Objective To compare the clinical therapeutic effects of continuous veno-venous hemofiltration (CVVH) and continuous veno-venous hemodiafiltration (CVVHDF) for treatment of patients with multiple organ dysfunction syndrome (MODS).Methods A prospective observation was conducted, seventy patients with MODS admitted to the Department of Critical Care Medicine of the Affiliated Hospital of Zunyi Medical College from September 2013 to December 2016 were enrolled, and they were divided into a CVVH group and a CVVHDF group according to different treatment, 35 cases in each group. In the CVVH group, the ultrafiltration fluid flow rate was set at 1800 mL/h, while in the CVVHDF group, the flow rate was set at 2000 mL/h for both substitution fluid and dialysate, and the blood flow of the two groups was 150-180 mL/min. The changes of creatinine (SCr), urea nitrogen (BUN), pH value, HCO3-, helper T cell (Th1, Th2) and Th1/Th2 ratio were compared between the two groups before and after treatment for 24, 48 and 72 hours.Results With the extension of time, SCr, BUN were reduced in both groups after treatment compared to those before treatment, 72 hoursafter treatment they reached the lowest value, and the degree of change in CVVHDF group was more significant than that in CVVH group [SCr (μmol/L): 150.62±32.09 vs. 180.41±30.52, BUN (mmol/L): 7.31±2.19 vs. 9.06±2.36. allP < 0.05], after treatment; the pH value, HCO3- level in the two groups had a tendency at first elevated and then lowered, 48 hours after treatment they reached the peak values, compared with those before treatment, the differences were statistically significant [CVVH group: the pH value 7.42±0.08 vs. 7.25±0.10, HCO3- (mmol/L) was 22.49±5.11 vs. 15.65±4.16; CVVHDF group: pH value 7.41±0.04 vs. 7.24±0.11, HCO3- (mmol/L) 23.24±4.78 vs. 15.65±4.16, allP < 0.05], 72 hours after treatment, they began reduced (CVVH group: pH value, HCO3- were 7.39±0.09, 22.35±4.91 respectively, CVVHDF group: pH value, HCO3- were 7.38±0.06, 23.13±4.61 respectively), but they were still significantly higher than those before treatment, and at each time point compared between the two groups, no statistical significant difference was seen (allP > 0.05). With the extension of therapeutic time, Th1, Th1/Th2 in two groups were gradually elevated after treatment, and 72 hours after treatment they reached the peak values; Th2 showed a trend of gradual decrease and after 72 hours of treatment it reached the lowest value, and the changes in CVVHDF group were more significant than those in CVVH group [Th1 (×10-2): 1.51±0.12 vs. 1.21±0.11, Th2 (×10-2): 1.64±0.65 vs. 1.70±0.18, Th1/Th2: 0.91±0.14 vs. 0.71±0.15, allP < 0.05].Conclusion Both CVVH and CVVHDF can effectively remove inflammatory mediators and metabolic products, adjust the balance of acid and base, regulate immune system in the body of patients with MODS, and the CVVHDF is more effective than CVVH.

With dwindling number of new antibiotics and inappropriate use of antibiotics, the emergence and spread of antibiotics resistance occurs commonly in healthcare institutions worldwide. In China, antibiotics are commonly overprescribed and misused. This study is to assess the effect of the nationwide special campaign on antibiotic stewardship program (ASP) at specialized hospitals in China by investigating prescription information from 2011 to 2012. Data on the hospital consumption and prescription of systemic antibiotics were obtained from four specialized hospitals, including maternity, children's, stomatological and cancer hospitals. Systematic random sampling was used to select outpatient prescriptions and inpatient cases. A total of 105 specialized hospitals in 2011 and 121 specialized hospitals in 2012 were analysed. The defined daily doses (DDDs) per 100 inpatient days, the percentage of antibiotic use in outpatient prescriptions, and the percentage of antibiotic use in inpatient cases were used as measurements of antibiotic use. The overall antibiotic use density in the selected hospitals decreased between 2011 and 2012 from 39.37 to 26.54 DDD/100 inpatient days (P<0.001). The percentage of antibiotic use in outpatient prescriptions (range: 24.12%-18.71%, P=0.109) and inpatient cases (64.85%-60.10%, P=0.006) also decreased within the two years. Significant changes were observed among regions and different hospitals within the two years. And antibiotic consumption was correlated with the type and size of specialized hospital in 2012, but not with the regions. This analysis of antibiotic consumption of specialized hospitals allows relevant comparisons for benchmarking and shows that national ASP has improved antibiotic rational use in China. The data will assist policymakers in formulating effective strategies to decrease antibiotic overuse and identify areas that require further work.

0.05).The serum PICP of tubercular meningitis children after 4 neeks glucocorticoid therapy (108.85?46.13) ?g/L was significantly lower than that in control group((154.38)?47.98) ?g/L and glucocorticoid- pretreatment (152.99?44.78) ?g/L (P

Chemical and Drug Induced Liver Injury ; Humans ; Ursodeoxycholic Acid ; adverse effects

Background Serum cystatin C levels can be used to predict morbidity and mortality in patients with cardiovascular disease. However, the clinical relevance of serum cystatin C levels in patients with hypertensive left ventricular hypertrophy (LVH) has rarely been investigated. We designed the present study to investigate whether serum cystatin C levels are associated with cardiac structural and functional alterations in hypertensive patients. Methods We enrolled 823 hypertensive patients and classified them into two groups:those with LVH (n=287) and those without LVH (n=536). All patients underwent echocardiography and serum cystatin C testing. We analyzed the relationship be-tween serum cystatin C levels and LVH. Results Serum cystatin C levels were higher in hypertensive patients with LVH than in those without LVH (P＜0.05). Using linear correlation analysis, we found a positive correlation between serum cystatin C levels and interven-tricular septal thickness (r=0.247, P＜0.01), posterior wall thickness (r=0.216, P＜0.01), and left ventricular weight index (r=0.347, P＜0.01). When analyzed by multiple linear regression, the positive correlations remained between serum cystatin C and interventricular septal thickness (β=0.167, P＜0.05), posterior wall thickness (β=0.187, P＜0.05), and left ventricular weight index (β=0.245, P＜0.01). Con-clusion Serum cystatin C concentration is an independent marker for hypertensive LVH.

Objective To investigate the correlation between toll-like receptor 9 (TLR9) gene 2848G/A polymorphism and primary antineutrophil cytoplasmic antibodies (ANCA) associated small vasculitis (AAV). Methods A case-control study was performed among 135 patients diagnosed with AAV and 140 disease-free control and we test the serum biochemical parameter. Polymorphism was analyzed by polymerase chain restricted fragments length polymorphism. As for statistic method, according to the character of data, we performed t-test, chi-square test, Spearman grade related analysis and one-way ANOVA. Results ① The frequencies of AA, GG, GA genotype of TLR9 2848 in AAV patients were 14.07%, 38.52%, and 47.71%, respectively; ② Significant increase in IgM was observed in AA genotype than GG+GA genotype in AAV patients (F=4.561, P<0.05). ③ There was no significant difference between AI and CI in AA, GA and GG genotype in AAV patients (F=2.115, 0.760, P>0.05). Conclusion AA, GA and GG genotypes are detected in TLR9 2848G/A in patients with AAV in Guangxi, without significant correlation with susceptibility to primary AAV in Guangxi.

Astragali Radix was firstly recorded in the "Shen Nong's Herbal Classic" as a top-grade and commonly used traditional Chinese medicine. Its frequently used slices include raw Astragali Radix and honey-processed products. In current studies, many reports were made on honey-processed Astragali Radix, whereas fewer study reports were made on the cutting process of Astragali Radix. Currently, because Astragali Radix is primarily cut by drug workers according to their operating experience, but with out specific cutting parameters, it is easy to cause the loss or mildew of active ingredients. As a result, the quality of Astragali Radix circulated in the market is not guaranteed, and the quality of their slices and preparations are hard to be controlled, which seriously impact the clinical efficacy. In response, this experiment was performed, in which the optimum cutting process of Astragali Radix was taken as the study objective, the Box-Benhnken central composite design in the response surface analysis was adopted, and the content and appearance character of astragaloside and calycosin-7-glucoside were regarded as the study indicators. Three factors, namely the softening time, the drying temperature and the drying time, were selected to optimize the cutting process of Astragali Radix and obtain the optimum cutting process parameters as follows: the softening time was 3 hours, the drying temperature was 50 degrees C, and the drying time was 4 hours. According to the verification test, the Astragali Radix cutting process is steady and feasible, which has certain significance for normalizing the cutting process of Astragali Radix.
Astragalus Plant ; chemistry ; Chemistry, Pharmaceutical ; methods ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; chemistry ; Glucosides ; chemistry ; Plant Roots ; chemistry

Objective To explore the optimum concentration of bioactive glass that promotes early enamel caries remineralization. Methods Fresh bovine incisors were selected and used for enamel specimen preparation. All specimens were randomly divided into two groups:micro hardness group and fluorescence group. Both groups were further divided into 3%, 6%and 9%groups. These specimens were placed in containers with demineralization liquid at 37℃for 72 hours. Then they were treat with 3%, 6%and 9%bioactive glass solution respectively twice a day for 5 minutes each. Samples in all three groups were dipped circularly into an artificial demineralization solution and an artificial saliva solution for 15 days. The mi?crohardness of enamel surface was measured before and after demineralization and remineralization. The different value of microhardness before and after remineralization was calculated. The thickness of fluorescence beneath the surface of early enamel caries was observed to evaluate the extend of remineralization effect. Results The difference in value of micro hard?ness in 6%group was the highest while that in 3%group was the lowest. The differences were significant. The difference in value of demineralization depth in 6%group was greater than those in 3%and 9%groups (P<0.05). There was no statistical?ly significance between those in 3%group and 9%group. Conclution The optimum concentration of bioactive glass solu?tion that promotes the remineralization of early enamel caries is 6%, which is ideal for remineralization of early enamel caries.

Objective To investigate the clinicopathology and immunophenotype of primary non- Hodgkin lymphoma(NHL)of the female genital system,and to analyze the prognosis of such tumors. Methods Clinicopathologic features of 43 cases of primary NHL of the female genital system were studied retrospectively,with the histological classification based on the Classification of Haematopoietic and Lymphoid Tumors(WHO,2001).Immunochemistry technique,in-situ-hybridization and polymerase chain reaction methods were used to detect the immunophenotype,epstein barrvirus(EB)virus infection status and immunoglobulin heavy chain gene rearrangement,respectively.Results(1)Primary lesions:there were 24 cases of lymphoma originating in the ovary,3 cases in the endometrium,10 cases in the cervix,2 cases in the vagina and 4 cases in the vulva.(2)Staging:12 cases(28%)were in stage Ⅰ,9 cases (21%)in stage Ⅱ,and 22 cases(51%)in stage Ⅲ.(3)Histological classification:37 cases(86%)were diffuse large B cell lymphoma(DLBCL),3 cases were Burkitt lymphoma and the remaining 3 cases were unspecified peripheral T-cell lymphoma according to biopsy,immunophenotype analysis,in-situ- hybridization technique and IgH gene rearrangement detection.(4)Prognosis analysis:increase in the level of lactic acid dehydrogenase,stage Ⅲ,DLBCL and single operation suggest poor prognosis.Conclusions Establishment of the diagnosis of primary NHL of the female genital system is based on biopsy, immunophenotype analysis,in-situ-hybridization technique and IgH gene rearrangement detection,which play important roles in diagnosis and differential diagnosis of the tumor.Combined therapy is the first choice of therapeutic regimens.

Humans ; Forensic Pathology