Objective To evaluate the clinical value of cardiovascular dual-phase scan of 256-slice spiral CT in diagnosis of left atrial appendage (LAA) thrombus before radiofrequency ablation in patients with atrial fibrillation. Methods A prospective study was conducted. Thirty-six patients with atrial fibrillation being prepared to undergo radiofrequency ablation admitted to the Fifth Central Hospital of Tianjin from October 2015 toJuly 2016 were enrolled, they were scanned using dual-phase cardiovascular protocol of 256-slice spiral CT, and then trans-esophageal echocardiography (TEE) was performed for the definite diagnose of thrombus. In the first phase of cardiac CT, the intelligent tracking method was used to determine the delayed time; in the second phase cardiac CT scan, 85 seconds was confirmed as the delayed time; TEE as the golden standard was used to evaluate the value of dual-phase CT in definite diagnosis of LAA thrombus.Results LAA low density filling defect was discovered in 5 patients in the first phase CT scan, the CT scan in the second phase, the filling defect still existed, and the diagnosis of LAA thrombus in 3 patients was made (of them 2 cases after TEE examination were diagnosed definitely as LAA thrombus, and the echo in 1 case was smoke-like on TEE, being at pre-thrombus status), 2 cases were confirmed as pseudo-filling defects (afterwards, their diagnosis was confirmed as pre-thrombus status because the echo shown on TEE was smoke-like). Two patients were confirmed as true thrombi on TEE, and there were 3 patients diagnosed as pre-thrombus state by TEE because of their echo smoke-like. TEE was used as the golden standard for diagnosis of thrombus, the following indexes could be calculated: in the first phase, the sensitivity of using CT scan to diagnose LAA thrombus was 100.0%, the specificity 91.2%, positive predictive value (PPV) 40.0%, and negative predictive value (NPV) 100.0%; while in the second phase of using CT scan for diagnosis of LAA thrombus, the above indexes were 100.0%, 97.1%, 66.7%, 100.0% respectively; the CT Kappa coefficient of the second-phase was larger than that of the first-phase CT (0.898 vs. 0.739), the difference being statistically significant (P < 0.05).Conclusions Dual-phase cardiovascular protocol of CT can detecte of LAA thrombus/pre-thrombus state, the PPV is significantly elevated after the second phase of CT scan for diagnosis of thrombus, and the consistency between the second phase CT diagnosis of thrombus and TEE diagnosis is higher than that between the first phase CT and TEE, therefore, using dual-phase cardiovascular protocol of 256-slice spiral CT in diagnosis of LAA thrombus in patients with atrial fibrillation before radiofrequency ablation has relatively high application value.

Objective To investigate the expression of macrophage migration inhibitory factor (MIF) in serum and renal tissue of septic rats with actue kidney injury (AKI), and to explore the effect of Chinese traditional medicine-Xuebijing injection on MIF expression as well as on acute kidney injury in rats with sepsis. Methods Sepsis model was reproduced in rats with cecal ligation and puncture (CLP).Eighty healthy SD rats were randomly divided into three groups:sham operation group(n=16), CLP model group (n=32), and xuebijing group(n=32). All rats were sacrificed at either 2, or 8, or 24 and or 48 hours after operations.MIF mRNA levels in renal tissues of septic rats were semi-quantified by Real-time PCR.The content of MIF in serum was determined by enzyme linked immunosorbent assay (ELISA). Serum creatinine (Cr) contents were measured by automatic biochemistry analyze. Results Compared with sham operation group, transcription of MIF mRNA in renal tissues of model group were significantly enhanced at 8, 24 and 48 hours after operations (P<0.01). Both contents of MIF and creatinine level in serum of model group rose obviously at 24 and 48 hours after operation (P<0.01);Compared with model group, the transcription of MIF mRNA in renal tissues of xuebijing group decrease obviously at 2, 8, 24 and 48 hours (P<0.01) and both contents of MIF and creatinine in serum of xuebijing group drop remarkably at 24 and 48 hours (P<0.01). Conclusion MIF is a kind of late cytokine which might participate in the pathogenesis of AKI in rats with sepsis.Xuebijing injection can inhibit MIF expression, and possess the protective effects on the kidney in rats with sep-sis.

Objective ①Observing urinary neutrophil gelatinase-associated lipocalin (uNGAL)'s concentration variation under the intervention of sepsis; ②Evaluatingu NGAL' s diagnostic value for early acute kidney injury (AKI).Method Fifty-six SD (Sprague Dawley) rats were randomly (random number) divided into four groups,including 16 rats in model group (CLG),16 rats in Xuebijing group (XBG),16 rats in Huangqi and Chaihu injection jointly applied group (HCG),and 8 rats in sham operation group (SOG).The septic models in CLG group,HCG group and XBG group were established by cecal ligation and puncture (CLP).Then,the rats in HCG group was treated with intraperitoneal injectionby Huangqi and Chaihu injections; the XBG group was treated with intravenous injection by Xuebijing injection; the SOG group was treated with open surgery without CLP.After the CLP,serial urine and serum samples were obtained at baseline (just prior to operation),6 h,12 h,18 h,24 h,36 h,48 h,and 72 h,and were measured by sCr,uCr,uNa,and uNGAL.The line graph of uNGAL' s concentration variation was plotted,based on the time.Diagnostic characteristics of urinary NGAL in predicting AKI were assessed by calculating the area under the receiver operating characteristic curve (AUC).Results After the CLP,the uNGAL of sepsis model rats increased quickly within 6 hours.The time points of each group model reaching their peak were 6 hours after CLP in CLG groupand 24 hours after CLP in HCG group and XBG group.These groups' uNGAL all decreased quickly after the peak.The cuNGAL of sepsis model rats was increased quickly within 6 hours after CLP,reached its peak at 24 hours after CLP.In CLG group,the line graphs of uNGAL or cuNGAL were almost overlapped.There is little difference in the concentration of uNGAL or cuNGAL at each time point (uNGAL:6h,t=0.691; 12h,t=1.627; 18 h,t=0.511,cuNGAL:6h,t =0.371 ; 12 h,t =0.474; 18 h,t =-1.187.Statistical significance of all above value was P ＞0.05).InXBG group,the line graph of uNGAL and cuNGAL were not overlapped,but difference between uNGAL and cuNGAL concentration at each time point was not significant (uNGAL:6 h,t =1.222 ; 12 h,t =1.178 ; 18h,t=1.272; 24h,t=0.918; 36h,t =0.442.cuNGAL:6 h,t =1.482; 12 h,t =1.314; 18 h,t=1.280; 24 h,t =0.280; 36 h,t =0.467.Statistical significance of all above value was P ＞ 0.05).In HCG group,uNGAL of AKI rats were higher than non-AKI rats at each time points since 6 hours later (6 h,t =2.351,P＜0.05; 12h,t=3.086,P＜0.01; 18h,t=2.535,P＜0.05;24h,t=2.150,P＜0.05;36h,t =2.485,P ＜ 0.05),The average cuNGAL of AKI rats and non-AKI rats have statistical significance at 6h,18 h,and 24 h (6 h,t=3.013.P＜0.01; 18 h,t =4.804,P＜0.01; 24 h,t=2.682,P＜0.05).At 6 h,Uout can increase cuNGAL' s ability of predicting AKI' s occurrence in 24 hours (AUC increased from 0.839 to 0.900,P ＜ 0.05).Conclusions The intervention to the sepsis rats have influence on the secretion volume and secretion sequence of NGAL in rat urine.uNGAL and cuNGAL are good predictor of AKI occurrence in sepsis rats.

Objective To assess the capability of serum and urine neutrophil gelatinase-associated lipocalin (NGAL) in predicting acute kidney injury (AKI) in septic patients.Methods From July 1, 2014 through December 31, 2014, a prospective observational study of septic patients without AKI was carried out in Renmin Hospital, Tianjin Hospital, and Nankai Hospital, Tianjin.The patients with AKI which was developed after admission to intensive care unit (ICU) were assigned to AKI group and the patients without AKI were assigned to non-AKI group.Clinical data and serum and urine sample were collected at the admission, and at 12, 24, 36, 48, 60, 72 ,84 and 96 hours after admission for detecting creatinine and NGAL.The measurement data accorded with normal distribution were used for t test or variance analysis of repeated measures;comparison of measurement data in non-normal distribution was carried out using the Mann-Whitney U test or Fridman test;comparison of count data was performed using Fisher exact probability method.ROC curve of serum or urine NGAL was plotted and the diagnostic values of serum or urine NGAL in predicting AKI were assessed by calculation of the area under the receiver operating characteristic curve (AuROC).Results Fifty septic patients were included.Thirty-five patients were in AKI group and fifteen in non-AKI group.The median age of AKI group was 73 and the median age of non-AKI group was 60 (IQR, 47-82).The urine NGAL (uNGAL) concentration in AKI group was higher than that in non-AKI group at the every interval and serum NGAL (sNGAL) was higher in AKI group than that in non-AKI group at only first twointervals.The uNGAL showed the capability of prediction for AKI progression at the 48 hour (AuROC=0.83,95% CI:0.70-0.97), 36 hours (AuROC=0.75,95%CI:0.59-0.91), 24 hours (AuROC=0.83,95%CI:0.70-0.95), 12 hours (AuROC=0.73,95%CI:0.60-0.88) prior to AKI occurred.The sNGAL showed capability of prediction at the 48 hours (AuROC=0.69,95%CI:0.51-0.88), 36 hours (AuROC=0.69,95%CI:0.52-0.87) prior to AKI occurred.Conclusions The sNGAL and uNGAL both were useful biomarker that predicted development of AKI in early stage.But the performance of sNGAL was slightly inferior to that of uNGAL for predicting development of AKI.

OBJECTIVETo study the influence of different technique process and prescription on hygroscopic property of pharmaceutical materials of traditional Chinese medecine (TCM) was studied.

METHODThe sample prepared with banlangen and different excipients had been put in certain suroundings for 24 hours, then the hygroscopic curves and their parameters of hydroscopicity were gotten; the influence of that on hygscopic property of banlangen was studied.

RESULTThe optimized damp-proof materials was polyoxylate II. The damp-proof effect enhanced with the increase of temperature and the excipient the decrease of and concentration of ethanol.

CONCLUSIONExcipients have different effect on hyproscopic property of banlangen, and the damp-proof technology has direct effect on it.

Desiccation ; Drug Compounding ; methods ; standards ; Drug Prescriptions ; Drugs, Chinese Herbal ; chemistry ; Ethanol ; chemistry ; Medicine, Chinese Traditional ; Quality Control ; Regression Analysis ; Temperature ; Time Factors ; Water ; chemistry ; Wettability

Objective To evaluate the different methods of blood purification for acute septic renal injury (AKI) in respect of outcome by using RIFLE(risk,injury,failure,loss and end-stage renal disease)criteria and A-PACHE Ⅱ score. MethodData of 96 patients with ASRI admired to ICU of Tianhe Hospital, Tianjin, from March 2004 to September 2006 were analyzed. Including criteria: 2001 International Sepsis Definitions Conference and 2004 RIFLE criteria of AKI. The methods of blood purification used continuous renal replacement therapy (CRRT, n=54) and imermittent hemodialysis (IHD, n=42).The patients of CRRT group could be classified into stages Ⅰ, Ⅱ and Ⅲ referred to RIFLE criteria. Excel was evaluated to set up clinical data base from documented material. Data were analyzed with SPSS version 11. 5 software. Physical signs, laboratory findings, variation of APACHE Ⅱ score and outcomes of patients were documented evaluated. Data of two groups compared using indepent samples T test, before and after the treatment compared using paired-samples T test, rate compared using chi-square test. Results①There were no statistical differences in APACHE Ⅱ score and creatinine (Cr) between CRRT group and IHD group before treatment (P>0.05). The mortalities of CRRT group and IHD group were 51.9％ and 52.4％, respectively (P>0.05), but the recovery rates of renal function in CRRT group and IHD group were 92.3％ and 65.0％ ,respectively (P< 0.05).②Mean arterial pressure (MAP),oxygen saturation (SpO2) of CRRT group were lower than those of IHD group (P<0.05) and they increased to some extent after treatment (P< 0.05). ③In the patients of stag Ⅰ ,the survival rate was 78.6％, APACHE Ⅱ score was 25.4± 2.5 before treatment, renal function recovery rate was 90.9％ ,and APACHE Ⅱ changed - 13.6 ± 4.3, while those relevant markers in the patients of stage Ⅲ were 38.1％, 36.1 ± 5.7,62.5 ％ and - 7.1 ± 4.2, respectively (P<0.05). ConclusionsThe RIFLE criteria has guiding significance for the early diagnosis and prognosis of ASRI,and the RIFLE and APACHE Ⅲ score may help to choose the optimum opportunity of treatment and the early CRRT as soon as possible after diagnosis can improve the outcome of patients with acute septic renal injury.

Objective: To analyze relationships between levels of 24 hour movement (physical activity, screen time and sleep) and childhood obesity in students aged 7-18 years. Methods: This study used data from students aged 7-18 years in the 2015 China health and nutrition survey, and assessed levels of physical activity, screen time and sleep based on the Canadian 24 hour Movement Guidelines for Children and Youth. Associations between levels of 24 hour movement and childhood obesity were assessed using multivariable Logistic regression models. Results: The overall rate of overweight and obesity was 21.56%. Proportions of students meeting the guidelines for physical activity, screen time, sleep and three behaviors combined were 24.84%, 38.69%, 57.08%, and 6.77%, respectively. After adjusting for age, sex, location of residence and nationality, students meeting the sleep guideline were less likely to be overweight and obese than those who did not(OR=0.73)， students meeting both sleep and screen time guidelines had a lower risk in overweight and obesity than those met neither guidelines(OR=0.58)(P<0.05). However, other behaviors and behavior combinations showed no significant associations with overweight and obesity. Conclusion Only a small proportion of students met all three 24 hour movement guidelines. Ensuring adequate sleep and limiting excessive screen time may be an important strategy for childhood obesity prevention and management.

Objective To evaluate and compare the imaging quality and diagnostic accuracy of two types of scanning techniques of 256-slice spiral CT angiography, prospective electrocardiogram(ECG)-gated sequence and non ECG-gated high-pitch sequence, used respectively for patients with Stanford type A aortic dissection (AAD) at the root of ascending aorta.Methods A retrospective study was conducted. Sixty-eight patients with AAD were definitely diagnosed by CT angiography were admitted to the Fifth Central Hospital of Tianjin from August 2015 to July 2017, and they were divided into two groups according to different scanning methods: 36 cases of AAD underwent prospective ECG-gated CT angiography (CTA) and 32 patients underwent non ECG-gated high-pitch CTA. A 3-grade scoring system was used to interpret the image quality of the aortic sinus, aortic valve junction zone and coronary artery opening. The CT value and noise value (SD) of aortic root were measured, the image signal to noise ratio (SNR) was calculated and compared with the discovery in exploratory operation; the patients' CTA imaging quality and the coincidence rate of lesion type diagnosis were compared between the two groups.Results All aortic CTA images could meet the diagnostic requirements. The imaging quality scores of aortic sinus, arotic valve junction zone and coronary artery opening images in ECG-gated CTA group were higher than those in non ECG-gated high-pitch CTA group (aortic sinus: 2.94±0.23 vs. 1.89±0.67, sinuscanal junction zone: 2.94±0.23 vs. 1.83±0.70, coronary artery opening images: 2.86±0.35 vs. 1.31±0.52, allP < 0.01); comparisons between the ECG-gated CTA group and non- ECG-gated CTA group in objective indexes, CT value, arotic SD value and SNR at the root of ascending aorta showed there were no statistically significant differences [the value of CT (HU): 425.20±94.38 vs. 439.29±86.78, the SD value of aorta (HU): 22.85±9.40 vs. 26.40±9.41, SNR: 21.23±8.16 vs. 19.70±9.98, allP > 0.05]. The coincidence rate between the diagnosis of AAD at the root of ascending aorta and the discovery in the exploratory operation in ECG-gated CTA group was higher than that in non ECG-gated CTA group [94.4% (34/36) vs. 68.8% (22/32),P < 0.01].Conclusion The diagnostic accuracy and image quality of AAD root of ascending aorta in prospective ECG-gated CTA group were significantly higher than those in non ECG-gated CTA group.

OBJECTIVETo investigate single-molecule detection and characterization of DNA replication.

METHODSSingle-stranded DNA (ssDNA) as the template of DNA replication was attached to DNA origami by a hybridization reaction based on the complementary base-pairing principle. DNA replication catalyzed by E.coli DNA polymerase I Klenow Fragment (KF) was detected using atomic force microscopy (AFM). The height variations between the ssDNA and the double-stranded DNA (dsDNA), the distribution of KF during DNA replication and biotin-streptavidin (BA) complexes on the DNA strand after replication were detected. Agarose gel electrophoresis was employed to analyze the changes in the DNA after replication.

RESULTSThe designed ssDNA could be anchored on the target positions of over 50% of the DNA origami. The KF was capable of binding to the ssDNA fixed on DNA origami and performing its catalytic activities, and was finally dissociated from the DNA after replication. The height of DNA strand increased by about 0.7 nm after replication. The addition of streptavidin also resulted in an DNA height increase to about 4.9 nm due to the formation of BA complexes on the biotinylated dsDNA. The resulting dsDNA and BA complex were subsequently confirmed by agarose gel electrophoresis.

CONCLUSIONSThe combination of AFM and DNA origami allows detection and characterization of DNA replication at the single molecule level, and this approach provides better insights into the mechanism of DNA polymerase and the factors affecting DNA replication.

Biotinylation ; DNA ; chemistry ; DNA Replication ; DNA, Single-Stranded ; chemistry ; DNA-Directed DNA Polymerase ; Electrophoresis, Agar Gel ; Microscopy, Atomic Force ; Nucleic Acid Hybridization ; Streptavidin

OBJECTIVETo apply Fuzzy mathematical methods to choose the best taste modifying prescription of oral solution of traditional Chinese drug.

METHODJin-Fukang oral solution was used as a model drug. The oral solution was prepared in different taste modifying prescriptions, whose tastes were evaluated by the fuzzy quality synthetic evaluation system.

RESULTCompound-sweeteners with Sucralose and Erythritol was the best choice.

CONCLUSIONFuzzy integrated evaluation can be used to evaluate the taste of traditional Chinese medicinal pharmaceuticals, which overcame the artificial factors and achieve more objective conclusion.

Administration, Oral ; Drugs, Chinese Herbal ; administration & dosage ; chemistry ; Fuzzy Logic ; Humans ; Models, Biological ; Sweetening Agents ; pharmacology ; Taste ; drug effects