ve Cardiac output is traditional measured by thermodilution technique. Recent advance in catheter technique has allowed continuous monitoring of cardiac output, but it is invasive and expensive. The new transesophageal Doppler echocardiography (HemosonicTM 100) can measure aortic blood flow (ABF) and ABF is closely related to cardiac output (CO) (CO= ABF/70%). The purpose of this study was to compare cardiac output continuously measured with transesophageal Doppler echocardiography and modified Swan-Ganz catheter. Methods Forty ASA II - III patients aged 40-65 yr undergoing elective coronary artery bypass (CAB) were included in this study. Premedication consisted of intramuscular diazepam 10 mg, morphine 10 mg and scopolamine 0.3 mg. Anesthesia was induced with midazolam 0.08 mg?kg-1, fentanyl 10?g?kg-1 and pipecuronium 0.1 mg?kg-1 and maintained with isoflurane inhalation, continuous infusion of propofol and intermittent boluses of fentanyl, midazolam and pipecuronium. The sensor of transesophageal Doppler echocardiograph (TDEE) was placed in the esophagus at the level of T5-6 vertebra after induction and tracheal intubation. The sensor faced backward toward descending aorta. Swan-Ganz catheter (CCO/Sv()2) was placed via right internal jugular vein. In addition intra-arterial BP, ECG, SpO2, PET CO2 and nasal temperature were monitored.Results Continuous cardiac output measured with TDEE and Swan-Ganz catheter (CCO/SvO2) were highly correlated (R = 0.801, P

To study the characteristics of pharmacological effects of property combinations of traditional Chinese medicines (TCMs) distributing in the stomach meridian based on medicinal property combination, in order to further define the association relationship between properties of TCMs and their pharmacological effects, and build a bridge for the interpenetration and combination between the medicinal property theory of TCMs and their pharmacological effects. On the basis of the studies on the medicinal property theory of TCMs distributing along the kidney meridian and their pharmacological effects, efforts were made to collect relevant data for medicinal properties and pharmacological effects and mine the characteristics of pharmacological effects that were corresponding to relevant medicinal property combination by processing materials related to medicinal properties and pharmacological effects with the association rules method. According to the analysis, TCMs distributing along the kidney meridian with different medicinal property combinations were significantly differentiated in the pharmacological effects, but shared identical pharmacological effects, such as immunological enhancement. In this study, TCMs distributing along the kidney meridian with different medicinal property combinations were taken as the carriers to closely integrate the traditional Chinese medicine theory with the modem study achievements, lay a solid foundation for further developing and enriching the traditional Chinese medical property theory, while providing a new perspective on the development of modem medicine.
Databases, Factual ; Drugs, Chinese Herbal ; chemistry ; therapeutic use ; Humans ; Kidney ; drug effects ; Kidney Diseases ; drug therapy ; Meridians

OBJECTIVETo discuss the rationality of the clinical replacement of traditional Chinese medicine (TCM) bear bile with bile acid constituents, and analyze the difference between these constituents and bear bile in drug properties.

METHODSummarizing the drug properties of bear bile by reference to medical literatures for drug properties of TCM bear bile and Science of Traditional Chinese Medicine (China Press of Traditional Chinese Medicine, 2007). Analyzing and summarizing the pharmacological effects of main bile acid constituents according to relevant literatures for studies on pharmacological effects of main bile acid constituents in CNKI database. Predicating the drug properties of these bile acid constituents by using the drug property predication model established by the study group according the pharmacological effects of main bile acid constituents in the paper, and compare the prediction results with the drug properties of bear bile.

RESULTBile acid constituents in bear bile were mostly cold in property, bitter in taste, and the combination of their drug properties could reflect the combined drug properties of bear bile.

CONCLUSIONAll of these bile acid constituents in bear bile could show part of effects of bear bile. Attention shall be given to regulate the medication scheme in clinical application according to actual conditions.

Animals ; Bile ; chemistry ; Bile Acids and Salts ; chemistry ; pharmacology ; Humans ; Medicine, Chinese Traditional ; Taste ; Ursidae

Objective To evaluate the usefulness of serum galactemannan(GM) for the diagnosis of invasive pulmonary aspergillosis (IPA) in critically ill patients. Methods Study was conducted between February 2007 and July 2008. Included patients on admission ICU who suffer from suspected IPA. GM test and culture were collected 2 weekly. Chnical feature, mycological evidence and optical density index (ODI) were noted. Clinically invasive fungal infection(IFI) were defined proven, probable and possible. The patients were classified into neutropenia, non-neutropenia and treated with immunosuppressive agents, non-neutropenia and non-immunosuppressive agents. To compared of the sensitivity and specificity of GM in different patients. Results 94 patients were included, 4 patients were proven, 29 patients were probable, 34 patients were possible IFI, 27 patients were non-IPA. The positive rate of the GM was 31.9% (30/94). The sensitivity and specificity of GM in proven cases and probable cases are 66.7% and 92.6%. GM assay tended to become positive earlier than the culture 2-10(5.33±2.17)d. We found that differences in patient diagnosis and selection might account for the disparities seen for positive rate for the GM test. There was positive in three of the four patients with proven, the positive rate of GM was 65.5% for probable cases, for possible cases was 17.6%, for non-IPA cases was 7.4% (P=0.001). For patient with neutropenia , treated with immunosuppressive agents and without immunosuppressive agents, the positive rate of GM was 52.9%vs 41.7% vs 34. 6% (P=0.015) ;the sensitivity was 80.0% vs 70. 0% vs 53.8% (P=0.011), the ODI was 1.365 (0.582-6.736) vs 1. 123 (0. 623-6.868) vs 0.554 (0.522-0.823), P=0. 005, respectively. Conclusion These results show that GM test is useful for early diagnosis IPA in critically ill patients. Differences in patient selection and diagnosis might account for the disparities seen for positive rate and sensitivity for the GM test. It has been higher sensitivity and ODI in the patient treated by immunosuppressive agents.

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.

OBJECTIVETo study the relationship between pharmacological effects and properties of traditional Chinese medicine by the decision tree algorithm.

METHODBased on of pharmacological effects of traditional Chinese medicine, the decision tree algorithm was applied in the study on the relationship between pharmacological effects and properties of traditional Chinese medicines. A model was established with the decision tree algorithm for the purpose of predicting the properties of traditional Chinese medicine components.

RESULTThe established model was reliable and stable, and could be used to predict the properties of traditional Chinese medicine components.

CONCLUSIONThe prediction for the properties of traditional Chinese medicine components with a decision tree model could reflect the theoretical connotation of the properties of traditional Chinese medicine components to some extent and provide a new method for studying the properties of traditional Chinese medicine components.

Drug Combinations ; Drug Therapy ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Humans ; Medicine, Chinese Traditional

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.

To establish a cell model in vitro that stable expressing HBV by integrating HBA1.3 DNA into cell chromosome. The HBV1.3 full-length DNA was obtained by digested pGEM-HBV1.3 plasmid with HindIII and then was linked with PU-21 vector digested by HindIII. This was resulted in generation of a recombined plasmid named PU21-HBV plasmid. The recombined plasmid was introduced into HepG2 cells by electroporation. The transfected cells were screened with G418. The insertion and expression of HBV were identified by X-gal staining, RT-PCR and Southern blot. The result of PU21-HBV plasmid sequence demonstrated that HBV1.3 DNA was linked correctly with PU-21 vector. A series of positive cell colonies were obtained with G418 screening followed transfecting PU21-HBV plasmid into HepG2 cells. The results of Southern blot and RT-PCR exhibit that HBV1.3 DNA had successfully integrated into the chromosomes of HepG2 cells and had functional HBV gene transcription. HBV1.3 DNA was inserted into HepG2 genome and could stable transcript HBV RNA. The stable HBV expression cell line was constructed successfully. There are LoxP sites in the trapping vector PU21. With the Cre enzyme, interesting genes could be excganged into the LoxP sites. Therefore, double stable expression of interesting gene and HBV cell lines could be generated. The cell lines will be useful for further research some target gene function on replication of HBV.

Objective To analyze the distribution and drug resistance of 130 clinical strains of acinetobacter (A ) .baumannii in 2012 .Methods The bacterial identification and the susceptibility test were performed by using the micro-organisms identification and susceptibility plate produced by the Zhuhai Deere Company .The data were collected and statistically analyzed by the SPSS 17 .0 software .Results 130 strains of A .baumannii were isolated from 1 391 clinical samples during 2012 ,the detection rate was 9.35% .Thesamplesweremainlyderivedfromsputum(89.23% )andthedepartmentwasmainlydistributedinICU(46.15% ).A. baumannii isolates showed the lowest resistant rates to cefoperazone-sulbactam and polymyxin B ,which were 6 .9% and 7 .7% re-spectively .The drug resistance rate against the third-generation of cephalosporin commonly used in clinic was more than 70% .The resistant rates to imipenem and meropenem were 44 .6% and 58 .5% respectively .The drug resistance rates of A .baumannii isolates to 13 usual antibacterial drugs in ICU were significantly higher than those in non-ICU departments(P<0 .05) .Conclusion The re-sistance of A .baumannii to antibacterial drugs is gradually serious ,which should be paid high attention to in clinic ,and at the same time the comprehensive measures of prevention and control of hospital infection should be adopted to reduce the spread of drug-re-sistant bacteria .

Objective To analyze the ultrasonic features of thyroid microcarcinoma (TMC) and the causes of misdiagnosis. Methods The ultrasonic features including shape, margin, echogenecity, microcalcification, vascularity and lymphadenopathy were analyzed retrospectively in 26 pathologically-proven TMC patients. Results In 26 cases, 11 cases were diagnosed correctly before operation (11/26, 42.31%), 12 cases were misdiagnosed (12/26, 46.15%) as adenoma or benign nodule, and 3 cases were missed diagnosed (3/26, 11.54%). Among the 23 cases detected on ultrasound, 21 cases were solid and hypoechoic (21/23, 91.30%);19 cases were ill-defined (19/23, 82.61%);12 cases were taller than wide in shape (12/23, 52.17%); 14 cases had microcalcification (14/23, 60.87%); 7 cases showed central or peripheral blood flow signals (7/23,30.43%) with arterial resistance index>0.70 in 3 lesions and<0.70 in 4 lesions. Conclusions Several ultrasonographic features are helpful in identiifcation of TMC, including hypo/iso-echogenecity, ill-deifned margin, taller-than-wide shape, microcalciifcation, arterial signals with high resistance index, and abnormal lymphadenopathy. Moreover, for cases with multiple lesions, to the potential co-existence of benign and malignant lesions should be considered.