Objective To investigate the influence of brain natrluretic peptide(BNP) in the prognosis of cardiac surgery.Methods Selected 115 cases of pafients with the first cardiac surgery.Their BNP concentration was measured before operation. Observed the relationship between BNP and postoperative atrial fibrillation,mechanical ventilation time,hospital stay,and the mortality of 30 d.Results Whether the patients had hypertension,diabetes,myocardial infarction history,left main stem disease and hemoglobin level or not,showed no definite relationship with BNP (P>0.05).Preoperative lower left ventricular ejection fraction (LVEF)(P=0.002) and European system for cardiac operation risk evaluation [(5±3)scores](P=0.003) were associated with higher BNP level.Postoperative mechanical ventilation time was(15.0±5.4)h,hospital stay was (32±11) d,showed a clear relationship with BNP(P= 0.035,0.001),but postoperative mediastinal infection,atrial fibrillation and mortality of 30 d had no definite relationship with BNP(P>0.05).Conclusion BNP can be used to predict the risk after cardiac surgery.

Objective To inquire the nutritional and immune status in patients with gallbladder carcinoma before and after radical cholecystectomy.Methods The nutritional and immune status in patients with gallbladder carcinoma were assessed in 1 week before surgery, and on 3rd day, 7th day, 14th day and 21st day after operation, respectively.Results All of the nutritional parameters but the serum level of iron, TIBC and transferrin recovered within 3 week after operation. Remarkable decrease of serum IgG, IgA, IgM and C3, C4 complement, IL-2, CD4, CD4/CD8 ratio, and the remarkable increase of serum SIL-2R and CD8(P＜0.01) on 3rd day after operation.Conclusion Adequate iron should be supplemented after the radical cholecystectomy for gallbladder carcinoma in the third postoperative week. Radical cholecystectomy with complete resection of the tumor and removal of lymph nodes played the important roles in the recovery of immune function.

BACKGROUND:By using ultrasound examination, renal function was conventionally assessed through measuring the blood flow parameters of large renal arteries in all levels and the rate of the color flow area in arter ies on the cross section of kidneys, in which method great errors have been induced.OBJECTIVE: This study was designed to assess the renal blood perfusion with use of the image analysis software package in the color Doppler system.DESIGN: It was an experimental study on animals.SETTING: This study was conducted in the Department of Functional Examination of Guangzhou First People' s Hospital.MATERIALS: The study had been accomplished at the Animal Laboratory of the General Hospital of Guangzhou Military Area Command of Chinese PLA from January 1999 to Aprial 2000. Eight healthy New Zealand rabbits were selected, 4 females and 4 males and weighing 2.5-3.5 kg.Sixteen kidneys of them were examined. A self-made contrast medium, with prevailing ingredient of albumin shelled and CsF8 gas-filled microbubbles,was used in this study.METHODS: After intravenous bolus injection of a fluorocarbon contrast medium, a color Doppler energy mapping, a color flow mapping and a power Doppler harmonic imaging of renal blood flow were collected successively and a time-density curve were created with system's standard software.MAIN OUTCOME MEASURES: The time-density curve of renal blood perfusion with contrast-enhanced color Doppler was a main outcome measurement in the study.RESULTS: All of the 8 rabbits entered the analysis procedure. The contrast-enhanced time-density curve of renal blood perfusion was singlepeaked, with a rapid incline and a subsequent slow decline. Quantitative analysis of interested sections could be performed by replaying the corresponding contrast-enhanced color Doppler images at a certain time after injection.CONCLUSION: The time-density curve of color flow mapping and color Doppler energy mapping is capable of reflecting the features of renal blood perfusion effectively. It can display not only the general renal perfusion but also the segmental regions with low perfusion, and thus to delineate the functional lesions in the kidneys.

Objective To study bacterial conditions in amniotic cavity of the third trimester and the delivery. Methods Patients underwent cesarean section due to various reasons were randomly enrolled in the study. Ten ml aqua amnii taken from using aspesis were cultured and the bacteria were identified and tested for drug sensitivity. All patients were not treated with antibiotics before and during operation,conventional antibiotics treatnent was used after operation. The patients were divided into 3 groups based on their status: 34 cases of premature rupture of membrane ( PROM ), thirty-four cases of labor without PROM, and 27 cases of pregnancy without PROM. The positive rate, species , distribution and drug sensitivity of bacteria in the 3 groups were analyzed. Results The positive rate was 61.8% (21/34) in PROM ,52. 9% ( 18/34 ) in labor without PROM,11.1% (3/27)in pregnancy without PROM. The positive rates were significantly different among the 3 groups (x2 = 17.29 ,P =0.000). However, there was no significant difference between the labor without PROM group and the pregnancy without PROM group ( x2 = 0.541 , P = 0.462 ). Staphylococcus epidermidis was the most common isolated bacteria, following by staphylococcus aureas, streptococcus, colon bacillus, and pseudomonas. There were no significant differences of bacterial species between labor without PROM and pregnancy without PROM( x2 = 11.9,P =0.535 ). The relative higher positive rate in the labor without PROM and PROM indicated that they were important inducement of bacteria infection. There were no significant difference on positive rate and bacteria species distribution between the PROM and labor without PROM group,which suggested that up-bound along vagina to amniotic cavity was the most common route of infection. Sensitive antibiotics should be given to the patients of PROM and labor without PROM targeted at staphylococcus,streptococcus, colon bacillus and monad. Antibiotics such as Cephems, Penicillins and Clindamycin were sensitive to various bacteria and safe to both mother and baby, thus were recommended. Quinupristin, Vancomycin,Furantoin, Fusidic ,Teicoplanin, Amikacin and Meropenem were also sensitive to various bacteria, but due to their side effects and the principle of ladder antibiotics using, they were recommended as second line antibiotics. Conclutions Up-bound along vagina to amniotic cavity is the most common route of infection. For rupture of membrane and labor without PROM patients, antibiotics should be given, and strict aseptic technique,washing cavity and incision, using antibiotics after operation are necessary to prevent infection.

Objective To explore the optimal b value in MR DWI for breast.Methods Forty patients with palpable masses of breasts underwent MR and DWI at b = 1000, 800 and 600 s/mm2 before surgery according prospective planning. Visual assessment, signal to noise ratio (SNR) of DWI and the ADC values of benign and malignant lesions were compared among three b values using one-way ANOVA test.The diagnostic value of ADC were analyzed by ROC curves.Results Of the 40 patients, there were 26 patients with malignant lesions and 14 patients with benign lesions verified by histopathology.36 patients with 42 lesions were examined by DWI, and detectabilities at three b values were alike.Most DWI at b = 1000, 800 and 600 s/mm2 were of high quality, and images of grade A were 75.0% (30/40), 77.5% (31/40) and 77.5% (31/40), respectively.Mean SNR at b = 1000, 800 and 600 s/mm2 were 63 ± 22,82 ± 27 and 96 ± 29 respectively.Compared with one another, there was statistically significant difference (P <0.01).Mean ADC of benign lesions at different b values were (1.44 ± 0.28) × 10-3, (1.50 ± 0.32) × 10-3 and (1.52±0.29) × 10-3 mm2/s respectively. Compared with one another, there was no statistically significant difference (P = 0.725).Mean ADC of malignant lesions were (1.00 ± 0.25) × 10-3, (0.98 ± 0.19) × 10-3 and (1.07 ± 0.22) × 10-3 mm2/s respectively.Compared with one another, there was also no statistically significant difference (P = 0.358).The area under the ROC curves at b = 1000,800 and 600 s/mm2 were 0.879,0.885 and 0.865 respectively.Threshold value to distinguish benign and malignant lesions were 1.295 × 10-3,1.435×10-3 and 1.335×10-3 mm2/s respectively.Sensitivity of diagnosing breast cancer were 80.0%, 92.0% and 84.0%, and specificity were all 90.0% . Positive predictive values were 95.2%, 95.8% and 95.5% at b = 1000, 800 and 600 s/mm2.Conclusion Combining SNR and the value of ADC in diagnosing benign and malignant breast lesions, the study indicated that b = 800 s/mm2 was the optimal b value in breast DWI.

In order to guarantee the quality of traditional Chinese medicines (TCMs), the crystallization transformation of complex extracts of TCMs and the influence of solid form on their physicochemical properties were studied.The extract of total flavonoids from Pueraria lobata was taken as a model.Crystallization transformation happened when lofting under different conditions, and the intrinsic dissolution tests were carried out.It was found that humidity was the key factor to induce crystallization of total flavonoids from Pueraria lobata.The greater the wettability was, the more the crystallization was.The dissolution rate of total flavonoids from Pueraria lobata with the most crystallization amount significantly decreased by 96.51% compared to the sample without crystallization.After further simulating the preparation process of total flavonoids from Pueraria lobata, it was found that the wet granulation process with introduced water would also lead to crystallization and reduced dissolution rate.As for all crystallization samples, there was an inversely proportional relationship between the dissolution rates and the amount of crystallization.The risk of crystallization existed both in the storage and preparation process of TCM extracts.Crystallization would significantly affect the dissolution rate, and thus the quality of TCM products.In this study, the crystallization transformation of amorphous complex TCM extracts was discovered, and the effect of the crystallization transformation on its dissolution behavior was systematically studied, which provides a new research idea for assuring the quality of TCM products and promoting the improvement of TCM preparation level.

Objective:To analyze survival in patients with advanced oral cancer from prospective clinical trials. Methods:From 2008 to 2010, 256 patients with oral cancer at clinical stage III/IVA were randomly categorized into two groups. Patients in the experi-mental group received neo-adjuvant chemotherapy, surgery, and post-operative radiation, and patients in the control group underwent surgery and post-operative radiation. All patients were routinely followed-up after treatments. Survival was analyzed using Kaplan–Meier method and log-rank test, and differences were considered statistically significant at P value lower than 0.05. Results: Each group was composed of 128 patients. With the median follow-up period of 60 months, the 5-year overall survival rate was 61.7%and the disease-free survival rate was 53.9%. The overall survival rate (P=0.350) and the disease-free survival rate (P=0.160) were not sig-nificantly different between the experimental and control groups. Patients with positive pathological response to neo-adjuvant chemo-therapy exhibited significantly improved overall survival (P＜0.05). Conclusion:Radical surgery should be emphasized to improve the prognosis of oral cancer. Functional reconstruction could also improve the quality of life and survival of patients. Despite that neo-adju-vant chemotherapy could not improve the survival of patients with advanced oral cancer in entirety, it could benefit patients exhibiting positive treatment responses.

Objective To investigate the effects of parenteral nutrition with ω-3 fatty acids on nutrition,inflammatory response,immunity and prognosis in criticallyill cancer patients.Methods 60 critically ill cancer patients were randomly divided into study group and the control group,30 cases each.All Patients were given isonitrogen and isocalorie enteral and parenteral nutrition for 2 weeks,which added ω-3 fatty acids in the study group by parenteral nutrition.The indicators of nutrition,inflammation,immune function were detected weekly.prognostic indicators (mortality,intensive care unit [ICU] length of stay,infectious complications) were compared.Results The indicators of nutrition,inflammatory reaction and immune function of study group were significantly improved than control group,and length of stay in ICU of study group was shorter than control group.There were less mortality and morbidity of infection complications in the study group compared with control group,but difference were not significant (P =0.13 and P=0.165).Conclusion ω-3 fatty acids supplementation of parenteral nutrition in critically ill cancer patients can improve nutritional status and immune function,reduce inflammatory response,shorten ICU length of stay,but not significantly improve ICU mortality and reduce infectious complications.

Objective:To evaluate the reliability and validity of the information needs assessment scales for breast cancer patients, so as to recommend an appropriate information needs assessment scale for breast cancer patients.Methods:Researches on the information needs assessment tools for breast cancer patients were retrieved by computer in PubMed, Embase, PsycINFO, EBSCOhost, WOS Core Collection, China National Knowledge Infrastructure (CNKI) , WanFang Data, and China Biomedical Literature Database. The inclusion criteria included that the research content was the breast cancer patient information needs scale/tumor patient information needs scale and the original research sample included breast cancer patients, and outcome indicators included reliability and validity. Exclusion criteria included assessment of information needs of family members/caregivers of breast cancer patients, assessment of unmet information needs, languages other than Chinese and English, comments, reviews, qualitative studies, systematic reviews, and Meta-analyses. The measurement characteristics of the scale were evaluated using the measurement characteristics evaluation criteria in the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) evaluation manual.Results:A total of 1 293 articles were retrieved, and 13 articles were finally included. The 13 scales had no hypothesis test of construct validity, cross-cultural validity, criterion validity and reactivity index. 11 of the scales were recommended as Grade B, and 2 were recommended as Grade C. Combined with the methodological quality evaluation results and measurement characteristics evaluation results, and the consistency between the research and development population and the user population, the Psychological Needs of Cancer Patient Scale and the Comprehensive Needs Assessment Tool in cancer (CNAT) are the optimal scales.Conclusions:There are currently no recommended scales according to the COSMIN guidelines. Considering the methodological quality, the evaluation results of measurement characteristics, and the consistency between the research and development population and the user population, the Psychological Needs of Cancer Patient Scale and the CNAT are the optimal scales.

Eleven compounds were isolated and purified from the ethyl acetate part of 80% ethanol extract of Ferula feruloides root by a combination of normal-phase silica gel column chromatography, Sephadex LH-20 dextran gel column chromatography and semi-preparative liquid chromatography and then modern wave spectrometry methods (NMR, MS, UV, IR) were used to identify the structures of the compounds, which were identified as baigene D (1), baigene E (2), baigene F (3), β-kirialovin (4), α-kirialovin (5), falcarindiol (6), ammoresinol (7), dshamirone (8), 2,3-dihydro-7-hydroxy-2S*,3R*-dimethyl-3-[4-methyl-5-(4-methy1-2-furyl)-3(E)-pentenyl]-furo[3,2-c]coumarin (9), 2,3-dihydro-7-hydroxy-2S*,3R*-dimethyl-2-[4,8-dimethyl-3(E),7-nonadi-enyl]-furo[3,2-c]coumarin (10), and baigene C (11). Compounds 1-3 are new coumarin analogues, and compounds 4-6 are firstly isolated from F. feruloides. The anti-proliferative activity of compounds 5, 7-11 against human gastric cancer (MKN-45) cells was evaluated using MTT assay, which showed that compounds 7-11 exhibited strong inhibitory activity, and compound 5 exhibited weak inhibitory activity.