Sepsis is a serious problem among the elderly population as its incidence and mortality rates dramatically increase with advanced age. More importantly, the elderly has increased vulnerability to developing sepsis due to diminished physiologic reserve, presence of comorbidities, immunosenescence and frequent instrumentation. Those who survive severe sepsis are more likely to have irreversible organ damage, cognitive impairments, and diminished overall function. Additionally, elderly patients with sepsis often present with atypical symptoms which further complicates and potentially delays diagnosis. Although sepsis is a serious life-threatening disease, recognition of this problem is very low compared to other age-associated diseases. Therefore, the purpose of this review is to analyze the challenges facing this cohort and how to optimize their management.

Fluid overload is frequently found in patients with intravenous fluid resuscitation,and recent studies showed the potential risks of fluid overload for organ failure and mortality.To avoid volume overload and its associated complications,strategies to identify fluid responsiveness are necessary.Apart from the amount of fluid utilized for resuscitation,the type of fluid used also impacts patient outcome.In recent years,there has also been an increasing focus on comparing various resuscitation fluids with respect to both benefits and risks.In this article,through analyzing the impact of fluid overload on patient outcome,we describe the differences in static and dynamic estimates of fluid responsiveness,and review the current literature regarding choice of intravenous fluids for resuscitation in critically ill patients to help clinicians to make appropriative decision on intravenous fluids prescription and to optimize patient outcome.

ObjectiveTo investigate the pattern of the relationship of craniopharyngiomas with pituitary stalks and hypothalamus. Furthermore, based on different patterns affirmed during the operations, surgical strategies were designed for radical excision. MethodsA series of 66 patients with primary suprasellar craniopharyngiomas were treated with microsurgical techniques and the relationships of the craniopharyngiomas with pituitary stalk and hypothalamus were analyzed prospectively. Appropriate surgical approaches were selected preoperatively according to the lesion's sizes and expanding directions. The relationships of the lesions to the pituitary stalks and hypothalamus were identified in detail and dissected carefully with protection of perforating vessels. ResultsThe patterns that pituitary stalks were involved by craniopharyngiomas were identified in 36 cases and divided into four types: no relation (5 cases), adhesion (10 cases), partial invasion (8 cases) and total invasion (13 cases). The anterior floor of the third ventricle was involved in 42 cases, in which it disappeared totally in 10 cases. Total resection was achieved in 58 case, subtotal resection in 8 cases. Diabetes insipidus (DI) was identified in 44 cases postoperatively. No surgical mortality, no recurrence was found during follow-up of mean 35 months. ConclusionThe appropriate selection of surgical approaches preoperatively, careful identification and according treatment of the relationships of the tumors with pituitary stalks and hypothalamus are the keys to protect the pituitary stalk; hypothalamus in craniopharyngiomas resection in adults.

Adolescent ; Child ; Child, Preschool ; Colitis, Ulcerative ; diagnosis ; therapy ; Crohn Disease ; diagnosis ; therapy ; Female ; Humans ; Male ; Prognosis ; Retrospective Studies

Objective To investigate the situation and progress in technology of brain computer interfaces (BCI) by using the bibliometric approach.Methods Literature searching was done in China national knowledge infrastructure (CNKI) database using keyword brain computer interface.Subsequent results were analyzed by using softwares concerning the periodical distribution,subjects' distribution,foundations,authors,institutes,journal types and key words.Results Overall 425 publications from 160 journals were included.The amount of the relevant articles showed an increasing trend in 2002 to 2012.The research in BCI in China was supported by a large amount of funds.There were a lot of Chinese authors and institutions participating in BCI study,and they were widely distributed across the country.However,only 32.56％ of all authors and 51.85％ of all institutions published more than 1 article.Moreover,research on BCI mainly was focused on the biomedical engineering aspect.Conclusions Research on BCI developed rapidly in the past 12 years in China and will continue to develop in the following decades.In the future studies,the focus should shift to clinical research instead of biomedical engineering,and to make this technology a useful clinical practice is the first priority.

Objective To observe the expression of leukocyte-function-associated antigen-1(LFA-1)immunoreaction in children with febrile seizures(FS),and explore the neuroimmunomodulation mechanisms in the pathogenesis of FS.Methods Adopting flow cytometry(FCM),the levels of LFA-1 contained in blood serum and peripheral blood mononuclear cells(PBMC)of 60 cases [simple FS(SFS)30 cases;complex FS(CFS)30 cases] with febrile convulsion were analyzed,and compared with those in a normal group(30 cases).Out of 60 children with FS group,the LFA-1 mRNA in 20 cases with SFS and 20 cases with CFS was analyzed,and LFA-1 mRNA in19 health children taken out from control group(30 cases)was analyzed.The real-time PCR was used to detect the expression of PBMC LFA-1 mRNA.Results The expression of LFA-1 in the surface of PBMC of the 3 groups,the highest LFA-1 level was in the SFS group(50.89?21.36),the lowest LFA-1 level was in the CFS group(34.35?11.45),and control group was(41.39?16.30).Significant differences were found in 3 groups(Pa

Objective: To construct subtracted cDNA libraries of stomach tumors and normal stomach tissue using suppression subtractive hybridization(SSH).Methods: cDNA Library subtraction was performed using the protocol described in the Clontech PCR-Select cDNA Subtraction Kit. cDNA was synthesized from 2 μg of poly A+RNA from the tumor and normal tissues using AMV reverse transcriptase. The tester and driver cDNAs were digested with RsaⅠ, a four-base-cutting restriction enzyme that yields blunt ends. The tester cDNA was then subdivided into two portions, and each was ligated with different cDNA adaptor. Two hybridizations were performed. In the first, an excess of driver was added to each sample of tester. Hybridization kinetics led to equalization and enrichment of differentially expressed sequences. During the second hybridization, the two primary hybridization samples were mixed together without denaturing and thus the templates were generated from differentially expressed sequences for PCR amplification. Using suppression PCR, only differentially expressed sequences were amplified exponentially and after second PCR amplification the background was reduced and differentially expressed sequences were further enriched. The cDNAs were then directly inserted into a T/A cloning vector to generate a stomach tumor-specific subtracted cDNA library. Results: The amplified library contained 800 positive clones. Plasmid inserts were PCR amplified and showed 250－700 bp inserts. Conclusions: The successfully constructed subtracted cDNA library of gastrocarcinoma and normal tissue enables us to compare two populations of mRNA and obtain clones of genes that expressed in one population but not in the other.The characterization of these genes will allow them to be exploited for their diagnostic and therapeutic potentials.

The contents of coumarins in the sulfur fumigated Angelicae Dahuricae Radix (Baizhi, ADR) were reduced significantly. To achieve the quality control of ADR, the qualitative identification of sulfur fumigated ADR and quantitative model of imperatorin content should be established. The near-infrared (NIR) spectrograms of non-sulfur and sulfur fumigated ADR were collected by NIR diffuse reflectance spectroscopy technology and pretreated by the method of first derivative derivation and vector normalization. The Ward's Algorithm method was used for the cluster analysis. The non-sulfur and sulfur fumigated ADR can be quickly identified in the range of 8,806. 0-3 811.0 cm(-1) based on the cluster analysis. The NIR quantitative model of imperatorin was established by the contents of imperatorin determined by HPLC in combination with partial least squares regression analysis. According to the calibration model established in this study, correlation coefficients (R2), the root-mean-square error of cross-validation (RMSECV), and the root-mean-square error of prediction (RMSEP) for imperatorin were 0.982 8, 0.006 8, 0.011 8, respectively. The quantitative model of imperatorin can be applied to determine the content of imperatorin in ADR accurately.
Angelica ; chemistry ; classification ; China ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; chemistry ; Quality Control ; Spectroscopy, Near-Infrared ; methods ; Sulfur ; chemistry

Objective To observe the porcelain treated with Nd∶YAG laser irradiation and hydrofluoric acid (HF), and to explore the influence of integrated treatment of Nd ∶ YAG laser irradiation and HF etching in the bond strength of brackets to porcelain.Methods 48 metal ceramic prostheses were randomly divided into untreated control group,HF group,grooved treatment group,0.75W laser group,1.05W laser group,1.45W laser group. All samples were bonded to the brackets.After temperature cycling test,the shear bond strength (SBS)and tensile bond strength (TBS)were measured.Results There were significant differences in SBS and TBS between various surface treatment groups and untreated control group (P < 0.01).The SBS and TBS of brackets bonded in HF group was significantly higher than those in 1.05W laser and 1.45W laser groups (P <0.05).The SBS and TBS in 1.05W laser and 1.45W laser groups were higher than those in HF group (P <0.05).The SBS and TBS in 1.05W laser group were higher than those in other groups (P < 0.05).SBS showed positive correlation with TBS (r =0.426,P =0.000).Conclusion The use of Nd∶YAG laser irradiation with the energy parameter of 1.05W and HF could increase the bonding with formation of composite resin,and the more SBS,the more TBS.

Brachytherapy ; adverse effects ; Female ; Humans ; Iodine Radioisotopes ; administration & dosage ; therapeutic use ; Male ; Medical Staff, Hospital ; Occupational Exposure ; analysis ; Radiation Dosage ; Radiation Monitoring