Prognostic value of arterial blood lactate for patients with cardiogenic shock receiving extracorporeal membrane oxygenation / 中华胸心血管外科杂志

Objective@#To investigate the prognostic value of arterial blood lactate for patients with cardiogenic shock receiving extracorporeal membrane oxygenation(ECMO).@*Methods@#A retrospective analysis was conducted. Twenty-three patients diagnosed with cardiogenic shock receiving veno-arterial(V-A) ECMO admitted to department of Emergency Intensive Care Unit(EICU) of Beijing Luhe Hospital Affiliated to Capital Medical University from January 2017 to December 2018 were enrolled.@*Results@#There were 10 cases in the survival group and 13 cases in the death group. Compared with survival group, APACHE-Ⅱ score was higher, CRRT applied higher percentage, PH and oxygenation index was worse in the death group(P<0.05). The lactate of the death group was significantly higher than that of the survival group at initial time at EICU, 1 h before ECMO and 0h before ECMO(P<0.05). During the ECMO operation, lactate levels in the death group at 8 h and 12 h were significantly higher than those in the survival group(P<0.05). There was no statistically significant difference in lactate clearance rate between the two groups before and after ECMO operation in each observation period(P>0.05). On the 2nd day of ECMO operation, CRRT usage time was shorter and daily liquid balance was more negative in the survival group(P<0.05). APACHE-Ⅱscore, initial lactate at EICU, lactate at ECMO 8 h and lactate at ECMO 12 h had predictive value for 30-day death of patients. The area under ROC curve(AUC) of initial lactate at EICU was 0.845, and 95% confidence interval(95%CI)=0.653-1.000. The AUC of ECMO 8 h lactate was 0.836, 95%CI: 0.634-1.000. The AUC of ECMO 12 h lactate was 0.873, 95%CI: 0.697-1.000. The AUC of APACHE-Ⅱscore was 0.891, 95%CI: 0.717-1.000. The sensitivity and specificity of prognosis prediction were 72.7% and 100% when lactate was more than 7.3 mmol/L at the time of admission into EICU as the optimal critical value.@*Conclusion@#Arterial blood lactate could be used as an important marker for evaluating the prognosis of cardiogenic shock patients on ECMO. The value of lactate clearance rate may be affected by combined CRRT.

Patent information analysis of 77 medical and health institutions in Zhejiang Province / 中华医学科研管理杂志

Objective To grasp the general situation of patent application and authorization of 77 medical and health institutions in Zhejaing,to provide reference and basis for promoting the patent application and conversion.Methods Patent data were searched through Bai Teng net patent database,and SPSS 19.0 was used for statistical analysis.Results The total number of patent application showed a trend of generally rise.There were 1430 valid invention patents in total,among which 264 were invention patents and 1166 utility model patents.The total number of patens as well as invention patents were positive correlated to province GDP GDP and doctors per thousand population (r=0.824,0.812,0.784,0.771 respectively,P＜0.001).The rate of collaborative patent application was 6.28％,and there was a significant difference (α=0.05/3,P＜0.001) in the collaborative patent applications around Hangzhou,provincial and other cities medical and health institutions.Conclusions The total number of patents in 77 medical and health institutions in Zhejaing has reached a certain scale,and the number of patents increase with the economic development and the number of doctors per thousand population.The effective patents present in concentrating in regions,and the proportion of invention patents was low.

Prognostic value of arterial blood lactate for patients with cardiogenic shock receiving extracorporeal membrane oxy-genation / 中华胸心血管外科杂志

Objective To investigate the prognostic value of arterial blood lactate for patients with cardiogenic shock re-ceiving extracorporeal membrane oxygenation( ECMO) . Methods A retrospective analysis was conducted. Twenty-three pa-tients diagnosed with cardiogenic shock receiving veno-arterial( V-A) ECMO admitted to department of Emergency Intensive Care Unit( EICU) of Beijing Luhe Hospital Affiliated to Capital Medical University from January 2017 to December 2018 were enrolled. Results There were 10 cases in the survival group and 13 cases in the death group. Compared with survival group, APACHE-Ⅱ score was higher, CRRT applied higher percentage, PH and oxygenation index was worse in the death group (P<0. 05). The lactate of the death group was significantly higher than that of the survival group at initial time at EICU, 1 h before ECMO and 0h before ECMO(P<0. 05). During the ECMO operation, lactate levels in the death group at 8 h and 12 h were significantly higher than those in the survival group(P<0. 05). There was no statistically significant difference in lactate clearance rate between the two groups before and after ECMO operation in each observation period(P>0. 05). On the 2nd day of ECMO operation, CRRT usage time was shorter and daily liquid balance was more negative in the survival group(P<0. 05). APACHE-Ⅱscore, initial lactate at EICU, lactate at ECMO 8 h and lactate at ECMO 12 h had predictive value for 30-day death of patients. The area under ROC curve( AUC) of initial lactate at EICU was 0. 845, and 95％ confidence interval (95％CI) =0. 653-1. 000. The AUC of ECMO 8 h lactate was 0. 836, 95％CI:0. 634-1. 000. The AUC of ECMO 12 h lactate was 0. 873, 95％CI:0. 697-1. 000. The AUC of APACHE-Ⅱscore was 0. 891, 95％CI:0. 717-1. 000. The sensi-tivity and specificity of prognosis prediction were 72. 7％ and 100％ when lactate was more than 7. 3 mmol/L at the time of ad-mission into EICU as the optimal critical value. Conclusion Arterial blood lactate could be used as an important marker for e-valuating the prognosis of cardiogenic shock patients on ECMO. The value of lactate clearance rate may be affected by combined CRRT.

Low concentration contrast medium and low radiation dose for infants and young children abdominal CT scanning / 中国介入影像与治疗学

Objective To assess the feasibility of low concentration contrast medium (270 mgI/ml) and low radiation dose (100 kV) for enhanced CT scanning in infants and young children abdominal CT examination.Methods Ninety children with abdomen tumors or abdominal injuries who underwent contrast-enhanced CT examination were selected.The patients were divided into 3 groups (each n＝ 30):Group A with tube voltage of 120 kV for non-contrast enhanced and parenchymal phase scanning and iodixanol contrast-medium (320 mgI/ml);group B with tube voltage of 100 kV for non-contrast enhanced and parenchyrnal phase scanning and iodixanol contrast-medium (270 mgI/rnl);group C with tube voltage of 100 kV for non-contrast enhanced and parenchymal phase scanning and iodixanol contrast-medium (270 mgI/ml).The 4-point scale was used to evaluate the quality of parenchymal phase imaging.The standard difference (SD) of CT value in subcutaneous fat,SNR and CNR of liver parenchyma,splenic parenchyma,renal cortical,renal vein,and abdominal aorta were measured at parenchymal phase,and CT dose index of volume (CTDI,ol),dose length product (DLP) and effective dose (ED) were recorded.The data were statistically analyzed among 3 groups.Results There was no significant difference of SNR,CNR nor objective scores of liver parenchyma,splenic parenchyma,renal cortical,renal vein and abdominal aorta among 3 groups (all P＞0.05).The differences of CTDIvol,DLP and ED among 3 groups were statistically significant (all P＜0.01).The CTDIvol had no statistical difference between group B and group C (P ＝ 0.001,0.002),DLP (P ＝ 0.013,0.004) and ED (P ＝ 0.03,＜0.001) of group A had statistical difference with those of group B and C.Conclusion CNR of the abdominal image can be guaranteed using low concentration contrast medium (270 mgI/ml) combined with 100 kV tube voltage for CT scanning of infants and young children,therefore satisfying clinical diagnostic requirements.

Construction and application of the health appropriate technology database in Zhejiang Province / 中华医学科研管理杂志

Objective Analyzing the construction process and application of health appropriate technology database in Zhejiang province and proposing related considerations and recommendations for the database construction.Methods To design and construct the technology database system,and using excel software to calculate statistic data.Results Established a health appropriate technology database,which contains 826 technologies that can be selected and promoted by the demonstration bases in the whole province.Conclusions The establishment of the technology database increased the efficiency of health appropriate technology transformation at the provincial level,and also provided a reference for the national-wide generalizing of health appropriate technology.

Research on performance evaluation index system for the innovative medical devices transforming project in Zhejiang Province / 中华医学科研管理杂志

Objective Establish an overall performance evaluation index system for innovative medical devices transforming project,a major science and technology project in Zhejiang province.Methods The weight of indexes was calculated using Delphi method,analytic hierarchy process and weight of percentile method.Results A three-level performance evaluation index system was established.First level included 3 indexes,as condition index,process index and result index,with weight of 0.3401、0.4042 and 0.2557 respectively.Meanwhile,second level and third level included 13 and 38 indexes.Conclusions The index system provide a performance evaluation tool for the innovative medical devices transforming project.

Quality assurance system of the standardized residency training bases in Zhejiang province: establishment and implementations / 中华医院管理杂志

A study of the quality assurance system building made at the training bases in Zhejiang since 2011 found the following.Five management systems on training quality have been established, covering basic clinical conditions, training management, faculty management and training, training assessment,and training incentives.PDCA is called into play for continuous improvement and perfection to develop a training quality management system of local features and continuous improvement.

Application of lingual bonding apparatus on anterior teeth in patients with deep overbite / 中国基层医药

Objective To introduce a new method to open bite.Methods Compound resin materials were used to make a bonding type deep-bite opening device on the lingual side of anterior teeth in 21 patients.Results 21 patients with deep overbite treatment by this method achieved satisfactory results.Average time in Ⅱ°deep bite pa tients was(3.5 ± 1.4)months,and(5.4 ± 1.2)months in Ⅲ°deep bite patients.Conclusion This device is favorable for rapidly opening deep-bite and is simple and effective.

Radiation dose reduction on mutidetector abdominal CT using adaptive statistical iterative reconstruction technique in children / 中华放射学杂志

Objective To investigate the feasibility to reduce radiation doses on pediatric mutidetector abdominal CT using the adaptive statistical iterative reconstruction technique (ASIR) associated with automated tube current modulation technique(ATCM).Methods Thirty patients underwent abdominal CT with ATCM and the follow-up scan with ATCM cooperated with 40％ ASIR.ATCM was used with agedependent noise index (NI) settings: NI =9 for 0-5 year old and NI =11 for ＞ 5 years old for simple ATCM group,NI =11 for 0-5 year old and NI =15 for ＞5 years old for ATCM cooperated with 40％ ASIR group(AISR group).Two radiologists independently evaluated images for diagnostic quality and image noise with subjectively image quality score and image noise score using a 5-point scale.Interobserver agreement was assessed by Kappa test.The volume CT dose indexes (CTDIvol) for the two groups were recorded.Statistical significance for the CTDIvol value was analyzed by pair-sample t test.Results The average CTDIvol for the ASIR group was (1.38 ± 0.64) mGy,about 60％ lower than (3.56 ± 1.23) mGy for the simple ATCM group,and the CTDIvol of two groups had statistically significant differences.(t =33.483,P ＜ 0.05).The subjective image quality scores for the simple ATCM group were 4.43 ± 0.57 and 4.37 ±0.61,Kappa =0.878,P ＜ 0.01 (ASIR group: 4.70 ± 0.47 and 4.60 ± 0.50,Kappa =0.783,P ＜ 0.01),by two observers.The image noise score for the simple ATCM group were 4.03 ±0.56 and 3.83 ±0.53,Kappa =0.572,P ＜ 0.01 (ASIR group: 4.20 ± 0.48 and 4.10 ± 0.48,Kappa =0.748,P ＜ 0.01),by two observers.All images had acceptable diagnostic image quality.Conclusion Lower radiation dose can be achieved by elevating NI with ASIR in pediatric CT abdominal studies,while maintaining diagnostically acceptable images.

Effects of Danggui-beimu-kushen Pill on expression of PCNA, bcl-2 and bax in BPH mice model / 国际中医中药杂志

Objective To study the effect of Danggui-beimu-kushen Pill on benign prostatic hyperplasia (BPH) and its possible mechanism. Methods BPH model mouse was produced by intraperitoneal injection of testosterone propionate. The high, medium and low dose treatment group was fed high, middle and low dose of Danggui-beimu-kushen Pill respectively, while the positive control group was fed Qianliekang liquid, 600 mg/kg. All mice were executed on the 21 day. Such values were observed as the prostate index changes, pathological changes of prostate by HE staining light microscopy and the expression changes of PCNA,bcl-2 and bax by immunohistochemistry. Results The prostate index of the treatment group was lower than the model group; the PCNA and bcl-2 expression were lower than the model group, while the bax expression was higher than the model group. Meanwhile; there is no significant difference among the treatment groups.Moreover, the difference between the treatment groups and the positive control group has no statistic meaning.Conclusion Danggui-beimu-kushen Pill can suppress BPH in mice. The mechanism may be related to the reduction expression of cell-proliferation protein PCNA and apoptosis profilin bcl-2, and the increase of bax expression.

Effects of valsartan on plasma resistin and microinflammation in patients with maintenance hemodialysis / 中华全科医师杂志

In total, 106 patients with maintenance hemodialysis (MHD) were divided into two groups based on their valsartan administration, and 53 healthy controls were recruited in the study. Plasma concentrations of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), resistin and high sensitivity C-reactive protein (hs-CRP) were measured by enzyme-linked immunosorbent assay (ELISA) before and after valsartan treatment. Plasma levels of resistin, IL-6, TNF-α and hs-CRP were all significantly increased in patients with MHD as compared to those in healthy controls (P＜0. 05). Among patients with MHD the plasma levels of resistin, IL-6 and hs-CRP in valsartan group were lower than those in non-valsartan group (P＜0. 05).

Establishment of a rat midpalatal suture expansion model / 中国组织工程研究

BACKGROUND: Monkeys, dogs, pigs, rabbits and other large animals have bean applied previously to prepare animal models of midpelatel suture expansion, but there are high cost, small sample size, difficult to obtain antibodies and other disadvantages, Wistar rats have wide heads to facilitate cavity operation, with low cost and high reproduction rata, as the midpalatal suture model, it is possible to overcome the above deficiencies. OBJECTIVE: To establish a rat model of midpalatal suture expansion, and to supply basement for further relative researches of animal models. METHODS: Twenty Wistar male rats of 5 weeks old, average weight of 65 g, were randomly divided into 2 groups, a experiment and a control, with 10 rats in each group. Rats in experimental group were placed on the expansion appliance, inserting into the diastema between the first and second molars, then stick to molar lingual using light-cured resin for retention. The rats in control group were sham operated, followed by one weak of active expansion. After expansion, the midpalatal sections were observed by X-ray and light microscopy. RESULTS AND CONCLUSION: Maxillary X-ray film showed that midpalatal suture in experimental group was significantly widened, molar lead to cheek. Observed by light microscopy, partial oral side of midpalatal suture in the experimental group was obviously enlarged, mesenchymst ceils were spindle, in the same direction to tension force, Below it, traumatic inflammatory response appeared, with a clear bleeding area. The midpalatal suture expansion model in rats is available, simple and reprodudble.

Establishment of a Rabbit Model of Hydronephrosis by Ureteropelvic Junction Obstruction and Its SPECT and CT Perfusion Imaging / 中国实验动物学报

Objective To study the possibility of establishment of an animal model of hydronephrosis by ureteropelvic junction obstruction,and to evaluate the value of CT perfusion imaging in assessment of the renal function in the animal models. Method Fifty 10-week-old male New Zealand rabbits were randomly assigned to two groups:sham-operated group with separation of the left ureter (20 rabbits),and model group (30 rabbits) with the left ureter embedded at the ureteropelvic junction under the psoas major muscle. The left kidney function in the two groups was confirmed to be normal by SPECT before operation. CT perfusion and SPECT imagings were performed to assess the left kidney function in the two groups at three months after surgery,and the results were compared with that of pathological examination. Statistical analysis was performed on the parameters of SPECT and CT perfusion imaging and glomerular filtration rate (GFR). Results The success rate of model establishment was 70%,showing pathological changes of chronic hydronephrosis. CT perfusion demonstrated that BF,BV,PS of the left renal cortex and medulla were decreased,and had a good positive correlation with the changes of GFR. Conclusions It is feasible to establish a rabbit model of chronic hydronephrosis by embedding the left ureter at ureteropelvic junction under the psoas major muscle,and CT perfusion imaging parameters can be used to evaluate the renal function in the animal models.

The application of dose-reduction simulation in neonatal head CT scan / 中华放射学杂志

Objective To determine the effects of dose reduction on multi-slice spiral CT(MSCT) of neonatal head and assess the lowest possible radiation for acceptable clinical images.Methods Fifty-seven newborns suspected intracranial hemorrhage were entered into the study and underwent MSCT scans.Original images at three anatomic levels (posterior fossa, basal ganglia, centrum semiovale) were collected and synthetic noise was added so as to simulate dose reductions of 25%, 40%, 50% and 70%, respectively by using the noise addition tool.A total of 855 image data sets were obtained for the 57 patients.Original and simulated dose-reduction scan images were analyzed.Image noise and image quality were assessed by two independent experienced pediatric radiologists using diagnostic acceptability score, subjective image noise score on a 5-peint scale and objective noise index.Image noise was measured by respectively placing region of interest (ROI) at cerebellum, thalamus and corona radiata of 3 different slices.And the noise index and mean value was calculated.The degree of inter-observer concordance was determined by Kappa statistical analysis.The Spearman statistical correlations between the noise index and diagnostic acceptability score were performed.Results On the images of original dose and simulated dose reductions of 25%, 40%, 50% and 70%, the diagnostic acceptability was 4.47±0.51, 3.96±0.33, 3.21±0.45, 2.92±0.32, and 1.85±0.57, respectively,the subjective image scores were 1.62±0.48, 1.99±0.48, 2.76±0.81, 3.19±0.67, and 4.27±0.54, respectively, the noise index were 1.90±0.19, 2.17±0.20.2.44± 0.25, 2.68±0.28, and 3.37±0.39, respectively.The two radiologists had good intembserver agreement for diagnostic acceptability (K=0.860, P=0.017) and for image noise scoff ng (K=0.630, P=0.022).There was significant statistical correlation between image noise index and diagnostic acceptability (r= 0.826,P=0.001).At 40% dose reduction to the standard protocol, the noise index was 2.44 and the image quality score was 3.21 which were considered clinically acceptable.Conclusion The study revealed that acceptable imagos could be obtained with mean noise index of 2.44 and 40% dose reduction.

Study on the prevention, control and elimination of pneumoconiosis in fluorite mine / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To prevent pneumoconiosis by strengthening comprehensive dust-proof and controlling its pathogenesis, and to discuss feasibility of pneumoconiosis elimination in our country.</p><p><b>METHODS</b>Comprehensive dust-proof was used for reducing the concentration of dust. Epidemiological investigation of pneumoconiosis was employed for evaluating the efficiency of pneumoconiosis prevention. Prospective tracking investigation was used for identifying the feasibility of the pneumoconiosis elimination.</p><p><b>RESULTS</b>The outcomes of dynamic observation of 35 years from 1962 to 1996 and results of prospective thirty years tracking investigation showed that after comprehensive dustp-roof, the average dust concentration and time weighted mean dust concentration in workers' operating conditions decreased from 366.0 mg/m3 and 163.4 mg/m3 to 1.2 mg/m3 and 1.3 mg/m3 respectively, and the declined rates reached 99.7% and 92.1%, respectively. After controlling pneumoconiosis pathogensis, the incidence rate of pneumoconiosis, its prevalence rate and mortality rate decreased from 24.8%, 85.5% and 5.9% to zero respectively.</p><p><b>CONCLUSION</b>The thirty years prospective tracking investigation validated that the incidence of pneumoconiosis was zero. So the goal to eliminate pneumoconiosis was achieved.</p>

Isolation and structure elucidation of novel glucan from Astragalus mongholicus / 中草药

Object To isolate the immunoactive polysaccharide from Astragalus mongholicus Bunge and elucidate its chemical structure Methods The polysaccharide was purified from water extracts of A mongholicus by ethanol precipitation, deproteination, selective precipitation with hexadecyltri methylammonium bromide, ion exchange and gel filtration chromatography Its homogeneity and molecular weight were estimated by gel filtration chromatography, the structure was deduced from sugar analysis, methylation analysis, Smith degradation, IR and 13 CNMR spectrophotometry Results A homogeneous polysaccharide A2Nb was obtained with a molecular mass of 360 000 , and composed of D glucose with a major linkage form of ? D (1→4) glucose Side chains were found at 6 O positions once in every 25 glucose residues Conclusion A high molecular weight glucan A2Nb was obtained from A mongholicus for the first time It showed the ability of promoting the proliferation of the splenocytes of mice