Hyperkalemia is one of the common ion metabolism disorders in clinical practice. Hyperkalemia is defined as serum potassium higher than 5.0 mmol/L according to the guidelines at home and abroad. Acute severe hyperkalemia can cause serious consequences, such as flaccid paralysis, fatal arrhythmia, and even cardiac arrest. The use of renin-angiotensin- aldosterone system inhibitors, β-blockers and diuretics, low-sodium and high-potassium diets, and the presence of related comorbidities increase the occurrence of hyperkalemia. Hyperkalemia risk exist in all clinical departments, but there is a lack of a standardization in the management of multi- department cooperation in hospital. Therefore, a number of domestic nephrology and cardiology department experts have discussed a management model for multi-department cooperation in hyperkalemia, formulating the management standard on hospital evaluation, early warning, diagnosis and treatment, and process. This can promote each department to more effectively participate in nosocomial hyperkalemia diagnosis and treatment, as well as the long-term management of chronic hyperkalemia, improving the quality of hyperkalemia management in hospital.

Objective To investigate the effect of Kangxian Yiai Prescription(KXYA)on the mTOR/HIF-1α/VEGF signaling pathway in a rat model of precancerous lesions of liver cancer.Methods A total of 40 male Wistar rats were divided into normal group,model group,KXYA group,and Biejia Rangan Tablets(BJRG)group,with 10 rats in each group.The rats in the normal group were given intraperitoneal injection of normal saline at a dose of 0.4 mL/100 g,and those in the other three groups were given intraperitoneal injection of diethylnitrosamine at a dose of 50 mg/kg to establish a rat model of the precancerous lesions of liver cancer.Immunohistochemistry and Western Blot were used to measure the expression level of GST-Pi,and quantitative real-time PCR and Western Blot were used to measure the mRNA and protein expression levels of mTOR,HIF-1α,VEGF,PKM2,and GLUT1.A one-way analysis of variance or the Kruskal-Wallis H test was used for comparison of continuous data between multiple groups,and the least significant difference t-test was used for further comparison between two groups.Results Compared with the normal group,the model group had a significant increase in the protein expression level of GST-Pi in liver tissue(P＜0.01),and compared with the model group,the KXYA group had a significant reduction in the protein expression level of GST-Pi(P＜0.05).Compared with the normal group,the model group had significant increases in the mRNA expression levels of GLUT1 and PKM2 in liver tissue(P＜0.01),and compared with the model group,the BJRG group and the KXYA group had a significant reduction in the mRNA expression level of GLUT1(P＜0.05).Compared with the normal group,the model group had significant increases in the protein expression levels of GLUT1 and PKM2 in liver tissue(P＜0.01).Compared with the normal group,the model group had significant increases in the mRNA expression levels of mTOR,HIF-1α,and VEGF in liver tissue(P＜0.01);compared with the model group,the BJRG group had significant reductions in the mRNA expression levels of mTOR and VEGF(P＜0.05),and the KXYA group also had significant reductions in the mRNA expression levels of mTOR and VEGF(P＜0.01).Compared with the normal group,the model group had significant increases in the protein expression levels of mTOR,HIF-1α,and VEGF in liver tissue(P＜0.01);compared with the model group,the BJRG group had a significant reduction in the protein expression level of mTOR(P＜0.01),and the KXYA group had significant reductions in the protein expression levels of mTOR,HIF-1α,and VEGF(P＜0.05);compared with the BJRG group,the KXYA group had a significantly higher protein expression level of mTOR(P＜0.01).Conclusion KXYA can inhibit the precancerous lesions of liver cancer by regulating the mTOR/HIF-1α/VEGF signaling pathway.

Objective:To investigate the effects of endotracheal intubation anesthesia versus laryngeal mask anesthesia on the incidence of pulmonary infection in young children undergoing surgery. Methods:A total of 100 young children who underwent surgery under general anesthesia in Hangzhou Children's Hospital from January 2020 to December 2020 were included in this study. They were randomly allocated into the endotracheal intubation anesthesia and laryngeal mask anesthesia groups ( n = 50/group). The symptoms of respiratory tract infection (nasal congestion, cough, sputum ringing, rale, and sputum excretion) and the incidence of pulmonary infection evaluated 24 hours after surgery were compared between the two groups. At the same time, the pathogens of infection and perioperative conditions as well as prognosis were also compared between the two groups. Results:The incidences of nasal obstruction, cough, sputum ringing, rale, sputum excretion, and pulmonary infection were 56.0% (28/50), 42.0% (21/50), 14.0% (7/50), rale 38.0% (19/50), 16.0% (8/50), and 38.00 (19/50) respectively in the endotracheal intubation anesthesia group, which were significantly higher than those in the laryngeal mask anesthesia group [28.0% (14/50), 14.0% (28/50), 4.0% (8/50), 24.0% (12/50) 4.0% (2/50), 6.0%(3/50), χ2 = 12.18, 21.47, all P < 0.001]. A total of 34 strains of pathogens were detected in the two groups, including 4 strains in the laryngeal mask anesthesia group and 30 strains in the endotracheal intubation anesthesia group. The 34 strains of pathogens included 7 strains of gram-positive bacteria (20.6%), 23 strains of gram-negative bacteria (67.6%), and 4 strains of fungi (11.8%). There was no significant difference in pathogen composition between the two groups ( χ2 = 1.04, P = 0.310). The time to recovery and the time to extubation in the laryngeal mask anesthesia group were (10.3 ± 3.1) minutes and (13.5 ± 2.4) minutes, which were significantly shorter than those in the endotracheal intubation anesthesia group [(16.1 ± 5.1) minutes, (19.5 ± 4.1) minutes, t = 3.17, 7.19, both P < 0.05]. There were no significant differences in the proportion of children who needed prolonged hospitalization and the proportion of children scheduled to undergo readmission between the two groups (both P > 0.05). Conclusion:Laryngeal mask anesthesia is simpler to operate, remarkably decreases the incidence of pulmonary infection, and is safer compared with endotracheal intubation anesthesia. Therefore, laryngeal mask anesthesia is preferred for general anesthesia for surgery in young children. The study is of great innovation and science.

Hypoxic microenvironment is a common phenomenon of liver diseases and runs through the whole process of the development and progression of liver diseases. In recent years, the research on liver fibrosis and hypoxic microenvironment of hepatocellular carcinoma has attracted more and more attention. Hypoxia-inducible factor (HIF) is the most important hypoxic stress factor found at present. This article reviews the characteristics of hypoxic microenvironment in the liver and liver diseases and further elaborates on the association of HIF overexpression with hepatocyte damage, formation of fibrosis, and malignant transformation of hepatocytes.

Objective:The incidence of breast cancer in Chinese women continues to rise. The large breast cancer cohort studies in China are relatively scarce. There are many bottlenecks in the construction of large clinical cohort for breast cancer diagnosis, treatment, and prognoses, such as inconsistent standards, high rates of lost follow-up, repeated construction, and inability to share. To better solving the difficulties and problems faced by large-scale clinical cohort research in China, this project will cooperate with several tertiary A hospitals to establish a breast cancer cohort in Chinese women. It also provides a data platform and technical support for breast cancer multi-center clinical cohort research.Methods:Based on the evidence-based medicine and expert opinion and consensus, we established a breast cancer cohort standardized indicator set-recording baseline information, diagnosis and treatment-related information of the enrolled patients, and collecting biological specimens. According to the technical specification of long-term follow-up for the endpoint, data management, and data security and in the large population-based cohort study, a standardized follow-up system for the diagnosis, treatment, and prognosis of breast cancer prospective cohorts is formed.Results:Based on standardized data sets and the computer discipline’s advantage from the University of Science and Technology Beijing, we integrate the new information technology methods, including dynamic information collection terminals and social networks. Thus, the quality of control programs on compliance and intelligence data was improved, and a Chinese women breast cancer cohort database was developed. By February 2020, 12 147 patients were included in the clinical cohort database. Biological specimens’resources in cohort construction were collected and cooperated with Shandong University to research the multi-center quality control system and shared evaluation system of biobanks. Building an open and shared biobank network and forming a full chain of breast cancer research platform.Conclusion:With the implementation of the "13 th Five-Year Plan" precision medicine research, this study provides a research foundation for precision diagnosis and treatment of breast cancer and provides data support for the country to formulate relevant medical policies.

Hepatitis B virus (HBV) infection is closely associated with bile acid. Recent studies have shown that HBV infection is involved in the regulation of bile acid metabolism through bile acid transporters and mediation of liver injury, and bile acid changes HBV biosynthesis through FXR. This article reviews the research advances in the association between HBV infection and bile acid and the role of bile acid in the diagnosis and treatment of HBV-related liver diseases, so as to provide new ideas for the clinical diagnosis and treatment of HBV infection.

Objective To investigate the status of blood specimen acceptability for clinical chemistry tests in routine medical laboratories of China. Methods The questionnaires were assigned to the laboratories which participated in the routine chemistry exter-nal quality assessment (EQA) programs proposed by National Health Commission for Clinical Laboratory. The questionnaires included general information of participants and information about unacceptable blood specimens. Participants were required to record all the in-formation concerning unacceptable blood specimen received from 1stto 31stJuly, 2017. The data from each laboratory were reported and collected via special online system.Results A total of 866 valid questionnaires were collected.Of 15 981 752 specimens received dur-ing the data collection period unqualified 122 00 specimens were rejected with overall rejection rate of 0.076%. The main reasons for unacceptable specimens were hemolysis (33.98%), insufficient specimen quantity (10.78%) and chylemia/lipemia (10.62%). The rejected specimens were related to the original laboratories, types of container and specimen, transportation manner and operating staff of blood collection. Conclusion Certain problems existed in the receiving and management system for unqualified blood specimen in our country and remaining to be perfected. The clinical laboratories should pay more attention for pre-examination stage, including routinely monitoring unacceptable specimens, analyzing related data at the most possible granular levels, identifying the main problem and taking effective measures.

Liquid Chromatography-Mass Spectrometry ( LC-MS) is becoming more and more widely used in clinical laboratory ,and LC-MS related quality management requires more rigid than it was .According to CLSI C62-A,this article provides a reference for the validation procedure of LC-MS assay, including limit of detection and lower limit of the measuring interval , linearity and dilution, imprecision, assay interferences and trueness.

Objective To establish a large animal ( sheep) model to serve the experiments of domestic pulsatile ventricular assist device.Methods Three small-tail Han-sheep were anesthetized and the vein access and artery access were achieved.The cardiopulmonary bypass was established through left thoracotomy.Ventricular fibrillation was induced. An hole was made in the apex of left ventricle and the apex cannulation was sutured to it.The aortic cannulation was su-tured to the descending aorta.The two cannulations were connected to the domestic pulsatile ventricular assist device ( DP-VAD) and the driver was turned on.The working of DPVAD and the conditions of the animals were observed.Results The DPVAD worked well and uni-directional blood flow was driven by positive and negative pressure.The left ventricle was unloaded and the blood pressure was raised up.Conclusion The establishment of sheep model of pulsatile ventrieular as-sist device may play important role for the research and development of DPVAD in our country.

Animals ; Embryonic Stem Cells ; virology ; Gene Expression Regulation, Enzymologic ; Histone Deacetylase 6 ; Histone Deacetylases ; biosynthesis ; genetics ; Infection ; genetics ; pathology ; virology ; Mice ; Mice, Knockout