Objective To evaluate the effect of dexmedetomidine on acute kidney injury after cardiac valve replacement with cardiopulmonary bypass (CPB).Methods One hundred patients of both sexes with rheumatic heart disease,aged 32-64 yr,weighing 46-75 kg,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ (New York Heart Association class Ⅱ or Ⅲ),scheduled for elective cardiac valve replacement with CPB,were divided into 2 groups (n =50 each) using a random number table:control group (group C) and dexmedetomidine group (group D).Dexmedetomidine was intravenously infused in a loading dose of 1 μg/kg over 10 min before induction of anesthesia followed by an infusion of 0.4 μg · kg-1 · h-1 until 24 h after operation in group D,while the equal volume of normal saline was given in group C.The urine output per hour during the postoperative 48 h period was recorded.At 6,12,24,36 and 48 h after operation,blood samples were collected from the median cubital vein for determination of serum creatinine levels.The development and severity of acute kidney injury were determined according to the urine output and serum creatinine level.Results Compared with group C,the incidence and severity of acute kidney injury were significantly decreased in the postoperative 48 h period in group D (P＜0.05).Conclusion Dexmedetomidine infused in a loading dose of 1 μg/kg over 10 min before induction of anesthesia followed by an infusion of 0.4 μg · kg-1 · h-1 until 24 h after operation can reduce the development and severity of acute kidney injury after cardiac valve replacement with CPB in patients.

Animals ; Humans ; Lymph Nodes ; pathology ; Lymphangiogenesis ; physiology ; Lymphatic Metastasis ; Lymphatic Vessels ; metabolism ; pathology ; Neoplasms ; metabolism ; pathology ; Vascular Endothelial Growth Factor C ; metabolism ; physiology ; Vascular Endothelial Growth Factor D ; metabolism ; physiology

Objective To investigate the relationship betw een the serum bilirubin level and the severity of disease and short-term outcome in patient w ith acute ischemic stroke. Methods A total of 120 consecutive inpatients w ith acute ischemic stroke w ere enroled and 105 healthy subjects at the same time w ere used as a control group. The biochemical indicators, such as serum total bilirubin, direct bilirubin, indirect bilirubin, blood lipid, and blood glucose w ere measured w ithin 24 h after admission. The National Institutes of Health Stroke Scale ( NIHSS ) w as used to assess the neurological deficits on the day of admission. The NIHSS score <8 w as defined as mild stroke and ≥8 w as defined as moderate to severe stroke. At discharge or 14 d after onset, the modified Rankin Scale (mRS) w as used to evaluate the clinical outcomes, 0-2 w as defined as good outcome and > 2 w as defined as poor outcome. The levels of serum total bilirubin, direct bilirubin, and indirect bilirubin w ere measured again. Results The levels of serum total bilirubin, direct bilirubin, and indirect bilirubin in the moderate to severe stroke group w ere significantly higher than those in the mild stroke group ( P <0.01) and the control group ( P <0.01). Multivariate logistic regression analysis show ed that the increased levels of serum total bilirubin (odds ratio [OR] 1.855,95%confidence interval [CI] 1.390-2.475; P <0.01), indirect bilirubin ( OR 3.380, 95%CI 1.271-11.901; P <0.05), and direct bilirubin ( OR 3.51, 95%CI 1.062-11.473; P <0.01) had significantly independent correlation w ith baseline disease severity. Univariate analysis show ed that the increased serum total bilirubin level on admission w as associated w ith the short-term poor outcome ( P <0.05), but after adjustment for other confounding factors, there w as no statistical significance ( OR 2.411, 95%CI 0.803-7.243, P >0.05). Conclusions The serum bilirubin level show ed stress increase in patients w ith cerebral infarction in acute phase; and it w as significantly associated w ith the degree of neurological deficit, but it w as not associated w ith short-term outcome. It might be a defense response to the body for stroke events.

Background:Nipple discharge cytology is a simple non-invasive method that may provide valuable information for detecting underlying malignancy.Several studies have investigated the diagnostic value of cytology in breast cancer patients with pathological nipple discharge,but the results have been highly variable.Herein we presented a systematic review and meta-analysis of published studies pertaining to the diagnostic capacity of nipple discharge cytology in patients with breast cancer.Methods:A systematic literature search was performed (Medline/PubMed,Embase,Cochrane Library databases,and Google Scholar) to identify studies that investigated the diagnostic capacity of cytology with regard to breast cancer in patients with pathologic nipple discharge.Two independent researchers identified articles that assessed the sensitivity and specificity of cytological evaluation for breast cancer detection in patients with pathologic nipple discharge published between January 2000 and October 2018.Articles were only included in the meta-analysis if they met predetermined criteria.The characteristics of each study and the data they yielded were summarized.Quality assessment of all articles included was performed using the Methodological Index for Non-randomized Studies Criteria (MINORS) and the Quality Assessment of Diagnostic Accuracy Study 2 (QUADAS-2).Heterogeneity was tested via Cochran Q test and the I2 statistic using Stata 12.0 and Meta-DiSc 1.4 software,and meta-analysis was performed.Results:A total of 286 articles were identified,of which 12 articles including a total of 1476 patients were deemed eligible for inclusion in the meta-analysis.A random-effects model assessing the capacity of nipple discharge cytology to predict breast cancer yielded pooled sensitivity 63％ (95％ confidence interval [CI]:53％-72％),specificity 95％ (95％ CI:87％-98％),positive likelihood ratio 12.35 (95 ％ CI:4.87-31.34),and negative likelihood ratio 0.39 (95 ％ CI:0.30-0.50).The diagnostic odds ratio was 31.88 (95％ CI:11.30-89.98).The area under the summary receiver operating characteristic curve was 0.79 (95％ CI:0.75-0.82).Conclusion:The current meta-analysis suggests that nipple discharge cytology is a useful diagnostic modality for detection of breast cancer in patients with pathological nipple discharge,with moderate sensitivity and high specificity.

BACKGROUNDThe low-temperature resistance aging performance of Yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) is the key effective factor that influences the long-term success rate of prosthesis. The objective of this study was to test and compare the aging performances for resisting low temperature of Lava Frame, Cercon Smart, and Upcera Yttria-stabilized zirconia core materials, via analyzing the micro and the crystal phases of the materials, and measure the three-point bending strength and the fracture toughness.

METHODSThe three zirconia green bodies were prepared as 60 test samples for three-point bending strength and as 60 test samples for fracture toughness. The test samples for three-point bending strength and fracture toughness were assigned to five groups and were treated respectively for 0, 5, 10, 15, and 20 hours to observe the micro and the crystal phases of the test samples. Then the three-point bending strength and fracture toughness were tested by X-ray diffraction (XRD).

RESULTSThe m phase content of Lava Frame was raised from 7.70% to 13.01%; the m phase content of Cercon Smart was raised from 4.95% to 8.53%; and Lava Frame is raised from 10.84% to 35.18%. The three-point bending strengths of the three zirconia core materials were higher than 1100 MPa and the fracture toughness was higher than 3 MPa·m(1/2). The three-point bending strength and the fracture toughness of Upcra zirconia decreased the most, followed by Lava Frame, and then by Cercon Smart.

CONCLUSIONThe aging resistance sequences of the three zirconia core materials are, from strong to weak, Cercon Smart, Lava Frame, and Upcera.

Ceramics ; chemistry ; Dental Porcelain ; chemistry ; Microscopy, Electron, Scanning ; Temperature ; X-Ray Diffraction ; Yttrium ; chemistry ; Zirconium ; chemistry

A simple and cost-effective indirect competitive enzyme-linked immune sorbent assay (ic-ELISA) was developed to rapidly screen the content of aflatoxin B1 (AFB1) in lotus seeds, and the results were confirmed by ultra-fast liquid chromatography-tandem mass spectrometry( UFLC-MS/MS). Matrix-matched calibration expressed a good linearity ranging from 0. 171 to 7. 25 µg · L(-1) for AFB, with R2 > 0.978. The medium inhibitory concentration( IC50 ) for AFB1 was 1.29 µg · L(-1), the recovery for AFB1 was 74.73% to 126.9% with RSD < 5%, and the limit of detection (IC10) was 0.128 µg · L(-1). The developed ic-ELSIA method was applied to rapid analysis of AFB, in 20 lotus seeds samples and the results indicated that the contents of AFB, in samples 1-15 were in the range of 1. 19- 115. 3 µg · kg(-1) and in 40% of the samples exceeded the legal limit(5 µg · kg(-1)), while the contamination rate of AFB, in samples 16-20 was 40%. Pearson correlation coefficient(r) reached 0.997 for AFB1 content in the samples detected by ic-ELSIA and UFLC-MS/MS methods. The results proved that the developed ic-ELISA method is simple, sensitive and reliable, and can be used for rapid and high-throughput screening of AFB1 in lotus seeds
Aflatoxin B1 ; analysis ; Drug Contamination ; Enzyme-Linked Immunosorbent Assay ; methods ; Loteae ; chemistry ; Seeds ; chemistry

Background The low-temperature resistance aging performance of Yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) is the key effective factor that influences the long-term success rate of prosthesis.The objective of this study was to test and compare the aging performances for resisting low temperature of Lava Frame,Cercon Smart,and Upcera Yttria-stabilized zirconia core materials,via analyzing the micro and the crystal phases of the materials,and measure the three-point bending strength and the fracture toughness.Methods The three zirconia green bodies were prepared as 60 test samples for three-point bending strength and as 60 test samples for fracture toughness.The test samples for three-point bending strength and fracture toughness were assigned to five groups and were treated respectively for 0,5,10,15,and 20 hours to observe the micro and the crystal phases of the test samples.Then the three-point bending strength and fracture toughness were tested by X-ray diffraction (XRD).Results The m phase content of Lava Frame was raised from 7.70％ to 13.01％; the m phase content of Cercon Smart was raised from 4.95％ to 8.53％; and Lava Frame is raised from 10.84％ to 35.18％.The three-point bending strengths of the three zirconia core materials were higher than 1100 MPa and the fracture toughness was higher than 3 MPa·m1/2.The three-point bending strength and the fracture toughness of Upcra zirconia decreased the most,followed by Lava Frame,and then by Cercon Smart.Conclusion The aging resistance sequences of the three zirconia core materials are,from strong to weak,Cercon Smart,Lava Frame,and Upcera.

Aged ; Female ; Fluorobenzenes ; therapeutic use ; Humans ; Hyperlipidemias ; blood ; drug therapy ; genetics ; Polymorphism, Genetic ; genetics ; Pyrimidines ; therapeutic use ; Rosuvastatin Calcium ; Sulfonamides ; therapeutic use

OBJECTIVEThe reporting of patient-reported outcomes (PRO) instrument development is vital for both researchers and clinicians to determine its validity, thus, we propose the Preferred Reporting Items for PRO Instrument Development (PRIPROID) to improve the quality of reports.

METHODSAbiding by the guidance published by the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) Network, we had performed 6 steps for items development: identified the need for a guideline, performed a literature review, obtained funding for the guideline initiative, identified participants, conducted a Delphi exercise and generated a list of PRIPROID items for consideration at the face-to-face meeting.

RESULTSTwenty three items subheadings under 7 topics were included: title and structured abstract, rationale, objectives, intention, eligibility criteria, conceptual framework, items generation, response options, scoring, times, administrative modes, burden assessment, properties assessment, statistical methods, participants, main results, and additional analysis, summary of evidence, limitations, clinical attentions, and conclusions, item pools or final form, and funding.

CONCLUSIONSThe PRIPROID contains many elements of the PRO research, and this assists researchers to report their results more accurately and to a certain degree use this instrument to evaluate the quality of the research methods.

Humans ; Outcome Assessment (Health Care) ; Practice Guidelines as Topic ; Research Report ; Research Support as Topic ; Treatment Outcome