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The gut microbiota and its metabolites play a critical role on health maintenance, because they are involved in the absorption and metabolism of nutrients in the human bodies. This is also similar to traditional Chinese medicine (TCM) view that the ascending and descending of Qi movement affects Yin-Yang, Qi-blood, pneuma and body fluid, viscera and meridians of our bodies. More and more studies have demonstrated that gut microbiota is closely related to the development and progression of diabetes and its complications. Gut microbiota disorder could affect host metabolic signaling pathways, thereby promoting the formation and development of diabetes. The smooth ascending and descending of Qi movement is the basic form of maintaining host metabolic homeostasis, whose dysfunction however can lead to internal environment disturbance. Based on the theory of ascending and descending of Qi movement, this paper focuses on the pathogenesis of imbalanced intestinal flora in the process of the induction of diabetes mellitus from a dynamic perspective. It is assumed that the imbalance of Qi ascending and descending may act as a trigger for such symptoms as lung Qi impairment, spleen deficiency to dissipating essence, liver Qi stagnation and kidney Yang deficiency. Under this circumstance, gut microbiota will be out of balance, which will further lead to the nutrient substance metabolic disturbance in the body, and thus induce diabetes. Thus, it is significant to explore the regulatory mechanism of gut microbiota and its metabolites on diabetes based on the theory of ascending and descending of Qi movement, so as to reveal the scientific connotation of TCM in regulating substance metabolism homeostasis in the body.
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As a direction of accounting development in the new period,management accounting could play an important role in public hospital management.At present,the public hospital had not yet established a perfect organizational structure and management model of management accounting,which lacked human resources management in the management accounting.The information construction lacked united planning resulted that management accounting was not effectively introduced into the links of hospital planning,strategy,control and evaluation.Through summarizing hospital value innovation mode,it promoted the integration of business and finance,established depended management accounting department,optimized the internal application environment of management accounting in public hospitals,promoted the management accounting construction of public hospitals,guarantee the value preservation of national assets and promoted the public welfare.
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Objective To provide reliable reference for improving teaching methods of case discus-sion, the teaching effectiveness evaluation on classroom-site segmented discussions of a patient case was completed in internal environment system. Methods The questionnaire survey was conducted among 250 clinic students of 8-year program and of 5-year program to investigate the teaching effectiveness following implementation of the teaching plan called"classroom-site segmented study of patient case debate competi-tion seminars". The contents of questionnaire survey included: the students' view on characteristics and advantages of this teaching plan and the reasons for favoring and supporting the plan. Investigation was conducted using an anonymous questionnaire. A total of 250 questionnaires were distributed and 247 valid questionnaires retrieved. Data collection and analysis were performed by using Excel and SPSS 17.0 statistical software, percentage of each observing parameter was calculated. Results ①The students' view on ad-vantages of the plan included following: reducing students' study burden by 78.5％ (194/247), increasing the students' engagement in class activities by 85.4％(211/247), improving teaching quality in class discus-sion by 80.5％ (198/246), enhancing team spirit among students by 78.5％ (194/246), expanding students' thinking and exploring space by 84.5％ (207/245), and similarity of this teaching plan to clinical diagnosis and treatment process reached to 84.0％(197/235). ②The students' reasons for favoring and supporting this plan included: reducing students' study burden by 83.4％ (206/247), improving teaching quality in class discussion by 72.4％(179/247), and training students' ability to search clinical information by 82.4％ (203/247). Conclusion Implementation of the teaching plan, "classroom-site segmented study of patient case debate competition seminars", in internal environment system has reduced students' study burden, improved teaching quality, and effectively trained students' clinic thinking, which is widely welcomed by students, therefore providing a positive valuable reference to other discussion class.
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The essential internal environment in human being involves water, electrolyte, and acid-base balance, which is the basis of balance and stability of internal environment in other systems. For burn patients, the balance of internal environment, referring to metabolism, nutrition, inflammatory response, and immunoreaction, is one of the most important aspects in burn disease. This paper aims to briefly elaborate the balance of internal environment after burn, with the purpose to promote the basic and clinical research in this field.
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Introducción: las alteraciones del medio interno conducen a una alta morbilidad y mortalidad, en pacientes portadores de oclusión intestinal, consideradas como una complicación grave si no se realiza una adecuada evaluación y corrección de estas. Objetivo: caracterizar el comportamiento de las principales alteraciones del medio interno relacionado con el balance ácido-básico en pacientes operados por oclusión intestinal mecánica. Métodos: se realizó un estudio observacional, descriptivo de serie de casos, de todos los pacientes operados por oclusión intestinal desde el 1ro de enero del año 2009 al 31 de diciembre del año 2012 en el Hospital Saturnino Lora Torres". El universo fue constituido por un total de 257 pacientes. Se seleccionó una muestra de 207. Fue calculada la prueba chi cuadrado de independencia para identificar asociación estadísticamente significativa entre variables seleccionadas. Resultados: existió predominio del sexo masculino así como los mayores de 61 años. Las bridas fueron la causa más frecuente de la oclusión. La etiología tumoral tuvo el resultado más significativo vinculado con la mayoría de las alteraciones del equilibrio ácido básico. El tiempo de evolución de los síntomas fue directamente proporcional a la aparición de los trastornos identificados. La mortalidad de la serie estuvo dominada por pacientes con diagnóstico de oclusión por neoplasia. Se identificó una alta incidencia de alteraciones hemogasométricas en pacientes que fallecieron. Conclusiones: la presencia de alteraciones ácido.básicas entorpece el curso y pronóstico de los pacientes con oclusión intestinal mecánica(AU)
Introduction: alterations of the internal environment leading to high morbidity and mortality in patients who suffer intestinal obstruction are considered serious complication if they are not adequately evaluated and corrected. Objective: to characterize the behavior of the main alterations in the internal environment related to the acid-base balance in patients operated on for intestinal mechanical obstruction. Methods: observational and descriptive case series study in patients operated on for intestinal obstruction from January 1st 2009 to December 31st 2012 in Saturnino Lora Torres hospital. The universe of study was made up of 257 patients, being the final sample 207 individuals. The chi-square statistic tests of independence were calculated to identify statistically significant association among the selected variables. Results: males as well as over 61 years-old patients prevailed. The intestinal adhesions were the most common cause of obstruction. The tumor etiology was the most significant outcome associated with most of the acid-base alterations. The length of progression of symptoms was directly proportional to the occurrence of identified disorders. The mortality of the series mainly occurred in patients with cancer occlusion due to high incidence of hemogasometric alterations present in deceased patients. Conclusions: the presence of acid-base alterations makes the course and prognosis of patients with mechanical intestinal obstruction gloomy(AU)
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Humans , Male , Female , Acid-Base Imbalance , Epidemiology, Descriptive , Intestinal Obstruction/pathology , Intestinal Obstruction/surgery , Observational StudyABSTRACT
[Objective] To investigate the environmental pollution status and infectious diseases in kindergartens and nurseries in 2012 in Baoshan District . [ Methods] The questionaire was used in com-bination with data from monitoring of the disinfection effect of environment , monitoring analysis of routine infectious disease and others . [ Results] The overall pass rate was 97.91% for environmental disinfec-tion in kindergartens and nurseries , and it was higher in public kindergartens and nurseries than in private ones.The conventional infectious disease in kindergartens and nurseries was mainly hane-foot-and-mouth disease (HFMD), whose incidence was higher in private kindergartens and nurseries than in public ones . And in terms of regional distribution , the incidence of HFMD was higher in streets and towns with more in-floating population than those with less .And the pass rate for the disinfection effect on the kindergartens nurseries and the incidence rate of HFMD were negatively correlated . [ Conclusion] Kindergartens and nurseries in our district should strengthen the complete configuration of hardware and software , establish standardized system of disinfection and isolation , and develop daily disinfection system , so as to reduce in-fectious disease .
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@#BACKGROUND: This study aimed to observe the effect of hemoperfusion (HP) cartridge on different internal environment indicators at different time points in patients with acute blood poisoning and to find alternative indicators for the detection of blood poisoning. METHODS: The levels of internal environment indicators (blood pH, PvCO2, PvO2, blood lactate, potassium, free calcium, bicarbonate, and blood glucose) before and after HP treatment were recorded for patients with acute poisoning at time points of 30 minutes and 120 minutes. After calculating the difference value δ, the statistical software was used to analyze the statistical difference of the influencea-v caused by HP cartridge at two time points. According to the formula, adsorption rate %= —— ×100, thea adsorption rate of each indicator was calculated respectively. RESULTS: The difference of indicators at different time points in inlet and outlet such as blood glucose, free-calcium, and lactate was statistically significant (P<0.05), but the difference in indicators such as pH, PvCO2, PvO2, potassium, sodium, and bicarbonate was not statistical y significant (P>0.05). CONCLUSION: During HP treatment, the indicators of blood glucose, free-calcium and lactate were significantly affected by HP cartridge, and the effect varies with time.
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Objective To investigate intraoperative changes of internal environment in infants undergoing living related liver transplantation (LRLT), and to explore appropriate treatment measures. Methods Twenty-five infants undergoing LRLT were retrospectively studied, including 12 males, 13 females, with age of (3. 4 ± 4. 6) months (ranging from 2-11 months), weight of (6. 8 ±1. 3) kg (ranging from 3. 1-8. 8 kg). Arterial blood samples were collected before the operation, at preanhepatic phase (5 min before cross-clamping), at anhepatic phase (5 min before opening inferior vena cava), 5 and 30 min after the opening inferior yena cava respectively, and at the completion of the surgery the pH value, bases excess (BE), the levels of sodium, potassium, calcium, glucose and lactate were determined. Results There were large fluctuations to the internal environment during operation. Compared with the preoperative values, the intraoperative concentrations of Na+ had no significant change; The pH value and blood level of K+ had no significant change at pre-anhepatic phase and anhepatic phase (P＞0. 05), the pH value was decreased at anhepatic phase Ⅰ (P＜0. 01 )and returned to the preoperative level at the end of the operation, and the blood level of K+ decreased at anhepatic phase and lasted till the completion of the surgery (P＜0. 01 ). The blood level of Ca2+ was decreased at pre-anhepatic phase and neohepatic phaseⅡ (P＜0. 05), and recovered at the end of the operation. Blood glucose concentration was increased significantly at preanhepatic phase to neohepatic Ⅱ, and still kept at the higher level until the end of operation. The lactate concentrations were increased significantly at pre-an.hepatic phase to neohepatic Ⅱ (P＜0. 01 ), and recovered at the end of operation. The BE was decreased at pre-anhepatic phase to neohepatic Ⅱ (P＜0. 05), and recovered at the end of the operation. Conclusion There are significant disruptions which are unique and inter-related to the internal environment parameters in infants during the operation of LRLT.Monitoring and accurate intraoperative managements for different physiological status at different phases are critical for the success of LRLT in infants.
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Objective To discuss the influence of blood exchange transfusions on hemato- microenvironment of neonates with hyperbilirubinemian.Methods Blood exchange transfusion was performed in 35 neonates.Mean transfusion volume was (136.9±27.4) ml/kg.The speed of blood exchange transfusion was 92 ml/(kg·h).Blood bilirubin,blood electrolyte,blood routine and blood sugar levels were measured before,during and after the transfusion.Results Serum total bilirubin (TB) decreased by 53.78% after blood exchange,but there was no change in Na~+,Cl~-,and blood sugar (P＞0.05),and K~+ was remarkably decreased from (4.45±2.40)mmol/L to (3.87±0.52)mmol/L (t=21.979,P＜0.05).TB,Hb,PLT,WBC,Ca~(2+) were decreased[TB from(511.52±80.21) μmol/L to (236.41±66.54) μmol/L;Hb from (145.20±11.70) g/L to (128.66±2.54) g/L;PLT from (207.84±70.67)×10~9/L to (134.86±48.61)×10~9/L;WBC from (16.90±10.56)×10~9/L to (8.94±7.44)×10~9/L,and Ca~(2+) from (1.26±0.32) mmol/L to (0.99±0.22) mmol/L,P＜0.05 or ＜0.01].Conclusions Blood exchange transfusion can not influence Na~+,Cl~-,and blood sugar,but has remarkable effect on total bilirubin,Ca~(2+),Hb,K~+,PLT,and WBC.
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Clinical practice has proved that regulating activities ofqi and recovering function ofthe liver in governing conveyance and dispersion, can make the chronic kidney disease(CKD) patients' symptoms improved actually.In this paper, we explore the ‘treatment ofchronic kidney disease through the liver' from the aspects ofanalyzing the relationship ofthe liver wood and kidney water's physiology and pathology, the theoretical origin ofthe treatment ofkidney disease through the liver, the liver and multi-system ofmodern medicine and so on.‘Treatment ofchronic kidney disease through the liver' is to apply regulating activites ofqi throughout the whole treatment course.It can help the liver restore the balance ofvarious systems steady state, the internal environment stability, so as to protecting the kidney function.It belongs to harmonizing therapy, the clinical specific prescription is Xiaochaihu Tang
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Objective To investigate the effect of somatostatin on the internal environment in the patients with intestinal obstruction. Methods 226 patients with acute intestinal obstruction were randomiy divided into A and B groups. In group A, the patients received routine therapy, and in group B the patients received routine therapy plus somatostatin. The clinical, laboratory and immunological indices in the both groups were detected. Results The clinical, laboratory and immunological indices of patients in group B were obviously better than those of patients in group A(P