Objective To explore the regularity of heat shock protein 70(HSP70)expression and its function in renal ischemia/reperfusion injury(IRI),and to reveal whether traditional Chinese medicine, Xuebijing injection(血必净注射液),induces HSP70 synthesis and has a protective effect on IRI.Methods One hundred and eight female Sprague-Dawley(SD)rats,(200?20)g in weight,were used in this experiment,and randomly divided into three groups(each n=36):control(A),model(B)and treatment group(C).The I/R model was established by clamping renal pedicles on both sides for 45 minutes to cause ischemia and then reperfusion was made.In group A,a similar model procedure was performed,but without ischemia.At 5-10 minutes before the IRI was performed,5 ml/kg of normal saline and 5 ml/kg of Xuebijing injection was injected through the femoral vein in group B and C respectively.In B and C groups,according to the durations of reperfusion for 0,6,12,24,36 and 48 hours,the rats were subdivided into six subgroups (each n=6).At the end of each time point,blood and renal tissue were collected to measure blood creatinine (SCr)and urea nitrogen(BUN),and Western blotting method was used to examine the expression of HSP70. In another kidney,renal tissue was obtained for hematoxylin and eosin(HE)staining pathological and immunohistochemical examinations.Results In B and C groups,the SCr and BUN levels at 6 hours after I/R were significantly higher than those in the A group,and those in the C group were lower than those in the B group(P

Objective To explore the application value of the real-time three-dimensional ultrasound Bi plane technology in evaluation of the foramen ovale blood in fetus.Methods The coronal plane of inferior vena cava entering the right atrium in 186 normal fetuses were obtained.The dimensions of foramen ovale (DFO) and inferior vena cava at the entrance of right atrium (DIVC) were measured in the coronal plane.The ratio of DFO and DIVC (DFO/DIVC) was calculated.The correlation be tween DFO/DIVC and gestational age was analyzed.Results There was no correlation between DFo/DIvc and gestational age (r=0.228,P＞0.05).There were 155 cases during second trimester (21 28 weeks),and the DFO was (4.46±0.57)mm,DIVC was (4.55±1.22)mm,DFO/DIVC was 1.03±0.22.There were 31 cases during late pregnancy (29-36 weeks),and the DFO was (5.20±0.43)mm,DIVC was (5.90±1.33)mm,DFO/DIVC was 0.92±0.17.The mean 95％ confidence interval of DFO/DIVC was (0.98,1.04),the 95％ normal reference range was (0.80,1.44).Conclusion The coronal plane of inferior vena cava entering the right atrium can be obtained with real-time three-dimensional ultrasound Bi-plane technology,the flow from the inferior vena cava enters right atrium which is divided by the upper atrial septum can be observed,which is important in evaluating the foramen ovale blood.

Selection of utilization of carbon source in soya oligosaccharide by three strains of S.cerevisiae was studied.The results showed that S.cerevisiae C could selectively utilize sucrose and the residual rate of stachyose and raffinose could be more than 96%.Using yeast extract as nitrogen source,the sucrose could be used up after 36 hours of culture.Further study showed that the content of sucrose in soya oligosaccharide powder was less than 1.3% after fermentation of waste water of soy whey and downstream processing.

OBJECTIVE: To evaluate the usefulness of impression cytology in diagnosing of ocular surface diseases. METHODS: Impression cytology was performed on 18 eyes with Sjgren's syndrome (dacryosialo-adenopathia atrophicans), 23 eyes with non-Sjgren's syndrome, 15 eyes after thermal or chemical burn at the scarred stage and 20 normal eyes. Conjunctival goblet cell density, conjunctival epithelial squamous metaplasia and corneal cytological features were evaluated respectively. RESULTS: In impression cytology, eyes of Sjgren's syndrome demonstrated a significantly higher grade of squamous metaplasia and lower goblet cell density (P<0.05) as compared with normal eyes and with eyes of non-Sj gren's syndrome in the bulbar conjunctiva, whereas no statistically significant difference of squamous metaplasia grade or goblet cell density was found in the palpebral conjunctiva (P>0.05) in these two groups. In thermal or chemical burned eyes at the scarred stage, the inferior, nasal and temporal bulbar conjunctiva showed higher conjunctival goblet cell density than in the normal eyes (P<0.01). Before surgery of ocular surface reconstruction, conjunctival goblet cells were detected on the corneal area in the 8 thermal or chemical burned eyes. However, the goblet cells in the corneal area of 7 burned eyes were completely resolved after successful ocular surface reconstruction. CONCLUSION The demonstrations of impression cytology in Sjgren's syndrome, thermal or chemical burn are distinctive. Impression cytology is a noninvasive,quick,easy and inexpensive technique, being a useful tool for diagnosis of ocular surface diseases.

Aortic Valve/surgery* ; Aortic Valve Stenosis/surgery* ; Cardiac Catheterization ; Heart Rupture ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation ; Humans ; Transcatheter Aortic Valve Replacement/adverse effects* ; Treatment Outcome

OBJECTIVE: To investigate the effect of obstructive sleep apnea (OSA) on different sleep stages, and the relationship between N3 stage of non-rapid eye movement sleep and respiratory abnormal events. METHODS: A total of 188 adult patients who underwent overnight polysomnography(PSG)monitoring in Sir Run Run shaw Hospital of Zhejiang University from June 24th to December 26th 2019 were enrolled in the study. OSA patients were classified into 3 groups (mild, moderate and severe) according to the apnea-hypopnea index (AHI). PSG data, AHI and the lowest SPO in each stage of sleep were compared among three groups. RESULTS: There was no significant difference in total sleep time and sleep efficiency among patients with different severity of OSA (all >0.05). The proportion of N3 stage in moderate and severe OSA groups were significantly smaller than that in mild OSA group (all <0.05). The proportion of N3 stage in severe OSA group was also smaller than that in moderate OSA group (<0.05). In addition, severe OSA group had a longer latency of N3 stage than mild and moderate OSA groups (all <0.05). The latency of N3 stage in moderate OSA group was longer than that in mild OSA group (<0.05). The AHI in N3 stage was markedly lower than that in other sleep stages (all <0.01), regardless of the severity of OSA. Supine AHI in N3 stage in mild and moderate groups was significantly lower than that in N1, N2 and rapid eye movement (REM) stages (all <0.01). Supine AHI in N3 stage in severe group was also lower than that in N2 and REM stages (<0.05 or <0.01). The lowest SPO in N3 stage was significantly higher than that in N1, N2 and REM stages (<0.05 or <0.01), regardless of the severity of OSA. CONCLUSIONS s The proportion of N3 stage is lower in OSA patients, and N3 stage has less sleep respiratory events than non-N3 stages. The results suggest that the increased N3 stage proportion may indicate less severity of OSA.

Objective To evaluate the melancholia incidence in the convalescence period of cerebral hemorrhage and its correlated factors.Methods Ninety-eight cerebral hemorrhage patients in the convalescence period were involved in this study.Melancholia was assessed by Hamilton depression scale (HAMD),neural functional deficiency was assessed by the national institute of health stroke scale (NIHSS),cognitive function deficiency was assessed by the Montreal cognitive assessment (MoCA) and neural functional deficiency recovery was assessed by modified Rankin scale (mRS).Hemorrhagic site and blood quantity were detected with CT.The blood flow of middle cerebral artery (MCA),anterior cerebral artery (ACA),posterior cerebral artery (PCA) was detected by TCD.Results The melancholia incidence in the convalescence period was 51.0％(50/98),34.0％(17/50) in males and 68.8％(33/48) in females,there was significant difference between the two (P ＜ 0.05 ).The scores of NIHSS and mRS had significantly positive correlation with HAMD (P ＜ 0.05 ),and had significantly negative correlation with MoCA (P ＜ 0.05 ).When the hemorrhagic site was in frontal lobe and blood quantity was 20-40 ml,the melancholia incidence was increased [76.2％ (16/21),62.5％ (25/40)].The average blood velocity of MCA,ACA and PCA in melancholia patients was significantly slower than that without melancholia patients,while resistance index was significantly higher in melancholia patients (P ＜ 0.05).Conclusions Melancholia incidence in the convalescence period of cerebral hemorrhage has positive correlation with sex,NIHSS,MoCA,hemorrhagic site and blood quantity.The average cerebral blood flow in the melancholia patients is significantly slower and resistance index is significantly higher.

Objective: To examine the modalities of treatment and clinical outcomes of emphysematous pyelonephritis (EPN), in order to improve the survival rate of EPN patients. Methods: Totally 14 patients diagnosed as EPN between October 2011 and November 2020 at Department of Urology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine were included in this article. Data collection including patient demographics, clinical manifestations, management and clinical outcomes were conducted by retrospective charts review, after receiving the institutional review board's approval. There were 11 females and 3 males with a median age of 59 years (range: 52 to 73 years). The lesions were located on the left side in 10 patients and right side in 4 patients. All the 14 patients suffered from fever, and present with severe sepsis or septic shock. The median time from symptom onset to admission to hospital was 3 days(range: 2 to 5 days). All cases had diabetes mellitus. Escherichia coli was the most common organism been cultured (11 cases), while Klebsiella pneumonia was the second (3 cases). CT scan showed bubbly or located gas in the renal parenchyma in 5 cases and presence of steaky or mottled gas in the renal parenchyma in 9 cases. All patients had been admitted to ICU for anti-septic shock therapy. Three patients had undergone percutaneous catheter drainage along with broad-spectrum antibiotics therapy while 3 patients had immediate nephrectomy, the other 8 cases had a combination of an initial percutaneous catheter drainage and second stage nephrectomy. Results: In this case series, 3 patients were died from EPN while the other 11 were survived. The median ICU stay time was 6 days (range: 3 to 11 days). Of the 3 patients died from EPN, 2 had undergone percutaneous catheter drainage along and 1 had received immediate nephrectomy. Among the 11 patients who were survived, only 1 had received percutaneous catheter drainage while the other 10 received nephrectomy (8 patients had staged nephrectomy). Follow-up was performed 6 months after discharge. Of the 11 surviving patients, 2 were lost to follow-up, and the remaining 9 patients had an creatine level of (118.4±29.4) μmol/L (range: 89 to 176 μmol/L). Conclusions: For patients coupled with diabetes who were initially diagnosed as acute pyelonephritis, the possibility of EPN should be considered when the disease progressed rapidly especially septic shock occurred. On the basis of empirical broad-spectrum antibiotics therapy and standardized anti-septic shock treatment, a combination of an initial percutaneous catheter drainage and second stage nephrectomy could be efficacious.
Aged ; Emphysema/therapy* ; Escherichia coli Infections ; Female ; Humans ; Male ; Middle Aged ; Pyelonephritis/therapy* ; Retrospective Studies ; Treatment Outcome

Abstract: Objective To detect the polymorphisms of drug resistance-related genes pvcrt-o and pvmdr1 of Plasmodium vivax in lazan city in the China-Myanmar border, in order to guide the treatment plan of Plasmodium vivax. Methods A total of 48 Plasmodium vivax samples were collected from Lazan in the China-Myanmar border in 2007, and fragments of pvcrt-o and pvmdr1 genes were amplified by PCR and sequenced. The sequences were aligned with the Salvador I (Sal-I) strain reference genome sequences to determine the presence of SNPs. Results The target fragments of pvcrt-o gene were amplified from 39 Plasmodium vivax samples, while pvmdr1 genes were amplified from 40 samples. Amongst them, 25 samples had AAG insertion before the 10th amino acid (K10 insertion) of pvcrt-o gene, accounting for 64.1%. Non-synonymous mutations were detected at three loci of pvmdr1 gene (T958M, Y976F, and F1076L), the mutation rates were 100%, 22.5%, and 55.0%, respectively. There were three haplotypes of pvmdr1 gene, of which the triple mutant 958M/976F/1076L accounted for 22.5% (9/40), the double mutant 958M/Y976/1076L accounted for 32.5% (13/40), and the single mutant 958M/Y976/F1076 accounted for 45.0% (18/40). The proportion of strains with pvcrt-o and pvmdr1 gene mutation is 63.16%, which is significantly different from those only with pvmdr1 mutation. Conclusions The proportion of pvcrt-o and pvmdr1 gene mutation of 48 Plasmodium vivax isolates is high in the China-Myanmar border, and there is a certain degree of correlation between the two gene mutations. To assess changes in Plasmodium vivax drug resistance in this region, it is required to improve the surveillance of these two molecular markers.

OBJECTIVE: To assess the lower tear meniscus height (LTMH), central tear film thickness (CTFT), and central corneal epithelial thickness (CCET) after deep anterior lamellar keratoplasty (DALK). METHODS: This was a retrospective cross-sectional study of 20 patients who had DALK in one eye over a three-month period. LTMH, CTFT, and CCET of the operated eyes and the unoperated fellow eyes were measured using high-definition optical coherence tomography (HD-OCT). Correlations between three OCT assessments and age, time following surgery, graft size, bed size, and the number of residual sutures were analyzed. RESULTS: Compared to patients with keratoconus, patients with other corneal conditions had significantly higher CCET in the fellow eye (P=0.024). For all patients, CCET in the operated eye was significantly negatively correlated with the number of residual sutures (R=-0.579, P=0.008), and was significantly positively correlated with time following surgery (R=0.636, P=0.003). In the fellow eye, a significant positive correlation was found between age and CCET (R=0.551, P=0.012), and a significant negative correlation between age and CTFT (R=-0.491, P=0.028). LTMH was found to be significantly correlated between operated and fellow eyes (R=0.554, P=0.011). There was no significant correlation between LTMH and age, bed/graft size, time following surgery, or residual sutures (all possible correlations, P>0.05). CONCLUSIONS Patients with keratoconus tend to have a thinner central corneal epithelium. Corneal epithelium keeps regenerating over time after DALK. DALK did not induce a significant change in tear volume compared with the fellow eye. Postoperative tear function might depend on an individual's general condition, rather than on age, gender, bed/graft size, time following surgery, or residual sutures.
Adult ; Corneal Transplantation ; Cross-Sectional Studies ; Epithelium, Corneal/pathology* ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tears ; Tomography, Optical Coherence