Objective To summarize the onset and the management of serious responsiveness during the tilt table test (TTT), and the prevention measures. Methods Thirty six elderly patients (26 males and 10 females, aged between 60 70) were tested with a tilt angle of 70 degrees for a maximum of 45 minutes and then processed with isoproterenol provocative tilt testing. ECG and blood pressure were monitored during the test and the peripheral intravenous cannula were maintained for all patients with normal saline. Results Twenty one of the 36 patients were defined as positive including 10 showing serious responsiveness. Of the 10 patients, 3 had a history of atherosclerosis involving internal carotid arteries; among the 3 with bradycardia, 2 were associated with II? A V block, and another one was with chronic atrial fibrillation. The serious reponsiveness included asystole for more than 5 seconds(3 cases) , serious bradycardia for more than 1 minute(3 cases) , and serious hypotension for more than 1 minute (4 case), respectively. Those with serious responsiveness were managed with returning to supine position, or intraveneous atropine, or CPR (2 cases), or oxygen given(4 cases). Only 2 hypotensive patients recovered gradually in 10 minute emergent management while others recovered rapidly and with no complication. Conclusions TTT may result in serious responsiveness especially in elderly patients though it is non invasive method. Therefore, proper patient selection according to the indications, control of isoproterenal infusion and close observation of vital signs are important for a safe consequence.

Objective To investigate the feasibility of L-[1- 13 C]phenylalanine breath test to assess liver function and determine the effective parameters of the test for quantitative assessment of liver function in adult. Methods Twelve healthy volunteers served as control group, and 26 liver cirrhotic patients with hepatitis B were divided into three groups, 10 patients in Child-Pugh classification A, 8 in B and 8 in C, An oral dose of 100 mg of nonradiative tracer L-[1- 13 C]phenylalanine were administered to all the subjects. Breath samples were taken before and different intervals within 360 min after administration. 13 CO_2 enrichment was measured by isotope ratio mass spectrometer. Results After the oral administration of L-[1- 13 C] phenylalanine, 13 C excretion reached a peak within 10-30 min. The parameters of 13 CO_2 excretion rate at 30 min ( 13 CO_2ER_ 30 ) , 13 C cumulative excretion of 60 min ( 13 C_ cum60 ), 75 min( 13 C_ cum75 ), 90 min( 13 C_ cum90 ) and 13 CO_2 half excretion time ( t _ 1/2 ) were shown sensitive, which could differentiate significantly the groups( P

Objective To investigate bone nutritional status of neonates and their mothers as well as the correlation between them by estimating the concentrations of 25-(OH)D3, calcium and phosphorus in maternal blood and cord blood at birth, and by measuring the bone speed of sound (SOS) of neonates and their mothers with quantitative ultrasound within 3 days after birth. Methods The concentrations of 25-(OH)D3, calcium and phosphorus in the serum were estimated both from 32 pregnant women who had a term delivery and from the umbilical cord at birth. Within 3 days after delivery, the bone SOS values of the mothers measured from their radius and neonates from their tibia were estimated and the correlation between the mothers and their neonates was analyzed. Thirty-nine non-pregnant healthy women who at the same age as the pregnant women were selected as control group and had their bone SOS measured. The difference of bone SOS between pregnant and healthy non-pregnant women was compared. Results There was positive correlation between cord blood and maternal blood 25-(OH)D3 concentration [(14. 7±7. 8) nmol/L and (30. 3±10. 2) nmol/L, r= 0 . 680, P=0. 000]. The calcium and phosphorus concentration in cord blood [2.36±0. 28)mmol/L and (1.57±0.76) mmol/L] were significant higher than that in maternal blood E(2.09± 0. 17) mmol/L and (1.04±0. 28) mmol/L], but no correlation was found (r=0. 146, P=0. 467; r=0. 148, P=0. 445). No significant correlation was shown in the bone SOS between the infants and their mothers[(3054±76)m/s and (4170+241)m/s, r=0. 223, P=0. 220]. The concentration of 25-(OH)D3 in cord blood was closely correlated with the bone SOS of infants(r=0. 412, P=0. 026). The SOS of healthy women was obviously higher than that of pregnant women [(4258±100)m/s vs (41704±241)m/s, P=0. 043]. Conclusions There are close correlations between fetus and their mothers in vitamin D status and also between vitamin D status and fetus bone development. Some pregnant women may be short of vitamin D in autumn and winter in Shanghai and we should monitor the bone nutritional states for pregnant women.

Objective To investigate the impact of isoniazid (INH)-resistant Mycobacterium tuberculosis (Mtb) on the prevalence and dissemination of multi-drug resistant tuberculosis (MDR-TB).Methods A total of 251 patients diagnosed with tuberculosis in designated hospitals of Guanyun,Jiangsu and Deqing,Zhejiang from 2010 to 2011 were included in the study.The drug susceptibility tests (DST) were performed on all the Mtb isolates available from the sputum cultures.Mycobacteral interspersed repetitive units-variable number tandem repeats (MIRU-VNTR) was conducted for genotyping for all available Mtb isolates.Chi-square test,Fisher exact test,ANOVA and non-conditional Logistic regression modelling were applied for data analysis.Results Among 251 patients with Mtb isolates and DST results available,72 (28.7％) were resistant to INH,including 13 were INH mono-drug resistant.Of the remaining 59 INH-resistant Mtb,34 (13.5％) were resistant to rifampin TB and 25 were resistant to streptomycin and/or ethambutol.The clustering analysis based on MIRU-VNTR genotyping revealed 29 clustered genotypes (including 105 isolates) and 146 unique genotypes (including 119 isolates).Twentyfive clusters contained drug resistant Mtb and 16 clusters of them comprised by 37 INH-resistant isolates and 20 MDR-TB isolates,which accounted for 51.4％ of the INH-resistant isolates and 58.8％ of the MDR-TB isolates.Single factor analysis showed that sex,age,previous tuberculosis treatment history and sputum smear results were all related to INH-resistant tuberculosis and MDR-TB (all P ＜ 0.05).Multiple factors analysis showed that previous tuberculosis treatment history was risk factor of MDR-TB (OR=8.40,95 ％CI:3.342-21.105),while the risk factors of INH-resistant tuberculosis were previous tuberculosis treatment history (OR=3.52,95％CI:1.570-7.910),pulmonary caviry (OR=2.27,95％CI:1.075-4.799) and sputum smear results (OR=0.50,95％CI:0.275-0.892).Conclusions That INH-resistant strain may evolve to the MDR-TB after recent transmission is a possible trend.Patients with previous treatment history and advanced age are at high risk of INH-resistant tuberculosis and MDR-TB.

OBJECTIVE:To evaluate the clinical efficacy of Shuanghuanglian injection in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD),and to observe its effects on the plasma levels of C-reactive protein (CRP),procalcitonin(PCT)and interleukin-6(IL-6). METHODS:A total of 100 AECOPD patients were randomly divided into observation group and control group,with 50 cases in each group. Control group received routine treatment,such as controlled oxygen therapy,intravenous dripping of moxifloxacin,bronchodilator for relieving asthma,mucolytic for eliminating phlegm,nu-tritional support. Observation group was additionally given Shuanghuanglian injection 1 ml/(kg·d)added into 5% Glucose injec-tion 250 ml intravenously,qd,on the basis of control group. Treatment course of 2 groups lasted for 10 d. Clinical efficacies of 2 groups were compared as well as the changes of serum levels of CRP,PCT and IL-6 before and after treatment and the occur-rence of ADR. RESULTS:After treatment,total effective rate of observation group was 96.0%,which was significantly higher than 82.0% of control group,with statistical significance(P<0.05). Before treatment,there was no statistical significance in se-rum levels of CRP,PCT and IL-6 between 2 groups (P>0.05). After treatment,serum levels of CRP,PCT and IL-6 were de-creased significantly in 2 groups,and those of observation group were significantly lower than those of control group,with statis-tical significance (P<0.05). There was no statistical significance in the incidence of ADR between 2 groups (P>0.05). CON-CLUSIONS:Shuanghuanglian injection can effectively improve serum inflammatory factors of AECOPD patients,and shows good clinical efficacy and safety.

Objectives To explore the nutritional status of fatty acids in the newborn and their mother, and the role of the placenta in fetal nutrition. Methods The composition of fatty acids in blood, placenta, and neonatal umbilical cord blood were determined and analyzed by gas chromatography in 20 normal pregnant women. Results In 20 pregnant women in the study, average age was 27.0±4.5 years, the average gestational age of their newborns was 38.0±3.0 weeks, the average birth weight of newborns was 3320±127 g. There were 18 types of fatty acids in maternal blood, umbilical cord and placenta, including saturated fatty acids, monounsaturated fatty acids, and polyunsaturated fatty acids. The total fatty acid content in maternal blood (3.51±0.57 g/L) was 5 times higher than that in umbilical cord blood (0.74±0.18 g/L), and there was statistically difference (P<0.05). The content of linoleic acid (LA) in maternal blood was higher than that in umbilical cord blood and placenta; the content of arachidonic acid (AA) and docosahexenoic acid (DHA) in placenta was significantly higher than that in maternal blood and umbilical cord blood; and the content of eicosapentaenoic acid (EPA) in umbilical cord blood was higher than that in maternal blood and placenta. All differences were significant (P<0.05). Conclusions Mothers preferentially transport long chain polyunsaturated fatty acids (AA and DHA) through the placenta to meet the needs of fetal and neonatal growth and development.

Objective To investigate the correlation between XRCC1 R280H,XRCCl TSS+29C/T genetic polymorphisma and susceptibility to non-Hodgkin lymphoma (NHL). Methods The MassARRAY method was applied to detect the DNA repair gene XRCC1 genetic polymorphisms in 73 cases of NHL and 540 cases of normal healthy controls. Chi-square test was performed to calculate the adjusted odds ratios (OR) and 95% confidence intervals (CI). Results For XRCCl R280H genotypes, there was a significant difference between frequencies of the G and A among patients and controls (P=0.001). However, XRCCl TSS+29C/T genotypes had no statistical difference as for the T and C frequencies between patients and controls (P = 0.383). The frequency of XRCCI R280H with at least one A genotype was lower in the NHL cases than in controls, indicating a decreased risk for NHL development (OR=0.309, 95 % CI =0.168-0.567), comparing with GG genotype. In XRCC1 TSS+29C/T genotypes, the frequeney of TC and CC genotype was higher in NHL cases than in controls and associated with an increased risk of NHL development (P=0.472, OR =1.262, 95 % CI =0.669-2.379). Conclusion DNA repair XRCCl gene possesses significant correlation with NHL.

Objective To observe the antimicrobial effect of a kind of Chinese medicine Qingre compound preparation on the common pathogenic bacteria of upper respiratory tract infection (URTI). Methods A total of 163 common pathogen?ic bacteria of URTI was selected in this study, including 74 non extended-spectrum β- lactamases (ESBLs)-producing Gram-negative bacteria (33 Escherichia coli, 24 Klebsiella pneumonia and 17 Pseudomonas aeruginosa), 10 ESBLs-produc?ing Gram-negative bacteria (6 Escherichia coli and 4 Klebsiella pneumoniae) and 79 Gram-positive bacteria [11 methicil?lin-resistant Staphylococcus aureus (MRSA), 46 methicillin-sensitive Staphylococcus aureus and 22 Streptococcus pneu?moniae]. Agar dilution method was adopted to perform the quantitative drug sensibility test. Agar plates that contained differ?ent concentrations of Qingre compound preparation were prepared. The bacterial suspension was planted on the plates. Then we observed the plates after incubation, and recorded the minimum inhibitory concentration (MIC). Results The antimicro?bial rates of Qingre compound preparation were 88, 176 and 22 g/L for MIC90 of Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. The antimicrobial effects of Qingre compound preparation were coincident on the MIC 90 of ES?BLs-producing strains and non ESBLs-producing strains. The accumulated antibacterial rates of different concentrations of medicine to Pseudomonas aeruginosa were the highest. The MIC90 values of Qingre compound preparation were 11, 11 and 22 g/L for MSSA, MRSA and Streptococcus pneumoniae. The MIC90 of MRSA was coincident with MSSA, but MIC50 of MRSA was slightly higher than that of MSSA. The accumulated antibacterial rates of different concentrations of medi cine to MSSA and MRSA were all higher than those of Streptococcus pneumonia. The accumulated antibacterial rate of MSSA was similar with that of MRSA. Conclusion The Chinese medicine Qingre compound preparation could restrain common patho?genic bacteria of URTI except Klebsiella pneumoniae. The antibacterial effect of Qingre compound preparation is significant?ly better in Ggram-positive bacteria than that of Gram-negative bacteria.

Objective To investigate the prevalence of latent tuberculosis infection(LTBI),and to identify the risk factors in primary schoolchildren from Shanghai through the population-based field investigation combined with the tuberculosis infection enzyme-linked immunospot assay(T-SPOT.TB)assay.Methods The children in grade 4 and 5 were enrolled from four primary schools in Pudong new district and Yangpu district of Shanghai.Questionnaire interview was applied to investigate the soeiodemographic and clinical information related to LTBI.The T-SPOT.TB assay was used to detect LTBI in the enrolled subjects.Univaitate and multivariate analyses were used to identify the risk factors associated with LTBI among the primary schoolchildren.Results Totally 472 schoolchildren were enrolled in the present study,with 439(93.0%)being vaccinated with bacillus calmette-guerin (BCG) and ten (2.1%) having contact history with tuberculosis (TB) patients.Among the 472 eligible subjects,16(3.4%) children were T-SPOT.TB positive,who had no clinical symptoms andsigns relevant to TB and were defined as LTBI.The LTBI prevalence in BCG vaccinated and unvaccinated children were 2.7% and 12.1%,respectively (OR:6.972;95%CI:1.834-26.500);those in TB contacts and children without TB contact history were 30.0% and 2.8%, respectively (OR: 16. 38; 95% CI: 3. 692-72. 700). Conclusions The prevalence of LTBI among senior schoolchildren in Shanghai is 3.4%. BCG vaccination is protective for children from LTBI, while daily contacts with TB patients increases the risk of LTBI in schoolchildren.

Objective: To evaluate the influence of recombinant human brain natriuretic peptide(rhBNP)on ventricular remodeling and ventricular systolic synchrony in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI).Methods: A total of 48 patients with AMI after PCI were randomized into two groups: rhBNP Group (n=25) and Routine treatment Group (n=23).Two dimension echocardiography was used to measure the index of left ventricular end-diastolic volume (LVEDVI), the index of left ventricular end-systolic volume (LVESVI), left ventricular ejection fraction (LVEF), the index of left ventricular mass (LVMI), the movement index of infarcted regional wall (RWMI) at 1 week, 4 weeks and 24 weeks after the treatment procedure.And at 1 week and 24 weeks period, equilibrium radionuclide angiography was performed respectively to evaluate the ventricular systolic synchrony.Results: ①1 week after PCI, LVESVI in rhBNP group was decreased and LVEF was increased than that in Routine treatment group (P<0.05, respectively).4 and 24 weeks after PCI, LVEDVI, LVESVI, LVEF were significantly different in rhBNP group than those in Routine treatment group (P<0.05,respectively).24 weeks after PCI, RWMI and LVMI were significantly decreased in rhBNP group than those in Routine treatment group(P<0.05,respectively).②24 weeks after PCI, phase shift, full width at half maximum and peak phase standard deviation were significantly improved in rhBNP group than those in Routine treatment group (P<0.05, respectively).Conclusion: Intravenous injection of rhBNP could inhibit left ventricular remodeling and improve left ventricular function.