscle circumference between control group and before and test group(P<0.05),but there was no significant difference in the BMI,subcutaneous fat thickness and arm muscle circumference in test group before and after treatment(P>0.05). CONCLUSIONS:Hemofiltration combined with Jisheng shenqi pill can improve microenvironment in vivo and immune function,reduce accelerated metabolic induced by inflammation and improve protein and energy reserves to improve life quality of patients.

Purpose To investigate the clinical effect of ultrasound guided drainage combined with different hardeners for simple breast cysts,and to further provide reference for individual treatment.Materials and Methods Clinical data of 117 cases breast simple cysts were analyzed retrospectively,of which 42 cases were routine ultrasound-guided puncture combined with fluid injection of hypertonic sugar (group A),40 cases were routine ultrasound guided drainage combined with ethanol injection therapy (group B),and 35 cases were routine ultrasound guided therapy alone (control group).The clinical efficacy and adverse reactions were compared among the three groups after treatment.Results The total effective rate of group A was 95.24％,group B was 97.50％,and control group was 82.86％.Total effective rate of group A and B had no significant difference (P＞0.05),which were both higher than control group (P＜0.05).The adverse reactions rate of group B was higher than group A and control group,which had statistical significance (P＜0.05).Conclusion Ultrasound guided injection of hypertonic sugar or ethanol after drainage treatment for simple breast cysts can both obtain satisfactory clinical results,but adverse reactions of the former one are mild,it should be widely applied.

Objective:To investigate the value of synthetic MRI for evaluating lumbar intervertebral disc degeneration.Methods:A total of 414 lumbar intervertebral discs from 85 patients were included prospectively from September 2018 to February 2019 in First Affiliated Hospital of China Medical University. The T 1, T 2 and proton density (PD) mapping were generated from synthetic MRI. Two doctors measured the T 1, T 2 and PD values to evaluate intraobserver agreement by using ICC. For Pfirrmann grade comparisons, the variables with normal distribution were analyzed with the one-way analysis of variance, whereas those with skewed distribution were analyzed with the Kruskal-Wallis H test. Furthermore, the ROC curves were used on significant parameters to evaluate their diagnostic efficacy. The Z test was used to compare the differences of area under the ROC curves (AUC). Results:The color of the quantitative mapping changed along with the increase of the Pfirrmann grade of the intervertebral discs, which corresponded to the decrease of the T 2WI signal intensity. The ICC values of the quantitative values of nucleus pulposus indicated excellent agreement (ICC>0.900), followed by anterior annulus fibrosus (ICC>0.700) and then the posterior annulus fibrosus (ICC>0.600). The results of the adjacent Pfirrmann grade comparisons were as follows: between Pfirrmann grade Ⅰ and Ⅱ, the differences of T 2 and PD values of nucleus pulposus were statistically significant ( P=0.004 and P<0.001, respectively); between Pfirrmann grade Ⅱ and Ⅲ, the differences of T 1, T 2 and PD values of nucleus pulposus were statistically significant (all P<0.001); between Pfirrmann grade Ⅲ to Ⅳ, the T 1, T 2 and PD values of nucleus pulposus (all P<0.001) and the T 1 and PD values of posterior annulus fibrosus ( P=0.025, P<0.001, respectively) had statistically significant differences; between Pfirrmann grade Ⅳ to Ⅴ, the difference of T 2 values of nucleus pulposus were statistically significant ( P=0.031). The AUC of T 2 values of nucleus pulposus between Pfirrmann grade Ⅱ to Ⅲ and grade Ⅳ to V were higher than those of the PD values ( Z=2.443, 3.591 and P=0.015,<0.001). Conclusions:Synthetic MRI can quantitatively evaluate lumbar disc degeneration, in which the T 2 value of nucleus pulposus may be the most effective parameter with high repeatability.

Objective To study the pathogenesis of lower limb motor disorder in vascular parkinsonism(VP)using diffusion tensor image(DTI). Methods A case?control study was performed in a cohort of 16 VP patients and 32 PD patients. Patients were all recruited from the first affiliated hospital of China Medical University from Dec. 2011 to Dec. 2012. The lower limb motor function of those patients was assessed using measurement scales. All patients received magnetic resonance image(MRI)and diffusion tensor image(DTI). Results Patients in VP group showed more seri?ous movement disorders such as freezing of gait(gait ignition failure)than these in PD group,and the movement disorders of their lower limbs prog?ress more rapidly in VP group than the PD group. Movement disorders of their lower limbs in VP group were related to fibers in bilateral frontal lobes (P=0.008). Movement disorder of their lower limbs in PD group were related to fibers in substantia nigra(P=0.030). There are statistically signifi?cant differences in both the FA values of substantia nigra,bilateral frontal lobes and the ADC values of frontal lobes,and the pars compacta and pars reticulata of substantia nigra between these two groups(all P<0.05). Conclusion Movement disorders of bilateral lower limbs are more seriously manifested in VP patients than in PD patients. The onset movement dysfunction of bilateral lower limbs is closely related to fibers in the frontal lobe.

Objective To evaluate accuracy of density measurements within coronary plaque by multi-slice spiral CT and factors that influence measurements. Methods Four adult cadaver hearts were used. Thrombus and pericardial fat which acquired from specimen (size 2.0, 1.5, 1.0 and 0.5 mm respectively) were placed into coronary artery to simulate coronary plaques. The contrast medium (three different concentrations 1: 30, 1:40, and 1:50) were injected into coronary artery. The raw date were reconstructed with two slice width ( 1. 00 and 0. 75 mm). Results When contrast medium concentrations was 1: 30, the CT values of thrombus were 109 HU ( slice width 1. 00 mm, size 2. 0 mm) , 115 HU ( slice width 1.00 mm, size 1.5 mm), 101 HU (slice width 0.75 mm, size 2.0 mm), 113 HU ( slice width 0. 75 mm,size 1. 5 mm) ; the CT values of fat were - 23 HU ( slice width 1. 00 mm, size 2. 0 mm) , -17 HU(slice width 1.00 mm, size 1.5 mm) , -9 HU(slice width 1.00 mm, size 1.0 nun), -27 HU ( slice width 0.75 mm, size 2. 0 mm) , - 19 HU (slice width 0.75 mm, size 1. 5 mm) , - 13 HU (slice width 0. 75 mm,size 1. 0 mm). When contrast medium concentrations was 1: 40, the CT values of thrombus were 79 HU( slice width 1.00 mm,size 2.0 mm) , 87 HU( slice width 1.00 mm, size 1. 5 mm) , 115 HU( slice width 1. 00 mm,size 1. 0 mm) , 73 HU(slice width 0. 75 mm,size 2. 0 mm) , 80 HU(slice width 0. 75 mm, size 1. 5 mm) , 110 HU( slice width 0. 75 mm, size 1. 0 mm) ; the CT values of fat were - 31 HU ( slice width 1. 00 mm, size 2. 0 mm) , - 22 HU ( slice width 1. 00 mm, size 1. 5 mm) , - 10 HU ( slice width 1.00 mm,size 1.0 mm) , -35 HU(slice width 0. 75 mm,size 2.0 mm) , -25 HU(slice width 0. 75 mm, size 1. 5 mm) , - 19 HU ( slice width 0. 75 mm, size 1. 0 mm). When contrast medium concentrations was 1:50, the CT values of thrombus were 53 HU ( slice width 1. 00 mm, size 2. 0 mm) , 60 HU ( slice width 1.00 mm,size 1.5 mm) ,63 HU(slice width 1.00 mm,size 1.0 mm) ,51 HU(slice width 0.75 mm,size 2. 0 mm) ,64 HU( slice width 0. 75 mm,size 1. 5 mm) ,67 HU( slice width 0. 75 mm,size 1. 0 mm) ,145 HU (slice width 0. 75 mm, size 0. 5 mm) ; the CT values of fat were - 39 HU ( slice width 1. 00 mm, size 2. 0 mm) , -28 HU( slice width 1. 00 mm,size 1. 5 mm) , - 22 HU( slice width 1. 00 mm,size 1. 0 mm) , 17 HU(slice width 1. 00 mm,size 0. 5 mm) , -41 HU(slice width 0. 75 mm,size 2. 0 mm), -36 HU(slice width 0. 75 mm, size 1. 5 mm ) , - 27 HU ( slice width 0. 75 mm, size 1. 0 mm ) , 3 HU ( slice width 0. 75 mm, size 0. 5 mm ) . The density values of thrombus were correlated with size ( t = - 6. 624, P 0. 05) not found statistically significant may be caused by both too close slice width (1.0 mm and 0. 75 mm) and few samples. The slice width(t= -2. 595,P

Objective To evaluate the clinical values of the TR band, analyze the factors about the hemorrhage delay at the same time. Methods Divided 98 patients who had accepted the radial artery interventional radiology into the observation group (52 cases) and the control group (46 cases) randomly. The TR band was used in the observation group and the routine nursing method was used in the control group. Results The incidence rate of complication in the observation group was significant lower than that of in the control group,P

ObjectiveTo observe the influence of different dietary protein intake (DPI) on nitrogen balance and nutritional indices in peritoneal dialysis (PD) patients, and explore the minimal DPI to maintain nitrogen balance.MethodsThirty-four PD patients were randomly divided into group A, B and C with DPI as 1.2, 0.9 and 0.6 g·kg-1·d-1 respectively. All the patients admitted into our hospital and completed a 10-day assessment for nitrogen balance, as well as nutritional status including serum albumin (Alb), pre-albumin at baseline, the 7th and 10th day. ResultsThe DPI of group A, B and C was (1.18±0.05), (0.87±0.02), (0.66±0.03) g·kg-1·d-1, whose differences were significant (P<0.01). The dietary energy intake (DEI) was 129.29 (117.57-133.89), 111.71 (100.42-133.47), 146.86 (128.03-163.18) kJ·kg-1·d-1 respectively. Nitrogen balance was positive in group A, B, C [2.99 (2.15-4.72) g, 1.20(0.59-1.89) g, 0.24 (-0.87-1.27) g]. The BUN decreased at the 7th and 10th day (P<0.01) in group C. The BUN and phosphorus in group A increased, but without significant difference as compared to baseline. No significant differences of nutritional status were found among three groups throughout the trial. ConclusionMinimal DPI 0.65 g·kg-1·d-1 plus the supplement of protein loss in dialysate can maintain the nitrogen balance in peritoneal dialysis patients.

Objective: To investigate the regulation of emodin on microRNA expressions in mouse model with sepsis by GeneChip microRNA array. Methods: Forty two c57 mice were randomly (random number) divided into 3 groups: sham operation group (sham group, n=14),sepsis group(n=14) and emodin group (n=14). The sepsis model of the mouse was subjected to cecal ligation and puncture (CLP). Mice in emodin group received intraperitoneal injection of emodin (40 mg/kg) half an hour before operation and every 12 hours after CLP. All mice were sacrificed 48 h after surgery and part of the ileum were removed for intestine tissue stained with hematoxylin eosin. The levels of tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6) and intestinal fatty acid binding protein (I-FABP) in peripheral blood were measured by enzyme-linked immunosorbent assay (ELISA). Total RNA of ileum tissues was extracted from the sepsis group and emodin group, and then subjected to miRNA microarray. The results of microarray were further verified by quantitative real-time PCR (qRT-PCR). Target genes of differentially expressed miRNAs were predicted and subjected to gene ontology (GO) and KEGG pathway enrichment analysis. Data of multi-groups were analyzed by one way variance (ANOVA) and inter-group comparisons were made by SNK-q tests. Mann-Whitney U test was used when homogeneity of variance were not met. The value of P<0.05 was considered statistically significant. Results: Compared to the sepsis group, the levels of serum TNF-α, IL-6 and I-FABP in the emodin group were decreased significantly. MiRNA microarray showed that 23 miRNAs were differentially expressed in the emodin group as compared to the sepsis group, among which 17 miRNAs were up-regulated and 6 miRNAs were down-regulated. qRT-PCR results were consistent with miRNA array data. Target genes of 10 selected miRNAs were predicted and subjected to bioinformatic analysis. A total of 3 410 target genes were significantly enriched in 2 072 GO biological process terms, 246 GO cellular component items and 277 GO molecular function terms. Moreover, KEGG pathway analysis showed that these differential miRNAs were involved in the regulation of PI3K-Akt signaling pathway, MAPK signaling pathway, and TNF signaling pathway. Conclusions Emodin can regulate the expression of multiple microRNAs, and play an important role in protecting the intestinal mucosal barrier via a variety of targets and pathways.

Objective:To study the physical activity level and its influence factors among residents in one suburb of Beijing,so as to provide specific interventions for different people in different circum-stances and to provide reference for health relevant policy-making in the future.Methods:In the study, 7 31 9 subjects aged 1 8 years or above were involved.The self-designed questionnaires based on Health Belief Model (HBM)had acceptable validity and reliability.The physical activity levels were calculated to classify sufficient or insufficient amount by a thousand-step equivalent greater than or equal to 6 or 1 0. Multiple variable Logistic regression was used to explore the influence factors of the physical activity among the residents.Results:The residents’median amount of physical activity in the suburb district of Beijing were 9.1 thousand-step equivalent with quartile of (3.8,20.4).The percentages of the thou-sand-step equivalent greater than or equal to 6 or 1 0 were 63.7% and 47.7%,respectively.The median amounts of physical activity from work or household chores,transportation and recreation physical activi-ties were 4.0,1 .0,0.0 and the components of the total amount of physical activity from those were 61 .7%,1 8.3% and 20.1 %,respectively.There were 8.6% residents whose life did notinvolve moder-ate or vigorous intensity activities.By using factor analysis,five factors were extracted from the scale based on the HBM;These factors together contributed to 63.7% of the sum of the squared loadings.The differences of physical activity levels on education level,age,gender,self-efficacy,cues,subjective and objective barriers were statistically significant (P <0.05).Those who were female,with older age,lower education level,higher self-efficacy,fewer cues,fewer subjective and objective barriers preferred to do more physical activities.Conclusion:The physical activity levels among the residents in the suburb dis-trict of Beijing are moderate and high,and most amount of physical activities from work or household chores.Those who are male and whose ages are from 1 8 to 29 years and whose education levels are of university or above should be focused on intervention.Specific interventions should be developed for dif-ferent people in different situations;More attention should be paid to improve the residents’self-efficacy and reduce the subjective and objective barriers of physical activity,and we also should actively advocate people to have more leisure exercise so as to improve the physical activity level among all residents.

Objective:To investigate the clinical features and risk factors of left ventricular systolic dysfunction in children with septic shock.Methods:A retrospective analysis was performed on the clinical data of children diagnosed with septic shock in the Department of Critical Care Medicine of Children’s Hospital, Capital Institute of Pediatrics from February 2016 to June 2021. Inclusion criteria: (1) patients met the diagnostic criteria of septic shock; (2) Cardiac ultrasound was performed within 48 h after shock treatment and was dynamically monitored during shock treatment. Exclusion criteria: (1) Previous history of chronic cardiac insufficiency, cardiomyopathy, or organic heart disease; (2) patients with acute cerebral infarction, cerebral hemorrhage and necrotizing encephalopathy; (3) congenital genetic metabolic diseases; and (4) incomplete information. Left ventricular systolic dysfunction was defined as a left ventricular ejection fraction (LVEF) <50% and a ≥10% decrease in the patient’s initial LVEF assessed on admission. Patients with left ventricular systolic dysfunction and without left ventricular systolic dysfunction were compared. Comparisons between groups were performed with unpaired Student’s t test, or Mann-Whitney U test, or chi-square test. Multivariate logistic regression analysis was used to analyze the correlation factors of left ventricular systolic dysfunction. Results:The incidence of left ventricular systolic dysfunction in children with septic shock was 30.0% with the lowest LVEF of (42±8)%. Left ventricular systolic dysfunction occurred on (2.4±1.3) days after shock onset, and the LVEF returned to normal on (6.7±3.3) days. Hematogenous infection was more frequent (77.8% vs. 40.5%, P=0.018), ventilator application (83.3% vs. 50.0%, P=0.033) and inotropes and vasopressor drugs (100.0% vs. 64.3%, P=0.009) were used more frequently in patients with left ventricular systolic dysfunction(n =18), compared with patients without left ventricular systolic dysfunction(n =42). Patients with left ventricular systolic dysfunction had a lower LVEF [(42±8)% vs. (67±5)%, P<0.001], a lower pediatric critical illness score [(64±13) vs. (76±14), P=0.003], a lower resuscitation success rate at 6 h (38.9% vs. 73.8%, P=0.010), a higher lactate at admission [3.80 (3.15, 5.88) mmol/L vs. 2.70 (1.85, 3.80) mmol/L, P=0.001) and a higher 28-d mortality (38.9% vs. 12.8%, P=0.025) compared with patients without left ventricular systolic dysfunction. Hematogenic infection ( OR=7.358, 95% CI: 1.198~45.197, P=0.031) and lactate at admission ( OR=1.743, 95% CI: 1.041~2.917, P=0.034) were independent risk factors for left ventricular systolic dysfunction. Conclusions:The incidence of left ventricular systolic dysfunction in children with septic shock was 30.0%. Left ventricular systolic dysfunction usually occurred on (2.4±1.3) days after shock onset and resolved within 7 days, which was associated with 28-d mortality. Hematogenous infection and high lactate value were independent risk factors for left ventricular systolic dysfunction.