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Objective:To screen the clinical parameters in predicting continuous renal replacement therapy (CRRT)-related hypotension in the patients with renal failure.Methods:A retrospective analysis was conducted. Patients with renal failure received CRRT admitted to Qingdao Municipal Hospital from July 1st, 2012 to June 30th 2019 were enrolled. Clinical data was recorded for the patients, including gender, age, weight, parameters before CRRT [systolic pressure (SBP), diastolic pressure (DBP), mean arterial pressure (MAP), central venous pressure (CVP), heart rate, blood routine examination, blood biochemistry, B-type natriuretic peptide (BNP), cardiothoracic ratio, left ventricular ejection fraction (LVEF)], CRRT duration, blood flow velocity, replacement fluid volume, net ultrafiltration volume, ultrafiltration rate and 30-day prognosis. The patients who had CRRT-related hypotension or whose net ultrafiltration was zero were enrolled as intolerance ultrafiltration group. Others were enrolled in normal ultrafiltration group. The parameters of the patients in the two groups were compared, and their predictive values in CRRT-related hypotension were evaluated by receiver operating characteristic (ROC) curve analysis.Results:There was significant difference in age, BNP, CVP, CRRT duration, net ultrafiltration volume, and ultrafiltration rate between the normal ultrafiltration group ( n 98) and intolerance ultrafiltration group [ n 13; age (years old): 66.21±12.21 vs. 74.54±5.93, BNP (ng/L): 1 617.57 (755.00, 2 296.25) vs. 398.95 (76.80, 703.00), CVP (cmH 2O, 1 cmH 2O = 0.098 kPa): 14.99±2.28 vs. 12.60±1.14, CRRT duration (hours): 23.71±11.48 vs. 14.51±8.99, net ultrafiltration volume (mL): 3 120.98 (1 863.75, 3 515.00) vs. 793.85 (0, 1 125.00), ultrafiltration rate (mL/h): 133.44 (98.72, 156.64) vs. 68.47 (0, 105.21), all P < 0.05]. ROC curve analysis showed that age, BNP, CVP, CRRT duration, net ultrafiltration volume and ultrafiltration rate had good predictive value for the CRRT-related hypotension [the area under ROC curve (AUC) and 95% confidence interval (95% CI): age was 0.734 (0.626-0.842), BNP was 0.868 (0.776-0.960), CVP was 0.846 (0.757-0.935), CRRT duration was 0.746 (0.595-0.897), net ultrafiltration volume was 0.926 (0.845-1.000), and ultrafiltration rate was 0.794 (0.620-0.969), respectively]. Furthermore, according to the cut-off point of ultrafiltration rate, the patients were divided into ≥99.50 mL/h group and < 99.50 mL/h group. There were statistical differences in BNP, CVP and net ultrafiltration volume between the two groups. ROC curve analysis showed that BNP and CVP had good prediction value for hypotension when ultrafiltration rate exceeds ≥ 99.50 mL/h. The AUC (95% CI) of BNP and CVP were 0.716 (0.604-0.828) and 0.749 (0.651-0.847), the sensitivity was 70.0%, 78.8%, and the specificity was 35.5%, 45.2%, respectively. Conclusion:The values of age, BNP and CVP are more useful than other parameters in predicting CRRT-related hypotension before the start.
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Objective: To construct the brain tissue damage models of newborn rats induced by hyperoxia, and to explore the effect of hyperoxia on the natriuretic peptide receptor-cyclic guanosine monophosphate (NRP-cGMP) signaling pathway in brain tissue of the newborn rats. Methods: A total of 60 newly born Wistar rats were divided into control group and hyperoxia model group, and there were 30 rats in each group. At the 1st, 3rd and 7th days after hyperoxia exposure, the brain tissues of 10 rats randomly selected from each group were gotten, and the body weights of the rats in two groups were detected. HE staining was used to observe the morphology of brain tissue of the rats in two groups; the ultrastructures of brain tissue of the rats in two groups were observed under transmission electron microscope. Western blotting method was used to detect the expression levels of natriuretic peptide receptor A (NPR-A) and natriuretic peptide receptor B (NPR-B) in brain tissue of the rats in two groups. ELISA method was used to determine the levels of cGMP in brain tissue of the rats in two groups. Results: The body weight of the rats in hyperoxia model group was significantly lower than that in control group at the 1st, 3rd and 7th days after hyperoxia exposure (P<0. 05). The HE staining results showed that at the 3rd day after hyperoxia exposure, the volume of the hippocampal pyramidal cells of the rats in hyperoxia model group was reduced, and the arrangement was sparse; at the 7th day after hyperoxia exposure, the hippocampal cells showed deep staining and shrinkage, and the cell boundaries were not clear. Under electron microscope, at the 3rd day after hyperoxia exposure, the mitochondrial double membrane structure of the rats in hyperoxia model group was destroyed, a few crest disappeared, and the number of mitochondria and synapses was decreased; the above damage conditions were aggravated at the 7th day after birth. The Western blotting results showed that at the 1st, 3rd and 7th days after hyperoxia exposure, the expression level of NPR-A in brain tissue of the rats in hyperoxia model group was higher than that in control group (P<0. 05). But only at the 1st day after hyperoxia exposure, the expression level of NPR-B in brain tissue of the rats in hyperoxia model group was higher than that in control group (P<0. 05). The ELASA results showed that at the 1st, 3rd and 7th days after hyperoxia exposure, the level of cGMP in brain tissue of the rats in hyperoxia model group was higher than that in control group (P
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The ALIPORC full-text database is targeted at a specific full-text database of acupuncture literature in the Republic of China. Starting in 2015, till now, the database has been getting completed, focusing on books relevant with acupuncture, articles and advertising documents, accomplished or published in the Republic of China. The construction of this database aims to achieve the source sharing of acupuncture medical literature in the Republic of China through the retrieval approaches to diversity and accurate content presentation, contributes to the exchange of scholars, reduces the paper damage caused by paging and simplify the retrieval of the rare literature. The writers have made the explanation of the database in light of sources, characteristics and current situation of construction; and have discussed on improving the efficiency and integrity of the database and deepening the development of acupuncture literature in the Republic of China.
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The materials of 48 acupuncture schools in the Republic of China were collected. Their features were analyzed in terms of school running, students enrolling, curriculum setting and course contents, etc. The acupuncture schools at that time were established by private organizations, and opened up correspondence education. These schools mainly relied on advertisements to enroll students, and partially got government supports. The students were on different levels. They emphasized systematic acupuncture curriculum and clinical practice. Most schools absorbed western contents into courses, while few schools taught traditional acupuncture theories. The education model of acupuncture school during the Republic of China was continued after the foundation of the nation, especially laying the foundation for the establishment of department of acupuncture.
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The authors collected 25 Japanese acupuncture-moxibustion works of Chinese translation version in modern times (1912-1960) and investigated them from 3 aspects, named the study on the mechanisms of acupuncture and moxibustion, the explanation of basic theory and clinical treatment with acupuncture and moxibustion. Generally speaking, Japanese acupuncture-moxibustion works of Chinese translation version explained the mechanisms of acupuncture and moxibustion in terms of the theory of western medicine rather than traditional one. It proposed the study on the phenomenon of meridian and collateral, which absorbed the anatomic knowledge of western medicine in the discussion on meridians, collaterals and acupoints; introduced diagnostic methods and techniques of acupuncture and moxibustion and adopted the classification of western medicine system and the diseases in western medicine to discuss the treatment with acupuncture and moxibustion. All of these reflect the academic characteristics of acupuncture and moxibustion in Japan at those times and the position of Chinese scholars, by which the Japanese medical works were introduced for the academic innovation.
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Sixty-seven textbooks in the Republic of China have been collected and divided into three stages according to their editing modes, named the early stage (1912-1927), the middle stage (1928-1939) and the late stage (1940-1949). The traditional teaching material of acupuncture was predominated at the early stage in the textbook compilation; meanwhile the editing mode was simple, and the content of it focuses on meridians, collaterals and acupoints and the modern scientific theories have been preliminarily introduced. The textbooks at the middle stage were edited as two modes, "western medicine+acupuncture" and "general introduction→meridian points→manipulation (techniques of acupuncture and moxibustion)→treatment". The knowledge in anatomy, physiology and pathology of western medicine has been involved in content, giving the great consideration to the clinical practicability. However, a part of textbooks still followed the traditional theory of acupuncture at the middle stage. At the late stage, the textbooks were edited align with "acupuncture science, moxibustion science, meridian point science and treatment science"; or in supplementation of the "diagnosis" on the base of "general introduction→ meridian points→techniques of acupuncture→treatment", or edited as "general introduction→points→treatment". The compilation of the textbooks at this stage not only followed but also improved the integration of western and Chinese medicine as that at the middle stage, which turned to be more scientific. Additionally, in the teaching content, the acupoint was much more considerable as compared with pulse and the section of diagnosis has been involved. As a result, a framework of acupuncture discipline has been established preliminarily by taking acupuncture technique, moxibustion technique, acupoints and treatment as the core. The development of the editing mode and content of textbooks played a great impact on the unified compilation of the acupuncture textbooks after the foundation of China.
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There are two clues in academic inheritance of acupuncture, including theoretical inheritance and empirical inheritance. Up to now, the mainstream of acupuncture theory has not been in conformity with empirical clinic, and could not explain new clinical techniques. The existing acupuncture theories are in need of strict re-examination, and new academic achievements shall be carefully absorbed. The literature review, concepts research and academic history study are considered as key pathways of acupuncture theory research.
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Acupuncture scientization was a consensus of most of acupuncture scholars who had long-term perspectives in the 20th century, among them Ms. ZHULian was the important one. Ms. ZHU Lian built a systemic new acupuncture" academic structure in practice and theory aspects. At the same time, as the main architect of Institute of Acupuncture-moxibustion of China Academy of Traditional Chinese Medicine, Ms. ZHU Lian was the first one who began to carry out the acupuncture clinical trail and laboratory experiment in modern way, which meant "acupuncture therapy" was transformed into "acupuncture science" by Ms. ZHULian's endeavor.
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Humans , Acupuncture , Education , History , Reference Standards , Acupuncture Therapy , History , Methods , Reference Standards , China , History, 20th Century , History, 21st Century , Science , HistoryABSTRACT
The acupuncture medical literature during the Republic of China is divided into four categories, including theoretical literature, acupuncture channels and acupoints drawing literature, translations, and teaching materials and medical cases. It is found that the theoretical literature focuses on inheriting the traditional theories as well as combining traditional Chinese and Western medicine. The drawings are becoming more and more precise, and in these drawing works anatomy begins to appear at that time. Translations are the achievements of communication between TCM and Western medicine, which promote the scientization of acupuncture greatly. Teaching materials are also influenced by Western medicine, presenting a rough frame of modern acupuncture disciplinary system. As important clinic data, medical cases have great clinical value. Overall, acupuncture medical literature during the Republic of China is widely published, which is influenced greatly by the Western medicine and presents a significant tendency of scientization.
Subject(s)
Humans , Acupuncture Points , Acupuncture Therapy , History , Books , History , China , History, 20th Century , TranslationsABSTRACT
Objective To investigate the relationship between the methylation of RET (proto-oncogene, RET) and Hirschsprung disease (HD), and understand its significance in the development of intestinal wall ganglion cells. Methods Twenty-one surgical removal specimens, which were all dilation segment of HD in Tianjin Children’s Hospital, were used as experimental group, and 5 samples of non-HD normal colon tissues were used as control group. The bisulfite sequencing (BSP)-direct detecting method was used to detect RET CpG island methylation status. The expression of RET protein was detected by immunohistochemistry in experimental group and control group. Results In the experimental group 12 cases (57.14%) were found methylation, but no methylation was found in control group. The average optical density of methylated RET protein was 0.201±0.015 in 12 cases. The average optical density of un-methylated RET protein was 0.364±0.023 in 9 cases (P<0.05). Conclusion RET CpG island methylation reduced protein expression levels of RET. The corollary RET gene methylation may influence the expression levels of RET protein, thereby affecting the ganglion cell development, and thus participating in the occurrence of HD.
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Objective To investigate the value of clinical parameters in predicting the initiation of renal replacement therapy(RRT) in acute kidney injury (AKI) patients with cardiorenal syndrome (CRS).Methods A total of 75 AKI patients hospitalized with CRS were enrolled.All patients received pharmacologic therapy on the beginning 3 days.The patients whose heart function improved were divided into control group (n=39),and the patients whose heart function worsened were divided into RRT group (n=36).Clinical and laboratory data on the first day and the fourth day were collected and analyzed.The factors on the first day were labeled asⅠ ,and those on the fourth day were labeled asⅡ. The ratio of some parameters calculated were labeled asⅡ/Ⅰ .Area under curve (AUC) of receiver operating characteristic curve (ROC) of these factors was used to evaluate the sensitivity and specificity in predicting the initiation of RRT.Results The patients in RRT group had significantly higher levels of BNP-Ⅱ,BNP Ⅱ / Ⅰ and creatinine Ⅱ / Ⅰ (P ＜ 0.01),and lower levels of 24 hours urine volume-Ⅰ and 24 hours urine volume-Ⅱ (P ＜ 0.01).From ROC curve analysis,the AUC of 24 hours urine volume-Ⅰ,24 hours urine volume-Ⅱ,creatinine Ⅱ / Ⅰ,BNP-Ⅱ levels and BNP Ⅱ/Ⅰ to predict RRT were 0.736,0.875,0.747,0.779 and 0.894 respectively.When the cutoff values of 24 hours urine volume-Ⅰ,24 hours urine volume-Ⅱ,BNP-Ⅱ levels,BNP Ⅱ / Ⅰ and creatinine Ⅱ / Ⅰ were 905 ml (sensitivity 75％,specificity 94.9％),1450 ml (sensitivity 75％,specificity 100％),3360 ng/L (sensitivity 72.2％,specificity 100％),1.37 (sensitivity 75％,specificity 100％) and 1.25 (sensitivity 72.2％,specificity 94.4％) respectively,the value of the parameters to predict RRT was high.Conclusions The 24 hours urine volume,BNP levels after treatment and the dynamic changes of BNP levels and creatinine levels can be used as predictors of the initiation of RRT in the AKI patients with CRS.
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Objective To report the experiertce of management of complicated renal stones by percu taneous nephrolithotripsy (PCNL) with pneumatic and ultrasonic power by ultrasound guidance. MethodsThree hundred and eighty two cases(218 males,164 females,4 74 years) who underwent PCNL by u sing the third generation Swiss LithoClast Master for kidney stones from 2004 to 2007 were retrospectivelyreviewed. Clinical data including operation time,stone free rate and complications were analyzed. ResultsPhaseⅠlithotripsy was performed in 397 sides and delayed phaseⅡlithotripsy in 8 sides. Twenty three casesunderwent simultaneous bilateral PCNL. The operation time ranged from 70 to 190 min,average time was(93±11)min. Nine cases needed blood transfusion. Severe complications did not occur during operations.Stone free rate was 91.8% (372/405). Residual stone fragment was found in 33 cases after delayed phase Ⅱlithotripsy and 14 cases received adjuvant extracorporeal shock wave lithotripsy. One hundred and forty sixcases were followed up for 3 to 24 months and showed no recurrence. Conclusion PCNL with pneumaticand ultrasonic power could be an efficient treatment for complicated kidney stones.