Ataxia Telangiectasia ; genetics ; Humans

Objective To approach the effect of different vasopressor on hemodynamics, volume responsiveness, fluid volume balance, renal function and prognosis in patients with acute respiratory distress syndrome (ARDS) complicated with septic shock.Methods A prospective single-blind randomized controlled trial was conducted. ARDS patients with septic shock admitted to the Department of Critical Care Medicine of Jiangxi Provincial People's Hospital from January 1st, 2015 to May 1st, 2016 were enrolled. The patients satisfied ARDS Berlin diagnostic criteria, over 15 years old, needing vasopressor after fluid resuscitation were enrolled. The patients were divided into norepinephrine group (NE group) and terlipressin group (TP group) by randomise number table derived by computer. Patients in TP group were given terlipressin (0.01-0.04 U/min) with an intravenous pump, while those of NE group were given norepinephrine (> 1μg/min) with an intravenous pump, and the target mean arterial pressure (MAP) was maintained at 65-75 mmHg (1 mmHg = 0.133 kPa). Hemodynamics and extravascular lung water index (EVLWI) were monitored by pulse indicator continuous cardiac output (PiCCO). The volume responsiveness of patient was evaluated by passive leg raising (PLR) test, and cardiac index (CI) change (ΔCI ≥ 10%) served as positive volume responsiveness. The differences in hemodynamics, EVLWI, oxygenation index (OI), lactate clearance rate (LCR), rate of positive volume responsiveness, urinary output, fluid volume balance, renal function, and prognostic indicators were compared between the two groups.Results Fifty-seven patients with ARDS complicated with septic shock were enrolled, with 26 patients in NE group, and 31 patients in TP group, thebaseline data in both groups was balanced with comparability. Compare with NE group, 48-hour and 72-hour heart rate (HR) in TP group was significantly slowed (bpm: 82.1±6.8 vs. 87.6±7.4, 81.3±6.1 vs. 85.6±8.3, bothP < 0.05), 72-hour central venous pressure (CVP) was significantly decreased (mmHg: 9.4±2.6 vs. 10.9±3.0,P < 0.05), but no significant difference was found in HR, MAP, CVP, CI, EVLWI, OI and LCR at other time points between the two groups. 48-hour and 72-hour positive volume responsiveness rate in TP group were significantly increased as compared with those of NE group (74.2% vs. 46.2%, 64.5% vs. 38.5%, both P < 0.05), urinary output on the 2nd day (mL/24 h: 2342.8±704.1 vs. 1944.6±684.3) and fluid volume balance (mL: -319.7±54.8 vs. -169.6±27.2) were significantly decreased (bothP < 0.05). There was no significant difference in positive volume responsiveness rate, urine output, fluid volume balance, and the level of serum creatinine at other time points between the two groups. There was no statistically significant difference in the following features between TP group and NE group: duration of mechanical ventilation (days: 8.41±2.97 vs. 9.67±3.56), length of intensive care unit (ICU) stay (days: 12.84±4.47 vs. 14.77±5.01), total length of hospital stay (days: 19.34±7.37 vs. 21.07±8.41), and 28-day mortality (29.0% vs. 30.8%, allP > 0.05).Conclusions Compared with norepinephrine, terlipressin for ARDS patients with septic shock is more conducive to restrict fluid load, improve the renal perfusion and increase urine output. However, in both groups therewas no significant difference in the efficiency of stabilizing hemodynamics, shortening the duration of mechanical ventilation, reducing ICU or hospital days and decreasing 28-day mortality.

AIM: Using functional magnetic resonance imaging, to inspect v sual cortex physical reactions stimulated by rotating grating, and to its components. METHODS: On 1.5T MR scanner, GRE-EPI imaging sequence was carried on 9 h discover ealthy volunteers, the visual cortex response data were processed after delinearation by SPM99.RESULTS: Different components of rotating grating excited different areas of the visual cortex. Dramatic response in the central part of the occipital lobe, which was related to white light stimuli, located at primary visual cortex. Response area in bilateral Broadaman 19 areas was related to vision-motion function. And weak response area in the central part of the occipital lobe was related to shape perception.CONCLUSION: Rotating grating conclude plenty of visual information, and it excites different areas of the optic center as a stimuli. fMRI is a valuable equipment to study the physiology of visual cortex.

Objective To detect genetic alterations in pleomorphic xanthoastrocytoma (PXA), and to investigate the mechanism of development of this neoplasm. Methods Three patients with PXA were studied. Comparative genomic hybridization (CGH) was performed to study chromosomal imbalances in PXA. Using immunohistochemical analysis, the expression of EGFR was detected in PXA. Results Using CGH analysis, genetic imbalance was detected on at least one chromosome for each case. One patient revealed multiple genetic alterations, including gains of 2p14-pter, 4p15-pter, 7p21-qter, 11q24-qter, 12 and 15q14-qter,as well as losses of 8p11.2-pter, 9p11-p23, 10p12-pter, and 13q14-qter. This patient experienced tumor recurrence and died one year later. Gain on Chromosome 7 and loss on Chromosome 8p were demonstrated in 2 of the 3 patients. Immunohistochemically, no EGFR positive reaction was found in all cases. Conclusion Detection of genetic alterations is very important in understanding the pathogenesis of PXA.

Objective To explore the influence of homocysteine(Hcy)on liver cystathionine-?-synthase(CBS)and methylenetetrahydrofolate reductase(MTHFR)system in apoE-/- mice,and determine the effects of atorvastatin and/or folate/vitamin B12 on liver CBS and MTHFR system.Methods Eighty male 6-week-old apoE-/- mice were randomly divided into two groups:65 mice were fed with a chow diet containing 2%(wt/vol)L-methionine(homomethionine group)and 15 mice were fed with normal saline(control group).Two months later,the 60 mice survived in homomethionine group were subdivided into four groups:group Ⅰ(untreated),Ⅱ(3 mg/kg atorvastatin),Ⅲ(3 mg/kg atorvastatin+2 mg/kg folate+30 ?g/kg vitamin B12)and Ⅳ(2 mg/kg folate+30 ?g/kg vitamin B12).After one month,Western blotting was performed to detect the liver CBS and MTHFR system protein expression in each group.Results The relative expression of liver CBS and MTHFR was significantly lower in group Ⅰ than in control group(P

After comparing the varieties of parameters in batch culture under different dissolved oxygen tension by Bacillus pumilus, we found that the demand of cell on oxygen in different phase isn' t consistent. Based on the analys is of the metabolic pathway of oxygen and the mechanism of the effect of dissolved oxygen tension on fermentation of D-ribose, a two-stage oxygen-supply control mode was proposed and experimentally proved to be available. High ribose yield and high glucose consumption rate were achieved during whole process for 44h, and the ultimate ribose concentration and cell concentration were 5.0% and 18.8% higher than former respectively.

Methyl parathion hydrolase (MPH, E.C.3.1.8.1) coding gene mph from Pseudomonas sp. WBC-3, isolated and identified by our lab, was successfully expressed in E. coli AD494 (DE3)/ pET32a(+) system as soluble fusion form at high level. The recombinant MPH showed nearly 4～5 fold higher specific activity to parathion than the enzyme from Pseudomonas sp. WBC-3. In addition, the thermal stability of the recombinant enzyme was improved comparing with the wild type enzyme.

OBJECTIVETo research domestic general situation and quality of the clinical treatment of posthepatitic cirrhotic ascites in Integrated Traditional Chinese and Western Medicine.

METHODSChose CNKI, VIP, Wang fang and CBM as data source and searched the literature of the clinical treatment of posthepatitic cirrhotic ascites in Integrated Traditional Chinese and Western Medicine which published officially from January 1980 to January 2010 and which received a Jaded score of 2 or greater to do a systematic evaluation, including the description of subjects, study design and methods, therapeutic efficacy and statistical methods.

RESULTS136 articles in all met inclusion criteria and 58 articles which received a Jaded score of 2 or greater did this research. The main problems of domestic posthepatitic cirrhotic ascites in Integrated Traditional Chinese and Western Medicine in 30 years included: randomized controlled trial design was unreasonable, lack of blinding, lack of standardized criteria, the sample size was small and lack of specific estimation methods, lack of compliance, case off and withdraw, ignoring adverse reaction and the research of life quality.

CONCLUSIONThe clinical treatment of posthepatitic cirrhotic ascites in Integrated Traditional Chinese and Western Medicine have a "personalized" and "diversity" character and the methods and standards of clinical research need to be improved.

Ascites ; drug therapy ; etiology ; Drugs, Chinese Herbal ; therapeutic use ; Hepatitis ; complications ; Humans ; Medicine, Chinese Traditional ; Phytotherapy ; Randomized Controlled Trials as Topic ; Treatment Outcome

Objective To evaluate the pharmacokinetics of remifentanil in adult patients undergoing general anesthesia.Methods Ten ASA Ⅰ or Ⅱ adult patients of either sex undergoing elective surgery under general anesthesia were enrolled in this study.The patients were premedicated with atropine 0.5 mg.Anesthesia was induced with fentany1-2 ?g?kg~(-1),lidocaine 0.5-1.0 mg?kg~(-1),propofol 1.5-2.0 mg?kg~(-1) and vecuronium 0.1 mg?kg~(-1) and maintained with isoflurane -O_2 inhalation and intermittent i.v.boluses of vecuronium after tracheal intubation.The patients were mechanically ventilated.P_(ET)CO_2 was maintained at 30-40 mm Hg. Remifentanil 5 ?g?kg~(-1) was injected i.v.over lmin after induction of anesthesia.Arterial blood samples were taken before(baseline)and at 1,2,3,5,7,10,15,20,25,30,45,60 and 90 rain after drug administration for determination of blood remifentanil concentration using high performance liquid chromatography/mass spectrometry. The data were analyzed using 3P87 pharmacokinetic program.Results The pharmacokinetic profile of remifentanil was best described by a “two-compartment” model.The distribution half-life(t_(1/2?))(1.6?0.5)min,the elimination half-life(t_(1/2?))(22?10)min,total clearance(CL)(2.1?0.4)L/min and the volume of distribution (V_d)(66?29)L.Conclusion The volume of distribution calculated in this study is significantly different from that reported in previous studies,indicating that there may be some difference in the pharmacokineties of remifentanil between different populations.

Objective To investigate the changes of serum cardiac troponin I(cTnI)and brain natriuretic peptide(BNP)in heart failure of children with pneumonia and their relationship with heart function.Methods Thirty healthy children aged from 5 months to 3 years old were randomly selected with 17 male and 13 female(healthy group).Thirty children with severe heart failure aged from 3 months to 2 years old were selected at the same time with 21 male and 9 female(heart failure group).Thirty children with ordinary pneumonia aged from 3 months to 3 years old were also sampled with 16 male and 14 female(ordinary pneumonia group).The peripheral bloods of 2-3 mL of all children were taken.The BNP level were measured by enzyme-linked immunosorbent assay and the cTnI level was determined by micro-particle enzyme immunoluminescent.Left ventricular ejection fraction(LVEF) and left ventricular fractional shor-tening(LVFS)were detected by echocardiography.SPSS 11.0 software was used to analyze the data.Results The levels of cTnI [(0.389?0.030) ?g/L] and BNP [(0.572?0.090) ?g/L] of heart failure group increased significantly compared with healthy and ordinary pneumonia group,while their LVEF and LVFS decreased significantly(Pa