Objective To form the expert consensus on the limb management of patients with transvenous temporary cardiac pacing,standardize the limb management of patients with transvenous temporary cardiac pacing,and reduce complications related to the limb.Methods Using evidence-based methods,the evidence in this field was searched,evaluated and summarized,and relevant recommendations and research conclusions were extracted and classified by the level of evidence quality,and then the first draft of the consensus was formed.From December 2023 to January 2024,through 2 rounds of expert consultation and 4 rounds of expert meetings,the content was adjusted and the consensus was reached.Results Totally 16 experts participated in the consultation.The positive coefficient is 100%;the authoritative coefficient is 0.847 and 0.836;the average value of each index is more than＞3.8;the coefficient of variation is less than 0.21.The Kendall's harmony coefficient of the 2 rounds of expert consultation is 0.372 and 0.314,respectively,which were statistically significant.The consensus covers the preoperative,intraoperative and postoperative on limb management of patients with transvenous temporary cardiac pacing.Totally 11 themes were involved,including the preoperative preparation,position and catheter fixation in operation,position and catheter fixation in postoperative,activity,turn and transfer,duty shift on limb,nursing care after withdrawal of the catheter,prevention of deep vein thrombosis of the operative limb and prevent infection.Conclusion The consensus is highly scientific,and it is helpful to standardize the limb management of patients with transvenous temporary cardiac pacing.

Objective To investigate the imaging features of primary Rosa-i Dorfman disease (RDD)in the central nervous system and to increase the understanding of the disease.Methods The MRI findings of 5 cases with primary RDD of the central nervous system were analyzed retrospectively,and the related literatures were reviewed.Results Four cases located in the cranium,1 case located in the spinal cord,and 5 tumors were attached to the brain (ridge)membrane.The tumor was equal and low signal on T1 WI,and equal or slightly high signal on T2 WI.Obvious enhancement could be seen on enhance study,and obvious enhancementwas visible in adjacent brain (ridge)membrane,in which 1 case involved the skull,with thickening and strengthening of the skull.Tumors were attached to the meninges in a wide range,the local meninges of 3 cases were penetrated by tumor.Conclusion If young and middle-aged males have no obvious specific clinical manifestations,the images of MRI are single or multiple lesions that are closely related to the brain (ridge)membrane in larger extent and easily penetrate the brain (ridge)membrane,the possibility of RDD should be considered.

BACKGROUND: Cisplatin acquired resistance is a vital problem in the chemotherapy of non-small cell lung cancer, which needs to be further addressed. In recent years, obtaining drug resistant cells from cell cultivation and serving for metabolomics research to find differential metabolites and get potential biomarkers, is a good reference for clinical research and cancer treatment. This study aimed to obtain metabolite information related to cisplatin resistance through metabolomics analysis. METHODS: Metabolites were extracted from A549 cells and cisplatin resistant A549/DDP cells, and ultraperformance liquid chromatography coupled with time of flight mass spectrometry was used to perform metabolomic analysis of endogenous molecules of the two cells and obtain metabolic differences. RESULTS: Through data analysis, 40 metabolites were identified as differential metabolites, mainly involving phospholipids, fatty acids, amino acids and metabolites related to energy metabolism. CONCLUSIONS The drug resistance of A549/DDP cells may be caused by the changes of cell membrane structure and related metabolic pathways.
A549 Cells ; Carcinoma, Non-Small-Cell Lung ; pathology ; Chromatography, High Pressure Liquid ; Drug Resistance, Neoplasm ; Humans ; Lung Neoplasms ; pathology ; Mass Spectrometry ; Metabolomics ; methods

Objective To study the clinical effect of terbutaline combined with budesonide suspension liquid in the treatment of children with chronic bronchitis .Methods A total of 116 children with chronic bronchitis were selected,and they were randomly divided into the control group and the observation group according to the digital table,58 cases in each group .Based on symptomatic treatment ,the control group was given budesonide treatment ,the observation group was treated with terbutaline combined with budesonide treatment,All the patients were treated for 7 days.The curative effect,clinical symptoms disappeared time and adverse reaction etc.were compared between the two groups.Results After treatment,the total effective rate of the observation group was 94.8％,which of the control group was 81.0％,the difference was statistically significant (χ2 =5.599,P<0.05).The cough disappeared time , wheezing disappearance time , rales disappearance time and wheeze disappeared time of the observation group were (5.1 ±1.4)d,(3.5 ±0.8)d,(3.9 ±1.1)d,(4.4 ±0.9)d,respectively,which of the control group were (8.2 ± 2.1) d,(4.7 ±1.2) d,(5.4 ±1.3) d,(7.1 ±1.4) d,respectively,the differences between the two groups were statistically significant(t=9.354,6.337,6.708,12.355,all P<0.05).The incidence rate of adverse reaction of the control group was 15.5％,which of the observation group was 13.8％,there was no statistically significant difference between the two groups(χ2 =0.034,P>0.05).Conclusion Terbutaline combined with budesonide suspension in the treatment of children with chronic bronchitis can significantly improve clinical symptoms ,improve clinical curative effect,and with good safety and great clinical significance .

Objective To investigate the clinical efficacy of inhalation of terbutaline,budesonide combined with Xiaoerkechuanling granules in the treatment of infantile asthma.Methods 96 children with asthma were selected and randomly divided to observation group and control group.The two groups were given routine drug treatment,the control group was given sulfate inhalation terbutaline atomization liquid and budesonide suspension on the basis of conventional treatment.The observation group was given Xiaoerkechuanling granules on the basis of the control group. The two groups were treated for 7 days.The clinical curative effect of the two groups,the changes of lung function and adverse reactions were observed.Results After treatment,the total effective rate in the observation group was 93.80%,which in the control group was 75.00%,the difference between the two groups was statistically significant (χ2 =3.200,P <0.05).The FEV1 ,FEV1 and FEV /FEV1 of the observation group were (3.49 ±0.61)L,(2.54 ± 0.47)L,(93.33 ±8.46)%,which were significantly better than those of the control group[(2.79 ±0.52)L,(1.96 ± 0.43)L,(75.98 ±5.8)%],the differences between the two groups were statistically significant(t =6.050,6.308, 11.693,all P <0.05).The incidence rate of adverse reaction in the observation group was 12.60%,which in the control group was 10.50%,there was no statistically significant difference between the two groups (χ2 =0.051,P >0.05 ).Conclusion Inhalation of terbutaline,budesonide combined with Xiaoerkechuanling granules for the treatment of asthma in children can significantly improve the patients'pulmonary function,improve clinical curative effect,and it has less adverse reaction and great clinical value.

A new triterpenoid saponin and fourteen known triterpenoids were isolated from the methanol extract of the stems and leaves of Callicarpa integerrima Champ, which is used in Chinese folk medicine for stopping bleeding, expelling the wind, dissipating stagnation, and treating scrofula, by using various chromatographies, such as silica gel, Sephadex LH-20 and RP-C18 column chromatography. Their structures were identified as a new compound 2alpha, 3beta, 19alpha, 23-tetrahydroxy-olean-12-en-28-oic acid-28-O-beta-D-glucopyranosyl-(1 --> 4)-beta-D-glucopyranoside (1), together with fourteen known compounds: oleanolic acid (2), 3-acetyl oleanolic acid (3), 3beta-O-acetyl ursolic acid (4), 2alpha-hydroxy-ursolic acid (5), 2alpha, 3beta, 19alpha, 23-tetrahydroxy-urs-12-en-28-oic acid (6), alpha-amyrin-3-O-beta-D-glucopyranoside (7), pomolic acid (8), betulinic acid (9), ursolic acid (10), 2alpha, 3beta, 19alpha, 23-tetrahydroxy-olean-12-en-28-oic acid (arjungenin) (11), 2alpha-hydroxy-oleanolic acid (12), hederagenin (13), 2alpha, 19alpha-dihydroxy-ursolic acid (14) and pruvuloside A (15), by the spectroscopic techniques of NMR, HMBC, IR and MS, separately. All these compounds were obtained from this plant for the first time, and compounds 3, 4 and 15 were isolated from genus Callicarpa L. for the first time.

The study is to develop an HPLC method for simultaneous determination of rhamnazin (1), rhamnocitrin (2), rhamnetin (3), rhamnazin-3-O-beta-D-glucopyranoside (4), rhamnazin-3-O-beta-D-xylopyranosyl-(1-->4)-beta-D-glucopyranoside (5), rhamnazin-3-O-beta-D-glucopyranosyl-(1-->4)-beta-D-glucopyranoside (6), and rhamnocitrin-3-O-beta-D-glucopyranosyl-(1-->4)-beta-D-glucopyranoside (7) in Nervilia fordii. The separation was performed on a Kromasil C18 column (250 mm x 4.6 mm, 5 microm) with 0.4% phosphoric acid-acetonitrile as the mobile phase in a gradient elution at a flow rate of 1.0 mL x min(-1). The detect wavelength was set at 256 nm, and the column temperature was set at 40 degrees C. There were good linear relationships between the logarithm values of concentrations and those of the peak areas of seven flavonoids (1-7) in the range of 0.55-70.00 microg x mL(-1) (r = 0.9997), 0.86-110.00 microg x mL(-1) (r = 0.9997), 0.39-50.00 microg x mL(-1) (r = 0.999 7), 0.55-70.00 microg x mL(-1) (r = 0.999 5), 1.33-170.00 microg x mL(-1) (r = 0.9998), 1.33-170.00 microg x mL(-1) (r = 0.9998), 0.16-20.00 microg x mL(-1) (r = 0.9995), respectively. The recoveries of the seven flavonoids were between 97.19%-99.45%, the relative standard deviations (RSDs) were between 0.91%-2.69%. The established method is rapid, accurate with high repeatability, which could provide scientific evidence for the quality control of Nervilia fordii.

Objective The risk for coronary artery bypass surgery is reported to be increased with age and associated with diabetes. We examined the outcomes of coronary artery bypass grafting (CABG) in patients with diabetes who were older than 70 years of age and evaluate the effect of diabetes on CABG in those patients. Methods From March 2000 to March 2008, the data of 649 patients older than 70 years of age were collected retrospectively and divided into diabetic group or non-diabetic group based on pre-operative diagnosis. The blood glucose level of patients was maintained between 7.0 mmol/L ( 126mg/dl) and 10.0 mmoL/L ( 180 mg/dl) porioporatively. Stats 7.0 was used for statistical analysis. The t test and χ~2 test were used to determine the differences in the numerical variables and categorical variables respectively. Results No statistical differences were observed between the two groups in the baseline variables, such as age [ ( 74.78±3.67 ) years for diabetic group vs. ( 75.00±3.65 ) years for non-diabetic group, P = 0. 4877 ], female patients ( 34.76% vs. 29.22%, P =0. 1663 ), ejection fraction [ ( 57.02±10. 10 ) % vs. ( 58.49±10. 39 ) %, P = 0. 1004 ) ], myocardial infarction history (26.20% vs. 28.35%, P =0. 5795), though there were more left main diseases in the diabetic group (52.41% vs.26.41%, diabetic vs. non-diabetic, P = 0. 0000 ). The overall in-hospital mortality was 6.32% (8.02% in the diabetic group vs. 5.63% in the non-diabetic group, P = 0. 2571 ). The main causes of death were sudden respiratory and cardiac arrest,low cardiac output syndrome ( LCOS), malignant arrhythmia, respiratory failure, renal failure, central nervous system compli-cations, and multiple organ failure. Major post-operative complications were bleeding, atrial fibrillation, plural effusion and pulmonary infection. Post-operative variables, such as EF (0.59±0. 13 in the diabetic group vs. 0. 61±0.15 in the non-dia-betie group, P =0. 1807), re-revascularization due to bleeding (2. 14% vs. 4.76%, P = 0. 1232), blood transfusion (89.84% vs. 84.63%, P = 0.0820) and the administration of vasoactive agent (21.93% vs. 27.71%, P= 0. 1286),were found no significant difference between the two groups. Conclusion Conclusions The early outcomes of CABG in aged patients are acceptable. The surgical consequences in diabetic patients may be similar to those in non-diabetic patients.

Objective To study the mechanism of U937 cell (human histocytic lymphema) apoptosis induced by ATP. Methods ATP (0\^23?g/L) was added into U937 cell cultured medium as experiment group, no ATP adding group as the control. Using immunofluorescent cytochemistry method to demonstrat the expresses of Cx43, F\|actin, vinculin. Results ATP induced U937 cell to form apoptotic bodies. Expresses of Cx43, F\|actin, vinculin were increased in ATP treated U937 cells.Conclusion ATP could induce U937 cell apoptosis. Apoptotic bodies formed from ATP treated U937 cells was correlated closely with express of Cx43, F\|actin, vinculin, It indicats that Cx43, F\|actin, vinculin play important roles in U937 cell apoptosis induced by ATP.

AIM: To study the enrichment-purification process of total triterpeniods from Rabdosia lophanthoides var.gerardianus with macro porous resin. METHODS: The purify of the total triterpeniods was used as marker to optimize the adsorptive capacity and elution characteristics. RESULTS: The result showed that 20 mL of the extraction solution(0.5 g/mL) was purified with a column of macro porous resin(d15 mm?h120 mm,V=20 mL,dried weight 10 g) and washed with distilled water,then eluted with 80 mL 60% ethanol and 160 mL 90% ethanol in proper order.With macro reticular resin to adsorb and purify,the elution ratio of total triterpeniods of 90% ethanol fraction was 93.2% and the purity reached above 20%. CONCLUSION: This process of applying macro reticular resin to adsorbing and purifying total triterpeniods from Herba Rabdosia lophanthoides var.gerardianus was successful.