Objective To design a novel oxygenator to solve the existing problems of extracorporeal membrane oxygenation(ECMO)machine in high transmembrane pressure difference,low efficiency of blood oxygen exchange and susceptibility to thrombosis.Methods The main body of the oxygenator vascular access flow field was gifted with a flat cylindrical shape.The topology of the vascular access was modeled in three dimensions,and the whole flow field was cut into a blood inlet section,an inlet buffer,a heat exchange zone,a blood oxygen exchange zone,an outlet buffer and a blood outlet section.The oxygenator was compared with Quadrox oxygenator by means of ANSYS FLUENT-based simulation and prototype experiments.Results Simulation calculations showed the oxygenator designed was comparable to the clinically used ones in general,and gained advantages in transmembrane pressure difference,blood oxygen exchange and flow uniformity.Experimental results indicated that the oxygenator behaved better than Quadrox oxygenator in transmembrane pressure difference and blood oxygen exchange.Conclusion The oxygenator has advantages in transmem-brane pressure difference,temperature change,blood oxygen ex-change and low probability of thrombosis.[Chinese Medical Equipment Journal,2024,45(3):23-28]

Objective The aim is to investigate the correlation between bisphenol A (BPA) exposure and tumor tissue ceramide (Cer) as well as serum tumor markers in colorectal cancer (CRC). Methods The morning urine and CRC tumor tissue were collected from 84 patients with CRC. The concentration of urine BPA was determined by liquid chromatography-mass spectrometer (LC-MS), urine BPA concentration was corrected with creatinine (Cr). Cer concentration of CRC tumor tissue was detected by Enzyme-linked immunosorbent assay (ELISA). The correlations of urine BPAcr, Cer content of CRC tumor tissue and tumor markers were analyzed. Results Cer content in CRC tumor tissue was positively correlated with BPAcr (r=0.784, P＜0.001). Regression analysis showed that the regression coefficient of Cer content in CRC tumor tissue and BPAcr was 0.218 (95% CI: 0.18-0.26), which was statistically significant (P＜0.001). There were significantly differences in CRC tumor tissue Cer and urine BPAcr between the CEA positive and negative groups, CA125 positive and negative groups, and CA19-9 positive and negative groups (all P<0.05), while there was no significant difference between AFP positive and negative groups in CRC tumor tissue Cer and urine BPAcr (P=0.247). Serum CEA, CA125 and CA19-9 were positively correlated with urine BPAcr (r values were 0.348, 0.251, 0.281, respectively, all P＜0.05) and Cer content in CRC tumor tissue (r values were 0.265, 0.309, 0.263, respectively, all P＜0.05). Conclusions BPA exposure may cause an increase of Cer in CRC tumor tissue and abnormalities in serum tumor markers, suggesting that BPA exposure may participate in the development and occurance of CRC by affecting the metabolism of Cer in CRC tumor tissue.

The quality of traditional Chinese medicine affects the clinical efficacy and the market research at home or abroad, which is closely related to the standardization of production. At present, Chinese market still exist in drug quality and nonstandard production phenomenon. In addition to the existing GMP production standards, it is still necessary to ensure the authenticity and reliability of traditional Chinese medicine by means of retrospect. Based on the Xinshenghua granule, starting from the authenticity of the whole process of production, this study designs and constructs the traditional Chinese medicine traceability system which is equipped with the Internet platform by using two-dimensional code as a trace tool. By making authentic record of the production process and quality transfer, it is convenient for consumers to know the drug information. The production traceability system provides guarantee for the standardization of traditional Chinese medicine development, in order to obtain the production source，the testing quality, whereabouts and responsibility.

Objective To investigate the bacterial distribution and resis-tance to antibiotic isolated from peritoneal fluid in China, 2012.Methods The bacteria isolated from peritoneal fluid in the tertiary hospitals were routinely identified.Disc diffusion test, minimun ihibitory concentration ( MIC) test and E-test were used to detect the antimicro-bial sensitivi-ty.Results Total of 10252 pathogenic strains were collec-ted from peri-toneal fluid specimens from 557 tertiary hospitals, which included Esche-richia coli 3215 strains ( 31.4%) , Klebsiella pneumoniae 860 strains ( 8.4%) , Enterococcus faecium 730 strains ( 6.9%) , Pseu-domonas aeruginosa 548 strains ( 5.3%) and Staphylococcus epidermidis 531 strains (5.2%).The resistance rate of Staphylococcus aureus strains to oxacillin were 47.4%, no vancomycin and linezolide resistant isolate were found.The rates of susceptibility of Escherichia coli, Klebsiella pneumoniae and Enterobacter cloacaeisolates to ceftriaxone were 28.2%, 50.8%and 41.0%, respectively;to meropenem were 96.7%, 88.8%and 96.5%, respectively.The rates of susceptibility of Pseudomonas aeruginosa to carbapenem, ceftazidime and cefepime were >60%, to quinolone was >75%.The rates of susceptibility of Acinetobacter baumannii isolates to cabarpenem were <40%, to amikacin were 50.8%.Conclusions The two most common species from peritoneal fluid in tertiary hospital were Escherichia coli and Klebsiella pneumonia.There were some difference in bacterial resistance to different antibiotics.

Objective To investigate the bacterial distribution and resist-ance to antibiotic of bone and joint infection in China, 2012.Methods The bacteria isolated from bone and joint in the tertiary hospitals were routinely identified.Disc diffusion test, minimum inhibitory concentra-tion ( MIC) test and E-test were used to detect the antimicrobial sensi-tivity.Results All the clinical stains isolated from 557 tertiary hospi-tals.2636 pathogenic strains were collected from bone and joint speci-men, which included Klebsiella pneumonia 370 strains (14.0%), Esche-richia coli 348 strains ( 13.2%) , Acinetobacter baumannii 319 strains (12.1%), Staphylococcus aureus 252 strains (9.6%) and Pseudomonas aeruginosa 167 strains ( 6.3%).The resistant rate of Staphylococcus aureus strains to oxacillin were 36.0%, no vancomycin and linezolid re-sistant isolate were found.The resistant rate of Escherichia coli, Klebsiella pneumonia and Enterobacter cloaecae strains to ceftriaxone were 64.6%, 33.0%and 37.4%, respectively, the resistant rate to imipenem were<2%.The resistant rate of Pseudomonas aeruginosa to carbapenem, ceftazidime and cefepime were <20%, the resistant rate to quinolone were <10%.The resistant of Acinetobacter buamannii to cabarpenem were <40%, the resistant rate to amikacin were 18.8%.The resistant rate of Acinetobacter lwoffii to cabarpenem were <1%, and the resistant rate to pipercillin and cefepime were <10%.Conclusion Gram negative bacteria were predominant organism in bone and joint infections in China, it may be related to the initial em-piric therapy always cover Staphylococcus.There were some difference in bacterial resistance to different antibiotics.These data present information for the proper treatment of bone and joint infections.

OBJECTIVETo assess the accuracy of cardiac output (CO) measured by transpulmonary thermodilution technique (TPTD)and explore the validity of intrathoracic blood volume index (ITBVI) for assessment of circulatory volume status.

METHODSTen immature pigs with a mean weight of (20.6±1.9)kg were studied during the conditions including normovolemia, hypervolemia, and hypovolemia. Simultaneous CO was measured in each condition using pulmonary artery thermodilution (PATD) method and TPTD. More specifically, CO (COPA) was determined with PATD, while CO (COTP) and ITBVI were determined with TPTD. All measurements were repeated 3 times. Central venous pressure (CVP) and heart rate were measured at the same time. The potential correlations of CVP and ITBVI with cardiac index (CI) and stroke volume index (SVI) in each blood volume status were analyzed.

RESULTSA total of 90 simultaneous measurements of COPA and COTP in 3 different blood volume conditions were made. The correlation coefficient between the two measurements was 0.977 (P<0.001) and the mean difference was (0.25±0.26)L/min (95%CI:0.20-0.30 L/min, P<0.001). The coefficient of variation of COTP was 3.7%, while COPA was 5.4%. Compared with those in normovolemia, CVP and ITBVI in hypervolemia significantly increased (P=0.002, 0.019), ITBVI in hypovolemia decreased significantly (P<0.001), and CVP in hypovolemia decreased insignificantly (P=0.05). Correlation analysis revealed a significant correlation between ITBVI with CI and SVI in normovolemia (r=0.741, P=0.014; r=0.885, P=0.001). In contrast, correlations between CVP with CI and SVI were poor.

CONCLUSIONSTPTD can accurately and precisely measure CO in different blood volume conditions. ITBVI measured by TPTD has better validity for the assessment of circulatory volume status than CVP.

Animals ; Blood Volume ; Cardiac Output ; Swine ; Thermodilution

BACKGROUNDSerum expression of cytokines may provide information about the clinical outcome of advanced non-small cell lung cancer (NSCLC) patients. This study aimed to investigate the relationship between serum cytokine levels and the clinical outcome of erlotinib treatment in a second or third line setting in patients with advanced NSCLC.

METHODSA total of 162 patients with advanced NSCLC who received erlotinib as either second or third line therapy were enrolled in this study. Blood samples were collected before the initiation of erlotinib treatment, and the levels of IL-1, IL- 2R, IL-6, and tumor necrosis factor (TNF)-α were assessed by enzyme-linked immunosorbent assay (ELISA). Cutoff points were defined as the median levels of IL-1 (low (≥26.5 pg/ml) and high (>26.5 pg/ml)), IL-2R (low ( = 115 pmol/L) and high (>15 pmol/L)), IL-6 (low (≤49.5 pg/ml) and high (>49.5 pg/ml)), and TNF-α (low (≤48.5 pg/ml) and high (>48.5 pg/ml)). Kaplan-Meier analysis was used to estimate the survival time, and Cox regression analyses were used to correlate cytokines and baseline clinical characteristics with clinical outcomes, including time to progression (TTP) and overall survival (OS).

RESULTSBetween January 2007 and May 2011, 162 patients were enrolled. Their median age was 58 years. In this group, 109 were males and 53 were females, 74 were former or current smokers and 88 were non-smokers. A total of 122 patients had adenocarcinoma, 27 had squamous cell carcinoma, and 13 had tumors with other types of histology. And 139 patients had an Eastern cooperative oncology group (ECOG) performance status of 0-1, while 23 scored at 2-3. Expression of IL-1, IL-2R, and IL-6 was not significantly associated with age, gender, ECOG performance status, smoking status, or histology and stage of tumor. Only TNF-α was associated with smoking status (P = 0.045). Survival analysis showed that patients with low levels of either IL-6 or TNF-α had a statistically longer TTP and OS than patients with high expression (P < 0.05). These cytokines remained significant upon multivariate analysis (P < 0.05).

CONCLUSIONIL-6 or TNF-α may serve as potential predictive biomarker for the efficacy of erlotinib.

Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; blood ; drug therapy ; Cytokines ; blood ; Erlotinib Hydrochloride ; Female ; Humans ; Lung Neoplasms ; blood ; drug therapy ; Male ; Middle Aged ; Protein Kinase Inhibitors ; therapeutic use ; Quinazolines ; therapeutic use

Objective To explore the effect of Ginkgo leaf extract and dipyridamole injection combined with methylcobalam on nerve conduction velocity of nerve entrapment sites in the upper limbs in patients with diabetic peripheral neuropathy (DPN).Methods Two hundred and eight type 2 diabetic patients with DPN,admitted to our hospital from January 2008 to June 2011,were selected in our study,and randomly divided into an observation group (n=103) and a control group (n=105).Dietary regulation,exercises and glucose control were conducted in both groups.In the control group,patients were given methylcobalamin at the dose of 1000 μg,three times a day.In the observation group,patients were given methylcobalamin (1000 μg,three times a day) plus Ginkgo leaf extract and dipyridamole injection of 20 mL once a day.All treatments lasted for four weeks.The sensory conduction velocity (SCV),motor conduction velocity (MCV) and sensory nerve action potential (SNAP),compound muscle action potential (CMAP) and distal motor latency (DML) of median and ulnar nerves were measured and compared before and four weeks after the treatments.Results The DML was shortened,and SCV and amplitude of median nerve were improved.Segmental MCV of above-below elbow,SCV and amplitude of ulnar nerve were significantly improved in both groups after the treatments as compared with those before treatment (P＜0.05); the total effective rate of the observation group was significantly higher than that of the control group (P＜0.05).Conclusion The nerve electrophysiological characteristics of nerve compression sites in the upper limbs is sensitive for assessing injury and treatment effect in patients with DPN; the combination of Ginkgo leaf extract and dipyfidamole injection and methylcobalam is superior than methylcobalam alone in improving the nerve conduction of diabetic patients.

Although previous publications suggest the 2009 pandemic influenza A(H1N1)virus was reassorted from swine viruses of North America and Eurasia, the immediate ancestry still remains elusive due to the big evolutionary distance between the 2009 H1N1 virus and the previously isolated strains. Since the unveiling of the2009 H1N1 influenza, great deal of interest has been drawn to influenza, consequently a large number of influenza virus sequences have been deposited into the public sequence databases. Blast analysis demonstrated that the recently submitted 2007 South Dakota avian influenza virus strains and other North American avian strains contained genetic segments very closely related to the 2009 H1N1 virus, which suggests these avian influenza viruses are very close relatives of the 2009 H1N1 virus. Phylogenetic analyses also indicate that the2009 H1N1 viruses are associated with both avian and swine influenza viruses circulating in North America. Since the migrating wild birds are preferable to pigs as the carrier to spread the influenza viruses across vast distances, it is very likely that birds played an important role in the inter-continental evolution of the 2009 H1N1virus. It is essential to understand the evolutionary route of the emerging influenza virus in order to find a way to prevent further emerging cases. This study suggests the close relationship between 2009 pandemic virus and the North America avian viruses and underscores enhanced surveillance of influenza in birds for understanding the evolution of the 2009 pandemic influenza.

OBJECTIVETo evaluate risk factors associated with morbidity and mortality in patients undergoing surgery for obstructing colorectal cancer.

METHODSOne hundred and eleven patients who underwent emergency surgery for obstructing colorectal cancer from January 2001 to December 2009 were retrospectively reviewed.

RESULTSForty-nine patients had obstruction proximal to the splenic flexure and 62 patients at or distal to the splenic flexure. The morbidity and mortality rates of the emergency surgery for malignant obstruction were 21.6% and 5.4%, respectively. Twenty-three patients received resection with primary anastomosis with intraoperative lavage for left-sided lesions. There was no difference in morbidity between right-sided cancer and left-sided cancer(P>0.05). Univariable analysis showed that complications rate was higher in patients with higher ASA score (3-4) and in those aged over 60 years. Multivariate logistic regression analysis revealed that ASA score(3-4) was an independent risk factor.

CONCLUSIONSEmergency surgery for obstructing colorectal cancer is associated with high rates of morbidity and mortality. Selection of the proper operation and intensive treatment after surgery are recommended in high risk patients.

Adult ; Aged ; Aged, 80 and over ; Chi-Square Distribution ; Colonic Neoplasms ; surgery ; Female ; Humans ; Intestinal Obstruction ; surgery ; Logistic Models ; Male ; Middle Aged ; Postoperative Complications ; Retrospective Studies ; Risk Factors