Simultaneous Determination of 11 Active Components in Yuhuai Tablets by HPLC-QAMS / 中国药房

OBJECTIVE：To establish the method for simultaneous determination of 11 active components in Yuhuai tablets ， such as gardoside ，shanzhiside，gardenoside，genipin 1-gentiobioside，geniposide，ziyuglycoside Ⅰ ，ziyuglycoside Ⅱ ，narirutin， naringin，hesperidin and neohesperidin. METHODS ：HPLC-QAMS method was adopted. The determination was performed on Agilent TC-C 18column（250 mm×4.6 mm，5 μm）with mobile phase consisted of acetonitrile （A）-0.1％ phosphoric acid solution （B） （gradient elution ）at the flow rate of 1.0 mL/min. The column temperature was set at 30 ℃. The detection wavelengths were set at 238 nm for gardoside ，shanzhiside，gardenoside，genipin 1-gentiobioside and geniposide ，203 nm for ziyuglycoside Ⅰ and ziyuglycoside Ⅱ，and 283 nm for narirutin ，naringin，hesperidin and neohesperidin. Using geniposide as an internal reference ，the relative correction factors of other 10 components relative to this component were calculated ，and the contents of each component in 10 batches of samples were calculated. The results obtained by HPLC-QAMS method were compared with those obtained by external standard method. RESULTS ：The linear ranges of gardoside ，shanzhiside，gardenoside，genipin 1-gentiobioside，geniposide， ziyuglycoside Ⅰ，ziyuglycoside Ⅱ，narirutin，naringin，hesperidin and neohesperidin were 0.87-43.50，1.99-99.50，4.06-203.00， 7.35-367.50，12.97-648.50，28.98-1 449.00，3.79-189.50，1.57-78.50，18.05-902.50，0.66-33.00 and 14.38-719.00 μg/mL（all r＞0.999 0）. RSDs of precision ，repeatability and stability （24 h）tests were all less than 2％（n＝6）. The average recoveries were 96.90％-100.10％，and RSDs were 0.67％-1.74％（n＝9）. E-mail：289931673@qq.com There was no significant difference in the contents of 10 active components as gardoside between HPLC -QAMS method and external standard method in 10 batches of Yuhuai tablets （P＞0.05）. CONCLUSIONS ：The HPLC-QMAS method established in this study is convenient and accurate. It can be used for the simultaneous determination of gardoside ，shanzhiside，gardenoside，genipin 1-gentiobioside，geniposide，ziyuglycoside Ⅰ，ziyuglycoside Ⅱ，narirutin，naringin，hesperidin and neohesperidin in Yuhuai tablets.

A study of effect and safety of different heating methods in continuous renal replacement therapy treatment / 中国实用护理杂志

Objective:To evaluate the effect and safety of different heating methods in continuous renal replacement therapy (CRRT) treatment.Methods:One-hundred and twenty critical patients, who hospitalized in the department of ICU of Nanjing University of TCM affiliated Hospital from Nov. 2018 to Aug. 2020, were enrolled in this study and divided randomly and equally into four groups: control group (heated by Prismaflex′s blood warming equipment), group A (heated by spiral-wound case blood warming equipment), group B (heated by 3M Bair Hugger warming carpet) and group C (heated by 3M displacement liquid warming equipment). All the patients were monitored levels of rectal temperature, forehead temperature, and temperatures of CRRT′s arterial and venous ends in 12 hours after CRRT treatment. The rates of low or high temperature and max fluctuation range of temperature were recorded.Results:The highest temperatures of rectal, arterial and venous ends of CRRT in three groups were (37.20±0.23)℃, (37.15±0.35)℃, (37.16±0.24)℃, (37.21±0.35)℃, (37.15±0.31)℃, (37.19±0.23)℃ and (36.49±0.52)℃, (36.36±0.46)℃, (36.68±0.22)℃, respectively. After CRRT treatment, the highest temperatures of rectal in each group were (36.85±0.31)℃, (36.75±0.35)℃ and (36.96±0.21)℃, respectively. The highest temperatures of arterial and venous ends of CRRT in each group were (36.81±0.32)℃, (36.65±0.31)℃, (36.99±0.20)℃, (36.34±0.41)℃, (36.20±0.42)℃ and (36.30±0.28)℃, respectively. The highest temperatures of rectal, arterial and venous ends of CRRT in Group A and C were higher than those in control group. The highest temperatures of rectal and arterial ends of CRRT in Group A and B were lower than those in Group C ( t values were 2.037-4.559, P<0.05). After CRRT treatment, the lowest rectal temperatures in three groups were (36.85±0.31)℃, (36.75±0.35)℃ and (36.96±0.21)℃, respectively. The lowest temperatures of arterial and venous ends of CRRT in three groups were (36.81±0.32)℃, (36.65±0.31)℃, (36.99±0.20)℃, (36.34±0.41)℃, (36.20±0.42)℃ and (36.30±0.28)℃, respectively. The lowest temperatures of rectal, arterial and venous ends of CRRT in Group A and C were higher than those in control group. The lowest temperatures of rectal and arterial ends of CRRT in Group A and B were lower than those in Group C ( t values were 2.032-6.194, P<0.05). After CRRT treatment, the fluctuation of rectal temperatures in three groups were (0.34±0.11)℃, (0.38±0.15)℃ and (0.26±0.11)℃, respectively. The fluctuation of arterial and venous ends of CRRT temperatures in three groups were (0.30±0.14)℃, (0.35±0.23)℃, (0.22±0.14)℃, (0.33±0.16)℃, (0.39±0.23)℃ and (0.26±0.09)℃, respectively. The fluctuation levels of rectal, arterial and venous ends of CRRT in Group A and C were higher than those in control group. The fluctuation levels of rectal and arterial ends of CRRT in Group A and B were lower than those in Group C ( t values were 2.032-6.194, P<0.05). After CRRT treatment, the fluctuation of △RBC in three groups were 0.11±0.07, 0.11±0.06 and 0.09±0.06, respectively. The fluctuation of △Fib in three groups were 0.83±0.32, 0.84±0.28 and 0.60±0.31, respectively. Correlation analysis showed C methods was most related with the fluctuation temperatures of venous ends of CRRT. Conclusion:Heating replacement fluid by 3M blood warming device is proved to be the best way to prevent heat loss in CRRT treatment.

Advances in the role of HECT-type E3 ubiquitin ligases in tumors / 国际外科学杂志

The occurrence and development of tumors is a complex process with multiple factors and multiple steps. Ubiquitination refers to a multi-step cascade of protein modification processes including ubiquitin, ubiquitin-activating enzyme, ubiquitin-binding enzyme, ubiquitin ligase and proteasome, which is important for maintaining eukaryotic homeostasis. mechanism. The E3 ubiquitin ligases family is an important component of the ubiquitin-proteasome system. This family includes many proteins that catalyze the ubiquitination of various protein substrates and promote their degradation by the proteasome system. Up to date, E3 ubiquitin ligases has played an important role in a variety of tumor cell biology processes, including cell proliferation, apoptosis and cycle regulation. HECT-type E3 ubiquitin ligases, one of the earliest studies of E3 ubiquitin ligases, is involved in the ubiquitination of transcriptional regulation of protein translation. This article reviews the recent research progress of HECT-type E3 ubiquitin ligases and its role in tumors.

MRI features and diagnosis of neonatal deep cerebral arterial infarctions / 中华放射学杂志

Objective:To explore the MRI features of neonatal deep cerebral arterial infarctions.Methods:The medical and MRI datas of 23 neonates with deep cerebral arterial infarctions from January 2011 to December 2018 in Beijing Children′s Hospital, Capital Medical University were retrospectively analyzed. Both 11 males and 12 females with ages between 1-28 d were recruited and MRI were performed within 2-20 d after symptom onset. The MRI featurs including location, morphology, signal characteristics, enhancement features and other accompanied signs were reviewed.Results:A total of 15 cases with arterial infarction and 8 cases with complication of purulent meningitis were identified. The median age at presentation were 2 d and 7 d respectively. The unilateral involvement were demonstrated in all neonates with arterial infarctions. Among them, 11 had deep infarcts and the main branch of the middle cerebral artery was involved in 4 neonates. MRI showed slightly hypo-intensity on T 1WI and slightly hyper-intensity on T 2WI with indistinct boundary and focal punctate hyper-intensity on T 1WI and hypo-intensity on T 2WI. In 8 cases secondary to purulent meningitis, unilateral involvement was found in 5 cases and bilateral involvement in 3 cases. All cases showed hypo-intensity on T 1WI and hyper-intensity on T 2WI with indistinct boundary. Among them, 7 cases were heterogeneous, with small cystic changes which appeared as slightly hyper-intensity on T 1WI and slightly hypo-intensity on T 2WI peripherally, as well as nodular or patchy restricted diffusion. Marked swelling of the lesion was found in 6 cases. Multiple patchy or ring enhancement was revealed in 5 cases. Iso-intensity and restricted diffusion in posterior horn of the lateral ventricle were found in 2 cases. Restricted diffusion in frontotemporal subarachnoid space was found in 5 cases. One case showed subdural effusion. Conclusion:Neonatal deep cerebral arterial infarctions have certain characteristic appearance on MRI. Lesions secondary to purulent meningitis can be bilateral involvement with heterogeneous MRI intensities, and different period of infarction signs could be found concurrently. MRI is beneficial to the differential diagnosis.

Advances in the role of HECT-type E3 ubiquitin ligases in tumors / 国际外科学杂志

The occurrence and development of tumors is a complex process with multiple factors and multiple steps.Ubiquitination refers to a multi-step cascade of protein modification processes including ubiquitin,ubiquitin-activating enzyme,ubiquitin-binding enzyme,ubiquitin ligase and proteasome,which is important for maintaining eukaryotic homeostasis.mechanism.The E3 ubiquitin ligases family is an important component of the ubiquitin-proteasome system.This family includes many proteins that catalyze the ubiquitination of various protein substrates and promote their degradation by the proteasome system.Up to date,E3 ubiquitin ligases has played an important role in a variety of tumor cell biology processes,including cell proliferation,apoptosis and cycle regulation.HECT-type E3 ubiquitin ligases,one of the earliest studies of E3 ubiquitin ligases,is involved in the ubiquitination of transcriptional regulation of protein translation.This article reviews the recent research progress of HECT-type E3 ubiquitin ligases and its role in tumors.

Effects of liraglutide intervention combined with PCI therapy on ventricular remodeling and cardiac function in patients with acute myocardial infarction and type 2 diabetes mellitus / 中华内分泌代谢杂志

Objective To analyze the influence of liraglutide intervention combined percutanous coronary intervention(PCI) therapy on acute myocardial infarction( AMI) with type 2 diabetes( T2DM) patients'myocardial injury, ventricular remodeling( VR), and cardiac function. Methods Eighty patients with AMI and T2DM were included in the study, and they were randomly divided into observation group and control group according to the random number table, each with 40 patients. The patients in the control group received metformin and conventional insulin combined PCI treatment, and the patients in the observation group received metformin and liraglutide combined PCI treatment. The changes in the values of ventricular remodeling indexes, cardiac function and serum related indexes were compared after 3 months treatment between the two groups. Results ( 1) The body weight and fasting blood glucose levels of the observation group were significantly lower than those of the control group( P＜0.05), and fasting insulin levels were significantly higher than those of the control group(P＜0.01). (2)The levels of N-terminal-pro-B- type natriuretic peptide ( NT-proBNP ), creatine kinase isoenzymes-MB ( CK-MB), and troponin I ( TnI) in the observation group 3 months after treatment were significantly lower than those in the control group(P＜0.05). (3)The levels of serum hypersensitive C-reactive protein(hs-CRP), tumor necrosis factor-α(TNF-α), and interleukin-6(IL-6) in the observation group were significantly lower than those in the control group 3 months after treatment( P＜0. 05). ( 4) The values of left ventricular end systolic diameter ( LVESD ), left ventricular end diastolic diameter (LVEDD), interventricular septum thickness ( IVST), left ventricular posterior wall thickness ( LVPWT), left ventricular mass index ( LVMI), left ventricular end systolic volume ( LVESV), and left ventricular end diastolic volume(LVEDV) in the observation group were lower than those in the control group; the values of left ventricular fraction shortening(LVFS), left ventricular ejection fraction(LVEF), and mitral valve early diastolic blood flow rate (VE)/atrial systolic flow velocity ( VA), all were higher than those of the control group ( P＜0. 05). Conclusion Lraglutide intervention combined with PCI therapy on AMI with T2DM patients may reduce myocardial injury, induce ventricular remodeling, enhance cardiac function, and improve prognosis.

Correlation between the level of glucagon like peptide-1 and the extent of coronary lesions in patients with coronary heart disease at different glucose tolerance state / 中华内分泌代谢杂志

Objective To explore the correlation between the level of glucagon like peptide-1 (GLP-1) and the extent of coronary lesions in coronary heart disease (CHD).Methods One hundred and ninety-two CHD patients included in the study were divided into simple CHD group (n =60),CHD accompanied with impaired glucose tolerance(IGT) group (n =67),and CHD accompanied with type 2 diabetes mellitus (T2DM) group (n =65).48subjects were used as controls.The levels of GLP-1 in all the patients were analyzed by ELISA.Oral glucose tolerance test (OGTF) was performed.Blood glucose,insulin,and C-peptide levels were measured.The area under curves of insulin(AUCINS),C-peptide (AUCC-P),glucose (AUCGlu),and GLP-1 (AUCGLP-1) were calculated.All the patients underwent coronary angiography and the extent of coronary lesions was analyzed by total amount of coronary narrow degree integral.The association of GLP-1 level with coronary narrow degree was analyzed by correlation analysis and multivariate linear stepwise regression analysis.Results The levels of blood glucose and AUCGlu during OGTT in CHD accompanied with T2DM group were significantly higher than those in CHD with IGT group (P＜0.01),while the levels of insulin and C-peptide,AUCINS,and AUCC-P were decreased (P＜0.05).The levels of blood glucose,insulin,C-peptide,AUCGlu,AUCINs,and AUCC-P in CHD accompanied with IGT group were significantly higher than those in control group and simple CHD group (P＜0.01).Compared with simple CHD group and CHD accompanied with IGT group,GLP-1 level in CHD accompanied with T2DM group was markedly decreased(P＜0.01) while coronary artery narrow degree was raised(P＜ 0.05).Compared with simple CHD group,CHD accompanied with IGT group showed lower GLP-1 level and higher coronary artery narrow degree(P＜0.01).Correlation analysis revealed that GLP-1 level was negatively correlated with the coronary artery narrow degree in CHD patients (P ＜ 0.01).Multivariate linear regression analysis showed that systolic blood pressure,high density lipoprotein-cholesterol,fasting C-peptide and GLP-1 had a predictive effect on the coronary narrow degree integral in CHD patients.Conclusion The level of GLP-1 is closely correlated with the coronary artery narrow degree in CHD patients,especially in patients accompanied by hyperglycemia.

Revision and Improvement of Quality Standard for Rosae Davuricae Radix Et Rhizoma / 中国药师

Objective: To revise the quality standard and provide scientific basis for the quality conctrol and utilization and devel-opment of Rosae Davuricae Radix Et Rhizoma. Methods: The historical evolution and resource distribution of Rosae Davuricae Radix Et Rhizoma were studied by herbalogical study and textual research. Macroscopic and microscopic identification were used to identify the transverse section and the powder. TLC was used to identify Rosae Davuricae Radix Et Rhizoma. The contents of moisture, total ash, acid insoluble ash and alcohol soluble extract were determined to make out the corresponding limits. An HPLC method was used to de-termine the content of ursolic acid with the following conditions: an Diamonsil C18column (250 mm×4. 6 mm, 5 μm) was eluted with the mobile phase of methanol-0. 5% phosphoric acid ( 87: 13), the column temperature was 30℃, the flow rate was 1. 0 ml·min-1 and the detection wavelength was 210 nm. Results: The samples showed good macroscopic and microscopic characteristics. TLC showed that the spots were clear with good resolution. According to the measurement results, the content of moisture, total ash, acid in-soluble ash and alcohol soluble extract from the samples was 5. 6%-7. 3% , 1. 5%-3. 2% , 0. 2%-1. 1% and 15. 8%-28. 1% , respec-tively. The linear range of ursolic acid was 0. 10-1. 99 μg (r=0. 999 9), the average recovery was 97. 5% with the RSD of 1. 3% (n=9). The content of ursolic acid in the samples were 0. 1320-0. 5730 mg·g-1. Conclusion: The established methods are suitable for the quality control of Rosae Davuricae Radix Et Rhizoma.

Study on Quality Standard of Ligularia fischeri / 中国药房

OBJECTIVE:To establish the quality standard of Ligularia fischeri. METHODS:TLC was used for qualitative identification of samples. The contents of moisture,ash and extract were determined. The content of ferulic acid in samples was determined by HPLC. The determination was performed on Waters SunFire C18column with mobile phase consisted of acetonitrile-0.1% phosphoric acid(13:87,V/V)at the flow rate of 1.0 mL/min. The detection wavelength was set at 319 nm, and column temperature was 30 ℃. The sample size was 10 μL. RESULTS:TLC spots were clear and well-separated without interference from genitive control. The moisture,total ash,acid-insoluble ash and extract of samples were 7.6%-9.4%, 11.7%-19.6%,5.9%-14.1% and 25.4%-37.5%,respectively. The linear range of ferulic acid were 0.021 2-0.636 8 μg(r=0.999 9). limited of quantation was 2.25 ng,the limited of detection was 0.75 ng. RSDs of intermediate precision, reproducibility and stability tests were all lower than 3.0%. The recoveries ranged 97.81%-100.59%(RSD=1.02%,n=9). CONCLUSIONS:The moisture,total ash and acid-insoluble ash of samples are no more than 10.0%,19.0%,12.0%;the extract and the content of ferulic acid are no less than 25.0% and 0.1%. Established standard can provide reference for quality control of L. fischeri.

Clinical efficacy and safety of a new epalrestat in diabetic peripheral neuropathy—a multicenter and randomized controlled clinical trial / 中华内分泌外科杂志

Objective To evaluate the efficacy and safety of new epalrestat on diabetic peripheral neuropathy (DPN) compared with Tang Lin.Methods A total of 235 patients with DPN were enrolled in our study.They were randomly divided into two groups:the new epalrestat group (n=117) and the Tang Lin group (n=118).Their clinical,biochemistry,electrocardiogram,clinical symptoms and physical examinations,by using Michigan Neuropathy Screening Instrument (MNSI),and electrophysiological assessments were performed.Results The mean changes of MNSI scores both decreased compared with baseline in two groups after treatment for 12 weeks (P＜0.05) and nerve conduction velocity improved in the two groups (P＜0.05),but there were no difference of MNSI scores and nerve conduction velocity between the two groups.There was no difference of adverse event,blood pressure,heart rate,blood and urine routine examinations,liver and renal function between the two groups.Conclusion The new epalrestat is effective and safe as Tang Lin in treatment of DPN.

The Derivation and Validation of a Scoring System for Clinical Prognosis in Patients Releiving Cardiac Resynchronization Therapy / 中国循环杂志

Objective: To create and validate a scoring system for predicting clinical prognosis in patients with cardiac resynchronization therapy (CRT). Methods: A cohort of 367 consecutive patients received CRT in our hospital from 2010-01 to 2015-12 were enrolled. The endpoint follow-up events were all-cause death including heart transplantation and heart failure re-admission. The patients were randomly categorized into 2 groups: Modeling group, to develop HEAL scoring system,n=300 and Veriifcation group, to validate HEAL model,n=67. HEAL system was established by Cox proportional hazards regression model, discrimination between HEAL and EARRN scoring systems was evaluated by AUC of ROC, HEAL calibration was assessed by Hosmer-Lemeshow test and clinical endpoint evaluation by 2 scoring systems were compared by Kaplan-Meier method. Results: Modeling group analysis indicated that hs-CRP (HR=1.137, 95% CI 1.072-1.205,P10. AUC for risk classification in Modeling group and Verification group were 0.719(95% CI 0.629-0.809) and 0.708 (95% CI 0.539-0.878), HEAL can well distinguish clinical prognosis in patients at different risk levels (log-rank test showed in Modeling groupP<0.001 and in Veriifcation groupP=0.002); Hosmer-Lemeshow test presented good calibration,P=0.952. All 367 patients were respectively evaluated by HEAL and EARRN scoring systems, HEAL had the better discrimination than EARRN as AUC 0.763 (95% CI 0.692-0.833) vs AUC 0.602 (95% CI 0.517-0.687). Conclusion: HEAL scoring system can effectively predict adverse prognosis in CRT patients, it had the better discrimination than EARRN system and was valuable to distinguish high risk patients in clinical practice.

Effect of artificial airway cuff pressure at different monitoring intervals on ventilator associated pneumonia in critical patients / 现代临床护理

Objective To investigate the effects of artificial airway cuff pressure at different monitoring intervals on ventilator associated pneumonia (VAP) in critical patients. Methods About 56 patients treated with mechanical ventilation from January 2015 to December were grouped by ward numbers:32 patients in the south ward were in the experiment group and 24 in the north ward were in the control group. The two groups were given the same routine care, e.g., mechanical ventilation by endotracheal intubation. In the experiment group, the cuff pressure was controlled to 30cm H2O every six hours and the control group was every 4h. The two groups were compared in terms of the incidence of VAP during mechanical ventilation, occurrence time of VAP, duration of mechanical ventilation and mortality. Result The incidence of VAP during mechanical ventilation, occurrence time of VAP, duration of mechanical ventilation, and mortality showed no significant differences between the two groups (P>0.05). Conclusions For mechanically ventilated patients, the cuff pressure controlled to 30cm H2O every 6h can not increase the incidence of VAP, duration of mechanical ventilation and mortality. It can reduce the nursing workload.

Improve image resolution in low-dose pediatric chest CT scans with combination of adaptive statistical iterative reconstruction and sharp recon kernel / 中国医学影像技术

Objective To explore the value of adaptive statistical iterative reconstruction (ASIR) and a sharp recon kernel to obtain high resolution pulmonary images in low-dose pediatric chest CT scans.Methods Totally 42 children underwent low-dose chest CT scans with ASIR were included.Age dependent noise index (NI) was used for dose optimization:NI=12 for 0-12 months old,NI=15 for ＞1 2 years old,NI=17 for 3-6 years old and NI=20 for ≥7 years old.Images were reconstructed to 0.625 mm using different recon kernels:Soft,Standard,Lung,and Chest kernel.ASIR blending was varied from 0 100％ to provide balanced image noise and spatial resolution.Two radiologists independently evaluated images for normal lung structures,abnormal CT findings and image noise on a 5 point scale with 3 being clinically acceptable.The best kernel,as well as the match with the best ASIR weight were analyzed statistically.Results CT images with lung kernel and ASIR 60％ were rated substantially better than those kernel.Conclusion ASIR 60％ with a sharp lung kernel can significantly improve image quality in low dose pediatric chest CT scans.

Impact of Atrial Fibrillation on Clinical Outcomes in Patients With Cardiac Resynchronization Therapy / 中国循环杂志

Objective: To explore the impact of atrial fibrillation (AF) on clinical outcomes in patients with cardiac resynchronization therapy (CRT). Methods: A total of 258 arrhythmia patients who received CRT in our hospital from 2010-01 to 2014-12 were retrospectively enrolled. According to AF occurrence, the patients were divided into 2 groups: AF group,n=42 and Non-AF group,n=216. The end point events were deifned by heart failure (HF) re-admission and all-cause death (including heart transplantation). Survival curve was drawn by Kaplan-Meier method, clinical prognosis was comparedbetween 2 groups with log-rank test and the impact of AF on end point prediction was analyzed by uni- and multivariate Cox proportional-hazards regression models. Results: There were 16.3% (42/258) patients combining AF. The following indexes were statistically different between AF group and Non-AF group: patients' age, the ratios of male gender and left bundle branch block (LBBB), eGFR, blood levels of creatinine, uric acid, big endothelin-1, left atrial diameter and application of amiodarone. With the median of 22 months follow-up study, there were 33/258 (12.8%) patients died, 5 (1.9%) received heart transplantation and 72 (27.9%) with HF re-admission. Survival analysisindicated that HF re-admission rate in AF group was higher than Non-AF group (χ2=6.651,P=0.010), all cause mortality was similar between 2 groups (χ2=0.528,P=0.468). Univariate Cox proportional-hazards regression analysis showed that AF, LBBB, higher blood levels of creatinine, big endothelin-1 and large left atrium were the suspiciousrisk factors for HF re-admission; increased blood levels of creatinine, big endothelin-1 and large left atrium were thesuspiciousrisk factors for all cause death. Multivariate Cox proportional-hazards regression analysis presented that AF was not the independent risk factor for HF re-admission and all-cause death, while largeleft atrium was the independent risk factor for HF re-admission (HR=1.041, 95% CI 1.007-1.075,P=0.018); large left atrium and increased serum creatinine were the independent risk factors for all cause death (HR=1.045, 95% CI 1.001-1.091,P=0.048) and (HR=1.008, 95% CI 1.001-1.015,P=0.035) respectively. Conclusion: AF was associated with the higher rate of HF re-admission in CRT patients; while no clear evidencesupported that AF was the independent risk factor for HF re-admission and all cause death in CRT patients.

Association of serum albumin level and clinical outcomes among heart failure patients receiving cardiac resynchronization therapy / 中华心血管病杂志

Objective@#To assess the relationship between serum albumin level and clinical outcome in heart failure (HF) patients receiving cardiac resynchronization therapy (CRT).@*Methods@#In this retrospective cohort study, 357 consecutive chronic heart failure patients receiving CRT between January 2010 and December 2015 were enrolled and divided into two groups based on pre-CRT serum albumin (albumin≥40 g/L, n=244; albumin<40 g/L, n=113). Clinical outcomes were defined as all-cause mortality (including heart transplantation) and rehospitalization due to worsening HF.Baseline characteristics were compared and all-cause mortality (including heart transplantation) and rehospitalization due to worsening heart failure (HF) were analyzed using Kaplan-Meier curves.Prognostic value of albumin level was evaluated in Cox proportional-hazards regression models.@*Results@#Over a median follow-up time of 21 months, 45 patients (12.6%) died, 4 patients (1.1%) underwent heart transplantation and 100 patients (28.0%) were rehospitalized due to worsening HF. HF patients with pre-CRT albumin<40 g/L were related with worse NYHA function class, lower HDL-C level and ACEI/ARB use compared to HF patients with pre-CRT albumin≥40 g/L. Kaplan-Meier analyses evidenced lower survival rate in HF patients (log-rank test: P=0.000 4, χ2=12.60) and higher rehospitalization rate due to worsening HF (log-rank test: P=0.009, χ2=6.82) in HF patients with pre-CRT albumin<40 g/L.Multivariate Cox analyses indicated that serum pre-CRT albumin <40 g/L was an independent risk factor for all-cause mortality (HR=2.019, 95%CI 1.125-3.622, P=0.018) and HF rehospitalization (HR=1.517, 95%CI 1.014-2.270, P=0.043).@*Conclusion@#Pre-CRT serum albumin level is associated with the severity of heart failure in CRT recipients.Patients with lower pre-CRT albumin level face increased risk of all-cause mortality and HF rehospitalization in chronic heart failure patients receiving cardiac resynchronization.

Three methods for controlling presacral massive bleeding during pelvic operations / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate three different methods for controlling presacral massive bleeding during pelvic operations.</p><p><b>METHODS</b>Clinical data of 11 patients with presacral massive bleeding during pelvic operation at The Sixth Affiliated Hospital of Sun Yat-sen University and 157 Branch Hospital of Guangzhou General Hospital of Guangzhou Military Command from January 2001 to January 2016 were analyzed retrospectively. Hemostasis methods for presacral massive bleeding during operation included gauze packing (whole pressure), drawing pin (local pressure) and absorbable gauze (absorbable gauze was adhered to bleeding position with medical glue after local pressure). Efficacy of these 3 methods for controlling bleeding was evaluated and compared.</p><p><b>RESULTS</b>Ten patients were male and 1 was female with average age of 65.2 (40 to 79) years old. Eight cases were rectal cancer, 2 were presacral malignancies and 1 was rectal benign lesion. Bleeding volume during operation was 300 to 2 500 (median 800) ml. From 2001 to 2012, 4 cases received gauze packing, of whom, 3 cases were scheduled Dixon resection before operation and then had to be referred to Hartman resection; 3 cases died of systemic failure due to postoperative chronic errhysis and infection, and 1 underwent re-operation. At the same time from 2001 to 2012, 5 cases received drawing pin, of whom, bleeding of 3 cases was successfully controlled and Dixon resection was completed. In other 2 cases with hemostasis failure, 1 case underwent re-operation following the use of gauze packing, and another 1 case received absorbable gauze hemostasis. All the 5 patients were healing. From 2013 to 2016, 2 cases completed scheduled anterior resection of rectum after successful hemostasis with absorbable gauze and were healing and discharged.</p><p><b>CONCLUSIONS</b>Gauze packing hemostasis is a basic method for controlling presacral massive bleeding. Drawing pin and absorbable gauze hemostasis are more precise and may avoid the change of surgical procedure. But drawing pin has the possibility of hemostasis failure. Absorbable gauze hemostasis with medical adhesive is effective, simple and fast.</p>

Enantiomeric Separation of Three Kinds of Aromatic Amino Acids by C18 Column Tandem Crown Ether Chiral Column / 分析化学

A reversed phase high performance liquid chromatographic ( RP-HPLC ) method was proposed by using C18 column tandem crown ether chiral column for simultaneous separation of three kinds of aromatic amino acid enantiomers. The chromatographic conditions, including mobile phase proportion, pH, column temperature and flow rate, were optimized. The experimental results showed that the three aromatic amino acid enantiomers could be successfully separated under the optimal conditions such as perchloric acid solution-acetonitrile ( 86:14, V/V, pH = 2 ) as mobile phase, column temperature of 20℃ and flow rate of 0. 4 mL/min. The separation under four HPLC column connection modes was further investigated. The results revealed that different kinds of amino acids could be separated on C18 column, but not for amino acid enantiomers; amino acid enantiomers could be separated on crown ether chiral column, but the chromatographic peaks of each amino acid enantiomers overlapped seriously; baseline separation of three amino acid enantiomers could be obtained under the connection of two columns, but the separation under different column connection sequence almost had no difference except the peak shape.

Feasibility of model-based iterative reconstruction in 80 kV low-radiation chest CT in children / 中国医学影像技术

Objective To evaluate the feasibility of model-based iterative reconstruction (MBIR) in low-dose chest CT (80 kV) examination in children.Methods Forty-four children who had post-operation scoliosis and received low dose chest CT scans were included.The fix tube voltage was 80 kV,fix current was 50 mA.Images were reconstructed with MBIR (observation group).The pre-operation scan were used 120 kV and 50 mA for acquisition,and images were reconstructed with filtered back-projection (FBP) mehed (control group).The subjective quality of the images was independently evaluated by two radiologists.Objective noises in the muscle and lung field were measured,the SNR,CNR were calculated,and the CTDIvol was record.Results The subjective noise score in the observation group was significantly higher than that in the control group (P＜0.05).Objective noise reduced about 40.36％,SNR increased 72.37％,CNR increased 78.69％,CTDIvol decreased by 66.52％,all of which had statistical difference between both groups (all P＜0.001).Conclusion Low-dose chest CT (80 kV) examination in children can meet the requirements of diagnosis for children.

CT in diagnosis of infantile hepatic hemangioendothelioma / 中国医学影像技术

Objective To explore the CT features of infantile hepatic hemangioendothelioma (IHH).Methods CT imaging features of 16 IHH patients confirmed by surgical pathology and clinical diagnosis were retrospectively reviewed.Results Of 16 patients,there were single lesion in 10 cases and multiple lesions in 6 cases.All the lesions were rich in blood supply,and the arterial phase showed obviously rings enhanced.Some linear enhancement towards to the center below the annular enhancement of solitary lesions were found.There were patchy enhancement in annular enhancement center area,and the area of enhancement obvious increasing in venous phase and delayed phase in 4 cases with multiple lesions,enhancement mode was similar to single lesion in 1 case with multiple lesions.The lesions of IHH Ⅱ were small and multiple,and showed intermittent line shaped edge enhancement;some lesions below the linear enhancement showed small nodular enhancement and the area of nodular enhancement enlarged in venous phase,the range of linear enhancement was not obvious.Conclusion CT manifestations of IHH have some characteristics,and the enhancement of CT is more important in the diagnosis of this disease.

17β-estradiol promotes proliferation, migration and TFF1 secretion in papillary thyroid cancer K-1 cells / 第三军医大学学报

Objective To investigate whether 17β-estradiol (E2) can stimulate the proliferation,migration,and secretion of trefoil factor family 1 (TFF1) in papillary thyroid cancer K-1 cells and explore the molecular mechanisms.Methods ELISA was used to detect the content of TFF1 in the supernatant of K-1 cells after the treatment of E2,propylpyrazoletriol (PPT,ERα agonist) or diarylpropionitrile (DPN,ERβ agonist).The expression of ERα and ERβ in the untreated cells was measured by Western blotting.ERα siRNA and ERβ siRNA by RNA interference were designed and synthesized,and the change of TFF1 was measured by ELISA again after the transfection.The interaction between TFF1 promoter and ER was evaluated by chromatin immunoprecipitation analysis (CHiP).The proliferation and migration were detected in the K-1 cells after E2 treatment by MTT assay and Transwell chamber test respectively.Festults After E2 treatment,the TFF1 content in the supernatant of K-1 cells was increased gradually,reached peak at 24 h,and then declined slowly.PPT treatment enhanced the secretion of TFF1 but DPN decreased it in the K-1 cells.Transfection of ERα siRNA obliterated the inductive effect of E2 on the secretion of TFF1,but that of ERβ siRNA increased the inductive effect in the K-1 cells.Western blotting showed that the expression level of ERα was higher than that of ERβ in the K-1 cells.ChIP results confirmed that ERα protein was bound to the promoter of TFF1 gene in K-1 cells.E2 treatment promoted cell proliferation and improved cell migration in the K-1 cells.Conclusion E2 induces the expression and secretion of TFF1 in K-1 cells through ERα-dependent manner,and thus promotes the proliferation and migration of the cells.