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.

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.

OBJECTIVETo investigate the clinical efficacy of cannulated screw fixation with percutaneous Poking reduction for the treatment of Sanders II, III calcaneal fracture.

METHODSFrom January 2012 to January 2014, 19 patients with Sanders II, III calcaneal fracture were treated with cannulated screw fixation with percutaneous Poking reduction. There were 14 males and 5 females, ranging in age from 19 to 58 years old, with an average age of (38.3 +/- 4.1) years old. The changes of Bohler angle and Gissane angle were measured and compared preoperatively and postoperatively to observe the recovery of the articular surface. The Maryland Foot Score was used to evaluate operation outcomes.

RESULTSAll the patients were followed up, and the duration ranged from 12 to 28 months with a mean of (22.3 +/- 5.3) months. The Bohler angle and Gissane angle were improved significantly after operation compared with those before operation (P < 0.05). The Maryland score was 83.2 +/- 8.4.

CONCLUSIONTreatment of calcaneal fractures with screw fixation with percutaneous Poking reduction has several advantages such as satisfactory outcome,less damage, fewer complications, quicker recovery, and shorter hospital stay,and it is one of the effective treatments for Sanders II and III calcaneal fractures.

Adult ; Bone Screws ; Calcaneus ; injuries ; surgery ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

The author analyzes the basic information in recent years,including overall students scale,students' age,application trends,etc.Some suggestions are made,regarding to recruiting plan,applicant qualification,recruiting mode,etc,in order to further improve the recruiting and graduate management.

Objective To study the relationship between alkaloids contents in Chinese traditional drug Yimu Cao ( the dried aerial parts of Leonurus artemisia ) and its growing environment. Methods Samples of the herb and the soil at its growing site were collected from 5 selected geographic regions. Reference literatures were reviewed and on-the-spot investigation conducted to understand the growth environment. RP-HPLC was performed to determine the alkaloid contents in the herb. Results Different regions had different environmental conditions, including the climate, soil, vegetation etc. Regardless of the soil, barren or fertile at the growing site, the herb of L. artemisia could grow well, but the contents of alkaloid in the herb varied greatly. The herb produced in 2 northern regions, where the soil is alkaline, had higher content of alkaloid (about 0.4%) than that produced in southern regions (0.1%~0.2%), where the soil is acidic. Conclusions The contents of organic matters, effective phosphorus, quick-acting potassium, and the pH value of the soil at the growing site were the factors that correlates with the alkaloid contents in the herb, among which the pH value of soil was the most important positive correlating factor. The alkaline soils in the north benefit the accumulation of alkaloids more than the acidic soils in the South does. The other probable factors affecting the alkaloid contents in Yimu Cao was the climate and genetic factors.

Objective To study the relationship between alkaloids contents in Chinese traditional drug Yimu Cao ( the dried aerial parts of Leonurus artemisia ) and its growing environment. Methods Samples of the herb and the soil at its growing site were collected from 5 selected geographic regions. Reference literatures were reviewed and on-the-spot investigation conducted to understand the growth environment. RP-HPLC was performed to determine the alkaloid contents in the herb. Results Different regions had different environmental conditions, including the climate, soil, vegetation etc. Regardless of the soil, barren or fertile at the growing site, the herb of L. artemisia could grow well, but the contents of alkaloid in the herb varied greatly. The herb produced in 2 northern regions, where the soil is alkaline, had higher content of alkaloid (about 0.4%) than that produced in southern regions (0.1%~0.2%), where the soil is acidic. Conclusions The contents of organic matters, effective phosphorus, quick-acting potassium, and the pH value of the soil at the growing site were the factors that correlates with the alkaloid contents in the herb, among which the pH value of soil was the most important positive correlating factor. The alkaline soils in the north benefit the accumulation of alkaloids more than the acidic soils in the South does. The other probable factors affecting the alkaloid contents in Yimu Cao was the climate and genetic factors.

The antitussive activity assay for the root extraction of Disporum cantoniense was carried out with coughing mice induced by ammonia liquor. The results showed that the ethanol and water extractions of D. cantoniense possess strong antitussive activity, and the high dose of the former was better than positive control, and then the constituents of the ethanol extraction were separated and purified by various modern chromatographic techniques. Their structures were identified by physico-chemical properties and spectroscopic data. As a result, eight compounds were isolated and identified as stigmast-4-en-3-one(1), (22E, 24R)-ergosta-5, 7, 22-trien-3beta-ol(2), obtucarbamate A(3), obtucarbamate B(4), neotigogenin(5), azo-2, 2'-bis[Z-(2,3-dihydroxy-4-methyl-5-methoxy) phenyl ethylene] (6),dimethyl {[carbonylbis (azanediyl)] bis( 2-methyl-5, 1-phenylene) j dicarbamate (7) , and quercetin-3-O-pB-D-glucopyranoside(8). All compounds were isolated from this plant for the first time, and the result of bioactivity-directed isolation showed that compounds 3, 4, and 6 had obvious effect on antitussive activity, and compound 6 had the same level as positive control.
Animals ; Antitussive Agents ; chemistry ; isolation & purification ; pharmacology ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; pharmacology ; Ethanol ; chemistry ; Female ; Liliaceae ; chemistry ; Male ; Mice

OBJECTIVETo study the effects of weather conditions and occupational hygiene on SARS outbreak.

METHOD(1) Meteorological parameters around SARS outbreaks in 2003 in 9 cities (Guangzhou, Beijing, Tianjin, Taiyuan, Hong Kong, Taipei, Singapore, Toronto and Hanoi) were analyzed; (2) Causes of hospital infection were also analyzed from an occupational hygiene point of view.

RESULTS(1) The amplitude of air temperature, air pressure and diurnal temperature difference were greater around SARS outbreaks in most of the cities. Higher airborne particles concentration and lower wind speed were measured prior to SARS outbreaks in the cities with the most serious epidemic situation. The ten-day mean value of air temperature before SARS outbreaks in 9 cities was 16.6 degrees C +/- 7.6 degrees C, suggesting that coronary virus infection, which has been considered to cause SARS by now, may be most active at 9 degrees C - 24 degrees C. (2) Occupational hygiene in hospital proved to be an important socio-behavior factor for SARS outbreak. All hospital infection could be attributed to defects in the key links of occupational hygiene.

CONCLUSIONSGreater fluctuations of air temperature and higher airborne particles concentration in winter and spring, as well as poor occupational hygiene conditions are significant promoters of SARS outbreak. Warning of atmospheric conditions favorable to SARS, and improvement in occupational hygiene management is the key to prevention from SARS outbreak.

Attitude to Health ; China ; epidemiology ; Cross Infection ; epidemiology ; prevention & control ; Disease Outbreaks ; prevention & control ; Humans ; Meteorological Concepts ; Severe Acute Respiratory Syndrome ; epidemiology ; prevention & control ; transmission

Diagnosis, Differential ; Ependymoma ; metabolism ; pathology ; Female ; Hemangioblastoma ; metabolism ; pathology ; Humans ; Ki-67 Antigen ; metabolism ; Meningeal Neoplasms ; metabolism ; pathology ; surgery ; Meningioma ; metabolism ; pathology ; surgery ; Middle Aged ; Mucin-1 ; metabolism ; Neoplasm Recurrence, Local ; Vimentin ; metabolism

Objective　To study the value of cardial troponin T (cTnT) and neuro-peptide Y (NTY) in hyperthyroic heart disease. Methods　The concentrations of serum cTnT and NTY were measured by ELISA method in 23 patients with hyperthyroidism, and were correlated with the myocardial systolic functions (cardic index, CI; ejective fration, EF) before and after the treatment. Results　The concentrations of cTnT, NTY, FT3, FT4 and blood pressure (BP) at the beginning were 0.13±0.04 ng/L, 192.8±7.1 ng/L, 36.79±4.94 ng/L, 52.96±16.18 ng/L and 123.69±10.06 mmHg, which after the treatment were 0.06±0.03 ng/L, 140.2±5.1 ng/L, 11.52±4.74 ng/L, 26.81±5.18 ng/L and 105.00±8.66 mmHg while TSH was lower at the beginning (1.21±0.45 U/L) than after the treatment (1.84±0.29 U/L) in hyperthyroidism (t=2.185, 2.08, 13.3, 4.53 and 4.84, respectively). The myocardial systolic functions were damaged in hyperthyroidism. The interrelations between NTY and CI, EF were negative in hyperthyroidism (r=-0.333 and -0.203, Y=276.21-21.785X; Y=0.632-2.902X, respectively). Conclusions　The concentrations of NTY and cTnT are higher in hyperthyroic heart disease. The higher the NTY and cTnT concentrations, the worse the myocardial systolic functions.