As the preferred treatment for most patients with hemodynamic instability in the intensive care unit (ICU),the fluid resuscitation can be limited by the cardiac function,that makes the fluid treatment has no responsiveness and may cause the risk of pulmonary edema increase.So,good fluid responsiveness is the basic condition to make fluid therapy successfully.For those patients,in order to lower the risk and correctly evaluate the fluid responsiveness,there are a large number of studies direct at the static and the dynamic pre-load parameters in animals and clinical patients.Those studies show that how to avoid the blindness of fluid expansion,accurately and effectively evaluate and forecast the fluid responsiveness.

Objective:To understand the development reality of pastes in Hubei province through the investigation of paste busi-ness in 2013. Methods:Issued by Hubei provincial administration of traditional Chinese medicine, a questionnaire investigation was a-dopted in the study. The implementation, usage amount, scope, composition of the users, price, technical personnel and propaganda of pastes were investigated and statistically analyzed in 91 TCM, integrated Chinese and western and national hospitals in our province. Results:The business conduction rate of pastes in Hubei province was nearly 61. 54% in 2013 with the production of approximately 45,000 batches and the technical personnel of 1 538. The paste business created great economic value of 0. 48 million yuan in 2013 with strengthened propaganda. However, the brand building was slightly weak. Conclusion:The business of pastes in Hubei province has developed rapidly and still shows great development potential.

H1N1 influenza A spread around the world in 2009.There were lots of patients in China too.We did this research to know the epidemiological feature and transmission route and strengthen the prevention and control measure of the influenza.Methods:We collected the nasopharyngeal swab and serum samples of 56 patients who had flu symptom from the infectious disease department of 1st hospital of Jilin University from October in 2009 to December in 2009.The specific antibody of the serum samples were detected by the blood clots suppression method and the H 1N1 RNA of the nasopharyngeal swab was detected by the Nest-RT-PCR assay.Results:The results of nucleic acid test showed that 21(37.5%) and 16(27.8%) samples were found NP and M of influenza A positive respectively and only 2 ( 3.6%) were found H1N1 of influenza A positive.The results of the blood clots suppression method showed that the serum samples of 27 patients (48.2%) could suppress the red blood cells blot of H 1N1 influenza A specifically and all the antibody titer was more than 1∶320.The antibody titer was more than 1∶5 120 in 8 of them.There′s significant difference of the serum antibody titer between the recovery phase and the acute phase.The specific H1N1 influenza A antibody of 27 (48.2%) serum samples in the recovery phase were positive and it was much higher than the result of nucleic acid test .Conclusion:The nucleic acid could be detected in the acute phase and the serum antibody detection could be done in the later stage .Using both the assays could increase the positive rate of H 1N1 influenza.

Objective To compare the scores from the simpliifed COMFORT scale with those from the bispectral index (BIS) and analyze the variation among different evaluators in children in an intensive care unit, and to investigate the reliability;validity of simpliifed COMFORT scale. Methods Twenty children between 3 and 16 years of ages on mechanical ventilation and sedation were simultaneously classiifed based on the BIS and the simpliifed COMFORT scale evaluated by 4 independent evalua-tors. The Kappa test was performed and the correlation between the two methods (Pearson correlation) was tested. Results In to-tal, 70 observations were performed on 20 patients. Based on the Kappa coefifcient, the agreement among evaluators ranged from 0.62 to 0.77 (P<0.001). There was a correlation between the BIS and the simpliifed COMFORT scale (r=0.53-0.61,P<0.01). Conclusions Due to the strong consistency between the independent evaluators and the correlation between the two methods, the reliability and validity of simpliifed COMFORT scale are preferable and simpliifed COMFORT scale is useful in classifying the level of sedation in children on mechanical ventilation.

Objective To investigate the serum concentration of soluble klotho (s-kl) in systemic lupus erythematosus (SLE) and lupus nephritis (LN) ,and elucidate its role in SLE and LN .Methods A total of 34 patients ,definitely diagnosis as SLE with un-treatment firstly ,were enrolled in this study .The patient were divided into two groups ,those who complicated with LN were assigned to LN group (15 cases) ,the others were distributed to SLE group (19 cases) .At the same time ,17 cases of routine physical examination people were take as control group .24 hours urine of all the cases was collected for examining urinary protein (Upro) .Routine hemocyte analysis ,serum biochemical parameters and ANA and dsDNA were measured by routine method .ELISA was used to detect s-kl ,25-hydroxy vitamin D (25-OH-D) and fibroblast grow th factor-23 (FGF-23) .Systemic lupus erythematosus disease activity index (SLEDAI) was performed in SLE and LN group ,and the creatinine clearance rate(CCr)was calculated accord-ing to the Cockcroft-Gault formula .Pearson′s and linear regression were applied to analyisis the correlation of relevant parameters . Results As compared with the control group ,there were statistically significant differences in mean arterial pressure ,blood rou-tine ,creatine kinase (CK) and lactate dehydrogenase (LDH ) ,complement (C3 and C4 ) and dsDNA in SLE and LN group (P <0 .05) .The level of Upro/24 h ,lipids (CHOL and TG) and creatinine (Scr) in LN group was significantly higher ,while serum al-bumin (ALB) and CCr were obviously lower than those in SLE group and control goup(P< 0 .05) .Difference of s-kl ,25-OH-D and FGF-23 in serum were not observed between SLE and control gropu(P> 0 .05) ,but the serum level of s-kl ,25-OH-D and FGF-23 in LN group were showed a statistical significance when compared with SLE or control group(P< 0 .05) .Meanwhile ,the SLEDAI score was higher in LN than in SLE group(P< 0 .05) .Correlation analysis indicted that s-kl exhibited a positive relationship with 25-OH-D ,C3 and C4 ,while showed a negative correlation with FGF-23 ,SLEDAI and dsDNA(all P< 0 .05) .However ,no any corre-lationt was revealed in regression analysis between the s-kl ,25-OH-D ,FGF-23 and the lupus activity .Conclusion The decrease of s-kl maybe one of the pivotal factors that up-regulated the level of FGF-23 in SLE and LN patients ,thus lead to the deficiency of vi-tamin D and lupus activity .

OBJECTIVETo observe the law of the meridian abnormal changes and the correlation with acupuncture efficacy based on the effectiveness study of electroacupuncture (EA) in treatment of severe functional constipation.

METHODSSeventy patients of severe functional constipation were randomized into an EA group and a sham-EA group, 35 cases in each one. In the EA group, Tianshu (ST 25) and Fujie (SP 14) were punctured deeply and stimulated with EA (dense-disperse wave, 2Hz/15 Hz, 0. 1 to 1. 0 mA), and Shangjuxu (ST 37) was needled. In the sham-EA group, the sites lateral to Tianshu (ST 25) and Fujie (SP 14) were punctured shallowly and stimulated with electricity. The site lateral to Shangjuxu (ST 37) was punctured shallowly. The treatment was given continuously for 8 weeks in the two groups, 5 times weekly in the first 2 weeks and 3 times weekly in the rest 6 weeks. WANG Juyi's meridian examination method was applied to detect the abnormalities of the spleen, stomach and large intestine meridians before treatment, and in 2, 4, 6 and 8 weeks among 70 patients separately. The frequency of complete spontaneous bowel movement (CSBM) every two weeks, meridian abnormal value and the relativity with CSBM change rate were compared in the patients between two groups.

RESULTSRegarding the increase of CSBM frequency, the effect started since the 2nd week in the EA group, with the treatment going on, CSBM frequency was increased apparently (all P<0. 05). In the sham-EA group, after 6 and 8-weeks of treatment, CSBM frequency was increased apparently as compared with that before treatment (all P<0. 05). The increase of CSBM frequency in the EA group was remarkably as compared with the sham-EA group at every time point (all P<0. 05). The abnormal value of the large intestine meridian in 2 weeks of treatment and the values of the stomach and spleen meridians and the relevant meridians in 4 weeks of treatment were all reduced apparently as compared with those in the baseline in the EA group (all P<0. 05). With the treatment time going on, the abnormal reflections on the large intestine and stomach meridians were reduced gradually (all P<0. 05), and the total change rate of abnormalities on the large intestine, stomach and spleen meridians presented the negative correlation with the total change rate of CSBM frequency (P<0. 01, P<0. 05).

CONCLUSIONIn the EA group, the efficacy on CSBM frequency in severe functional constipation is advantageous and stable as compared with the sham-EA group. Acupuncture at the relevant acupoints of the spleen, stomach and large intestine meridians achieves the definite regulation to the meridian abnormalities. It is discovered that the abnormal changes in the spleen, stomach

Acupuncture Points ; Adult ; Aged ; Constipation ; physiopathology ; therapy ; Defecation ; Electroacupuncture ; Female ; Humans ; Male ; Meridians ; Middle Aged ; Treatment Outcome ; Young Adult

Objective To use ultrasonic cardiac output monitor(USCOM)to monitor the hemodynamics of children who un-derwent congenital heart disease(CHD)surgery before and after fluid therapy,and to examine the accuracy of the hemodynamic parameters central venous pressure(CVP),stroke volume variation(SVV),corrected flow time(FTc)and smith madigan inotro-py index(SMII)in predicting fluid responsiveness of children post operation.Methods USCOM was used to monitor the hemo-dynamic parameters of post-operative children before and after fluid therapy.The change of SVI(ΔSVI)was calculated based on the stroke volume index(SVI)before and after fluid therapy,and the inotropic scores(IS)were obtained based on the doses of in-otropic drugs used.Children with ΔSVI≥ 15% were defined to be responders who responded to fluid resuscitation and those with ΔSVI < 15% as non-responders.Two subgroups were also established in terms of IS:IS ≤ 10 group and IS > 10 group.Results Among the parameters(CVP,FTc and SM,etc.),only the area under the ROC curve(AUC)of SVV was signifi-cantly different between before and after fluid therapy(AUC 0.776,P < 0.01).Subgrouping analysis also showed significant difference in only the AUC of SVV between IS≤ 10 group and IS> 10 group(AUC:0.732,P =0.045 or 0.813,P =0.002). Conclusion SVV monitored by USCOM,in contrast to CVP,FTc and SMII,can predict the fluid responsiveness in children af-ter congenital heart surgery.Prediction of fluid responsiveness by SVV shows higher accuracy in IS>10 group than in IS≤10 group.

Islet transplantation is one of the effective therapies for diabetes mellitus. Nevertheless, multiple issues still exist, such as shortage of donors and adverse reactions caused by long-term use of immunosuppressants, which limit the islet survival post-transplantation. Microencapsulated islet transplantation may overcome these difficulties to certain extent, whereas many factors, such as the destruction of immune isolation microenvironment within the microcapsules and insufficient supply of oxygen and nutrients, constrain the application of microencapsulated islet transplantation in clinical practice. In recent years, how to enhance the effect of microencapsulated islet transplantation has been gradually studied. The application of stem cells in microencapsulated islet transplantation has steadily become a research hot spot. Therefore, the optimizing strategies for microencapsulated islet transplantation and the application of stem cells in microencapsulated islet transplantation were reviewed, and the potential improvement techniques of microencapsulated islet transplantation were investigated in this article, aiming to provide reference for further clinical application of microencapsulated islet transplantation.

Objective To investigate the effect of compound Fufangteng mixture-containing serum on the proliferation of bone marrow mesenchymal stem cell (BMSC) and its mechanism. Methods Rat BMSC were isolated, cultured and purified in vitro by direct adherence method. Cell morphology was observed. Surface markers were identified by flow cytometry. The rats were treated with compound Fufangteng mixture at a dose of 3 mL/(kg·d) by gavage for 14 d, and then the drug-containing serum was collected. BMSC were divided into the blank control group, drug-containing serum group, Notch1 small interfering ribonucleic acid (siRNA) group and Notch1 siRNA+drug-containing serum group. The proliferation rate of BMSC was detected and the relative expression levels of Notch1 signaling pathway-associated messenger ribonucleic acid (mRNA) and proteins were measured in each group. Results Microscopic observation showed that the first generation BMSC were seen in the long spindle shape, and grown in the parallel or spiral pattern. The third generation BMSC positively expressed CD90 and CD44, whereas were negative for CD45. Compared with the blank control group, the proliferation rate of BMSC in the drug-containing serum group and Notch1 siRNA+ drug-containing serum group was significantly increased, whereas that of BMSC was significantly decreased in the Notch1 siRNA group (all P < 0.05). Compared with the Notch1 siRNA group, the proliferation rate of BMSC was significantly increased in the Notch1 siRNA+drug-containing serum group (P < 0.05). Compared with the blank control group, the relative expression levels of Hey1 and Delta-like ligand (DLL)1 mRNA and proteins were significantly up-regulated in the drug-containing serum group, whereas those were significantly down-regulated in the Notch1 siRNA group and Notch1 siRNA+drug-containing serum group (all P < 0.05). Compared with the Notch1 siRNA group, the relative expression levels of Hey1 and DLL1 mRNA and proteins were significantly up-regulated in the Notch1 siRNA+drug-containing serum group (all P < 0.05). Conclusions Compound Fufangteng mixture-containing serum may promote the proliferation of rat BMSC, and its mechanism is probably associated with the activation of Notch1 signaling pathway.

Objective To evaluate the effect of mesenchymal stem cell (MSC) coated-islets on instant blood-mediated inflammatory reaction (IBMIR) after islet transplantation. Methods MSC labeled with tracer and human islets were placed into an ultra-low adsorption cell culture dish, shaken and mixed twice at an interval of 0.5 h, and then incubated at 37 ℃ and 5% CO₂ for 24 h to obtain MSC-coated islets. The coating effect of MSC and in vitro function of the islets were assessed. A blood circulation tube-shaped model was established in vitro. In the blank control group, 0.2 mL of islet culture solution was added. In the islet group, 800 islet equivalent quantity (IEQ) of uncoated islets were supplemented. In the MSC-coated islets group, 800 IEQ of MSC-coated islets were added, and circulated for 60 min at 37 ℃. A portion of 0.5 mL blood sample was taken for routine blood test at 0, 30 and 60 min, respectively. After 60 min circulation, the blood sample was filtered with a 70 μm filter to collect plasma, blood clots and islets. Blood clots and islets were subject to hematoxylin-eosin (HE) staining and immunohistochemical staining. Morphological changes and the aggregation of CD11b-positive cells surrounding the islets were observed. The contents of plasma thrombin-antithrombin complex (TAT), tissue factor (TF), C3a, C5b-9, interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α, monocyte chemoattractant protein (MCP)-1 and IL-8 were determined by enzyme-linked immune absorbent assay. Results After 24 h co-incubation, the islets were coated by MSC, with a coating degree of approximately 80%. In the islet and MSC-coated islet group, a large quantity of neutrophils and monocytes were observed surrounding the blood clots and islets, and the quantity of CD11b-positive cells in the MSC-coated islet group was less compared with that in the islet group. After co-incubation with the whole blood for 0, 30 and 60 min, the quantity of platelets, neutrophils and monocytes was declined in the MSC-coated and islet groups, and gradually decreased over time. Compared with the blank control group, the quantity of platelets, monocytes and neutrophils was lower, whereas the TF content was higher in the MSC-coated islet group. Compared with the islet group, the quantity of platelets, monocytes and neutrophils was higher, whereas the TAT and TF contents were less in the MSC-coated islet group, the differences were statistically significant (all P < 0.05). Compared with the blank control group, the expression levels of C3a, C5b-9, IL-6, TNF-α and IL-8 were up-regulated in the MSC-coated islet group. Compared with the islet group, the expression levels of C3a, C5b-9, IL-1β, IL-6, TNF-α, IL-8 and MCP-1 were down-regulated in the MSC-coated islet group, and the differences were statistically significant (all P < 0.05). Conclusions MSC-coated islets may reduce the exposure of islet TF in the blood and prevent the incidence of IBMIR during the coagulation response stage, thereby mitigating the injury and loss of islet allograft in the early stage of islet transplantation.