OBJECTIVE: To observe the characteristics of changes in non-invasive hemodynamic parameters in neonates with septic shock so as to provide clinical reference for diagnosis and treatment. METHODS: A observational study was conducted. The neonates with sepsis complicated with septic shock or not admitted to neonatal intensive care unit (NICU) of the First Affiliated Hospital of Shantou University Medical College were enrolled as the study subjects, who were divided into preterm infant (< 37 weeks) and full-term infant (≥ 37 weeks) according to the gestational age. Healthy full-term infants and hemodynamically stable preterm infants transferring to NICU after birth were enrolled as controls. Electronic cardiometry (EC) was used to measure hemodynamic parameters, including heart rate (HR), mean arterial pressure (MAP), stroke volume (SV), stroke volume index (SVI), cardiac output (CO), cardiac index (CI), systemic vascular resistance (SVR) and systemic vascular resistance index (SVRI), before treatment in the septic shock group, at the time of diagnosis of sepsis in the sepsis without shock group, and before the discharge from the obstetric department or on the day of transferring to NICU in the control group. RESULTS: Finally, 113 neonates with complete data and parental consent for non-invasive hemodynamic monitoring were enrolled, including 32 cases in the septic shock group, 25 cases in the sepsis without shock group and 56 cases in the control group. In the septic shock group, there were 17 cases at the compensated stage and 15 cases at the decompensated stage. There were 21 full-term infants (20 cured or improved and 1 died) and 11 premature infants (7 cured or improved and 4 died), with the mortality of 15.62% (5/32). There were 18 full-term infants and 7 premature infants in the sepsis without shock group and all cured or improved without death. The control group included 28 full-term infants and 28 premature infants transferring to NICU after birth. Non-invasive hemodynamic parameter analysis showed that SV, SVI, CO and CI of full-term infants in the septic shock group were significantly lower than those in the sepsis without shock group and control group [SV (mL): 3.52±0.99 vs. 5.79±1.32, 5.22±1.02, SVI (mL/m²): 16.80 (15.05, 19.65) vs. 27.00 (22.00, 32.00), 27.00 (23.00, 29.75), CO (L/min): 0.52±0.17 vs. 0.80±0.14, 0.72±0.12, CI (mL×s^-1×m^-2): 40.00 (36.67, 49.18) vs. 62.51 (56.34, 70.85), 60.01 (53.34, 69.68), all P < 0.05], while SVR and SVRI were significantly higher than those in the sepsis without shock group and control group [SVR (kPa×s×L^-1): 773.46±291.96 vs. 524.17±84.76, 549.38±72.36, SVRI (kPa×s×L^-1×m^-2): 149.27±51.76 vs. 108.12±12.66, 107.81±11.87, all P < 0.05]. MAP, SV, SVI, CO and CI of preterm infants in the septic shock group were significantly lower than those in the control group [MAP (mmHg, 1 mmHg ≈ 0.133 kPa): 38.55±10.48 vs. 47.46±2.85, SV (mL): 2.45 (1.36, 3.58) vs. 3.96 (3.56, 4.49), SVI (mL/m²): 17.60 (14.20, 25.00) vs. 25.50 (24.00, 29.00), CO (L/min): 0.32 (0.24, 0.63) vs. 0.56 (0.49, 0.63), CI (mL×s^-1×m^-2): 40.01 (33.34, 53.34) vs. 61.68 (56.68, 63.35), all P < 0.05], while SVR and SVRI were similar to the control group [SVR (kPa×s×L^-1): 1 082.88±689.39 vs. 656.63±118.83, SVRI (kPa×s×L^-1×m^-2): 126.00±61.50 vs. 102.37±11.68, both P > 0.05]. Further analysis showed that SV, SVI and CI of neonates at the compensation stage in the septic shock group were significantly lower than those in the control group [SV (mL): 3.60±1.29 vs. 4.73±1.15, SVI (mL/m²): 19.20±8.33 vs. 26.34±3.91, CI (mL×s^-1×m^-2): 46.51±20.34 vs. 61.01±7.67, all P < 0.05], while MAP, SVR and SVRI were significantly higher than those in the control group [MAP (mmHg): 52.06±8.61 vs. 48.54±3.21, SVR (kPa×s×L^-1): 874.95±318.70 vs. 603.01±111.49, SVRI (kPa×s×L^-1×m^-2): 165.07±54.90 vs. 105.09±11.99, all P < 0.05]; MAP, SV, SVI, CO and CI of neonates at the decompensated stage in the septic shock group were significantly lower than those in the control group [MAP (mmHg): 35.13±6.08 vs. 48.54±3.21, SV (mL): 2.89±1.17 vs. 4.73±1.15, SVI (mL/m²): 18.50±4.99 vs. 26.34±3.91, CO (L/min): 0.41±0.19 vs. 0.65±0.15, CI (mL×s^-1×m^-2): 43.34±14.17 vs. 61.01±7.67, all P < 0.05], while SVR and SVRI were similar to the control group [SVR (kPa×s×L^-1): 885.49±628.04 vs. 603.01±111.49, SVRI (kPa×s×L^-1×m^-2): 114.29±43.54 vs. 105.09±11.99, both P > 0.05]. CONCLUSIONS Full-term infant with septic shock exhibit a low cardiac output, high vascular resistance hemodynamic pattern, while preterm infant with septic shock show low cardiac output and normal vascular resistance. At the compensated stage the hemodynamic change is low output and high resistance type, while at the decompensated stage it is low output and normal resistance type. Non-invasive hemodynamic monitoring can assist in the identification of neonatal septic shock and provide basis for clinical diagnosis and treatment.
Humans ; Shock, Septic/physiopathology* ; Infant, Newborn ; Hemodynamics ; Female ; Male ; Case-Control Studies ; Infant, Premature

Objective To assess the incidence of contrast-induced nephropathy(CIN)in patients with chronic thromboembolic pulmonary hypertension(CTEPH)after receiving balloon pulmonary angioplasty(BPA),and to evaluate the effect of the contrast agents on renal function.Methods A total of 143 CTEPH patients,who received BPA at the China-Japan Friendship Hospital of China from December 2018 to May 2022,were enrolled in this study.The clinical data,hemodynamic indicators,and serum creatinine(SC)concentrations within one week before and 48-72 h after BPA were collected.The estimated glomerular filtration rate(eGFR)was calculated according to the Modification of Diet in Renal Disease(MDRD)formula.The SC concentration and eGFR changes before and after each BPA procedure were compared.The incidence of CIN and its risk factors were evaluated,and the changes in hemodynamics,SC and eGFR after the initial and last time of BPA treatment were analyzed.Results A total of 192 BPA procedures were performed in 115 CTEPH patients,including 88 BPA procedures in males and 103 BPA procedures in females.The mean amount of contrast agent used for each BPA was(145.58±47.26)mL.After BPA,12 patients developed 13 times of CIN,with an incidence of 6.8％.There was no significant differences(P＞0.05)in the baseline characteristics and SC concentration before BPA between CIN patients and non-CIN patients.In terms of the hemodynamic indexes,the mixed venous oxygen saturation(SvO2)in CIN patients was significantly lower than that in non-CIN patients(58.58％±10.38％vs.66.15％±8.02％,P=0.002),and no statistically significant differences(P＞0.05)in the other hemodynamic indexes existed between CIN group and non-CIN group.No statistically significant differences in SC concentration and eGFR existed before and after each BPA procedure.In patients who had received several BPA procedures,significant improvements in the SC[(78.09±18.760)μmol/L vs.(82.26±21.37)μmol/L,P＜0.001]and eGFR[(86.08±21.22)mL/(min·1.73 m2)vs.(82.07±22.05)mL/(min·1.73 m2),P=0.007]was achieved when compared with their baseline values.Conclusion CTEPH patients may develop CIN after receiving BPA treatment.After receiving several BPA treatments the patient's clinical symptoms and hemodynamics can be improved,and the patient's renal function is also significantly improved.

Objective To explore characteristics of time-domain and time-frequency of task-related electroencephalogram(EEG)in patients with post-stroke aphasia(PSA).Methods From January,2018 to December,2021,18 PSA patients(PSA group)were recruited from Dongzhimen Hospi-tal,Beijing University of Chinese Medicine,and nine healthy subjects(control group)were recruited with matched gender,age and education level.EEG data based on the Chinese word-picture matching task were col-lected,and the average amplitude of N400 and event-related synchronization(ERS)/desynchronization(ERD)were analyzed.The PSA group was assessed with Chinese Rehabilitation Research Center Aphasia Examination(CRRCAE).Results The effect of N400 was significant on left frontal,central frontal,right frontal,left central and central areas.The average amplitude of N400 was higher on the frontal area in PSA group than in the control group,and it was low-er on right temporal-parietal area.For word-picture mismatching,average amplitude of N400 at FPZ was moder-ately correlated with auditory comprehension(r=0.483,P<0.05),the average amplitude of N400 at T8 was moderately correlated with repetition(r=0.584,P<0.05)and reading aloud(r=0.556,P<0.05),and the aver-age amplitude of N400 at P6 was moderately correlated with speaking(r=0.476,P<0.05)and reading(r=0.502,P<0.05).For word-picture matching,the average amplitude of N400 at P7 was moderately negatively cor-related with calculation(r=-0.481,P<0.05).Compared with the control group,the energy decreased in θ and αfrequency bands with absence of ERS in PSA group,and it increased in β frequency band with absence of ERD.Conclusion The activities of Chinese word-picture matching task-related EEG have been inhibited on right temporal-pa-rietal area for PSA patients,and it compensatively increases on frontal area,while the energy decreases in θ and αfrequency bands with ERS deficiency,and increases in β frequency band with ERD deficiency.

Objective To investigate the efficacy of Bifidobacterium triple live bacteria enteric-coated capsules in the adjuvant treatment of patientys with gestational diabetes mellitus(GDM)complicated with depression,and its effect on intestinal flora and inflammatory indicators.Methods A total of 168 patients with GDM complicated with depression were selected and randomly divided into the control group(81 cases,treated with psychological counseling,dietary control and appropriate exercise)and the observation group(87 cases,treated with Bifidobacterium trilactis enteric-coated capsules on the basis of the control group,2 capsules each time,twice a day).Both groups were treated for 1 month continuously.The therapeutic effects were evaluated after treatment.The depression degree of patients was evaluated by Self-Rating Depression Scale(SDS)before treatment and one month after treatment.The fasting blood glucose(FBG)and 2-hour postprandial blood glucose(2 hPG)of patients were detected.The intestinal flora was detected by fluorescence quantitative PCR.The inflammatory indicators serum tumor necrosis factor-α(TNF-α)and serum C-reactive protein(CRP)were detected by enzyme-linked immunosorbent assay and immunoturbidimetry.The neutrophil and lymphocyte counts in peripheral venous blood were detected by automatic blood analyzer,and the neutrophil-to-lymphocyte ratio(NLR)was calculated.The adverse drug reactions were recorded.Results The total effective rate was 96.55%in the observation group,which was higher than that of the control group(87.65%,P＜0.05).After 1 month of treatment,the SDS score,FBG,2 hPG,serum TNF-α,CRP and NLR were decreased in both groups,and those of the observation group were lower than the control group(P＜0.05).One month after treatment,there was no significant difference in the number of intestinal flora compared with that before treatment in the control group.The number of Lactobacillus and Bifidobacterium in the observation group was increased compared with that before treatment,while the number of Escherichia coli and Bacteroides fragilis decreased.After 1 month of treatment,the number of Lactobacillus and Bifidobacterium in the observation group was higher than that in the control group,while the number of Escherichia coli and Bacteroides fragilis was lower than that in the control group(P＜0.01).The adverse reaction rate of the observation group was 3.45%,and there was no significant difference compared with 1.23%of the control group.Conclusion Bifidobacterium triple live bacteria enteric-coated capsules has a good clinical effect in the adjuvant treatment of GDM with depression,which can effectively control blood glucose level,improve intestinal flora,reduce inflammatory reaction and has good safety.

OBJECTIVE To investigate the intervention effect and its potential mechanism of Yifei xuanfei jiangzhuo formula by inhibiting mitochondrial fission in a vascular dementia(VaD)model rats.METHODS VaD rat model was established by bilateral common carotid artery ligation.The experimental animals were randomly divided into sham operation group(SHAM),model group(MOD),Yifei xuanfei jiangzhuo formula low-dose group(YFXF-L),Yifei xuanfei jiangzhuo formula high-dose group(YFXF-H),and Donepezil hydrochloride group(positive control),with 9 animals in each group.After 30 days of intervention,the spatial learning memory ability was assessed by Morris water maze experiment;HE staining was used to observe histopathological changes in CA1 area of hippocampus;ELISA was used to detect the levels of serum inflammatory factors[interleukin-1β(IL-1β)and IL-4];Western blot was used to detect the expressions of heat shock protein 90(HSP90)/mixed lineage kinase domain-like protein(MLKL)/dynamin-related protein 1(Drp1)pathway-related proteins,mitochondrial fusion proteins(MFN1,MFN2),and adenosine triphosphate synthase 5A(ATP5A)in hippocampal tissues.The immunohistochemistry was used to detect the level of phosphorylated MLKL(p-MLKL);real-time fluorescence quantitative PCR was adopted to detect mRNA expressions of HSP90,MFN1,MFN2 and ATP5A.RESULTS Compared with SHAM group,the escape latency of rats in the MOD group was significantly prolonged,the number of crossing the platform was significantly reduced,and the hippocampal tissues showed typical neuronal damage characteristics,the positive expression level of p-MLKL and the serum level of IL-1β significantly increased,while the serum level of IL-4 significantly decreased,the protein and mRNA expression of HSP90,as well as the protein expressions of p-MLKL/MLKL and p-Drp1(Ser616)/Drp1 were all significantly increased in hippocampal tissue,the protein and mRNA expressions of MFN1,MFN2 and ATP5A,and protein expression of p-Drp1(Ser637)/Drp1 were all significantly decreased(P＜0.05).After the intervention of Yifei xuanfei jiangzhuo formula,above indicators in each treatment group were all significantly reversed(P＜0.05).CONCLUSIONS Yifei xuanfei jiangzhuo formula may alleviate neuronal damage and neuroinflammatory responses in VaD rats by regulating the HSP90/MLKL/Drp1 signaling pathway,inhibiting mitochondrial fission,thereby maintaining mitochondrial dynamic balance and improving mitochondrial function.

Objective To explore characteristics of time-domain and time-frequency of task-related electroencephalogram(EEG)in patients with post-stroke aphasia(PSA).Methods From January,2018 to December,2021,18 PSA patients(PSA group)were recruited from Dongzhimen Hospi-tal,Beijing University of Chinese Medicine,and nine healthy subjects(control group)were recruited with matched gender,age and education level.EEG data based on the Chinese word-picture matching task were col-lected,and the average amplitude of N400 and event-related synchronization(ERS)/desynchronization(ERD)were analyzed.The PSA group was assessed with Chinese Rehabilitation Research Center Aphasia Examination(CRRCAE).Results The effect of N400 was significant on left frontal,central frontal,right frontal,left central and central areas.The average amplitude of N400 was higher on the frontal area in PSA group than in the control group,and it was low-er on right temporal-parietal area.For word-picture mismatching,average amplitude of N400 at FPZ was moder-ately correlated with auditory comprehension(r=0.483,P<0.05),the average amplitude of N400 at T8 was moderately correlated with repetition(r=0.584,P<0.05)and reading aloud(r=0.556,P<0.05),and the aver-age amplitude of N400 at P6 was moderately correlated with speaking(r=0.476,P<0.05)and reading(r=0.502,P<0.05).For word-picture matching,the average amplitude of N400 at P7 was moderately negatively cor-related with calculation(r=-0.481,P<0.05).Compared with the control group,the energy decreased in θ and αfrequency bands with absence of ERS in PSA group,and it increased in β frequency band with absence of ERD.Conclusion The activities of Chinese word-picture matching task-related EEG have been inhibited on right temporal-pa-rietal area for PSA patients,and it compensatively increases on frontal area,while the energy decreases in θ and αfrequency bands with ERS deficiency,and increases in β frequency band with ERD deficiency.

Objective To investigate the efficacy of Bifidobacterium triple live bacteria enteric-coated capsules in the adjuvant treatment of patientys with gestational diabetes mellitus(GDM)complicated with depression,and its effect on intestinal flora and inflammatory indicators.Methods A total of 168 patients with GDM complicated with depression were selected and randomly divided into the control group(81 cases,treated with psychological counseling,dietary control and appropriate exercise)and the observation group(87 cases,treated with Bifidobacterium trilactis enteric-coated capsules on the basis of the control group,2 capsules each time,twice a day).Both groups were treated for 1 month continuously.The therapeutic effects were evaluated after treatment.The depression degree of patients was evaluated by Self-Rating Depression Scale(SDS)before treatment and one month after treatment.The fasting blood glucose(FBG)and 2-hour postprandial blood glucose(2 hPG)of patients were detected.The intestinal flora was detected by fluorescence quantitative PCR.The inflammatory indicators serum tumor necrosis factor-α(TNF-α)and serum C-reactive protein(CRP)were detected by enzyme-linked immunosorbent assay and immunoturbidimetry.The neutrophil and lymphocyte counts in peripheral venous blood were detected by automatic blood analyzer,and the neutrophil-to-lymphocyte ratio(NLR)was calculated.The adverse drug reactions were recorded.Results The total effective rate was 96.55%in the observation group,which was higher than that of the control group(87.65%,P＜0.05).After 1 month of treatment,the SDS score,FBG,2 hPG,serum TNF-α,CRP and NLR were decreased in both groups,and those of the observation group were lower than the control group(P＜0.05).One month after treatment,there was no significant difference in the number of intestinal flora compared with that before treatment in the control group.The number of Lactobacillus and Bifidobacterium in the observation group was increased compared with that before treatment,while the number of Escherichia coli and Bacteroides fragilis decreased.After 1 month of treatment,the number of Lactobacillus and Bifidobacterium in the observation group was higher than that in the control group,while the number of Escherichia coli and Bacteroides fragilis was lower than that in the control group(P＜0.01).The adverse reaction rate of the observation group was 3.45%,and there was no significant difference compared with 1.23%of the control group.Conclusion Bifidobacterium triple live bacteria enteric-coated capsules has a good clinical effect in the adjuvant treatment of GDM with depression,which can effectively control blood glucose level,improve intestinal flora,reduce inflammatory reaction and has good safety.

OBJECTIVE To investigate the mechanism of Yifei xuanfei jiangzhuo formula （YFXF） against vascular dementia （VD）. METHODS The differentially expressed genes of YFXF （YDEGs） were obtained by network pharmacology. High-risk genes were screened from YDEGs by using the nomogram model. The optimal machine learning models in generalized linear， support vector machine， extreme gradient boosting and random forest models were screened based on high-risk genes. VD model rats were established by bilateral common carotid artery occlusion， and were randomly divided into model group and YFXF group （12.18 g/kg， by the total amount of crude drugs）， and sham operation group was established additionally， with 6 rats in each group. The effects of YFXF on behavior （using escape latency and times of crossing platform as indexes）， histopathologic changes of cerebral cortex， and the expression of proteins related to the secreted phosphoprotein 1 （SPP1）/phosphoinositide 3-kinase （PI3K）/protein kinase B （aka Akt） signaling pathway and the mRNA expression of SPP1 in cerebral cortex of VD rats were evaluated. RESULTS A total of 6 YDEGs were obtained， among which SPP1， CCL2， HMOX1 and HSPB1 may be high-risk genes of VD. The generalized linear model based on high-risk genes had the highest prediction accuracy （area under the curve of 0.954）. Compared with the model group， YFXF could significantly shorten the escape latency of VD rats， significantly increase the times of crossing platform （P＜0.05）； improve the pathological damage of cerebral cortex， such as neuronal shrinkage and neuronal necrosis； significantly reduce the expressions of SPP1 protein and mRNA （P＜0.05）， while significantly increase the phosphorylation levels of PI3K and Akt （P＜0.05）. CONCLUSIONS VD high-risk genes SPP1， CCL2， HMOX1 and HSPB1 may be the important targets of YFXF. YFXF may play an anti-VD role by down-regulating the protein and mRNA expressions of SPP1 and activating PI3K/Akt signaling pathway.

Objective:To investigate the safety and efficacy of balloon pulmonary angioplasty (BPA) for residual pulmonary hypertension (PH) of chronic thromboembolic pulmonary hypertension(CTEPH) after pulmonary endarterectomy (PEA).Methods:Patients diagnosed as PH after PEA in China-Japan Friendship Hospital from Oct 2016 to Jun 2022 were included. The indication for BPA was decided on the basis of a consensus of the multi-disciplinary team for all patients with CTEPH. Before treatment, the patient′s exercise tolerance and pulmonary artery flow parameters were evaluated. A comparative analysis of various parameters before BPA treatment and at the last BPA was conducted. 6-min walk distance (6MWD) was analyzed using the paired Wilcoxon test; N-terminal pro-brain natriuretic peptide (NT-proBNP), mixed venous oxygen saturation, mean pulmonary arterial pressure (mPAP), cardiac index (CI) and pulmonary vascular resistance (PVR) were compared using the paired-samples t-test. WHO functional class was compared using McNemar′s test. Results:Twenty patients with a total of 130 vessels underwent 46 sessions of BPA treatment. The postoperative 6-minute walk distance (6MWD) [447 (415, 485) m] showed a significant improvement compared to the preoperative baseline [389 (335, 470) m] ( Z=6.52, P<0.05), Postoperative mixed venous oxygen saturation (72.0%±1.9%) showed a significant improvement compared to the preoperative levels (64.0%±2.7%) ( t=2.14, P<0.05).Postoperatively, plasma NT-proBNP [(351.9±129.9) pg/ml], mPAP [(24.2±1.9) mmHg], and PVR [(3.0±1.4) WU] significantly decreased compared to preoperative levels [(982.5±426.2) pg/ml, (33±2.1) mmHg, (8.0±1.6) WU)] ( t=3.38, 1.22, 2.10, P<0.05 for all). Postoperatively, there was a significant improvement in WHO functional class (Ⅰ，Ⅱ，Ⅲ，Ⅳ: 14, 4, 2, 0 cases) compared to preoperative status (Ⅰ，Ⅱ，Ⅲ，Ⅳ: 0, 13, 5, 2 cases) ( χ2=20.17, P<0.05). Four cases of pulmonary artery dissection and one episode of hemoptysis occurred postoperatively, with no other complications reported. Conclusions:BPA can significantly improve exercise tolerance and hemodynamic parameters for residual PH after PEA. BPA is a relatively safe and effective treatment for residual PH after PEA.

The tea beverages will be endowed with distinct aroma and taste, as well as various biologically active compounds including probiotic factors, when fermented with lactic acid bacteria (LAB). However, at present, few studies on the dynamics of flavors in tea soup at different fermentation stages were conducted. In this study, the composition of monosaccharides, aromatic components, free amino acids, and organic acids were measured, when the black tea beverages were fermented with Lactobacillus coryniformis FZU63 which was isolated from Chinese traditional kimchi. The results indicated that monosaccharides including glucose, fructose, mannose and xylose in black tea beverages are the main carbon sources for fermentation. In addition, the abundance of aromatic compounds in black tea soup are increased significantly at different fermentation stages, which endow the fermented black tea soup with fruit aroma on the basis of flowery and nutty aroma. Moreover, some bitter amino acids are reduced, whereas the content of sweet and tasty amino acids is elevated. Furthermore, the levels of lactic acid, malic acid, citric acid and other organic acids are accumulated during the fermentation. Additionally, sensory evaluation displays that black tea beverage is acquired with comprehensive high-quality after being fermented for 48 h. This study provides a theoretical basis to steer and control the flavor formation and quality of the fermented tea beverages during LAB fermentation.
Tea/chemistry* ; Beverages/microbiology* ; Camellia sinensis ; Fermentation ; Acids ; Amino Acids ; Glucose