Objective To investigate the clinical role of central venous pressure(CVP) to evaluate fluid responsiveness in septic shock patients. Methods 66 septic shock patients were studied, every patient was administered a volume challenge, before and after it, CVP, intrathoracic blood volume index (ITBVI),global end-diastolic volume index(GEDVI), cardiac index(CI), stroke volume index(SVI) were measured by PiCCO method. All the obtained values were analyzed by statistics method. Results Initial CVP in responders is significantly different from that in nonresponders; △ITBVI, △GEDVI, △CI, △SVI, △HR (△:changes) before and after volume challenge in responders were significantly different from those in nonresponders; the significance of △ITBVI, AGEDVI to predict volume responsiveness was strong indicated by high values of areas under the receiver operating characteristic curves (0.674 and 0.700, respectively).If patients were regrouped by CVP≤11 mm Hg(1 mm Hg=0.133 kPa) and CVP > 11 mm Hg, initial ITBVI and GEDVI in responders were not significantly different from that in nonresponders; △ITBVI,△GEDVI, △CI, △SVI before and after volume challenge in responders were significantly different from those in nom'esponders. Conclusion In septic shock patients, CVP play a guidance role to predict and evaluate volume responsiveness and when CVP was > 11 nun Hg, a positive response will be less likely. Initial volumetric parameters(intrathoracic blood volume and global end-diastolic volume) play a questionable role in predicting and evaluating volume responsiveness, changes before and after volume challenge maybe helpful.

Objective To investigate the influence of electrocardiogram(ECG)-controlled dose modulation on exposure dosage and image quality of cardiac CT imaging in a cardiac phantom with simulated fluctuant heart rate.Methods The basal heart rate of the cardiac pulsating phantom was set as 60 bpm.the experimental situations were divided as 6 groups according to different heart rates.The cardiac imaging was performed on the cardiac phantom when the ECG-controlled dose modulation was firstly turned off.The exposure dosage of each scan sequence was documented.The standard deviation of the CT values of the phantom was measured on the central slice after coronal reformation of the raw data.The quality of 2D and 3D images were scored.Thell cardiac imaging was performed when ECG modulation was on and set as four groups according to different modulation parameters.All the data were documented as before.The results from the five groups with and without ECG modulation current were analyzed bv F test and comparative rank sum test using the statistical software SPSS 10.0.Results Statistical analysis showed no significant difference(P＞0.05)between the SNR of images(SD value was 27.78 and 26.30)from the groups that full mA output at wide reconstruction phase(69%～99%)when the heart rate was fluctuant(≥7.5 bpm).There was also no significant difference(P＞0.05)between the quality of the 2D and 3D images.But there was a significant difference(P＜0.01)between the SNR of images(SD value was 26.78 and 29.90)that full mA was only used at 85%reconstruction phase when the heart rate Was fluctuant(≥7.5 bpm).The exposure dosage was remarkably reduced when the ECG modulated current was on than when it Was off under fluctuant heart rate.Furthermore.there were significant difierence(P＜0.01)among the difierent ECG modulated current parameter groups.The exposure dosage can be reduced by 44.7%under the situation that the heart rate was fluctuant.Whell the fluctuation of the heart rate was≤12.5 bpm,there wag no obvious relationship between the fluctuation of the heart rate and the exposure dosage (the variation was from 0.1 to 1.1 mSv),but if the heart rate fluctuation was＞12.5 bpm,the exposure dosage would increase obviously (from 0.6 to 1.7 mSv).Conclusion For cardiac imaging with 16-slice row CT,the application of ECG modulated current can effectively reduce the exposure dosage without compromising the image quality even if heart rate was fluctuant.

Objectlve To research and analyze the hemod)rnamic status of refractory septic shock associated cardiac dysfunction.Methods 70 refractory septic shock patients were studied.In the duration of pulmonary artery catheter(PAC)-directed hemodynamic optimization,the patients were divided into a cardiac dysfunction group and a control group.Hemodynamic parameters,arterial blood lactate concentration and APACHE II scores were obtained instantly after the placement of a PAC,then lactate clearance in 24 hours was surveyed and calculated.Subsequently the two groups of patients were regrouped by nonsurvivor and survivors respectively.All the obtained values were analyzed with statistic methods.Results 37% of the refractory septic shock patients was complicated with cardiac dysfunction.The age of the patients complicated with cardiac dysfunction was significantly higher than that of the patients of the control group.Central venous pressure(CVP),pulmonary artery obstruction pressure(PAOP),pulmonary artery pressure (PAP),systemic vascular resistance index(SVRI),pulmonary vascular resistance index(PVRI)and oxygen extraction ratio(O2ext)in the cardiac dysfunction group were significantly different from those in the control group.Cardiac output(CO),cardiac index(CI),oxygen delivery index(DO2I)and mixed venous oxygensaturation(S-v O2)were significantly lower than those of the patients in the control group.S -v O2 had a strong correlation witIl CI.If the patients were regrouped by nonsurvivors and survivors.in the patients complicated with cardiac dysfunction APACHE II scores were significantly higher in the nonsurvivors than survivors:the lactate clearance in 24 hours(median-25%)of the nonsurvivors was significantly lower than that of nonresponders(median 22%),P＜0.05.Conclusion (1)In refractory septic shock patients,cardiac dysfunction maybe the main reason leading to bad outcome.(2)Higher CVP and PAOP and lower S -v O2 indicate the onset of cardiac dysfunction.(3)The patients with significantly high initial arterial blood lactate level and the low lactate clearance in 24 hours had bad outcome.

The results of open-field test,step-through passive avoidance task and radial-arm maze experiment showed that changes of locomotor activity,anxiety-related behaviour and ability of learning and memory were associated with the increased apoptosis of neurons in hippocampus in rats with perinatal hypothyroidism.

In this article, the research of chemical constituents and bioactivities in recent ten years has been reviewed of plants from the 12 genera in Flacourtiaceae related to the medicinal resources in China. The research in China about the plants from Flacourtiaceae was done very little, but many literatures have been reported abroad. The plants from Flacourtiaceae mostly contain the constituents such as aromatic glucosides, lignanoid glucosides, diterpenoids and cyclopentenoid cyanohydrin glucosides et al. These compounds or plant extracts mainly show antibacterial, antiviral, antitumor, hypolipidemic and hypoglycemic activities. The research of plants from Carrierea, Itoa and Bennettiodendron of Flacourtiaceae in China is still blank. The systemic research about chemical constituents and bioactivities of plants from these genera will play important roles in the discovery of novel natural products and active constituents, and provide valuable reference for the classifying of plants from these genera.
Animals ; Anti-Bacterial Agents ; isolation & purification ; pharmacology ; Antineoplastic Agents, Phytogenic ; Diterpenes ; chemistry ; isolation & purification ; pharmacology ; Flacourtiaceae ; chemistry ; classification ; Flavonolignans ; chemistry ; isolation & purification ; pharmacology ; Glucosides ; chemistry ; isolation & purification ; pharmacology ; Humans ; Hypolipidemic Agents ; isolation & purification ; pharmacology ; Molecular Structure ; Plant Extracts ; isolation & purification ; pharmacology ; Plants, Medicinal ; chemistry ; classification

The purpose of this study was to explore the significance of abnormal karyotype in diagnosis and prognosis estimation of myelodysplastic syndrome (MDS). Chromosome analysis were performed in 306 cases of MDS using the short-term culture of bone marrow cell and G-banding technique, and in partial cases FISH technique was used for this analysis. 93 out of 306 cases were followed up. The results showed that 144 cases (47.1%) had clonal chromosome aberrations. The most common chromosomal aberrations included +8, translocation, complex or high complex karyotype, -7/7q-, 20q-/-20, trisomy 1 or partial trisomy 1, +11/+11q-, -9/9q-, +9/9q+, -Y, dup(1q), +21. The rate of abnormal karyotype in refractory anemia with erythroblasts (RAEB) and refractory anemia with erythroblasts-transformation (RAEBT) were much higher than in refractory anemia (RA) and refractory anemia with sideroblasts (RAS) (P < 0.05). The rate of abnormal karyotype among those cases with mutagen contact history were higher than those in cases without mutagen contact history. The patients with abnormal karyotype had a mean survival time much shorter than patients with normal karyotype (P < 0.005) and had a higher risk transforming into acute leukemia (P < 0.05). The worst outcome was observed in those patients with a complex or high complex karyotype, -7/7q- and trisomy 11. In conclusion, MDS is highly heterogeneous disorders and karyotype analysis is helpful for its diagnosis, treatment selection and prognosis estimation.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Chromosome Aberrations ; Female ; Humans ; Karyotyping ; Male ; Middle Aged ; Myelodysplastic Syndromes ; genetics ; mortality ; Prognosis

Mast cells participate in allergies and inflammation by secreting a variety of pro-inflammatory mediators. Curcumin, the active component of turmeric, is a polyphenolic phytochemical with anti-tumor, anti-inflammatory, anti-oxidative, and anti-allergic properties. The effects of curcumin on compound 48/80-induced mast cell activation and passive cutaneous anaphylactoid reactions are unknown. In this report, we investigated the influences of curcumin on the passive cutaneous anaphylactoid response in vivo and compound 48/80-induced mast cell activation in vitro. The mechanism of action was examined by calcium uptake measurements and cAMP assays in mast cells. Curcumin significantly attenuated the mast cell-mediated passive cutaneous anaphylactoid reaction in an animal model. In agreement with this in vivo activity, curcumin suppressed compound 48/80-induced rat peritoneal mast cell (RPMC) degranulation and histamine release from RPMCs. Moreover, compound 48/80-elicited calcium uptake into RPMCs was reduced in a dose-dependent manner by curcumin. Furthermore, curcumin increased the level of intracellular cAMP and significantly inhibited the compound 48/80-induced reduction of cAMP in RPMCs. These results corroborate the finding that curcumin may have anti-allergic activity.
Animals ; Calcium ; Curcuma ; Curcumin ; Histamine ; Histamine Release ; Hypersensitivity ; Inflammation ; Mast Cells ; Models, Animal ; Rats

The bear bile has been used as a traditional drug medicine and has been known to have anti-tumor, anti-inflammatory and anti-oxidant effects. The purpose of this study is to investigate the inhibitory effect of bear bile on compound 48/80-induced mast cell activation in vitro and anti-dinitrophenyl (DNP) IgE-mediated vascular permeability in vivo. For this, the effects of bear bile on the degranulation, histamine release, calcium influx and the change of the intracellular cAMP levels of rat peritoneal mast cells (RPMCs) and the influences of the oral treatment of bear bile on IgE-mediated cutaneous vascular permeability were studied. the results were as follows; the compound 48/80-induced degranulation, histamine release and calcium influx of RPMCs were inhibited by pretreatment with bear bile, the cAMP levels of RPMCs were increased by pretreatment with bear bile, and bear bile inhibited anti-DNP IgE-mediated cutaneous vascular permeability. From the above results, it is suggested that bear bile contains some substances which inhibit anti-DNP IgE-mediated vascular permeability and mast cell activation. Bear bile potentially may serve as an effective therapeutic agent for allergic diseases.
Animals ; Antioxidants ; Bile ; Calcium ; Capillary Permeability ; Histamine Release ; Immunoglobulin E ; Mast Cells ; Rats ; Ursidae

BACKGROUNDThe lowering of body temperature is a common, almost reflexive step in the daily care of septic shock patient. However, the effect of different magnitudes of fever control on the outcome of refractory septic patients with a very poor outcome is controversial and has yet to be explored.

METHODSThis prospective trial examined sixty-five refractory septic shock patients with a core temperature higher than 38.5°C. Patients were randomly assigned to a group achieving a "low temperature" range (LT group: 36.0 - 37.5°C) or to a group achieving a "high temperature" range (HT group: 37.5 - 38.3°C) by physical methods including a water-flow cooling blanket and ice packs. A target core temperature was achieved in 1 - 2 hours post-treatment, and maintained for 72 hours. Averaged values of core temperature as well as hemodynamic, respiratory, and laboratory variables were analyzed at baseline and during the first 72 hours after fever control.

RESULTSThirty-four (52.31%) patients were assigned to the LT group and thirty-one (47.69%) patients were assigned to the HT group. The mean core temperature was significantly lower in the LT group than in the HT group (36.61 vs. 37.85°C, respectively; P < 0.0001). The average heart rate (HR) (75.5 vs. 91.9 beats/min, respectively; P < 0.0001) and the mean cardiac output (CO) (5.35 vs. 6.45 L/min, respectively; P = 0.002) were also statistically significant lower in the LT group than in the HT group. The averaged serum lactate level was significantly higher in the LT group compared to the HT group (5.59 vs. 2.82 mmol/L, respectively; P = 0.008). Fibrinogen and activated partial thromboplatin time were also different between the two groups. The 28 days mortality was significantly higher in the LT group than in the HT group (61.8 vs. 25.8%, respectively; P = 0.003). A Cox-regression model analysis showed that mean core temperature during the 72 h period was an independent predictor of 28 days mortality (odds ratio (OR) = 0.42, 95%CI 0.25, 0.6; P = 0.001).

CONCLUSIONControlling fever to a lower range (36.0 - 37.5°C) may be harmful to patients with refractory septic shock by worsening tissue perfusion, compared to controlling it within a higher range (37.5 - 38.3°C). An understanding of the mechanisms responsible for these observations requires further investigation.

Adult ; Aged ; Aged, 80 and over ; Female ; Fever ; drug therapy ; physiopathology ; Humans ; Male ; Middle Aged ; Prospective Studies ; Shock, Septic ; drug therapy ; physiopathology ; Temperature ; Young Adult

The aim of this study was to investigate the expression status of the helicase antigen (HAGE) transcript and its clinical significance in patients with acute myeloid leukemia (AML) and chronic myeloid leukemia (CML). The expression of HAGE cDNA in bone marrow mononuclear cells from AML and CML patients was detected by using real-time quantitative PCR. The results indicated that overexpression of HAGE transcript (117.12% - 9842.70%, median 434.96%) was detected in 14.8% (11/74) AML patients. AML patients with HAGE cDNA expression were significantly older than those HAGE-negative patients (median 67 and 45 years, respectively, p = 0.001). HAGE cDNA expression was more frequently present among the patients with acute monoblastic leukemia (M(4) and M(5), 7 of 20, 35.0%), compared to the patients with acute non-monoblastic leukemia (M(1), M(2), M(3) and M(6), 4 of 54, 7.4%) (p = 0.007). 28.6% (8/28) cases with normal karyotypes showed HAGE cDNA overexpression, significantly higher than 7.5% (3 of 40) in those with chromosomal abnormalities (p = 0.041). Overexpression of HAGE transcript was found in 9 (34.6%) CML cases and more frequently observed at accelerated phase and blast crisis (4/4, 100%) than that at chronic phase (5/22, 22.7%) (p = 0.008). It is concluded that HAGE cDNA expression is relevant to specific subtypes of AML and to the progression of CML.
Blast Crisis ; Bone Marrow Cells ; metabolism ; DEAD-box RNA Helicases ; genetics ; metabolism ; DNA, Complementary ; Gene Expression ; Humans ; Karyotype ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; genetics ; metabolism ; Leukemia, Myeloid, Acute ; genetics ; metabolism ; Neoplasm Proteins ; genetics ; metabolism ; RNA, Messenger ; genetics