Child ; Humans ; Liver Failure ; therapy ; Liver Transplantation ; Male ; Plasma Exchange

Objective To compare the effects of biphasic square waveform (BSW) with low or high energy on external defibrillation.Method Adult swine model of closed chest ventricular fibrillation induced by electricity was established.Eighteen swine,weighing (30?3.3) kg were randomly divided into three groups:50-50-50 J group (n=6),30-50-75 J group (n=6),120-150-200 J (n=6).After three minutes of ventricular fibrillation without treatment,the pigs in the three groups were defibrillated accordance to the above sequences. Results 30 J BSW didn't succed to external defibrillate.The first defibrillation successful rate of 50 J and 120 J BSW was 5/6.The total defibrillation successful rate of every group was 100%.All pigs quickly had spontaneous circulation after defibrillation and survived more than 24 hours.ST-T change of low-energy was less than that of high-energy.After resuscitation,myocardial function decreased,but there had not significant differences between groups.Conclusions In the study,30J BSW could not reach successful defibrillation,and 50 J and 120 J BSW had similar defibrillation efficacy.The ideal energy of BSW external defibrillation was 50 J.

Objective To understand the status of soil?transmitted nematode infections in Xiding Township,Menghai Coun?ty,Yunnan Province,so as to provide the reference for formulating the strategy of soil?transmitted nematodosis control. Meth?ods Soil?transmitted nematode eggs in feces were detected by the Kato?Katz method,and the eggs of Enterobius vermicularis were detected by the cellophane tape method in children. The soil samples were collected from vegetable ,fruit and other crop fields of 15 residents randomly to detect hookworm. Results The stool samples from 1 002 residents were examined and the soil?transmitted nematode infection rate was 20.06%(201/1 002). The infection rates of hookworm,Ascaris lumbricoides and Trichu?ris trichura were 18.96%(190 cases),1.70%(17 cases)and 0.90%(9 cases)respectively. The percentages of people with light infection of hookworm,A. lumbricoides and T. trichura were 97.37%(185/190),88.24%(15/17)and 100%(9/9)respec?tively. No infection of E. vermicularis was found. Fifteen soil samples were tested,and no hookworm was found in the soil. Con?clusion The infection rate of soil?transmitted nematode in Xiding Township,Menghai County is high,but the infectiosity is light. The control and monitoring of soil?transmitted nematodosis should be strengthened in this area.

Background Noninvasive positive pressure ventilation (NIPPV) has been proposed to shorten the duration of mechanical ventilation in intubated patients,especially those who fail initial weaning from invasive mechanical ventilation (IMV).However,there are also some discrepancies in terms of weaning success or failure,incidence of re-intubation,complications observed during study and patient outcomes.The primary objective of this update was to specifically investigate the role of NIPPV on facilitating weaning and avoiding re-intubation in patients intubated for different etiologies of acute respiratory failure,by comparing with conventional invasive weaning approach.Methods We searched randomized controlled trials (RCTs) comparing noninvasive weaning of early extubation and immediate application of NIPPV with invasive weaning in intubated patients from PubMed,Embase,Cochrane Central Register of Controlled Trials,Web of Knowledge and Springerlink databases.Records from conference proceedings and reference lists of relevant studies were also identified.Results A total of 11 RCTs with 623 patients were available for the present analysis.Compared with IMV,NIPPV significantly increased weaning success rates (odds ratio (OR):2.50,95％ confidence interval (C/):1.46-4.30,P=0.0009),decreased mortality (OR:0.39,95％ CI:0.20-0.75,P=0.005),and reduced the incidence of ventilator associated pneumonia (VAP) (OR:0.17,95％ CI:0.08-0.37,P ＜0.00001) and complications (OR:0.22,95％ CI:0.07-0.72,P=0.01).However,effect of NIPPV on re-intubation did not reach statistical difference (OR:0.61,95％ CI:0.33-1.11,P=0.11).Conclusions Early extubation and immediate application of NIPPV is superior to conventional invasive weaning approach in increasing weaning success rates,decreasing the risk of mortality and reducing the incidence of VAP and complications,in patients who need weaning from IMV.However,it should be applied with caution,as there is insufficient beneficial evidence to definitely recommend it in terms of avoiding re-intubation.

Objective To evaluate the efficacy and potential renal impairment of one-year combination therapy de novo of adefovir dipivoxil(ADV) and lamivudine(LMV) for decompensated cirrhosis related to HBV. Methods A total of 36 patients with decompensated cirrhosis related to HBV, nobody had nucleos(t)ide analogs(NAs) treatment history, were recruited and were divided into two group(control group and observation group) randomly. A monotherapy of LMV (100 mg per day ) was selected to individuals in control group(n = 18), in contrast, a combination therapy de novo of ADV( 10 mg per day) and LMV( 100 mg per day) was applied to those in observation group( n = 18). Basic approaches including liver protection, symptom-driven intervention, and supporting therapy, were given to all of the individuals. A course of one year was applied to all. Liver function, Child-Pugh score, serum creatinine(sCr) level,virological response(VR) rate, and virological breakthrough rate were observed pro- and post- treatment, differences between the two populations were analysed statistically. Results ( 1 ) The averages of gender,age, HBeAg status, HBV viral load, sCr level, and Child-Pugh score were all compatible in the two groupsat baseline( P ~ 0. 05 for all). (2) At the endpoint of treatment, none of deaths was reported. Comparing with the status before treatment in each group itself, liver function, Child-Pugh score, and viral load were improved statistically (P <0. 01 for all), especially in observed group( P <0. 01 for all variables, vs control group), as for VR rate, result is significant superior to that of control group too(88. 89% vs 66. 67% , P <0.05). (3) Virological breakthrough occurred to none in observed group and three cases (16. 67% ) in control group, all of them were confirmed to be rtM204V variant in the following detection of direct sequencing. (4) Elevated level of sCr didn't arised at the end of treatment in two groups. Conclusion Present study reveals that in populations with decompensated cirrhosis related to HBV, one-year combination therapy de novo of ADV and LMV is superior to monotherapy of LMV, and the renal safety is favorable within one year.

OBJECTIVETo explore the short-term effectiveness and the cause of the early complications of lumbar disc herniation with Coflex system in order to provide evidence for the prevention.

METHODSFrom November 2007 to August 2008, 37 patients (20 males and 17 females) were treated with Coflex system. The age was from 33 to 70 years with an average of 52 years and the history was from 6 to 50 months with an average of 16.5 years. Complications were observed and the short-term effectiveness was evaluated by scores of JOA and ODI before and after operation.

RESULTSAll patients were followed up from 1 to 2 years with an average 20 months. The JOA score increased from 9.09 +/- 1.10 preoperatively to 25.40 +/- 1.20 in the last follow-up. ODI decreased from 24.70 +/- 4.80 preoperatively to 4.80 +/- 1.00 in the last follow-up. The VAS score decreased from 7.86 +/- 0.80 preoperatively to 3.20 +/- 0.50 in the last follow-up. The symptoms remarkably improved. Complications occurred in 4 pa-tients (10.8%), among them, persistent low back pain was in 1 case and conservative treatment did not work; opposite lower limb pain was in 1 case at the 3rd week after operation and symptomatic treatment was effective; displacement of Coflex was in 1 case and Coflex breakage happened in 1 case at the 6th month after operation, but both did not have related clinical symptom.

CONCLUSIONCoflex can obtain good clinical outcomes in treating lumbar disc herniation, but it has special complications. The indications and manipulations should be chosen properly.

Adult ; Aged ; Female ; Humans ; Internal Fixators ; Intervertebral Disc Displacement ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Postoperative Complications ; etiology ; prevention & control ; Prostheses and Implants

OBJECTIVESTo investigate the protective effects of Sapindus saponins in spontaneously hypertensive rats, and the possible cellular and molecular mechanisms.

METHODSThirty-two 16-week-old spontaneously hypertensive rats were randomly divided into four groups (8 in each group): model group (placebo), positive control group (27 mg/kg of Captopril Tablets), Sapindus saponins groups (27 mg/kg and 108 mg/kg, respectively). Another 8 healthy Wistar-Kyoto strain (WKY) rats were used as the normal group. The animals were treated for 8 weeks. Blood pressure of rats was determined by non-invasive blood pressure meter (BP-6). Furthermore, the contents of angiotensin II (Ang II) in plasma and myocardial tissue were determined by enzyme-linked immunosorbent assay (ELISA), the gene expression of receptor angiotensin type 1 (AT1R) in aorta was determined by quantitative realtime polymerase chain reaction (qRT-PCR). The protein expression of transforming growth factor-β1 (TGF-β1) and AT1R in heart was determined by immunohistochemical staining. The protein expression of p-phosphorylation of p38 mitogen-activated protein kinase (p-p38MAPK) was determined by Western blotting. The contents of interleukin (IL)-1, IL-6 and tumor necrosis factor (TNF) in serum were determined by radioimmunoassay. And the histopathological and morphological changes of aorta and heart tissue samples were assessed semi-quantitatively by hematoxylin-eosin (HE) or Masson staining.

RESULTSThirty minutes after single or continuous treatment, systolic blood pressure (SBP) was reduced significantly in Sapindus saponins groups. And the contents of AngII, IL-1, IL-6 and TNF-α in serum, the expression of AT1R mRNA, p-p38MAPK and TGF-β1 were significantly suppressed dose-dependently (P<0.05 or P<0.01). With the Sapindus saponins treatment, compared with those of the model group, the cardiac and aortic pathological changes were ameliorated significantly.

CONCLUSIONSOur findings suggest that Sapindus saponins might have protective effects in spontaneously hypertensive rats, the cellular and molecular mechanisms of which might be relevant to the regulation of inflammatory responses mediated by p-p38MAPK signal pathway based on activated Ang II and AT1R.

Angiotensin II ; metabolism ; Animals ; Aorta ; drug effects ; pathology ; physiopathology ; Blood Pressure ; drug effects ; Collagen ; metabolism ; Female ; Hypertension ; blood ; drug therapy ; enzymology ; physiopathology ; Interleukin-1 ; blood ; Interleukin-6 ; blood ; Male ; Phosphorylation ; drug effects ; Protective Agents ; pharmacology ; therapeutic use ; Rats, Inbred SHR ; Receptor, Angiotensin, Type 1 ; metabolism ; Renin-Angiotensin System ; drug effects ; Sapindus ; chemistry ; Saponins ; pharmacology ; therapeutic use ; Transforming Growth Factor beta1 ; metabolism ; Tumor Necrosis Factor-alpha ; blood ; p38 Mitogen-Activated Protein Kinases ; metabolism

OBJECTIVETo investigate the effects of transfection of agrin gene on the recovery of muscle function after a free neurovascular muscle transfer.

METHODSThe electrical gene transfection was performed when the gracilis muscle of the SD rat was completed free neurovascular transfer. The experimental group was treated with pCS2+ -agrin, the group with plasmid pCS2+ as the negative control and the group with normal saline as the frank control. The muscle function, expression of neural agrin and the junctional nAChR number was measured after the operation.

RESULTSAt 4, 5 and 10 weeks postoperatively, the pCS2+ -agrin group was significantly better than the control groups in muscle function (P < 0.05 ). The immunohistochemical staining showed an increasing deposition of the agrin protein near the endplate at 1 and 5 weeks after the operation, but decreasing remarkably to the level of control groups at 10 weeks postoperatively. The pCS2+ -agrin group was significantly more than the control groups in junctional nAChR number at every points of the time postoperatively.

CONCLUSIONSTransfection of agrin gene in the transferred muscle may increase the early recovery of muscle function.

Agrin ; genetics ; Animals ; Female ; Genetic Therapy ; Genetic Vectors ; Muscle Proteins ; genetics ; Muscle, Skeletal ; transplantation ; Rats ; Rats, Sprague-Dawley ; Recovery of Function ; Transfection

Objective:To observe the effect of tuina exercise on simple obesity in college students.Methods:Fifty-seven college students with simple obesity were divided into two groups according to the stratified randomization method.Twenty-eight in the tuina exercise group were trained in tuina exercise;while 29 in the auricular acupoint sticking group were treated with acuricular acupoint sticking.The tuina exercise group was trained once every other day,and 10 times made one course.The auricular acupoint sticking was replaced once every 4 d,and 5 times made one course.After 2-course treatment,the total therapeutic effect,weight,body mass index (BMI),waist and hip circumferences,serum total cholesterol (TC),triglyceride (TG),high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were assessed.Results:The total therapeutic effect was 86.2％ in the auricular acupoint sticking group and 85.7％ in the tuina exercise group.There was no significant difference between the two groups (P＞0.05).After treatment,the weight,BMI,waist and hip circumferences were decreased and the differences were statistically significant (all P＜0.05).The waist and hip circumferences in the tuina exercise group were lower than those in the auricular acupoint sticking group,showing statistically significant differences (all P＜0.05).After treatment,there were no significant intra-group differences in TC,TG,HDL-C and LDL-C in the two groups (all P＞0.05),and the between-group differences were not significant (all P＞0.05).Conclusion:Tuina exercise has reliable effect in treating obesity.It can produce more significant improvements in waist and hip circumferences than auricular acupoint sticking.But no obvious effect is shown in blood lipid indicators.

Chinese medicine processing is a kind of traditional pharmaceutical technology,which can reduce toxicity,enhance the curative effect,change the properties and facilitate dispensing preparations in clinical use.The technology of detoxification is a great pioneering work for the safe application of toxic Chinese medicine,which can reduce the side effects of certain drugs,ensure the clinical safe use and expand the scope of clinical application through processing.In this paper,we searched the toxic Chinese medicine and the processing technology in ancient literatures of TCM,and then we summarized and analyzed their lat-est studies at home and abroad.Thus,we make a summary of toxic Chinese medicine including its classification,site of action,the toxic components,detoxification and its clinical application.Meanwhile,we proposed an opinion that toxic Chinese medi-cines with the same processing technology had common detoxification rules.Therefore,we hope this work will provide new perspectives for the research on the processing of toxic Chinese medicine and the mechanism of detoxification.