Objective To determine postoperative resting energy expenditure ( REE) in children with congenital heart disease ( CHD) requiring open heart surgery , to compare measured resting energy expenditure (MREE) with current predictive equations (PEE), and to investigate the possible influencing factors on the metabolic status of the postoperative CHD children .Methods From February 2015 to June 2015 , 150 ventila-ted children admitted to the cardiac intensive care unit after surgery for congenital heart disease in Shanghai Children's Medical Center were enrolled consecutively .Indirect calorimetry ( IC) measurements were performed using metabolic cart 4 hours after surgery .General clinical data were recorded .Results Totally 104 male and 46 female patients were enrolled, with a median age of 14 months (8.3-36.0 months).The non-protein re-spiratory quotient of patient was 0.79 ±0.20, MREE was (264.76 ±61.74) kJ/(kg· d), and PEE using Schofield equations was (278.51 ±93.42) kJ/(kg· d).Although there was no significant differences (P=0.096 ) between MREE and PEE , the agreement was poor between them ( R2 =0.119 ) .Multivariate stepwise regression analysis showed that MREE had significant positive correlation with risk adjustment in congenital heart surgery (RACHS-1) score (P=0.012) and negative correlation with age (P=0.010).Up to 97.33%of children (146/150) had lower energy intake compared with MREE on the 1st postoperative day .Conclu-sions MREE does not increase after surgery in CHD children;however , the substrate utilization is influenced . Factors influencing the postoperative REE include RACHS-1 score and age.The energy intake at 1st day after surgery is generally lower than REE in these children .

BACKGROUND: Recent studies have indicated that cellular apoptosis might be related with the pathological process of diabetic penis erection function disorder. OBJECTIVE: To observe the expression of apoptosis inhibiting gene Bcl 2 and apoptosis inducing gene Bax in the penis cavernosal tissue of diabet ic rats based on the diabetic rat model. DESIGN: A randomized controlled experimental study. SETTING: The Central Laboratory of Jiamusi University. MATERIALS: Fifty male adult Wistar rats were selected. The rats wererandomly divided into normal control group (n=10) and the model group(n=40). The rats in the model group were divided into subgroups according to whether they had diabetes mellitus, namely alloxan medicine control group (n=9) and diabetes mellitus group (n=12). METHODS: The experiment was conducted at the Central Laboratory of Jiamusi University. 20 g/L Alloxan was injected intravenously into the tails of the rats in the model group at a dose of 50 mg/kg. Urine and blood sugar were examined 48 hours after the injection. Diagnosis of diabetes was established when urine sugar was (+++)～ (++++) and blood sugar was above 16.67 mmol/L. The rats in the alloxan group (n=9) were not found to have diabetes mellitus. The rats in the diabetic group were found to have diabetes mellitus, and dead rats were excluded. The blood sugar and urine sugar were measured before experiment and 48 hours, 2, 4, 6and 8 weeks after the experiment. After 8 weeks, the penises were harvested and fixed in 10% neutral formaldehydum polymerisatum. The remaining structures were thoroughly embedded in paraffin, and sections were obtained. Then, apoptosis and the protein of Bcl-2 and Bax were detected in the erectile tissues. 0.5 cm of the middle-section of bulbocavernosus body was collected, and it was then fixed in 10 g/L neutral formaldehydum polymerisatum at 4 ℃ for 24 hours. Then, 5-7 μ m paraffin sections were obtained. The cellular apoptosis was detected with in situ end labeling method. Bcl-2 and Bax gene expressions were detected with histochemical staining. MAIN OUTCOME MEASURES: Cellular apoptosis in the erectile tissues of the rats and genes Bcl-2 and Bax expressions. RESULTS: Nineteen rats died after model establishment and 31 rats entered the stage of the result analysis. ①Cellular apoptosis of the erectile tissues of the rats: The apoptosis rate in the diabetic group was significantly higher than that in the normal control group and alloxan group (16.26±6.63)%,(0.38±0.02)%, (0.40±0.03)%,(q=4.45, P ＜ 0.01). ② Expression of Bcl-2gene of the erectile tissues of the rats: Bcl-2 gene expression of the diabetic group was significantly lower than that in the normal control group and alloxan group [(12.04±2.30)%,(20.88±3.02)%,(21.23±2.58)%,q=4.45,P＜0.01].③Expression of Bax gene in the erectile tissues of the rats: Bax gene expression of the diabetic group was significantly higher than that in the normal control group and alloxan group [(18.35±2.00)%, (9.33±0.56)%,(10.32±0.63)%, (q=4.45, P ＜ 0.01)]. ④ The ratio of Bcl-2 to Bax: The ratio of Bcl-2 to Bax of the diabetic group was significantly lower than that in the normal control group and alloxan group. CONCLUSION: That the cellular apoptosis of the erectile tissues in rats with diabetes mellitus increased suggests that cellular apoptosis is related with diabetic erectile dysfunction. Also, Bcl-2/Bax was down-regulated,and this indicates that Bcl-2 and Bax cooperates in the cellular apoptosis in the diabetic erectile tissues.

To observe the proliferation of T lymphocytes stimulated by CML and AML cells which were induced by rhGM-CSF and rhIL-4, and the secretion of IFN-gamma from proliferated T lymphocytes, the expression of CD80, CD86 and HLA-DR on CML and AML cells induced by GM-CSF and IL-4 was assayed by flow cytometry in vitro. Then one-way mixed lymphocyte reaction was carried out, with induced leukemia cells as stimulating cells and auto-T lymphocytes as reactive cells. The secretion of IFN-gamma from T lymphocytes was determined by double antibody sandwich ELISA. The results showed that GM-CSF and IL-4 significantly upregulated the expression of CD80, CD86 and HLA-DR on CML cells and CD80 and CD86 on AML cells, which could stimulate the T lymphocyte proliferation and high secretion of IFN-gamma (in CML group) of autologous T lymphocytes. It is concluded that the CML and AML cells induced by GM-CSF and IL-4 have the ability to present tumor specific antigen to auto-T lymphocyte.
Adult ; Aged ; Aged, 80 and over ; Female ; Granulocyte-Macrophage Colony-Stimulating Factor ; pharmacology ; Humans ; Interferon-gamma ; biosynthesis ; Interleukin-4 ; pharmacology ; Leukemia, Myeloid ; immunology ; Lymphocyte Activation ; drug effects ; Male ; Middle Aged ; Recombinant Proteins ; pharmacology ; T-Lymphocytes ; drug effects ; immunology

To understand the kinds and the characteristics of combination of traditional Chinese medicines and western medicines using on adults with type 1 diabetes in general hospitals,This research brings into 4 602 hospitalized adult patients with type 1 diabetes from hospital information system (HIS) of 13 third class A hospitals. These research objects were hospitalized in December 2003-July 2011. The research analyzes the operating frequency and associated usage of western medicines and traditional Chinese medicines by the method of frequency statistics and association rules. Through the analysis, the research says that in the clinical treatment of adult patients with type 1 diabetes, the western medicine used most frequently is insulin, a total of 1 539 cases, accounted for 8.47%; the traditional Chinese medicine used most frequently is oral agents of pseudo-ginseng, a total of 183 cases, accounting for 6.25%; the combinations of Chinese and western medicines commonly used include Huoxue Huayu Tongmai Shuluo decoction + vasodilator, support degree is 45.93%, followed by Huoxue Huayu Tongmai Shuluo decoction + vasodilator + hypoglycemic drugs, support degree is 45.50%; Huoxue Huayu Tongmai Shuluo decoction + vasodilator + nutritional agent, support degree is 36.29%.
Adult ; Aged ; Aged, 80 and over ; Diabetes Mellitus, Type 1 ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Electronic Health Records ; Female ; Humans ; Hypoglycemic Agents ; therapeutic use ; Insulin ; therapeutic use ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Panax

To control the quality of Humulus scandens, the quality standard was established in this study. According to the method recorded in the Appendix of Chinese Pharmacopoeia (2010 Edition) , the water and ash inspections were carried out. The component luteoloside and cosmosiin in Humulus scandens were identified and assayed by TLC and HPLC. The results showed a strong characteristics microscopic of Humulus scandens, and trichoromethane-methanol-formic acid (10: 3: 0. 3) as the mobile phase of TLC, the spots at 365 nm with a UV lamp was clear. The 16 batches of samples were analyzed by HPLC with a gradient elution of acetonitrile and phosphate solution (0.2%) at a flow rate of 1.0 mL · min(-1) and detected at 350 nm. The content of luteoloside was 0.015%- 0.651% (average 0.148%); the content of cosmosiin was 0.003%-0.118% (average 0.036%). The linear calibration curve of luteoloside and cosmosiin was acquired in the ranges of 0.011-0.364 g · L(-1) (r = 1.000 0) and 0.003-0.096 g · L(-1) (r = 1.000 0), respectively. The average recovery was 100.5% and 98.5%, respectively. The methods are convenient and reliable, which can be ap- plied for quality assessment of Humulus scandens.
China ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; analysis ; standards ; Humulus ; anatomy & histology ; chemistry ; Quality Control

Objective To investigate the changes in toll-like receptor 4 (TLR4) and nuclear transcription factor-κB (NF-κB) expression in the livers of diabetic rats after exercise at different intensities.Methods Fifty Sprague-Dawley rats were randomly divided into a control group (NC),a diabetic group (DM),a low intensity exercise group (LIE),a medium intensity exercise group (MIE) and a high intensity exercise group (HIE),each of 10.The control group was given a normal diet.Type 2 diabetes was induced in the others through feeding a high-fat and high-sugar diet,as well as injecting a small dose of streptozotocin intraperitoneally.The three exercising groups swam to 40％,70％ and 100％ of their exhaustion times once a day,6 d/w for 6 weeks.Due to infection,drowning and other reasons,only 8 rats in each of the DM,LIE and MIE groups,as well as 7 in the HIE group survived.After the intervention,body weight,liver weight and fasting blood glucose (FBG) were tested.The expression of TLR4 and NF-κB mRNA in the livers was tested using RT-PCR technology,and the expression of TLR4 and NF-κB protein in the liver was tested using immunohistochemistry.Results Compared with the NC group,the average body weight and liver weight of the other four groups decreased significantly,while the FBG and the expression of TLR4 and NF-κB mRNA and protein increased significantly.There were significant differences among the exercise groups with the lowest values in the MIE group.Conclusion Six weeks of aerobic exercise can reduce FBG and the level of expression of TLR4 and NF-κB mRNA and protein in the liver,at least in rats.The effect of exercise at medium intensity is best.

Objective To observe the changes of soluble L-selectin(sL-selectin) concentrations in children with viral encephalitis(VE) and probe its significance in pathogenesy and clinic.Methods Selecting 30 children with VE,including 14 mild case and 16 severe case.Collecting their venous blood and cerebrospinal fluid(CSF) in acute and recovery stage.Using double antibody sandwich enzyme-linked immunosorbent assay(ELISA) method to measure sL-selectin concentrations of serum and CSF and comparing with control group,respectively.Results SL-selectin concentrations from serum and CSF in the acute stage were significantly higher than those of control group(all P0.05).Conclusions L-selectin may participate in the pathologic course in VE.The concentrations of sL-selectin from serum and CSF are related with the patients′ condition and it has important reference value in judging patients′ condition,assessing their prognose and guiding clinical treatment.

Objective To develop a rapid and accurate technique for pathogens identification from positive blood cultures by matrix-assisted laser desorption ionization-time of flight mass spectrometry ( MALDI-TOF MS) .Methods A total of 266 culture-positive blood samples from clinical laboratory in the Second Affiliated Hospital of Soochow University during January to July 2015 were collected.The blood was transferred into separation-gel tubes, and the bacteria were enriched and purified by differential centrifugation.MALDI-TOF MS was applied to identify the bacteria and the results were compared with conventional bacterial culture. Results Among 266 culture-positive blood samples, 260 were monomicrobial cultures and 6 were polymicrobial cultures.Of 260 monomicrobial cultures, 98.8% (257/260) and 96.2% ( 250/260 ) of organisms were identified at the genus level and the species level, respectively.Of 140 Gram-negative bacterial isolates, 99.3% (139/140) and 97.9% (137/140) were identified at the genus level and the species level, respectively.Of 120 Gram-positive bacteria isolates, 98.3%(118/120) and 94.2% (113/120) were identified at the genus level and the species level, respectively.None of the 6 polymicrobial cultures were identified.Conclusion MALDI-TOF MS can directly identify the bacteria from positive blood cultures, which provides a rapid and accurate method for the diagnosis of bloodstream infection.

Objective To analyze the clinical features,methods of treatment and prognosis of primary neurogenic tumors of mediastinum in patients taking surgical intervention.Methods A database was maintained retrospectively of all patients undergoing surgery for tumor and pathologically diagnosed with primary neurogenic tumors of mediastinum,managed in the Department of Thoracic Surgery,Zhongshan Hospital,Fudan University,Shanghai between Jan.,2008 and Dec.,2014.This work analyzed retrospectively the information about clinical and imaging features,surgical techniques and outcome extracted from medical records.Results Among the 131 cases,78 cases (59.5％) were males,53 cases (40.5％) were females;72 cases were diagnosed incidentally (55.0％),while the other 59 cases (45.0 ％) suffered from different symptoms.The posterior mediastinum was the most principal location with 61 cases in the left and 69 cases in the right,and 1 case remained in the anterior mediastinum.Total 98 cases (74.8％) underwent surgeries via video-assisted thoracic surgery (VATS),5 cases (3.8％) took VATS surgery with small incision,and 28 cases (21.4％) experienced open thoracotomy,with no mortality during perioperative period.Gross total resection was obtained in 130 patients (99.2％).The remaining patient underwent a palliative resection for malignant schwannomas.Of the patients,98 cases had benign schwannomas (74.8％),24 cases had gangliocytomas (18.3％),2 cases had malignant schwannomas (1.5％),2 cases had neurofibromas (1.5％),2 cases had paragangliomas (1.5％),2 cases hadprimitive neurotodermal tumor (PNET) (1.5％) and 1 case had neuroblastomas (0.8％).All patients were followed up from 12 to 95 months with an average of 53 months.A patient with PNET died of tumor metastasis,a patient with malignant schwannomas died after palliative ectomy,and 2 cases died of other reasons.The rest survived until Jan.,2016 with tumor free.Conclusions Nearly no specific clinical symptoms occur in neurogenic tumors of mediastinum.Most of neurogenic tumors of mediastinum are benign with optimistic prognosis after surgical treatment.While malignant neurogenic tumorsusually come with poor prognosis,which places special emphasis on early diagnose together with surgical treatment.