Mixed venous-arterial carbon dioxide difference combined with passive leg raising in guiding volume management for patients post off-pump coronary artery bypass grafting / 中华危重病急救医学

Objective To investigate whether mixed venous-arterial carbon dioxide difference (Pv-aCO2) combined with passive leg raising (PLR) could better guide volume management for patients post off-pump coronary artery bypass grafting (OPCABG).Methods Eighty patients experienced OPCABG, and admitted to Tianjin Chest Hospital from June 1st to October 1st in 2016 were enrolled. They were randomly divided into two groups: observation group given Pv-aCO2 combined with PLR directed therapy and control group given central venous pressure (CVP) directed therapy, 40 cases in each group. The difference in body temperature (T), heart rate (HR), mean arterial pressure (MAP), CVP, oxygenation index (PaO2/FiO2), mixed venous oxygen saturation (SvO2), Pv-aCO2, blood lactate (Lac), fluid intake, scores of the vasoactive agents at 6 hours post-operation, sequential organ failure assessment (SOFA) of 24 hours, mechanical ventilation time, the length of intensive care unit (ICU) stay, and hospitalization time were compared. The correlation between Pv-aCO2 and cardiac index (CI), Pv-aCO2 and Lac were analyzed by Spearman analysis in observation group.Results The T, HR, MAP, CVP, PaO2/FiO2, SvO2 and Lac at 6 hours post-operation were higher than those at admission in two groups, and Pv-aCO2 were significantly decreased. The SvO2 and fluid intake in observation group were higher than those in control group [SvO2: 0.671±0.068 vs. 0.634±0.052, fluid intake (mL): 454±151 vs. 304±106, bothP < 0.05], Pv-aCO2, Lac and scores of the vasoactive agents were lower than those in control group [Pv-aCO2 (mmHg, 1 mmHg = 0.133 kPa): 6.1±1.8 vs. 7.0±1.8, Lac (mmol/L): 1.7±0.5 vs. 2.8±0.6, scores of the vasoactive agents: 3.18±1.01 vs. 4.48±1.50, allP < 0.05], mechanical ventilation time and the length of ICU stay were less than those in the control group (hours: 16.52±6.41 vs. 21.96±9.00, 45.51±9.36 vs. 51.76±13.66, bothP< 0.05). There was no significant difference in SOFA, hospitalization time between the two groups. There was negative correlation with Pv-aCO2 and CI (r = -0.752,P < 0.01), and no correlation with Pv-aCO2 and Lac (r = -0.154,P = 0.171).Conclusion Pv-aCO2 combined with PLR can better guide volume management in the patients post OPCABG, reduce the usage of vasoactive agents and decrease the mechanical ventilation time and the length of ICU stay.

Investigation on patient satisfaction with single or bridge crown for repair of consecutive missing posterior teeth in the maxilla / 中国组织工程研究

BACKGROUND: Patient subjective satisfaction is of great significance for the clinical use of implant denture.OBJECTIVE: To investigate the patient satisfaction with single or bridge crown for repair of consecutive missing posterior teeth in the maxilla.METHODS: We selected 203 patients with consecutive missing of maxillary first and second molar teeth, who had received single (n=99) or bridge (n=104) crown for implant restoration 1 year ago. All patients were surveyed with a subjective satisfaction questionnaire and visual analogue scale.RESULTS AND CONCLUSION: There was no significant difference in sex and age (35-64 years) between the two groups. Food impaction ratio and crown off ratio were higher in the bridge crown group than the single crown group.Noticeably, most patients did not have the habit of using dental floss. The overall satisfaction scores were 88.96% in the single crown group and 85.32% in the bridge crown group, respectively. Four indexes with less than 80 scores in the two groups were that I dare to use the implant teeth to bite hard food, my implant teeth are easily cleaned, it takes me less time to clean my implant teeth than natural teeth, and I think the dental implant price is acceptable. Results from the analysis of variance showed that food impaction influenced chewing effect (P=0.047), made the use of dental floss difficult (P=0.031), made patients discomfort (P=0.038), and the use of dental floss could enhance the cleaning effect on dental implant (P=0.019), and largely reduced brushing bleeding (P=0.029). In conclusion, patients with missing maxillary posterior teeth can obtain higher satisfaction after single crown or bridge crown repair. However, food impaction and crown off become more serious after repair with bridge crown, while the repair with single crown exhibits better performance.

Features of preoperative contrast-enhanced ultrasound of breast cancer: relationship with the syndrome classification in traditional Chinese medicine / 南方医科大学学报

<p><b>OBJECTIVE</b>To analyze the relationship between the features of preoperative contrast-enhanced ultrasound and the differentiation of symptoms and signs for syndrome classification by traditional Chinese medicine (TCM).</p><p><b>METHODS</b>Eighty-two patients with malignant breast tumor were examined with contrast-enhanced ultrasound before the operation. The tumor diameter was greater than 2.0 cm in 48 cases and below 2.0 cm in 34 cases. According to the curative effect standard of TCM disorder, differentiation of symptoms and signs for classification of syndrome were performed, and the ultrasonic manifestations of different syndrome types were compared.</p><p><b>RESULTS</b>In patients with maximum tumor diameter < or = 2 cm, Chong and Ren disorder type and liver Qi stagnation type were prevalent. In those with tumor diameter of <2 cm, Zeyi liver Qi stagnation type and virtual drug junction were more common. The mass peak intensity, slope of increase, enhancement intensity index and time-intensity curve of ultrasound differed significant between different syndrome types (P<0.05).</p><p><b>CONCLUSION</b>The preoperative ultrasound features of breast cancer are associated with the syndrome types in TCM.</p>

Application of genetic algorithm in formulation optimization of microemulsion for transdermal delivery / 药学学报

Using naproxen as model drug, the formulation of microemulsion vehicle for transdermal delivery was optimized by genetic algorithm. The ranges of microemulsion composed of Tween 80, IPM, alcohol and water, were defined through construction of the pseudo-ternary phase diagrams. Systematic model microemulsions containing naproxen 1.12% were prepared by a three-factor, three-level center design method, and their diffusion studies via excised rabbit skin were performed. Using the quadratic regression model of steady-state permeation rate (Js) of naproxen as objective function, the consequence of center design experiment was optimized by genetic algorithm, and the formulation of microemulsion with highest permeation rate for naproxen was screened. The optimum formulation was composed of 21.41% Tween 80, 15.17% alcohol, 4.14% IPM, and 59.28% water, and the anticipated Js was 183.57 microg x cm(-2) x h(-1). The results of back substitution test showed the steady-state permeation rate of naproxen microemulsion prepared according to optimum formulation was 189.43 microg x cm(-2) x h(-1), which was higher than anticipated value. This result demonstrated optimizing formulation of microemulsion for transdermal delivery by genetic algorithm is feasible, reliable and reasonable.

Changes in endothelial cellular adhesion molecule mRNA expressions in the cerebral blood vessels of rats with prestroke condition caused by simulated cold wave / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the changes in the mRNA expression of endothelial cellular adhesion molecules in the cerebral blood vessels in rats with prestroke condition caused by simulated cold wave.</p><p><b>METHODS</b>Two-kidney two-clip renovascular hypertension was induced in 48 male SD rats, which were subsequently randomly assigned into cold wave exposure and non-exposed group (n=24). Each group was further divided into 4 sub-groups according to their systolic blood pressure, namely the sham-operated group with blood pressure (BP)<140 mmHg, mild hypertensive group with BP of 160-199 mmHg, moderate hypertensive group with BP of 200-219 mmHg, and severe hypertensive group with BP no less than 220 mmHg. Cold wave exposure was simulated by housing the rats in an artificial climate chamber with 3 cycles of 12 h light at 22 degrees celsius; and 12 h dark at 4 degrees celsius;. The non-exposed group was kept at 22 degrees celsius; throughout the experiment. After the exposure, the rats were sacrificed and the tissues of the frontal lobe were slice into 2.0-mm-thick coronal sections for real-time RT-PCR detection of vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1), and p-selectin mRNA expressions. The 5.0-microm-thick frozen sections from the bregma section underwent in situ hybridization of VCAM-1, ICAM-1, and p-selectin. The other sections were stained with HE to observe the infarct lesions, and the rats with cerebral infraction were excluded from the statistical analysis.</p><p><b>RESULTS</b>In rats with cold wave exposure-induced prestroke condition and BP <220 mmHg, VCAM-1, ICAM-1, and p-selectin mRNA expressions all increased compared with those in the non-exposed group. In rats with BP>or=220 mmHg and cold exposure, the expressions all decreased to some extent compared with those in the non-exposed treatment. In the non-exposed rats, a positive correlation of BP to VCAM-1, ICAM-1, and p-selectin mRNA expressions were noted, and this correlation was also found in cold-wave-exposed rats with BP <220 mmHg; VCAM-1, ICAM-1, and p-selectin mRNA expressions decreased dramatically in the exposed rats with BP >or=220 mmHg compared with those in rats with BP <220 mmHg.</p><p><b>CONCLUSION</b>Persistent and severe hypertension impairs the modulatory function of the cerebral vascular endothelia, which is a prerequisite for the stroke vulnerability. The modulatory function deteriorates as the BP further increases.</p>

Multi-center phase II clinical trial of humanized anti-epidermal factor receptor monoclonal antibody h-R3 combined with radiotherapy for locoregionally advanced nasopharyngeal carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safty of the humanized anti-epidermal factor receptor monoclonal antibody h-R3 in combination with radiotherapy for locoregionally advanced nasopharyngeal carcinoma.</p><p><b>METHODS</b>Totally, 137 patients from 7 medical center around China were randomly divided into combined therapy group or control group. There was no difference in Karnofsky performance score between two groups. All patients in both groups received radical conventionally fractionated radiotherapy to the total dose of D(T) 70-76 Gy. For the combined therapy group, h-R3 was added at a dose of 100 mg i.v. weekly for 8 weeks started at the beginning of radiotherapy.</p><p><b>RESULTS</b>Of the 137 eligilbe patients, 70 were in the combined therapy group treated by h-R3 plus radiotherapy and 67 in the control group by radiotherapy alone. The intent-to-treat (ITT) population consisted of 130 patients, while the per-protocol (PP) population was composed of 126 patients. The efficacy was assessed respectively at three point of time: the end of treatment, the 5th- and 17th-week after treatment. The complete response (CR) of the combined therapy group was significantly higher than that of the control group in both ITT and PP (ITT: 65.63%, 87.50%, 90.63% versus 27.27%, 42.42%, 51.52%; PP: 67.21%, 90.16%, 93.44% versus 27.69%, 43.08%, 52.31%; P < 0.05, respectively). The most common h-R3-related adverse reactions were fever (4.3%), hypotension (2.9%), nausea (1.4%), dizziness (2.9%) and rash (1.4%), which could be reversible if treated properly. Radiotherapy combined with 100 mg h-R3 i. v. weekly was tolerable and did not aggravate the side effects of radiation. The quality of life in the combined therapy group was comparable to that in the control group.</p><p><b>CONCLUSION</b>This phase 1 multicenter clinical trial shows that h-R3 in combination with radiotherapy is effective and well-tolerated for the treatment of locoregionally advanced nasopharyngeal carcinoma.</p>

Comparative study on clinical effect of postoperative arterial infusion chemotherapy and systemic chemotherapy in gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To compare the clinical effect of postoperative arterial infusion chemotherapy and systemic chemotherapy in gastric cancer.</p><p><b>METHODS</b>From July 1997 to July 2002, the patients undergoing radical gastric resection were randomly divided into two groups, and received systemic or arterial infusion chemotherapy three weeks after radical resection. Systemic chemotherapy was carried out for two courses with 5-fluorouracil (5-FU), pirarubicin (THP), and mitomycin (MMC) administered according to FAM program, while arterial infusion chemotherapy for four courses with the same anticancer drugs infused via the celiac artery. The outcomes were compared.</p><p><b>RESULTS</b>Systemic chemotherapy was carried out in 188 cases, and arterial infusion chemotherapy in 180 cases. There were no significant differences in sex, age, tumor location, histological type, TNM stage and surgical procedure between the two groups (P > 0.05). The 1, 3, 5 year survival rates were 87.2%, 53.7% and 43.1% in systemic chemotherapy, and 93.3%, 72.2% and 53.6% in arterial infusion chemotherapy respectively (P< 0.01).</p><p><b>CONCLUSION</b>The survival rate of the patients with arterial infusion chemotherapy is higher than that with systemic chemotherapy, which indicates that arterial infusion chemotherapy can remarkably improve the prognosis of the patients with gastric cancer.</p>

The Application of Designing Experiments from Scientific Research in Microbiology Courses / 微生物学通报

This paper discussed the application of designing experiments from scientific research in Micro-biology courses and its effects on the teachers and students. The problems of the application of designing experiments in Microbiology courses were analyzed. The practice of the teaching reform showed that it give great advantages for the undergraduates with the enhancement of their ability on theory application and sci-entific innovation. This teaching reform could be widely popularized.