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Objective: To explore the efficacy and safety of endoscopic diaphragm incision in pediatric congenital duodenal diaphragm. Methods: Eight children with duodenal diaphragm treated by endoscopic diaphragm incision in the Department of Gastroenterology of Guangzhou Women and Children's Medical Center from October 2019 to May 2022 were enrolled in this study. Their clinical data including general conditions, clinical manifestations, laboratory and imaging examinations, endoscopic procedures and outcomes were retrospectively analyzed. Results: Among the 8 children, 4 were males and 4 females. The diagnosis was confirmed at the age of 6-20 months; the age of onset was 0-12 months and the course of disease was 6-18 months. The main clinical manifestations were recurrent non-biliary vomiting, abdominal distension and malnutrition. One case complicated with refractory hyponatremia was first diagnosed with atypical congenital adrenal hyperplasia in the endocrinology department. After treatment with hydrocortisone, the blood sodium returned to normal, but vomiting was recurrent. One patient underwent laparoscopic rhomboid duodenal anastomosis in another hospital but had recurred vomiting after the operation, who was diagnosed with double duodenal diaphragm under endoscope. No other malformations were found in all the 8 cases. The duodenal diaphragm was located in the descending part of the duodenum, and the duodenal papilla was located below the diaphragm in all the 8 cases. Three cases had the diaphragm dilated by balloon to explore the diaphragm opening range before diaphragm incision; the other 5 had diaphragm incision performed after probing the diaphragm opening with guide wire. All the 8 cases were successfully treated by endoscopic incision of duodenal diaphragm, with the operation time of 12-30 minutes. There were no complications such as intestinal perforation, active bleeding or duodenal papilla injury. At one month of follow-up, their weight increased by 0.4-1.5 kg, with an increase of 5%-20%. Within the postoperative follow-up period of 2-20 months, all the 8 children had duodenal obstruction relieved, without vomiting or abdominal distension, and all resumed normal feeding. Gastroscopy reviewed at 2-3 months after the operation in 3 cases found no deformation of the duodenal bulbar cavity, and the mucosa of the incision was smooth, with a duodenal diameter of 6-7 mm. Conclusion: Endoscopic diaphragm incision is safe, effective and less invasive in pediatric congenital duodenal diaphragm, with favorable clinical applicability.
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Male , Child , Female , Humans , Infant , Infant, Newborn , Retrospective Studies , Thorax , Endoscopy , Physical Examination , Adrenal Hyperplasia, CongenitalABSTRACT
Objective To develop a magnetic anastomosis device for infrahepatic inferior vena cava and verify its feasibility and safety in rat models. Methods According to the anatomical characteristics of rat inferior vena cava, a magnetic device suitable for end-to-end anastomosis of infrahepatic inferior vena cava was designed and manufactured. The device consisted of the inner and outer rings. The inner ring was a coated neodymium-iron-boron magnetic ring, and the outer ring was made of polyetheretherketone by 3D printing. Ten fine holes are evenly distributed on the outer ring, of which 5 fine holes were used to load the fine needles, and the other 5 fine holes were mutually connected with the fine needles of the contralateral anastomosis ring during anastomosis. The outer ring was uniformly loaded with fine needles and then bonded with the inner ring to form a magnetic anastomosis complex. Bilateral ends of vessels passed through the anastomosis ring and were fixed to the fine needles, and then end-to-end vascular anastomosis was performed by mutual attraction of two magnetic anastomosis rings. Twenty SD rats were selected and received end-to-end anastomosis of infrahepatic inferior vena cava with magnetic anastomosis device. The time of vascular occlusion, postoperative survival, postoperative anastomotic patency, gross observation and histological examination of anastomotic stoma were analyzed. Results All rats successfully completed end-to-end magnetic anastomosis of the infrahepatic inferior vena cava, and the time of vascular occlusion was 4~6 min. One rat died at 10 d after operation, and the other rats survived within postoperative 2 months. The patency rates of anastomotic stoma in surviving rats at postoperative 1 d, 3 d, 1 month and 2 months were 100%, 100%, 95% and 95%, respectively. At 2 months after operation, no obvious displacement and angulation of the anastomosis device were seen. No signs of corrosion and cracking of the anastomosis rings were observed. No evident hyperplasia and edema of surrounding tissues were noted. Bilateral ends of vessels were completely healed, and no obvious stenosis or thrombosis was found at the anastomotic stoma. Histological examination showed high continuity of bilateral vascular walls of anastomotic stoma, the inner surface of anastomotic stoma was covered by endothelial cells, and no thrombus or fibrous tissue was attached. Conclusions It is safe and feasible to utilize the self-designed magnetic anastomosis device to perform end-to-end magnetic anastomosis of infrahepatic inferior vena cava in rat models.
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OBJECTIVES@#To study the predictive factors for glucocorticoid therapy by analyzing the association between the clinical features and treatment regimens in children with eosinophilic gastroenteritis.@*METHODS@#A retrospective analysis was performed on the medical data of 182 children with eosinophilic gastroenteritis who were admitted to Guangzhou Women and Children's Medical Center from January 2012 to December 2020. According to whether glucocorticoids were used, these children were divided into a glucocorticoid treatment group and a control group. The two groups were compared in terms of age, history of allergy, clinical symptoms, laboratory examination results, endoscopic findings, and pathological results of gastrointestinal mucosa. A multivariate logistic regression analysis was performed for the results with statistical significance.@*RESULTS@#Of the 182 children, 36 (19.8%) received glucocorticoid therapy. The rates of hematochezia, anemia, and mucosal ulceration/luminal stenosis under endoscopy and the mucosal eosinophil infiltration count were significantly higher in the glucocorticoid treatment group than those in the control group (@*CONCLUSIONS@#Mucosal ulceration/luminal stenosis under endoscopy or a significant increase in the mucosal eosinophil infiltration count based on pathology suggests that glucocorticoid therapy can be considered in children with eosinophil gastroenteritis.
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Child , Female , Humans , Enteritis/drug therapy , Eosinophilia/drug therapy , Gastritis , Glucocorticoids/therapeutic use , Retrospective StudiesABSTRACT
Objective:To analyze the cancer incidence and mortality in Yixing City， Jiangsu Province in 2019. Methods:The cancer incidence and mortality in Yixing residents in 2019 were collected. Based on the data， the incidence and mortality rate， standardized incidence and mortality rate and age-specific incidence and mortality rate of cancer were calculated， and the incidence and death of major malignant tumors were also analyzed. Life table method was used to calculate life expectancy and life expectancy without cause of death. Results:The crude incidence of cancer in Yixing in 2019 was 308.61/105， the ASR China was 175.24/105， and the ASR World was 134.56/105. The crude mortality of cancer was 258.78/105， the ASR China was 125.19/105， and the ASR World was 93.01/105. The cancer incidence rate and mortality rate in males were higher than those in females. The top 5 cancers in incidence were lung， gastric， colorectal， thyroid， and esophageal cancers. The top 5 cancer deaths were lung， gastric， liver， esophageal， and colorectal cancers. In 2019， the life expectancy of Yixing residents was 82.53 years old， and the life expectancy without cause of cancer death was 86.15 years old. The biggest loss of life expectancy in the population was caused by lung cancer， followed by gastric cancer and liver cancer. Conclusion:The mortality rate of malignant tumors in Yixing is at a high level. Cancer prevention and treatment should be focused on lung cancer， thyroid cancer and malignant tumors of the digestive tract.
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OBJECTIVE： To evaluate the DNA damage response of procarbazine hydrochloride （PCZ） and ethyl carbamate （EC） to different tissues in rats by performing alkaline comet assay， to validate the feasibility of alkaline comet assay of various tissues. METHODS： Totally 30 SD rats were randomly divided into 6 groups according to body weight， with 5 rats in each group， such as negative control group （hyperpure water）， PCZ 75 mg/kg group， PCZ 150 mg/kg group， EC 400 mg/kg group， EC 800 mg/kg group， positive control group （N-ethyl-N-nitrosourea 40 mg/kg）. Those rats were given relevant medicine intragasttrically for 4 d； clinical symptoms of rats were observed and body weight was recorded during experiment. Within 3 h after last medication， the rats were sacrificed； liver， renal and lung weight were weighed； liver， kidney， lung and peripheral blood lymphocytes were collected. The single cell suspension was prepared to perform alkaline comet assay. After lysis， unwind， electrophoresis and dying， tail DNA％ and tail distance of samples were analyzed by Komet 6.0 software. RESULTS： Compared with negative control group， body weight， liver and renal weight of rats were decreased significantly in PCZ 75 mg/kg group， PCZ 150 mg/kg group and positive control group 4 d after medication （P＜0.05 or P＜0.01）. Body weight of rats were decreased significantly in EC 800 mg/kg 4 d after medication （P＜0.05 or P＜0.01）； there was no statistical significance （P＞0.05）. Compared with negative control group， tail DNA％ and tail distance in liver， kidney and peripheral blood lymphocytes were increased significantly in PCZ 75 mg/kg group， PCZ 150 mg/kg group and positive control group （P＜0.05 or P＜0.01）； PCZ showed more significant effects on liver and lung. Tail DNA％ and tail distance of liver， kidney and peripheral blood lymphocytes were increased significantly in EC 800 mg/kg group （P＜0.05 or P＜0.01）， and tail DNA％ and tail distance of renal tissue was increased significantly in EC 400 mg/kg group （P＜0.05）. CONCLUSIONS： PCZ induced stronger DNA damage； liver and lung are the major genotoxicity target of PCZ. EC-induced DNA damage is relatively weak， and kidney is the most sensitive organ for EC-induced genotoxicity.
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Nutritional therapy is very important for critically ill children. Most children need to put nasogastric tube for enteral nutrition. Severe esophageal stricture, gastric compression, gastric retention and gastric outlet obstruction may require endoscopic catheterization; dysphagia caused by various reasons, or children who need long￣term catheterization for enteral nutrition,need percutaneous endoscopic gastrointesti￣nal stoma catheterization. Gastroscopy￣guided intubation is divided into nasal intubation of gastric tube,nasal intubation of jejunum tube and nasal intubation of three￣chamber gastrointestinal tube. Percutaneous endoscopic gastrointestinal stoma catheterization can be performed through gastrostomy,jejunostomy and duodenostomy. Choosing suitable catheterization method can help all kinds of critically ill children to establish enteral nutri￣tion pathway as soon as possible and promote recovery of illness.
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To explore the effect of icaritin on preventing the vascular calcification in mouse induced by vitamin D2. Methods: Fifty male C57BL mice were randomly assigned to a control group (n=10) and a model group (n=40). Mice in model group were treated with gradient-concentration of icaritin for 8 weeks. Then, they were consecutively treated with vitamin D2 for 4 days. Meanwhile, mice in negative control group were treated with the same dosage of PBS. At the end of the treatment, aortae were collected to examine the concentration of Ca, the area of calcification and the expression of α-smooth muscle actin (α-SMA) and Runx2. Results: Compared with the negative control group, the weight of mice and the concentration of Ca in the positive control (vitamin D2+0 mg/kg icaritin) group declined significantly (P<0.05) after injection of vitamin D2. Compared with the positive control group, the Ca concentration, the area of calcification, and the expression of Runx2 were significantly declined at the middle dosage of icaritin (vitamin D2+0.2 mg/kg icaritin) group (P<0.05). Conclusion: Icaritin could effectively prevent the vascular calcification in mice.
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Animals , Male , Mice , Aorta , Flavonoids , Mice, Inbred C57BL , Muscle, Smooth, Vascular , Vascular CalcificationABSTRACT
Extracellular vesicles (EVs), including apoptotic bodies, microvesicles and exosomes, play a crucial role in cell-to-cell communication. EVs derived from various cell types have the potential to deliver complex information to endothelial cells and to induce either pro- or anti-angiogenic signaling.
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Humans , Cell-Derived Microparticles , Endothelial Cells , Extracellular Vesicles , Neovascularization, PathologicABSTRACT
Objective To observe the effect of electroacupuncture at " Baihui"," Shenshu" and " Taixi" points on learning and memory,the expression of Aβ and insulin degrading enzyme(IDE) in the brain of SAMP8 mice.Methods Eight-month-old SAMR1 and SAMP8 mice were treated with electroacupuncture at " Baihui"," Shenshu" and "Taixi" points for eight consecutive weeks.The distribution and expression of Aβ and IDE in the brain prefrontal cortex of mouse were observed using immunohistochemistry and Western blot.Learning and memory function was assayed by Morris water maze(MWM).Results Compared with the normal control group,the brain prefrontal cortex of SAMP8 mice showed increased Aβ levels ((179.02± 15.11) ％),decreased IDE protein expression ((51.35 ± 14.94) ％).MWM showed the escape latency in SAMP8 mice was significantly longer than that in the control group (P＜0.05).Compared with the model group,Aβ levels in SAMP8 mice were markedly decreased in electroacupuncture group((119.72±9.21)％) and memantine-treated group ((116.84 ± 12.09) ％).IDE protein levels were increased by ((92.06 ± 8.05) ％) and ((83.84± 15.28) ％) after treatment with electroacupuncture and memantine relative to model group.MWM showed the escape latency was significantly shorter in SAMP8 mice treated with electroacupuncture and memantine than that in the model group(P＜0.05).Conclusion Electroacupuncture at " Baihui"," Shenshu" and "Taixi" points can inhibit Aβ levels,increase the expression of IDE and improve the learning and memory function of SAMP8 mice.
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Heat-clearing and detoxifying Chinese herbs (HDCHs) are mainly used to treat carbuncle, sore throat, erysipelas, gills, dysentery and other diseases induced by heat-toxicity. Inflammation is a defensive response to damaging factors in living organism with vascular system. In recent years, a large amount of experimental and clinical studies showed that HDCHs had good therapeutic effect on inflammation. This review analyzed the anti-inflammatory mechanism of 11 HDCHs by retrieving literature in past 5 years, including Lonicerae Japonicae Flos (Jinyinhua), Lonicerae Flos (Jinyinhua), Lonicerae Japonicae Caulis (Rendongteng), Forsythiae Fructus (Lianqiao), Rhizoma Coptidis（Huanglian）, Gardeniae Fructus (Zhizi), Andrographis Herba (Chuanxinlian), Taraxaci Herba (Pugongying), Scrophulariae Radix (Xuanshen), Pulsatillae Radix (Baitouweng), and Agrimoniae Herba (Xianhecao). The data showed that the regulatory effect of HDCHs on inflammation may be involved mainly in the nuclear factor-κB (NF-κB), mitogen-activated protein kinase (MAPK) or janus kinase-signal transducers and activators of transcription (JAK-STAT) pathway, with similarity of action links among these three. Based upon the analysis of literature, we proposed some promising directions in this research field, providing a reliable theoretical basis for both experimental researches and clinical practices of HDCHs.
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The mechanism for icaritin to improve postmenopausal osteoporosis (PMOP) has not been clarified. The aim of this study was to investigate the role of estrogen receptor α36 (ERα36) in the proliferation promotion and anti-apoptosis effects of icaritin on osteoblasts and the underlying mechanism of downstream signal transduction. The ERα36 knockdown human osteosarcoma MG63 cell model was constructed by transfection of shRNA vector. Cell proliferation was detected by CCK-8, the apoptosis was detected by flow cytometry, and the activation of ERK and AKT signaling pathways was detected by Western blot. The results showed that the effects of icaritin on the proliferation and apoptosis of MG63 cells were significantly decreased after ERα36 knockdown, and icaritin could up-regulate the levels of ERK and AKT phosphorylation in MG63 cells, which could be reduced by ERα36 knockdown. The effect of icaritin on the proliferation of MG63 cells was significantly decreased by pretreating the cells with U0126 (an ERK signaling pathway blocker) and LY294002 (an AKT signaling pathway blocker), respectively. Furthermore, anti-apoptotic effect of icaritin on MG63 cells was significantly decreased after the cells were pretreated with U0126, but not with LY294002. These results suggest that icaritin exerts proliferation promotion and anti-apoptosis effects on osteoblasts through ERα36 and its downstream ERK and AKT signaling pathways.
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To confirm the etiology of a dead case for a 6 year-old female Ailurus fulgens,one strain of the predominant bacteria from pathologic tissues(heart,liver,spleen,lung and other samples) of the dead Ailurus fulgens were examined and isolated.The isolate was named R1 and no other bacteria were isolated.The bacterial etiological examination(morphological characteristics,biochemical characteristics and 16S rDNA gene detection)of R1 showed that it was identifed as K.peneumoniae.Artificial infection to mice about R1 was also conducted in this study.R1 had strong pathogenicity to mice and the LD50 is 6.5 × 104 CFU/mL.Moreover,the clinical and pathological features of the dead mice were consistent with that of the Ailurus fulgens.To find effective therapeutic drugs of curing other Ailurus fulgens,antibiotic sensitivity test of R1 was conducted,and the results revealed that R1 was highly sensitive to cefotaxime et al,moderately sensitive to amikacin and resistant to penicillin.These data showed that K.peneumoniae was bacterial pathogen leading to death of the Ailurus fulgens and it had strong resistance to penicillins,macrolides and virginiamycin and it had broad drug resistance spectrum.However,R1 is sensitive to cephalosporins and aminoglycoside antibiotics.
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Objective To discuss the establishment of gastric ulcer liver depression syndrome rat model and the therapeutical effects of electroacupuncture. Methods As the result of Open-field experimental method, 60 SPF male SD rats were selected as experimental animals. After 7 days of adaptive feeding, 60 rats were randomly divided into blank group, model group, model control group, and electoracupuncture group, 15 rats in each group. Except for the blank group, the other three groups were stimulated by chronic unpredictable stimulation to establish rat depression model. Then model control group was once again stimulated by chronic unpredictable stimulation for 13 days;electoracupuncture group was treated at Gan Shu (BL18) and Liang Qiu (ST34) acupoints for 13 days. General state of rats, Open-field experimental results and gastric ulcer index were observed. BDNF was measured by RT-PCR. GAS content was measured by ELISA. Results After modeling for 21 days, except for the blank group, the other three groups appeared listlessness, limb weakness, and fur dry and lose luster, appetites reduced, etc. After modeling for 34 days, compared with model group, model control group had more severe general state than model group. After acupuncture treatment, the general state of acupuncture group was improved. The horizontal and vertical activity sore in model group decreased significantly compared with the blank group (P<0.01). Compared with the model group, the horizontal and vertical activity sore in model control group decreased significantly (P<0.05), and increased significantly in the electroacupuncture group (P<0.01). Ulcer index in the model group increased significantly compared with the blank group (P<0.01). Ulcer index in the model control group increased significantly compared with the model group (P<0.01). Ulcer index in electroacupuncture group decreased significantly (P<0.01). BDNF mRNA expression in hippocampus of model group decreased significantly compared with the blank group (P<0.01). Compared with model group, the BDNF mRNA expression in hippocampus of model control group decreased significantly (P<0.05). The BDNF mRNA expression in the electroacupuncture group increased significantly (P<0.01). The GAS content in the model group increased significantly compared with the blank group (P<0.01). Compared with the model group, the GAS content in the model control group increased significantly (P<0.05). The GAS content in the electroacupuncture group decreased significantly (P<0.05). Conclusion The establishment of depressive rat gastric ulcer model which combining disease and syndrome together proves the feasibility of this animal experimental model. Electroacupuncture for Gan Shu (BL18) and Liang Qiu (ST34) can improve the efficacy of this model.
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Objective To observe the effects of electroacupuncture at Ganshu (BL18) and Zusanli (ST36) on depression state and gastrointestinal motility and relevant protein expressions in brain of rats with stress-induced depressive functional dyspepsia. Methods Totally 48 Wistar rats were randomly divided into normal, model, electroacupuncture (EA) and sham-operation group, with 12 rats in each group. Depressive functional dyspepsia model was established by chronic unpredictable mild stress protocols. From day 15 to day 28, the EA group was given electroacupuncture at BL18 and ST36, and the sham-operation group was stimulated by electroacupuncture at 1/3 and 2/3 of the tail. Body weight test, open field test and sucrose preference test were measured on day 0, day 14 and day 28. After 14-day administration, gastric residual volume and intestinal propulsion rate of semisolid paste were detected. The expression of βCaMK inⅡ lateral habenulas and BDNF in hippocampus were measured by Western blot. Results Compared with the normal group, the weight, the sucrose preference rate, the behavior score, the small intestinal propulsion rate of semisolid paste and the expression of BDNF in hippocampus decreased significantly both in the model group and sham-operation group (P<0.01), and the gastric residual volume of semisolid paste and the expression of βCaMK inⅡ lateral habenulas increased significantly (P<0.01). Compared with the model group, the weight, the sucrose preference rate, the behavior score, the small intestinal propulsion rate of semisolid paste and the expression of BDNF in hippocampus increased significantly in EA group (P<0.01), and the gastric residual volume of semisolid paste and the expression of βCaMK inⅡ lateral habenulas decreased significantly (P<0.01). Compared with the sham-operation group, the expression of βCaMKⅡ in lateral habenulas decreased significantly, the expression of BDNF in hippocampus increased significantly in EA group (P<0.01). Conclusion Electroacupuncture at Ganshu (BL18) and Zusanli (ST36) can improve depression and gastrointestinal motility of rats with depressive functional dyspepsia, which may be related to the inhibition of βCaMK inⅡ lateral habenulas and the activation of BDNF in hippocampus dyspepsia.
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<p><b>OBJECTIVE</b>To analyze the efficacy of percutaneous endoscopic gastrostomy (PEG) in pediatric patients.</p><p><b>METHOD</b>From October 2011 to October 2014, children in the gastrointestinal ward of Guangzhou Women and Children's Medical Center received PEG or jejunal tube PEG(JET-PEG). The success rate, operation time were recorded. The changes of their weight, enteral nutrition calories and the incidence of pneumonia before and after the first 6 months of operation were compared. Follow-up was conducted until October 2014, the recent and long term complications, the length of indwelling time, the replacement or removal of the tube were recorded, the patients swallowing function or the primary disease's outcomes were observed.</p><p><b>RESULT</b>Of the 13 cases, 10 were male, 3 were female, their average age was 2 years (range 1.8 months-9 years). We performed PEG for 12 of the patients who had congenital craniofacial problems that led to feeding difficulties or recurrent cough and pneumonia (6/12), or neurological disorders (6/12) with inability to swallow, and in one case JET-PEG was performed, this child suffered from chronic intestinal pseudo-obstruction with vomiting and abdominal distension. The gastrostomy was successful in all the patients through one operation, the average operation time of PEG was (25 ± 3) minutes, JET-PEG was 60 minutes. One local skin infection was noted, no long-term complication occurred. In the first 6 months after operation, all the patients gained weight((5.5-30.5) kg postoperation vs. (3.0-30.0) kg preoperation), and 12 cases' enteral nutrition calories increased (from (209-502) to(272-543) kJ/(kg·d)), the incidence of pneumonia decreased in the children who had recurrent pneumonia before the operation (from (0-1.5) to (0-0.16) per month). Until October 2014, their average length of gastric tube indwelling time was 17.8 months (range 4-36 months). In 4 cases PEG tube was removed when they could eat completely independently, the other 9 needed enteral vein nutrition via PEG tube or jejunal tube, in 3 of them balloon type gastric fistula tube was applied. Two of the 13 cases who had cleft palate received stomatological operations when their weight grew to meet the standard.</p><p><b>CONCLUSION</b>PEG and JET-PEG are safe and effective method for enteric nutrition feeding in pediatrics, the technique causes minimal trauma and has rapid postoperative recovery, few complications, good aesthetic appearances and simple nursing, it can significantly improve their nutritional status and quality of life.</p>
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Child , Child, Preschool , Female , Humans , Infant , Male , Enteral Nutrition , Methods , Gastrostomy , Incidence , Nervous System Diseases , Therapeutics , Pneumonia , TherapeuticsABSTRACT
BACKGROUND: The quality of treatment for critically ill children varies widely at different hospitals. This study aimed to analyze the characteristics of mortality in a pediatric emergency department (PED) at a tertiary children's hospital in Guangzhou, China and to investigate the risk factors associated with the mortality. METHODS: The mortality of pediatric patients at the hospital from 2011 to 2013 was retrospectively analyzed using descriptive statistics. RESULTS: Altogether 466919 patients visited the PED during the period and 43925 of them were admitted for further observation. In 230 deaths, the ratio of boys to girls was 1.4:1, and their age ranged from 2 hours to 16 years (median, 5 months). The time from admission to death ranged from 0 to 216 hours (median, 1.5 hours). There were 92 (40％) patients who died within 24 hours after admission and 104 (45.2％) patients who died on arrival. The prominent causes of the deaths were respiratory diseases, neuromuscular disorders, cardiovascular diseases, and sepsis, most of which were ascribed to severe infection. Sixty-five deaths were associated with more than one concomitant problem. The top concomitant problems were congenital malformation, low gestational age, and severe birth asphyxia. CONCLUSIONS: In our center, 40％ of the patients in the PED died of fatal acute diseases, and pneumonia was the first leading cause of the deaths. Almost half of the deaths occurred on arrival and the rest were due to end-stage malignant diseases. This study emphasized the importance of prevention of birth deficits by reducing deaths in infants and children.
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Objective Through death analysis of critically ill children with interhospital transportation,to explore the cause of death and its influencing factors.Methods We collected the data of death cases within 24 hours who were one-way transported from primary hospital to the emergency department of Guangzhou Women and Children's Medical Center between July 2012 and May 2014.We analyzed the diseases type,physiopathologic status,and the treating measures in the process of transportation.Results There were total 1 122 cases,34 children died,the mortality was 3.0％,7 cases died before admission,27 cases died within 24 hours after admission.The first three types of diseases were respiratory system diseases(8/34,23.5％),nervous system diseases (7/34,20.6％) and accidental injury (6/34,17.6％).The physiopathologic status were analyzed according to physiological status and laboratory data at admission.Most of the children had a variety of physiopathologic status.Electrolyte disturbances were found in 22 cases(81.5 ％),metabolic acidosis and respiratory failure in 19 cases (70.4％).Most cases had intravenous channel (33/34,97 ％),intravenous infusion (32/34,94.1％)and electrocardiogram monitoring (30/34,88.2％),none of the cases received vasoactive agents in transportation.Conclusion Insufficient disease evaluation before the transportation of critically ill children,inadequate monitoring and treating measures on the way are important factors causing the death of children.
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Objective: To observe the effect of ivabradine (IVA) on atrial and ventricular monophasic action potential duration (MAPD) and its proarrhythmic action at presence of sea anemone toxin-II (ATX-II) in isolated rabbit heart modelin vitro. Methods: The perfusion of isolated heart from female New Zealand white rabbit was conducted by Langendorff method in vitro. Left atrial and left ventricular endo- , epi-cardial action potential were recorded when pacing with ifxed frequency of 350 ms (in correspondence with the heart rate of 171 times/min) to observe the effect of IVA alone and ATX-II (3 nmol/L) with IVA on MAPD90. In addition, to observe the action of IVA alone and ATX-II with IVA on proarrhythmia when IVA reducing the heart rate to autonomous cardiac rhythm as (156±10) times/min. Results: IVA at (3-10) μmol/L prolonged atrial and ventricular endo- , epi-cardial MAPD90 by (15.9 ± 2.0) ms, (31.5 ± 4.0) ms and (23.9 ± 3.0) ms (n=6,P<0.01), respectively. ATX-II at 3 nmol/L prolonged atrial and ventricular MAPD90 by (36.5 ± 5.0)ms and (19.9 ± 3.0) ms, (19.5 ± 4.0) ms (n=6,P<0.01) respectively. With ATX-II treatment, IVA at (6-10) μmol/L decreased atrial MAPD90 by (14.4 ± 4.0) ms (n=6,P<0.01), it induced atrial arrhythmia. With 3 nmol/L of ATX-II treated ventricle, IVA at (3-10) μmol/L obviously prolonged endo- and epi-cardial MAPD90 by (36.2 ± 7.0) ms and (27.5 ± 5.0) ms(n=6,P<0.01), respectively. IVA didn’t increase ventricular beat-to-beat variability and transmural dispersion of MAPD90 no matter with or without ATX-II treatment, no ventricular arrhythmia occurred. Conclusion: IVA prolongs both atrial and ventricular MAPD, with increased late sodium current, IVA may induce atrial arrhythmia but not ventricular arrhythmia in experimental rabbits in vitro.
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The heel vessel belongs to the eight extra meridians in human meridian system, which is closely related to the human motion function. Balance function plays an essential role in successful completion of activities in daily life, so the physiological function and pathology of heel vessel as well as human balance function are analyzed, and from the aspect of running course of heel vessel and syndrome, the correlation between heel vessel and human balance function is explored, and the application status of acupoints related to heel vessel for balance dysfunction is introduced. It is believed that heel vessel is closely related to human balance function, especially the motion regulation mechanisms of balance function, and it is hoped that new ideas and methods can be provided for acupuncture treatment for the balance function disorders.
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Humans , Acupuncture Points , Acupuncture Therapy , Meridians , Postural BalanceABSTRACT
<p><b>OBJECTIVE</b>To explore the analgesic effect and action mechanism of electroacupuncture (EA) on gastric ulcer rats with liver-depression syndrome.</p><p><b>METHODS</b>Through open-field experimental method, 45 qualified SPF-grade male SD rats were selected and divided into a blank group, a model group and an EA group according to random number table method, 15 rats in each group. The model of gastric ulcer rats with liver-depression syndrome was established in the model group and the EA group by using chronic unpredictable stimulation combined with acetic acid burning method. Rats in the blank group did not receive intervention. Rats in the model group were treated with fixation and immobilization for 13 days. Rats in the EA group were treated with EA at "Liangqiu" (ST 34) and "Ganshu" (BL 18); EA voltage was 2 V; disperse-dense wave was selected with 4 Hz of disperse wave and 15 Hz of dense wave, and the intensity of EA was according to the slight vibration of local skin and; muscles; the needles were retained for 20 min, once a day for consecutive 6 days; there was an interval of 1 day' and the treatment was given for 2 weeks. The general condition, open-field experimental result and gastric ulcer index were observed; the western blotting method was applied to measure the expression of vanilloid receptor subtype 1 (VR1) in hypothalamus and gastric antral mucosal, and ELISA method was applied to test the expression of 5-hydroxytryptamine (5-HT) and norepinephrine (NE) in hippocampus.</p><p><b>RESULTS</b>After model establishment, the general behavior condition in the model group was inferior to that in the blank group, which was obviously improved after EA. The range of motion in the model group was less than that in the blank group (P<0.01) while that in the EA group was higher than that in the model group (P<0.01). The ulcer inhibition rate was. 54.95%, and the ulcer index in the EA group was lower than that in the model group (P<0.01). Compared with; the blank group, the expression of VR1 in hypothalamus and gastric antral mucosal in the model group was increased (P<0.05); compared with the model group, the expression of VR1 in the EA group was reduced (P<0.05). Compared with the blank group, the expression of 5-HT an NE in hippocampus in the model group was significantly reduced (both P<0.01); compared with the model group, the expression of 5-HT and NE in the EA group was increased (both P<0.01).</p><p><b>CONCLUSION</b>EA at "Liangqiu" (ST 34) and "Ganshu" (BL 18) has certain analgesic effect in gastric ulcer rats with liver-depression syndrome, which is likely to be related with lowering the contents of VR1 in hypothalamus and gastric antral mucosal and increasing the content of 5-HT and NE in hippocampus.</p>