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Objective:To investigate the effect of septic shock rapid response team (SSRRT) on the compliance and prognosis of hour-1 bundle therapy strategy in emergency department patients with septic shock.Methods:This study was conducted on emergency patients with septic shock who were admitted to Huai’an First Hospital Affiliated to Nanjing Medical University from January 2020 to December 2021. The inclusion criteria were emergency patients with septic shock who met the international guideline for surviving sepsis campaigns (Sepsis 3.0). Exclusion criteria: age<18 years, pregnant patients, patients transferred from another hospital who had received fluid resuscitation and/or vasoactive drugs, patients requiring emergency surgery, patients with emergency detention time<1 h, patients who refused to place central venous catheterization or had contraindications for catheterization, and patients who refused to give informed consent. SSRRT was established in January 2021. According to the establishment of SSRRT, patients were divided into the pre-SSRRT intervention group and the post-SSRRT intervention group. The general clinical data of the enrolled patients were collected, including vital signs, lactate, fluid resuscitation volume, maximum vasoactive drug pumping rate at the diagnosis of septic shock, implementation of hour-1 bundle therapy strategies, and ICU and 28-day mortality. Statistical software SPSS 25.0 was used. Pearson chi-squared test was used to compare categorical variables between groups, and Mann-Whitney U test was used to compare continuous variables between groups.Results:A total of 289 emergency patients met the inclusion criteria, 115 patients were excluded, and 174 patients were eventually included, including 83 patients in the pre-SSRRT group and 91 patients in the post-SSRRT group. Compared with the pre-SSRRT group, the proportion of lactate monitoring (54.2% vs. 100.0%, P<0.001), blood culture (27.7% vs. 93.4%, P<0.001), antibiotics (57.8% vs. 97.8%, P<0.001), fluid resuscitation volume ≥ 30 mL/kg (4.8% vs. 34.1%, P<0.001), and mean arterial pressure ≥ 65 mmHg (49.4% vs. 68.1%, P<0.001) were significantly increased. There was no significant difference in ICU mortality (50.6% vs. 37.4%, P=0.079) or 28-day mortality (53.0% vs. 38.5%, P=0.054) between the two groups. Conclusions:SSRRT can significantly improve the compliance of hour-1 bundle therapy strategy implementation in patients with emergency septic shock, and has a trend of decreasing mortality.
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Objective:To investigate the static and dynamic trends of scientific research efficiency of the critical care medicine in hospitals affiliated S university during the 13th Five-Year Plan period.Methods:Based on the scientific research data of 16 hospitals affiliated to Beijing S University from 2014 to 2020, the scientific research investment funds and the number of physicians involved in scientific research were selected as input evaluation indexes, and the number of science citation index (SCI) papers, Chinese science citation database (CSCD) papers, and the number of masters and doctors trained were selected as output evaluation indexes, and the evaluation index system of scientific research efficiency of critical care medicine was constructed. SPSS version 23.0 software was used for descriptive data statistics, and data envelopment analysis (DEA)-BCC model and DEA-Malmquist index model of DEAP 2.1 software were used for static and dynamic evaluation of its scientific research efficiency from 2016 to 2020, respectively.Results:① The scientific research technical efficiency (TE) of critical care medicine in 16 hospitals affiliated with S universities varied greatly from 2016 to 2020, but pure technical efficiency (PTE) and scale efficiency (SE) were at a good level, and 6-11 affiliated hospitals in critical care medicine kept DEA effective for 5 consecutive years. ② Dynamic analysis of their total factor productivity (TFP) of scientific research from 2016 to 2020 showed a trend of rising and then falling and then rising again. The mean value was 0.985. The technical efficiency change (TEC) showed a decreasing and then increasing trend, and the technical progress change (TC) showed a slow increasing and then decreasing trend, with a mean value of 0.953. While the mean values of TEC, pure technical efficiency change (PTEC) and scale efficiency change (SEC) were above 1, which showed that the growth of total factor productivity index of research and innovation depended more on the technical efficiency index.Conclusions:The "gain effect" and "catch-up effect" of scientific research efficiency in the specialty of critical care medicine in hospitals affiliated S universities are obvious, but the "growth effect" is not obvious. "Although the research efficiency of the 13th Five-Year Plan period has been significantly improved, there is still much room for improvement in scientific and technological innovation and international academic influence.
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Objective To explore dynamic characteristics of the gait for the elderly with different fall risks before and after obstacle crossing. Methods Twenty-seven elderly people in community were graded as fall risk by using the time up and go test and five-time sit to stand test. The plantar pressure parameters of the elderly before and after obstacle crossing were measured and analyzed by foot pressure measurement system. Results There was no significant difference in the characteristic value of bimodal curve of overall plantar pressure between the high and low fall risk groups before and after obstacle crossing(P>0.05). The center of pressure (COP) trajectory in X direction of high fall risk group after obstacle crossing was significantly greater than that of low fall risk group (P0.05). Conclusions The support time of the elderly with high fall risk is longer than that of the elderly with low fall risk during obstacle crossing, the peak pressure of plantar metatarsal region of the crossing leg increases, and the plantar COP curve shows asymmetry, with an increase in transverse range of the coronal plane. In clinical evaluation, plantar pressure characteristics of people with fall risks during obstacle crossing should be focused on.
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Objective:To compare the effect of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on the abdominal visceral fat of obese women.Methods:Sixty-eight obese female college students were randomly divided into an HIIT group ( n=23), an MICT group ( n=22) and a control group ( n=23). The control group was not given any training intervention. The MICT group performed continuous exercise at an intensity of 60% of each person′s maximum oxygen uptake (VO 2max) until 300kJ of work had been performed. Those in the HIIT group performed repeated 4-minute bouts of cycling at 90% of their VO 2max with 3-minute intervals until 300kJ of work had been performed. The interventions lasted 12 weeks. The subjects′ visceral fat (AVFA) and abdominal subcutaneous fat (ASFA) were measured using computed tomography. Whole-body fat mass (FM) and FM in the android, gynoid and trunk regions were detected using dual energy X-ray absorptiometry before and 48 hours after the final session. Results:After the intervention, the average AVFA, ASFA, percentage of fat mass (FM%), whole-body FM, and FM in the abdominal, gluteo-femoral and trunk regions of the HIIT group and MICT group were significantly lower than before the intervention, but there was no significant difference between them. No significant differences were observed in any of the control group′s indexes.Conclusions:Both HIIT and MICT can reduce the abdominal visceral fat of obese female college students, and the effects of the two exercise modes are equivalent.
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To establish septic myocardial inhibition rat model by echocardiography. Methods Twenty adult male Sprague-Dawley (SD) rats were divided into control group and model group according to the random number table method, with 10 rats in each group. The rat model of septic myocardial inhibition was reproduced by intraperitoneal injection of 10 mg/kg lipopolysaccharide, while the control group was given the same volume of saline. The left ventricular end-diastolic diameter (LVDd), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic diameter (LVDs), left ventricular end-systolic volume (LVESV), left ventricular ejection fraction (LVEF), right ventricular end-diastolic diameter (RVDd), right ventricular end-systolic diameter (RVDs), heart rate (HR), positive pulmonary artery flow rate and aortic flow rate were measured at 8 hours after model establishment by echocardiography. Then the rats were sacrificed to harvest serum and myocardial tissue. The levels of serum tumor necrosis factor-α(TNF-α), nuclear factor-κB (NF-κB), interleukin-1 (IL-1), cardiac troponin I (cTnI) and B-type brain natriuretic peptide (BNP) were measured by enzyme linked immunosorbent assay (ELISA). The mRNA expressions of TNF-α, IL-1 and NF-κB in myocardium were detected by real-time polymerase chain reaction (real-time PCR). The pathological changes of myocardium were observed by hematoxylin-eosin (HE) staining under light microscope. Results Compared with control group, myocardial inhibition was obviously observed in model group, manifesting as enlargement of overall shape of heart, and prominent increase of HR (bpm: 449.0±21.1 vs. 356.7±23.3, P < 0.01); left ventricular and right ventricular functions were affected, LVDd, LVDs, LVEDV, LVESV were enlarged [LVDd (mm):10.03±0.95 vs. 7.04±0.71, LVDs (mm): 5.95±0.71 vs. 3.07±0.05, LVEDV (mL): 2.11±0.53 vs. 0.81±0.21, LVESV (mL): 0.51±0.16 vs. 0.07±0.01, all P < 0.05], LVEF was significantly decreased (0.760±0.046 vs. 0.901±0.025, P < 0.01), RVDd was significantly increased (mm: 4.48±0.58 vs. 3.22±0.20, P < 0.05), and positive pulmonary artery velocity was significantly decreased (cm/s: 64.2±9.3 vs. 89.0±0.8, P < 0.05). Compared with control group, the levels of serum NF-κB, TNF-α, IL-1, BNP and cTnI in model group were significantly increased [NF-κB (ng/L):103.84±6.55 vs. 57.29±41.34, TNF-α (ng/L): 1 198.32±164.07 vs. 835.45±24.01, IL-1 (ng/L): 1 089.90±221.96 vs. 746.19±165.83, BNP (ng/L): 1 097.36±293.84 vs. 454.71±197.79, cTnI (ng/L): 6 938.59±1 400.21 vs. 3 731.90±1 349.31, all P < 0.01], the mRNA expressions of TNF-α, NF-κB and IL-1 in myocardial tissue were significantly increased (2-ΔΔCT: 1.50±0.42 vs. 0.71±0.40, 1.10±0.17 vs. 0.63±0.06, 1.77±0.67 vs. 0.10±0.03, all P < 0.05). It was shown by HE staining that the structure of myocardial tissue in control group was distinct, the arrangement of myocardial fibers was neat, and transverse was clear; the structure of myocardial tissue in model group was loose, blurred, and the cells were swollen, with obvious pathological changes. Conclusions Cardiac function was assessed by echocardiography, expression of inflammatory factors, myocardial markers and pathological changes. It was verified that intraperitoneal injection of 10 mg/kg endotoxin could successfully prepare a rat model of septic myocardial inhibition.
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Objective To assess the predictive value of early phrase echocardiography and cardiac biomarkers in patients with severe sepsis. Methods A retrospective analysis of severe septic patients (patients with acute coronary syndrome and end stage renal disease were excluded) in department of intensive care unit of Capital Medical University Affiliated Beijing Shijitan Hospital from January 2013 to December 2017 was conducted. The acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) score, N-terminal prohormone of brain natriuretic peptide (NT-proBNP), cardiac troponin I (cTnI), myoglobin (MYO), creatine kinase (CK), MB isoenzyme of creatine kinase (CK-MB) within 6 hours after admission, and bedside echocardiography indexes [left ventricular ejection fraction (LVEF), the ratio of the peak blood flow velocity in the early stage of the mitral valve and the peak blood flow rate of the mitral valve (E/A ratio)] within 6 hours after diagnosis were recorded. The differences of indexes between patients with decreased contractile function (LVEF < 0.50) group and normal group, and the difference between dead group and survival group within 28-day were compared. Receiver operating characteristic (ROC) curve and Logistic regression analysis were conducted to assess the early detected prognostic value in severe sepsis patients. Results ① A total of 316 patients were enrolled in the survey period. Decreased cardiac systolic function (LVEF < 0.50) was found in 89 cases (28.2%), and cardiac diastolic function impaired (E/A ratio < 1) in 269 cases (85.1%); while 79 cases (25.0%) had both systolic function and diastolic function impairment. ② NT-proBNP and cTnI were statistically different between cardiac systolic function impaired group and normal group. Further Logistic regression analysis showed that only NT-proBNP was significantly correlated with LVEF [β=-1.311, odds ratio (OR) = 0.269, P < 0.001]. ③ Eighty-two of 316 cases were died in 28-day, and the 28-day mortality rate was 25.9%. Compared with the survival group, the ratio of E/A < 1, APACHEⅡ score, NT-proBNP, cTnI, MYO, CK and CK-MB were significantly increased in death group. The ROC curve analysis showed that the above indexes had diagnosed value for prognosis in severe sepsis patient, among which NT-proBNP and cTnI had higher predictive value [the area under ROC curve (AUC) were 0.920 and 0.901 respectively, both P < 0.001]. Multivariate Logistic regression analysis showed that APACHEⅡ score (β= 0.282, OR = 1.326, P < 0.001) and NT-proBNP (β= 0.402, OR = 1.261, P < 0.001) were independent risk factors for prognosis in patients with severe sepsis. Conclusions The LVEF values measured by echocardiography in early phrase were unrelated to 28-day prognosis. APACHEⅡ score, E/A ratio, NT-proBNP, cTnI, MYO, CK and CK-MB were related to 28-day prognosis. APACHEⅡ scores and NT-proBNP were independent prognostic factors in severe sepsis patient.
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Objective:To observe the effect of acupuncture plus medium-frequency electric stimulation on bladder function after radical hysterectomy for cervical cancer. Methods:A total of 170 patients confirmed by biopsy and surgical pathology and treated with radical hysterectomy for cervical cancer were randomly divided into an acupuncture group, an observation group and a control group by random digital table. Fifty-six cases in the acupuncture group were treated with acupuncture after surgery, one session each day, till the extubation day; 58 cases in the observation group were treated with acupuncture plus medium-frequency electric stimulation after surgery, one session each day, till the extubation day; and 56 cases in the control group didn't receive any intervention, and the catheter was retained till the extubation day. On the postoperative day 14, all groups were dealt with catheterization to determine the residual urine volume, in order to observe the occurrence rate of urinary retention and the recovery of bladder function and to compare the differences of the therapeutic effects among the groups. Results:The occurrence rates of urinary retention were respectively 16.1%, 20.7% and 46.4% in the acupuncture group, observation group and control group, with significant differences (P<0.05). When comparing the acupuncture group and the observation group with the control group, there were significant differences (bothP<0.05). In comparison between the acupuncture group and the observation group, there was no significant difference (P>0.05). The recovery rates of bladder function in the three group were respectively 42.9%, 60.3% and 41.1% without significant differences (P>0.05). Moreover, there were no significant between-group differences (P>0.05), but acupuncture plus medium-frequency electric stimulation showed a better tendency. Conclusion: The single application of acupuncture therapy is effective and able to prevent urinary retention after radical hysterectomy for cervical cancer. Acupuncture plus medium-frequency electric stimulation can effectively enhance the recovery of bladder function and reduce the residual urine volume in the bladder to the maximum.
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Objective:To observe the effect of acupuncture plus medium-frequency electric stimulation on bladder function after radical hysterectomy for cervical cancer. Methods:A total of 170 patients confirmed by biopsy and surgical pathology and treated with radical hysterectomy for cervical cancer were randomly divided into an acupuncture group, an observation group and a control group by random digital table. Fifty-six cases in the acupuncture group were treated with acupuncture after surgery, one session each day, till the extubation day; 58 cases in the observation group were treated with acupuncture plus medium-frequency electric stimulation after surgery, one session each day, till the extubation day; and 56 cases in the control group didn't receive any intervention, and the catheter was retained till the extubation day. On the postoperative day 14, all groups were dealt with catheterization to determine the residual urine volume, in order to observe the occurrence rate of urinary retention and the recovery of bladder function and to compare the differences of the therapeutic effects among the groups. Results:The occurrence rates of urinary retention were respectively 16.1%, 20.7% and 46.4% in the acupuncture group, observation group and control group, with significant differences (P<0.05). When comparing the acupuncture group and the observation group with the control group, there were significant differences (bothP<0.05). In comparison between the acupuncture group and the observation group, there was no significant difference (P>0.05). The recovery rates of bladder function in the three group were respectively 42.9%, 60.3% and 41.1% without significant differences (P>0.05). Moreover, there were no significant between-group differences (P>0.05), but acupuncture plus medium-frequency electric stimulation showed a better tendency. Conclusion: The single application of acupuncture therapy is effective and able to prevent urinary retention after radical hysterectomy for cervical cancer. Acupuncture plus medium-frequency electric stimulation can effectively enhance the recovery of bladder function and reduce the residual urine volume in the bladder to the maximum.
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Objective To evaluate the effect of combination therapy with milrinone and esmolol on hemodynamics and cardiac function in patients with septic myocardial depression. Methods From October 2010 to October 2013,after the hemodynamics and cardiac function were evaluated by pulse indicator continuous cardiac output (PICCO),74 sepsispatients withCI < 2.2 L/min · m2 after fluid resuscitation were enrolled in the study and were divided into group A with intravenous injection of dobutamine hydrochloride ,and group B with intravenous injection of milrinone and esmolol,with 37 cases in each group. The patients'PICCO indicators, echocardiography and cardiac biomarker(CK,CK-MB,MYO,cTnI and ProBNP)in two groups were compared before and after 3-day treatment. Results (1)CI and GEF were significantly increased in group B after 3-day treatment when compared with those in group A.(2)Compared with those in group A,early diastolic mitral flow velocity/end diastolic mitral velocity (E/A) and right ventricular diastolic diameter(RVD) in group B had statistical significance.(3) CK-MB,cTnI and ProBNP decreased significantly in group B when compared with those in group A. Conclusion Combination therapy with milrinone and esmolol can increase cardiac ejection function,slow down the heart rate,reduce the heart blood and vascular preload,lessen the injury of myocardial and improve heart function.
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Objective To study the differences in the inclination of lower incisors among the female patients with beautiful profiles in different vertical skeletal types so as to provide the clinical treatment design for a certain guiding. Methods 137 cephalometric films of female patients with beautiful profiles were selected and divided into three groups based on the vertical facial types(∠SNMP):small degree(n = 31),average degree(n = 89) and larger degree groups(n=17). The angles of∠L1/MP and∠L1/A-Pog were measured and treated with covari-ance analysis for detecting the differences between the groups. Results The index of L1-MP(°)was the smallest in the larger degree group,the largest in the small degree group and average in the average group,with significant differences between the three groups(F = 17.38,P 0.05). Conclusion Lower incisors have compensatory inclined lingually in the group of higher mandible angle,but labially in the group of lower mandible angle.
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Objective To investigate mortality risk factors in patients with severe cardiorenal syndrome treated with continuous hemofiltration therapy. So we can optimally select patients who may benefit more from this therapy. Methods The clinical data of 68 severe cardiorenal syndrome patients admitted to the ICU of Beijing Shijitan Hospital from May 2012 to May 2015 were retrospectievly analyzed and evaluated. These patients were divided into two groups based on survival or death during hospitalization. Logistic regression analysis was employed to identify independent risk factors for death of patients with severe cardiorenal syndrome during ICU stay. Results There were 36 cases in the death group and 32 cases in the survival group. In the death group, the age,mechanical ventilation rates, vasoactive drug application rates, leukocytes, neutrophils, C-reactive protein,left ventricular end-diastolic diameter and left ventricular end-systolic diameter were significantly higher than those in the survival group,while hemoglobin, serum creatinine, left ventricular ejection fraction, average single amount of dehydration in continuous hemofiltration process were significantly lower than those in the survival group. Logistic regression analysis showed that age, vasoactive drug application rates, APACHEⅡscore and leukocytes were independent risk factors of mortality. Conclusions Cardiac function, mechanical ventilation therapy, average single amount of dehydration in continuous hemofiltration, hemoglobin, C-reactive protein were closely related to the prognosis of severe cardiorenal syndrome patients. The patient′s age,infection, vasoactive drug application, APACHEⅡ score were important risk factors of mortality during hospitalization.
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@#Objective To observe the effects of 8-week aerobic exercise on skeletal muscle glycogen content and exercise endurance and investigate the possible mechanism in rats with chronic heart failure. Methods 30 Sprague-Dawley rats were submitted to heart failure sedentary (H) group, heart failure traning (HT) group and sham operation (S) group. The heart failure model was established with coronary artery ligation. HT group performed an 8-week treadmill running. The skeletal muscle glycogen content was determined with anthracenone, exercise endurance with exhaust duration of graded exhausted exercise test, glucose uptake rate, activity of glycogen synthase (GS) and glycogen phosphorylase (GP) with radicisotope, protein expression of total GS, phospho-GS (p-GS), total GP and phospho-GP (p-GP) with Western Blotting. Correlation analysis was conducted between glycogen content and exhaust duration. Results The skeletal muscle glycogen, exhaust duration, glucose uptake rate, GS activity and p-GP protein reduced (P<0.05), while serum insulin, GP activity and p-GS protein raised (P<0.05) in the H group compared with those in the S group. The skeletal muscle glycogen, exhaust duration, glucose uptake rate, GS activity and p-GP protein increased (P<0.05), while serum insulin, GP activity and p-GS protein decreased (P<0.05) in the HT group compared with those in the H group. There was positive correlation between glycogen content and exhaust duration (P<0.05). Conclusion Prolonged aerobic exercise enhanced skeletal muscle glycogen content and exercise endurance in rats with chronic heart failure, which may be related to the improvement of insulin sensitivity, muscle glucose uptake, increase of glycogen synthesis and decrease of glycogen breakdown.
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[ ABSTRACT] AIM:To investigate the effects of long-term aerobic exercise on the heart and sympathetic neural remodeling ( structure and function remodeling) in heart failure rats induced by myocardial infarction.METHODS:Heart failure model after myocardial infarction was performed by ligating anterior descending coronary artery in the Wistar rats. Four weeks after operation, the rats were randomly divided into sham operation sedentary ( S) group, heart failure sedenta-ry ( H) group and heart failure exercise ( HE) group.The animals in HE group underwent 10-week treadmill running, while those in S group and H group were sustained in a resting state.The cardiac structure and function including left ven-tricular internal diameter at diastole ( LVIDd) , left ventricular internal diameter at systole ( LVIDs) , left ventricular anteri- or wall diameter at diastole (LVAWDd), left ventricular anterior wall diameter at systole (LVAWDs), left ventricular pos-terior wall diameter at diastole ( LVPWDd) and left ventricular posterior wall diameter at systole ( LVPWDs) , and cardiac function parameters including fractional shortening (FS) and left ventricular ejection fraction (LVEF) were measured by echocardiography.The myocardium was collected for histopathological observation with Masson staining, and the collagen volume fraction ( CVF) was determined.The concentrations of norepinephrine ( NE) in the myocardium and plasma were measured by high-pressure liquid chromatography.The frequency domain analysis was applied for determining the heart rate variability (HRV) via subcutaneous recording electrode involving total power (TP), normalized low power (LFn), nor-malized high power ( HFn) and LF/HF ratio.The mRNA expression of collagen type I ( Col-I) , collagen type III ( Col-III) , atrial natriuretic factor ( ANF) ,α-myosin heavy chain (α-MHC) ,β-myosin heavy chain (β-MHC) , sarcoplasmic endoplasmic reticulum Ca2+-ATPase (SERCA2a) was detected by real-time PCR.The protein levels of nerve growth factor (NGF) and its receptor (TrkA), and tyrosine hydroxylase (TH) were measured by Western blotting.RESULTS:(1) Compared with S group, body weight ( BW) , LVIDd, FS, LVEF, TP, HFn, the mRNA expression ofα-MHC and SER-CA2a, and the protein levels of NGF, TrkA and TH decreased (P<0.05).Left ventricular weight (LVW), left ventricu-lar mass index (LVMI), LVAWDd, LVAWDs, LVPWDd, LVPWDs, CVF, plasma and myocardial NE content, LFn, LF/HF, and the mRNA expression of ANF,β-MHC, Col-I and Col-III increased ( P<0.05) in H group.(2) Compared with H group, LVW, LVMI, LVIDd, FS, LVEF, TP, HFn, the mRNA expression ofα-MHC and SERCA2a, and the pro-tein levels of NGF, TrkA and TH were raised (P<0.05), while CVF, plasma and myocardial NE content, LFn, LF/HF, and the mRNA expression of ANF, β-MHC, Col-I and Col-III decreased ( P<0.05 ) in HE group.CONCLUSION:Long-term aerobic exercise training leads to inhibition of heart and sympathetic neural remodeling and improvement of cardi-ac function and autonomic modulation in the rats after myocardial infarction.
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Objective To observe the effects of 8-week aerobic exercise on skeletal muscle glycogen content and exercise endurance and investigate the possible mechanism in rats with chronic heart failure. Methods 30 Sprague-Dawley rats were submitted to heart failure sed-entary (H) group, heart failure traning (HT) group and sham operation (S) group. The heart failure model was established with coronary ar-tery ligation. HT group performed an 8-week treadmill running. The skeletal muscle glycogen content was determined with anthracenone, exercise endurance with exhaust duration of graded exhausted exercise test, glucose uptake rate, activity of glycogen synthase (GS) and gly-cogen phosphorylase (GP) with radicisotope, protein expression of total GS, phospho-GS (p-GS), total GP and phospho-GP (p-GP) with Western Blotting. Correlation analysis was conducted between glycogen content and exhaust duration. Results The skeletal muscle glyco-gen, exhaust duration, glucose uptake rate, GS activity and p-GP protein reduced (P<0.05), while serum insulin, GP activity and p-GS pro-tein raised (P<0.05) in the H group compared with those in the S group. The skeletal muscle glycogen, exhaust duration, glucose uptake rate, GS activity and p-GP protein increased (P<0.05), while serum insulin, GP activity and p-GS protein decreased (P<0.05) in the HT group compared with those in the H group. There was positive correlation between glycogen content and exhaust duration (P<0.05). Conclu-sion Prolonged aerobic exercise enhanced skeletal muscle glycogen content and exercise endurance in rats with chronic heart failure, which may be related to the improvement of insulin sensitivity, muscle glucose uptake, increase of glycogen synthesis and decrease of glycogen breakdown.
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Research on novel pullulanase has major significance on the domestic industrialization of pullulanase and the breakdown of foreign monopoly. A thermophilic bacteria LM 18-11 producing thermostable pullulanase was isolated from Lunma hot springs of Yunnan province. It was identified as Anoxybacillus sp. by 16S rDNA phylogenetic analysis. Full-length pullulanase gene was cloned from Anoxybacillus sp. LM18-11. The optimum temperature of the pullulanase was between 55 and 60 degrees C with a half-life as long as 48 h at 60 degrees C; and its optimum pH was between 5.6 and 6.4. V(max) and K(m) of the pullulanase was measured as 750 U/mg and 1.47 mg/mL, which is the highest specific activity reported so far. The pullulanase crystals structure showed a typical alpha-amylase family structure. The N-terminal has a special substrate binding domain. Activity and substrate binding were decreased when the domain was deleted, the V(max) and K(m) were 324 U/mg and 1.95 mg/mL, respectively. The pullulanase was highly heterologous expressed in Bacillus subtilis by P43 promoter. The extracellular enzyme activity was 42 U/mL, which increased more than 40 times compared to the initial strain. This pullulanase has good application prospects.
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Anoxybacillus , Classification , China , Glycoside Hydrolases , Metabolism , Hydrogen-Ion Concentration , Phylogeny , RNA, Ribosomal, 16S , Genetics , TemperatureABSTRACT
Objective:To explore the predictive value of relevant hemodynemics indexes on cardiac shock prognosis by PiCCO technology. Methods:A total of 54 consecutive patients with cardiac shock treated in our hospital from 2012-01 to 2013-05 were studied. The patients’ general information with hempdynemics indexes as cardiac index (CI), extra vascular lung water index (EVWI), general ejection fraction (GEF), general end diastolic index (GEDI), systolic vascular resistance index (SVRI) were monitored by PiCCO technology at before and 48 hours after treatment. Based on 28 days surviving condition, the patients were divided into 2 groups:Survival group, n=28 and Death group, n=26. The levels of above indexes were compared between 2 groups and their predictive values on cardiac shock prognosis were calculated by ROC curve analysis. Results:Compared with Death group, Survival group presented much higher CI, GEF and much lower EVWI, SVRI at before and 48 hours after treatment, P0.05. With 48 hours treatment, the ROC analysis showed AUCEVWI=0.846 with cut-off point at 7.5ml/kg, AUCCI=0.884 with cut-off point at 3.46 L/(min·m2) and AUCGEF=0.853 with cut-off point at 16.5%;the sensitivity and speciifcity of EVWI, CI, GEF were 79.2%and 81.0%, 82.8%and 83.0%, 74.1%and 88.7%respectively. Multivariate Logistic regression analysis indicated that CI and EVWI were the independent predictors for cardiac shock prognosis. Conclusion:PiCCO monitoring technology may guide the balance of relevant hempdynemics indexes in patients with cardiac shock. With 48 hours treatment, the levels of CI and EVWI had predictive value for cardiac shock prognosis.
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Objective To investigate the effect of non invasive cardiac output monitoring(NICO)system in pig model with acute respiratory distress syndrome(ARDS),and to provide experimental basis for clinical application. Methods Eleven anaesthetized and ventilated ARDS male pig models were induced by intravenously infusing 0.2 mL/kg oleic acid. Lung recruitment was condocted by pressure control ventilation on pigs with ARDS. The optimal positive end-expiratory pressure(PEEP)was determined by optimal dead space fraction〔the ratio of dead space to tidal volume(VD/VT)〕. Cardiac output(CO)was determined by NICO,the respiratory function was monitored, and the VD/VT,dynamic compliance(Cdyn),oxygenation index(PaO2/FiO2),the volume of alveolar ventilation(Valv) and arterial blood oxygen saturation(SaO2)were recorded before infusing oleic acid,after stabilization of ARDS model and at optimal PEEP level,and the intrapulmonary shunt fraction(Qs/Qt)was calculated. CO was also determined by application of pulse indicated continuous cardiac output(PiCCO),and the linear regression analysis between CO determined by NICO and CO determined by PiCCO was conducted. Results Seven experimental ARDS pigs model were successfully established. The optimal PEEP identified by the lowest VD/VT method was(15.71±1.80)cmH2O (1 cmH2O=0.098 kPa). Compared with before infusing oleic acid,VD/VT and Qs/Qt after stabilization of ARDS model were significantly increased〔VD/VT:(72.29±8.58)% vs.(56.00±11.06)%,Qs/Qt:(21.04±15.05)%vs.(2.00±1.32)%,both P0.05). There was linear correlation between CO determined by NICO and CO determined by PiCCO(r2=0.925,P<0.001). Conclusions NICO technique provides a useful and accurate non invasive estimation of CO and respiratory function.VD/VT provided by NICO can titrate the optimal PEEP in patients with ARDS.
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Objective To investigate the value of inflammatory biomarkers such as procalcitonin (PCT),C-reactive protein (CRP),and endotoxin in early diagnosis of bacteriemia patients infected with gram-negative bacteria.Methods A cohort of 79 bacteriemia patients infected with gram-negative bacteria admitted from February 2011 to May 2013 were enrolled for retrospective study.Collected data for analysis included gender,age,disease severity (APACHE Ⅱ score),bacterial isolates from blood culture and other general information.The inflammatory biomarkers such as white blood cell (WBC),neutrophils (NEU),Creactive protein (CRP),procalcitonin (PCT),and endotoxin were assayed within 6 hours after admission.SPSS version 16.0 software was used for statistical analysis.The test of normality was used for analysis of continuous variables,t-test for inter-group comparison and non-parametric statistics for non-normal distribution variables.The AUC of ROC was calculated for determining the sensitivity and specificity of biomarkers for diagnosis of bacteriemia.Results (1) Statistically positive correlations were found among serum PCT,CRP,and endotoxin levels (PCT/CRP =0.916,PCT/endotoxin =0.496,Endotoxin/CRP =0.387),and between those and APACHE Ⅱ score were (PCT/APACHE Ⅱ =0.505,Endotoxin/APACHE Ⅱ =0.467,CRP/APACHE Ⅱ =0.278),respectively,in bacteriemia patients infected with gram-negative bacteria.(2) The receiver operating characteristic (ROC) curve indicated that AUC PCT =0.715 (sen 64.6％,spe 80.7％),AUC CRP =0.666 (sen 67.7％,spe 78.6％),AUC endotoxin =0.771 (sen 78.8％,spe 81.8％) in gram-negative bacteria bloodstream infection patients.(3) The AUC PCT =0.865 (sen 86.2％,spe 77.5％),AUC CRP =0.733 (sen 72.4％,spe 75.0％),AUCendotoxin =0.618 (sen 70.7％,spe 67.5％) in bacteriemia patients infected with gram-negative bacteria in severe sepsis and septic shock group.Conclusions The plasma PCT,CRP,and endotoxin have early predictive value in bacteriemia patients infected with Gram-negative bacteria.In sepsis stage,the level of serum endotoxin has the most significant value for diagnosis.In severe sepsis and septic shock stages,the PCT is the most value for diagnosis of bacteriemia.All biomarkers are positively correlated with severity of the disease.
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<p><b>BACKGROUND</b>Hemorrhagic fever with renal syndrome (HFRS) is endemic in Junan county, Shandong Province, China. We conducted geographic information system (GIS)-based spatial analysis with the objective of estimating the spatial distribution of rodent populations and their hantavirus infection patterns, to describe the spatial relationships of hantavirus strains in small ecological areas and to identify key areas in endemic areas of HFRS for future public health planning and resource allocation.</p><p><b>METHODS</b>Rodent sampling was conducted in seven villages in Junan county from February 2006 to January 2007 using field epidemiological surveillance. Dynamics of hantavirus infection and population densities in rodents were investigated. Spatial statistical techniques including Ripley' L index and nearest neighbour hierarchical (NNH) clustering analysis were conducted to reveal the spatial structure of rodent populations in seven villages. Phylogenetic analysis and two-dimensional minimal spanning tree (2-D MST) models were employed to describe the spatial relationship of hantavirus strains.</p><p><b>RESULTS</b>Data showed that Mus musculus was the most common species in our study area, followed by Rattus norvegicus. Ripley's L index and NNH analysis showed that the spatial distribution of all captured rodents, Mus musculus and Rattus norvegicus in seven villages were clustered and there were hotspot areas of rodent distribution. The branches of 2-D MSTs had similar topologies to those of corresponding phylogenetic trees, and hantavirus strains exhibited obvious connective traces in seven villages.</p><p><b>CONCLUSIONS</b>These results contribute to the understanding of the spatial distribution of rodent populations and hantavirus infection patterns in small areas, and identify priority areas within the epidemic areas for the development of a better prevention strategy against hemorrhagic fever with renal syndrome in a small ecological area.</p>
Subject(s)
Animals , Humans , Rats , Geographic Information Systems , Orthohantavirus , Hemorrhagic Fever with Renal Syndrome , Epidemiology , Virology , Rodentia , VirologyABSTRACT
<p><b>BACKGROUND AND OBJECTIVE</b>PubMed is generally acknowledged for its scientificity in literature coverage and authority of literature retrieval . In recent years, many studies have been published in China about radiation oncology. We aimed to investigate the literatures about radiation oncology in China covered by PubMed over the past five years.</p><p><b>METHODS</b>We collected primary data by searching the PubMed database using the related subject words. The collected data were analyzed and evaluated by bibliometric methods.</p><p><b>RESULTS</b>In the past five years, 550 articles by Chinese authors related to radiotherapy were indexed in PubMed. These articles were published in 160 journals among 26 Chinese provinces/cities. These articles mainly focused on radiation dose and computer-aided radiation therapy. Sixty-four articles were published by Chinese Journal of Cancer , which ranked the top. Forty-four articles were published by the International Journal of Radiation Oncology Biology Physics (IF=4.29), with the largest number among SCI journals. One hundred and sixteen articles from Guangdong Province were covered, accounting for 21.09%.</p><p><b>CONCLUSIONS</b>Over the past five years, the discipline of radiation oncology has been greatly developed. The literatures mainly focus on clinical radiation oncology and their regional distribution is uneven.</p>