Kinematic and Dynamic Study on Traditional Chinese Cervical Manipulation / 医用生物力学

Objective To simultaneously collect and analyze the kinematic and dynamic parameters for two techniques of traditional Chinese cervical manipulation ( TCCM), and quantitatively describe its biomechanical characteristics. Methods A senior practitioner completed the TCCM (positioning and directional rotation pulling, lateral flexion, respectively) on 10 healthy subjects, and the fluorescent marker balls were pasted on the operator to capture manipulation movements. The dynamic parameters and the surface electromyography ( sEMG) signals were collected by pressure-sensitive gloves and wireless sEMG acquisition system. Results The upper arm muscle was the main force muscle during TCCM, and biceps brachii had the highest contribution rate. The range of motion (ROM), speed, pulling force, and time during cervical spine positioning and directional rotation pulling were all greater than those during cervical spine lateral flexion. The integrate electromyography ( iEMG) and root mean square (RMS) for each muscle of the operator during cervical spine positioning and directional rotation pulling were higher than those during cervical spine lateral flexion. Conclusions The overall ROM, three-dimensional (3D) motion angle, load intensity and time during CCTM have the characteristics of high speed, low amplitude and strong force, reflecting the biomechanical characteristics of ‘ cunjin ’ ( one-inch punch ) in traditional Chinese medicine. This study provides references for further standardizing manual teaching and training and improving clinical safety.

Analysis of influencing factors for lung metastasis of hepatocellular carcinoma after liver transplantation and application value of its nomogram prediction model / 中华消化外科杂志

Objective:To investigate the influencing factors for lung metastasis of hepato-cellular carcinoma after liver transplantation and application value of its nomogram prediction model.Methods:The retrospective cohort study was conducted. The clinicopathological data of 339 hepatocellular carcinoma patients with lung metastasis after liver transplantation who were admitted to Zhongshan Hospital of Fudan University from January 2015 to June 2019 were collected. There were 299 males and 40 females, aged from 23 to 73 years, with a median age of 54 years. According to the random numbers showed in the computer, all 339 patients were divided into training dataset consisting of 226 and validation dataset consisting of 113, with a ratio of 2:1. All patients underwent classic orthotopic liver transplantation. Observation indicators: (1) analysis of clinicopathological data of patients in the training dataset and validation dataset; (2) follow-up; (3) analysis of influencing factors for lung metastasis of hepatocellular carcinoma after liver transplanta-tion; (4) construction and evaluation of nomogram prediction model for lung metastasis of hepatocellular carcinoma after liver transplantation. Follow-up was conducted using outpatient examination and telephone interview to detect lung metastasis of patients up to November 2020. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the paired t test. Measurement data with skewed distribution were represented as M( P25, P75) or M(range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute number or percentages, and comparison between groups was conducted using the chi-square test. The Kaplan-Meier method was used to calculate lung metastasis rate and draw lung metastasis curve. The Log-rank test was used for survival analysis. The COX proportional hazard model was used for univariate and multivariate analysis. Based on the results of multivariate analysis, the nomogram prediction model was constructed. The prediction accuracy of the nomogram model was evaluated using C-index and receiver operating characteristic (ROC) curve. The calibration curve was used to evaluate the prediction error of the model. Results:(1) Analysis of clinicopathological data of patients in the training dataset and validation dataset: there was no significant difference in general data between patients in the training dataset and validation dataset ( P>0.05). (2) Follow-up: 226 patients in training dataset and 113 patients in validation dataset were followed up. The follow-up time of training dataset was 5.2 to 69.0 months, with a median follow-up time of 29.3 months, and the follow-up time of validation dataset was 4.3 to 69.0 months, with a median follow-up time of 30.4 months. Up to the last follow-up, 48 cases of the training dataset and 22 cases of the validation dataset had lung metastasis, with the incidence and median time of lung metastasis were 21.24%(48/226), 19.47%(22/113) and 8.5 months, 7.8 months, respectively. There was no significant difference in lung metastasis between patients in the training dataset and validation dataset ( χ2=0.144, P>0.05). (3) Analysis of influencing factors for lung metastasis of hepatocellular carcinoma after liver transplantation: results of univariate analysis showed that age, alpha fetoprotein, tumor diameter, tumor differentiation degree, vascular invasion, systemic immune inflammation index and postoperative treatment were related factors for lung metastasis of hepatocellular carcinoma after liver transplantation ( hazard ratio=0.465, 3.413, 1.140, 3.791, 2.524, 2.053, 1.833, 95% confidence interval as 0.263?0.822, 1.740?6.695, 1.091?1.191, 1.763?8.154, 1.903?3.349, 1.047?4.027, 1.038?3.238, P<0.05) . Results of multivariate analysis showed that age, tumor diameter and vascular invasion were independent influencing factors for lung metastasis of hepatocellular carcinoma after liver transplantation ( hazard ratio=0.462, 1.076, 2.170, 95% confidence interval as 0.253?0.843, 1.013?1.143, 1.545?3.048, P<0.05). (4) Construction and evaluation of nomogram prediction model for lung metastasis of hepatocellular carcinoma after liver transplantation: the C-index was 0.810 (95% confidence interval as 0.758?0.863) and 0.802 (95% confidence interval as 0.723?0.881) of the nomogram prediction model for lung metastasis of hepatocellular carcinoma after liver transplanta-tion in the training dataset and validation dataset, respectively, showing good discrimination ability. The area under ROC of 0.5-, 1- and 2-year nomogram prediction model in the training dataset and the validation dataset were 0.815(95% confidence interval as 0.725?0.905), 0.863(95% confidence interval as 0.809?0.917), 0.835(95% confidence interval as 0.771?0.900)and 0.873(95% confidence interval as 0.801?0.945), 0.858(95% confidence interval as 0.760?0.956), 0.841(95% confidence interval as 0.737?0.945), respectively, which illustrated that the model had good predictive ability. The formula of nomogram prediction model=33.300 06+(?33.300 06)×age(≤50 years=0, >50 years=1)+2.857 14×tumor diameter (cm)+31.585 71×vascular invasion (M0 stage of microvascular invasion staging=0, M1 stage of microvascular invasion staging=1, M2 stage of microvascular invasion staging=2, visible tumor thrombus=3). The optimal threshold of nomogram risk score was 77.5. Patients with risk score ≥77.5 were assigned into high risk group, and patients with risk score <77.5 were assigned into low risk group. The 0.5-,1- and 2-year lung metastasis rate of patients in the high risk group and low risk group of the training dataset were 16.7%, 39.2%, 46.4% and 1.4%, 4.1%, 6.9%, respectively, showing a significant difference between the two groups ( χ2=54.86, P<0.05). The 0.5-,1- and 2-year lung metastasis rate of patients in the high risk group and low risk group of the validation dataset were 17.6%, 29.0%, 39.5% and 0, 3.1%, 4.8%, respectively, showing a significant difference between the two groups ( χ2=25.29, P<0.05). Conclusions:Age, tumor diameter and vascular invasion are independent influencing factors for lung metastasis of hepatocellular carcinoma after liver transplantation. The nomogram prediction model based on age, tumor diameter and vascular invasion can predict risk of lung metastasis for hepatocellular carcinoma patients after liver transplantation accurately.

Relationship between Oxygen Uptake Efficiency Slope and Left Ventricular Systolic and Diastolic Function in Elderly Patients with Coronary Heart Disease / 中国运动医学杂志

Objective To investigate clinical significance and the correlation between oxygen uptake efficiency slope(OUES) measured by the cardiopulmonary exercise test(CPET) and echocardiographic left ventricular function in elderly patients with coronary heart diseases after the percutaneous coronary intervention.Methods Patients aged 65 years and over after PCI and CPET were enrolled to collect relevant parameters including the peak oxygen consumption(VO2peak),oxygen pulse(VO2/HR),OUES and cardiorespiratory fitness(CRF) index,also mitral annulus systolic peak speed(Sm),early diastolic mitral flow velocity Em and mitral annular early diastolic peak velocity Em ratio(E/Em) using the echocardiography.Patients with systolic velocity of mitral annulus(Sm)≥8 cm/s were assigned to the normal Sm group,while the rest were selected into the lower Sm group.The correlation between the cardiopulmonary fitness and cardiac function was analyzed.Results Four hundred and two patients were enrolled,with an average age of 71 ± 5 years,283 males(70.40％),and 119 females(29.60％).Among them,111 (27.61％) were 75 years of age or older,202(50.25％) ranging from 65 to 69 and 89 (22.14％) between 70 and 74.Totally 227 patients were diagnosed as angina pectoris(56.47％),62 as acute myocardial infarction (15.42％),and 113 patients with old myocardial infarction (28.11％).It was found that the heart systolic function was associated with CRF:Sm and OUES were positively correlated independently(r=29.220,P=0.001);Em was positively related to VO2peak(r=0.176,P＜0.001) andOUES (r=0.151,P=0.003).However,E/Em was negatively correlated with VO2peak (r=-0.199,P＜0.001),VO2/HR (r=-0.118,P=0.018) and OUES (r=-0.201,P＜0.001).The left atrial pressure was negatively correlated with VO2peak (r=-0.187,P＜0.001),VO2/HR (r=-0.108,P=0.030) and OUES (r=-0.185,P＜ 0.001).Left ventricular ejection fraction and left ventricular end diastolic diameter were not found to be related to cardiorespiratory fitness parameters (P＞0.05).Conclusion The cardiopulmonary exercise test can be used as a practical method to evaluate and guide the rehabilitation exercises.The CRF parameters can evaluate the heart function exercise and is significantly correlated to the resting cardiac systolic and diastolic function parameters.

Predictive value of immature granulocytes for persistent systemic inflammatory response syndrome in patients with acute pancreatitis: analysis of 1 973 cases / 中华危重病急救医学

Objective To analyze the clinical value of immature granulocytes in peripheral blood for prediction of persistent systemic inflammatory response syndrome (SIRS) in patients with acute pancreatitis (AP). Methods 1 973 patients with AP in Hunan People's Hospital from 2012 to 2017 were retrospectively enrolled and divided by SIRS duration into the persistent SIRS group, temporary SIRS group and non-SIRS group. The independent risk factor for persistent SIRS in AP patients was evaluated by Logistic regression analysis, and predictive value of immature granulocytes for persistent SIRS in AP patients was analyzed by the receiver operating characteristic (ROC) curve. Results These 1 973 AP patients (1 165 males, 59.0%) with an average age of 49 (40, 60) years old, including 288 persistent SIRS, 189 temporary SIRS and 1 496 non-SIRS cases. There was no significant difference in gender, age and etiology among three groups. Compared with non-SIRS group, more severe symptoms were observed in the temporary and persistent SIRS groups. Moreover, The acute physiology and chronic health evaluation Ⅱ(APACHEⅡ), CT severity index (CTSI), multiple organ failure (MOF) and acute respiratory distress syndrome (ARDS) incidence, mortality and C-reactive protein (CRP), white blood cell count (WBC), procalcitonin (PCT) and immature granulocytes in persistent SIRS group were further higher than those in the temporary SIRS group [APACHEⅡ: 9 (6, 12) vs. 5 (3, 7), CTSI: 6 (4, 6) vs. 4 (3, 6), MOF incidence: 92.0% vs. 32.8%, ARDS incidence: 39.9% vs. 10.1%, morbidity: 11.1% vs. 4.2%, CRP (mg/L): 25.00 (0.80, 212.25) vs. 0.80 (0.80, 123.50), WBC (×109/L): 15.17±6.78 vs. 14.84±5.86, PCT (μg/L): 0.23 (0.10, 1.76) vs. 0.10 (0.10, 0.31), immature granulocytes: 1.95 (0.90, 4.95) % vs. 0.80 (0.40, 2.10) %, all P < 0.05]. Logistic regression analysis showed that besides pancreatic necrosis, WBC and CRP, immature granulocyte was an independent risk factor for persistent SIRS associated with AP [odds ratio (OR) = 1.844, 95% confidence interval (95%CI) = 1.372-2.220]. ROC curve showed that immature granulocytes had better predictive value for persistent SIRS, the area under the curve (AUC) was 0.806, which was significantly higher than the APACHEⅡ (AUC = 0.783), CTSI (AUC = 0.752), PCT (AUC = 0.676), CRP (AUC = 0.677), WBC (AUC = 0.644). The cut-off value of immature granulocyte was 0.65%, the sensitivity was 84.0%, the specificity was 66.3%, the positive predictive value was 62.4%, and the negative predictive value was 76.3%. Conclusion Immature granulocyte in peripheral blood is a potential indicator for persistent SIRS in AP patients.

Establishing intraosseous access and central intravenous line placement in critically ill patients: a randomized controlled study / 中华急诊医学杂志

Objective To compare the time consumed for the procedure done,satisfaction and safety of the establishment of intraosseous (IO) access and central intravenous line placement (CVL) in critically ill patients using a randomized controlled trial.Methods The patients were randomly divided into the IO access group versus CVL group according to the inclusion criteria.The IO access and CVL were established,respectively for medicine or fluid administration.The success rates at the first attempt,time required for procedure completed,satisfaction and complications were recorded.Results During the study period,24 patients were enrolled,and divided equally and randomly into IO group (n=12) and CVL group (n=12).There were no significant differences in age,gender,BMI between the two groups.The patients with shock and cardiac arrest accounted for 83.3 ％ in IO group and 58.3 ％ in CVL group,respectively.The success rates at the first attempt was 91.7 ％ in IO access group versus 66.7 ％ in CVL group (P=0.158).the time required for procedure done was significantly shorter in IO access group (74.9 ±43.7)s compared with CVL group (944.0 s±491.5 s) (P＜0.01).The satisfaction of operators at the instruments used was 8.0±1.1 for IO access group versus 7.2±0.8 for CVL group (P==0.053).The overall satisfaction of the operators at the entire course of procedure was 3.7 + 0.7 in IO access group versus 3.9±0.3 in CVL group (P=0.377).Complications were not observed during the study period in the two groups.Conclusions The success rate at the first attempt was significantly higher in IO access group compared with CVL grouThe mean time consumed for procedure completed in IO group was much shorter than that in CVL group,and the operation was simple and practicable.During the emergency care of critical patients,if the peripheral intravenous line placement was difficult to establish,and IO access could be a choice of alternative used as a bridging procedure to rapidly establish the vascular access and win the rescue opportunity.

Effect of ultraviolet radiation on expression of transient receptor potential ankyrin 1 in HaCaT cells / 中华皮肤科杂志

Objective To investigate the photoregulation of transient receptor potential ankyrin 1 (TRPA1) in HaCaT cells,and to explore its mechanisms.Methods Cultured HaCaT cells were divided into 225-mJ/cm2 UVA radiation groups and 25-mJ/cm2 UVB radiation groups.HaCaT cells in the UVA radiation groups were further classified into 6 groups:blank control group 1 receiving no treatment,retinal group 1 treated with 12 μmol/L retinal alone,UVA group treated with 225 mJ/cm2 UVA radiation alone,retinal + UVA group (UVA-TRPA1 control group),retinal + UVA + 500 μmol/L cinnamaldehyde group (UVA-TRPA1 agonist group) and retinal + UVA + 1 mmol/L camphor group (UVA-TRPA1 antagonist group).Additionally,HaCaT cells in the UVB radiation groups were also further classified into 6 groups:blank control group 2 receiving no treatment,retinal group 2 treated with 12 μmol/L retinal alone,UVB group treated with 25-mJ/cm2 UVB radiation,retinal + UVB group (UVB-TRPA1 control group),retinal + UVB + 500 μmol/L cinnamaldehyde group (UVB-TRPA1 agonist group) and retinal + UVB + 1 mmol/L camphor group (UVB-TRPA1 antagonist group).Real-time fluorescence-based quantitative PCR (qPCR) and Western blot analysis were performed to determine the mRNA and protein expression of TRPA 1 respectively.Flow cytometry was conducted to investigate changes of calcium influx in HaCaT cells in the above groups.Results qPCR and Western blot analysis showed that TRPA1 mRNA and protein were expressed in HaCaT cells.The fluorescence intensity of calcium influx significantly differed among the blank control group 1,retinal group 1,UVA group and retinal + UVA group (155.06 ± 7.62,148.37 ± 18.77,166.92 ± 3.71 and 331.333 ± 40.563;F =44.509,P ＜ 0.01),as well as among the blank control group 2,retinal group 2,UVB group and retinal + UVB group (150.20 ± 1.73,171.66 ± 56.23,147.56 ± 6.60 and 250.44 ± 9.13;F =85.261,P ＜ 0.01).Additionally,retinal + UVA/UVB groups showed significantly higher fluorescence intensity of calcium influx compared with the blank control groups (q =18.442,6.052,P ＜ 0.01).The TRPA1 agonist cinnamaldehyde and its antagonist camphor could regulate the UVA-and UVB-induced calcium influx (P ＜ 0.001).Compared with the blank control group 1 and 2 respectively,the fluorescence intensity of retinal-dependent calcium influx was significantly higher in the UVA/UVB-TRPA1 agonist group (q =14.934,32.770,P ＜ 0.001),and significantly lower in the UVA/UVB-TRPA1 antagonist group (q =7.986,14.596,P ＜ 0.001).Conclusion TRPA1 is expressed in HaCaT cells,and UVA or UVB can regulate the calcium influx in HaCaT cells by adjusting the activity of TRPA 1.

Effect of ultraviolet radiation on expression of transient receptor potential ankyrin 1 in HaCaT cells / 中华皮肤科杂志

Objective To investigate the photoregulation of transient receptor potential ankyrin 1 (TRPA1) in HaCaT cells,and to explore its mechanisms.Methods Cultured HaCaT cells were divided into 225-mJ/cm2 UVA radiation groups and 25-mJ/cm2 UVB radiation groups.HaCaT cells in the UVA radiation groups were further classified into 6 groups:blank control group 1 receiving no treatment,retinal group 1 treated with 12 μmol/L retinal alone,UVA group treated with 225 mJ/cm2 UVA radiation alone,retinal + UVA group (UVA-TRPA1 control group),retinal + UVA + 500 μmol/L cinnamaldehyde group (UVA-TRPA1 agonist group) and retinal + UVA + 1 mmol/L camphor group (UVA-TRPA1 antagonist group).Additionally,HaCaT cells in the UVB radiation groups were also further classified into 6 groups:blank control group 2 receiving no treatment,retinal group 2 treated with 12 μmol/L retinal alone,UVB group treated with 25-mJ/cm2 UVB radiation,retinal + UVB group (UVB-TRPA1 control group),retinal + UVB + 500 μmol/L cinnamaldehyde group (UVB-TRPA1 agonist group) and retinal + UVB + 1 mmol/L camphor group (UVB-TRPA1 antagonist group).Real-time fluorescence-based quantitative PCR (qPCR) and Western blot analysis were performed to determine the mRNA and protein expression of TRPA 1 respectively.Flow cytometry was conducted to investigate changes of calcium influx in HaCaT cells in the above groups.Results qPCR and Western blot analysis showed that TRPA1 mRNA and protein were expressed in HaCaT cells.The fluorescence intensity of calcium influx significantly differed among the blank control group 1,retinal group 1,UVA group and retinal + UVA group (155.06 ± 7.62,148.37 ± 18.77,166.92 ± 3.71 and 331.333 ± 40.563;F =44.509,P ＜ 0.01),as well as among the blank control group 2,retinal group 2,UVB group and retinal + UVB group (150.20 ± 1.73,171.66 ± 56.23,147.56 ± 6.60 and 250.44 ± 9.13;F =85.261,P ＜ 0.01).Additionally,retinal + UVA/UVB groups showed significantly higher fluorescence intensity of calcium influx compared with the blank control groups (q =18.442,6.052,P ＜ 0.01).The TRPA1 agonist cinnamaldehyde and its antagonist camphor could regulate the UVA-and UVB-induced calcium influx (P ＜ 0.001).Compared with the blank control group 1 and 2 respectively,the fluorescence intensity of retinal-dependent calcium influx was significantly higher in the UVA/UVB-TRPA1 agonist group (q =14.934,32.770,P ＜ 0.001),and significantly lower in the UVA/UVB-TRPA1 antagonist group (q =7.986,14.596,P ＜ 0.001).Conclusion TRPA1 is expressed in HaCaT cells,and UVA or UVB can regulate the calcium influx in HaCaT cells by adjusting the activity of TRPA 1.

Clinical observation of brucea javanica oil combined with 125I and chemotherapy on Stage Ⅲ-Ⅳ Pa-tients with non-small cell lung cancer / 中国综合临床

Objective To investigate the clinical efficacy and side reaction of brucea javanica oil ( BJO) combined with 125I and chemotherapy on stageⅢ?Ⅳpatients with non?small cell lung cancer ( NSCLC) . Methods One hundred and twenty cases on stageⅢ?Ⅳpatients with NSCLC were randomly divided into two groups,60 cases received BJO combined with 125I and chemotherapy treatment(observation group),the other 60 cases received 125I combined with chemotherapy treatment(control group). Results The objective response rate(ORR) and disease control rate (DCR) were 71. 7%,86. 7% of observation group and 66. 7%,85. 0% of control group,there were no significant difference(χ2=0. 352,0. 069;P>0. 05) . The improvement rate of KPS score in observation group was significantly superior to that in control group, the difference was significant (76. 7% vs. 55. 0%;χ2=6. 261,P<0. 05) . The incidence of myelosuppression and gastrointestinal adverse e?vents in observation group was significantly lower that in control group ( 68. 3% vs. 83. 3%,41. 7% vs. 61. 7%;χ2=3. 883,4. 805;P<0. 05) . Conclusion BJO combined with 125I and chemotherapy for treating on stageⅢ?Ⅳ patients with NSCLC can reduce the toxicity and side effects caused by chemotherapy,and significantly im?prove the clinical symptoms and quality of life of patients.

Expression of NRP-1 in gastric cancer tissue and its correlation with clinicopathological characteristics and prognosis / 重庆医学

Objective To detect the expression of NRP‐1 in gastric cancer tissue ,to analyze its relationship with clinicopath‐ological features ,and to explore its value in judging the prognosis of gastric cancer .Methods The clinical pathologic data and prog‐nosis situation in 168 cases of gastric cancer were retrospectively analyzed .The expression of NRP‐1 in gastric cancer tissue and normal tissue was detected by the immunohistochemical method .The relationship between the expression of NRP‐1 with the clinico‐pathological features and prognosis was investigated .Whether NRP‐1 serving as a reference indicator for judging the prognosis of gastric cancer was evaluated .Results (1) In 168 cases ,the NRP‐1 expression in gastric cancer tissue was higher than that in nor‐mal tissue (66 .7% vs .8 .33% ,P<0 .05) .(2) The NRP‐1 expression was related with the tumor size ,differentiation degree ,infil‐trative depth ,lymph node metastasis and TNM stage(P<0 .05) .(3)The median survival time in the patients with high NRP‐1 ex‐pression was shorter than that in the patients with low NRP‐1 expression (P<0 .05) .(4) The multiple factor analysis by COX pro‐portional hazard model showed that the NRP‐1 expression was an independent risk factor for the prognosis of gastric cancer(P<0 .05) .Conclusion (1)NRP‐1 plays an important role in the incidence and development process of gastric cancer and its expression is closely related with the malignant biological behavior of gastric cancer .(2)The high NRP‐1 expression prompts poor prognosis .(3) NRP‐1 may be expected to be regarded as one of the indexes for judging the biologic behaviors and prognosis of gastric cancer .

Immunogenicity of recombinant Lactobacillus casei expressing VP2 protein of infectious bursal disease virus in chickens / 生物工程学报

In order to determine immunogenicity and protective effect in chickens, we used the IBDV (Infectious bursal disease virus)-Vp2/Lactobacillus casei as antigen transfer system. First, the immunized and control chickens were challenged by IBDV/DQ at lethal dose to determine the protective ratio. Second, chickens were orallyand intranasally vaccinated twice with 10(9) CFU/mL pLA-VP2/L. casei, pLA/L. casei and PBS as negativecontrol and commercial vaccine as positive control. The bursa injury and the lesion score wererecorded post challenge. The level of specific IgG and sIgA in pLA-VP2/L. casei and positive control groups was significantly higher than that in negativecontrol groups. The protection efficacy in pLA-VP2/L. casei oral group was higher than that inintranasal group. The SI. of pLA-VP2/L. casei oral group was significant higher than other groups. The lesion score indicated the pLA-VP2/L. casei was safer than commercial vaccine for bursa. Collectively, the pLA-VP2/L. casei could be a vaccine candidate for IBDV.

Chronic continuous massive pericardial effusion / 中华老年医学杂志

A 77-year-old man was admitted to our hospital at July 5th,2010 with an unexplained massive pericardial effusion for 10 years.With dyspnea for one month and normal vital signs without pulsus paradoxus,other physical examination included a small amount of moist rale,normal heart sounds,jugular vein engorgement,positive hepatojugular reflux,hepatosplenomegaly and pitting edema of the extremities.The patient had a complex past history with lymph node tuberculosis,primary artertial hypertension,polycythernia vera,chronic renal insufficiency and hypothyroidism (Hashimoto's thyroiditis),and moreover,received a high dose radiation of 31p in 1967. Family history is negative.The patient had no cardiac tamponade or pericardial constriction during 10 years,he received pericardiocentesis twice,and pericardial effusion was exudative with a high proportion of monocyte.There was no evidences of tuberculosis infection,hypothyroidism,malignant tumor,severe heart failure,uremia,trauma,severe bacterial or fungus infection,chronic myeloid leukemia or bone marrow fibrosis during the admission. The patient refused anti tuberculosis,indwelling catheter drainage or surgical therapy.In this rare case,the aetiology of chronic massive pericardial effusion is most probably chronic idiopathic recurrent pericarditis.

Clinical analysis on 60 cases of intrahepatic cholestasis with pregnancy / 中国基层医药

Objective To investigate the clinical manifestation and therapeutic result of 60 cases of intrahepatic cholestasis of pregnancy.Methods The clinical manifestation and treatment on 60 cases with intrahepatic cholestasis of pregnancy(ICP)Retrospectively analyzed.Results 60 patients with ICP were showed cutaneous pruritus.Compared with the pre-ICP group,AST,ALT,TBIL、DBIL and TBA of patients in the after-ICP group were obviously increased,and perinatal mortality of patients in the after-ICP group were obviously increased.Conclusion It was a key point for reducing the death rate by means of earlier diagnosis,earlier treatment,earher monitor and to terminate pregnancy with an adequate laboring way.

Comparison of treatment effect between lifting laparoscopic surgery and open surgery for uterus myoma / 中国医师进修杂志

Objective To compare therapeutic effect on two surgical methods of uterus myoma between lifting laparoscopic surgery and open surgery, and evaluate the advantage,disadvantage and surgical indication for lifting laparoscopic surgery. Methods The clinical data of uterus myoma patients separately from lifting laparoscopic surgery(79 cases, group A) and open surgery (87 cases, group B) were retrospectively analyzed,the data such as total bleeding volume,operation time, anus exhausting time,postoperative hospitalization time, period of temperature returning to normal, and abdominal scar, catheter retention time and postoperative using analgesics were analyzed between two groups. Results The total bleeding volume,anus exhausting time,catheter retention time, period of temperature returning to normal, postoperative hospitalization time in group A [(58.4 ± 31.6) ml,(19.5 ± 2.5) h,(11.1 ± 2.5) h,(1.3 ± 0.8) d, (5.1 ± 1.9)d] were lower than those in group B [(99.1 ±45.6) ml, (35.8 ±4.0) h, (21.5 ±2.4) h, (2.6 ± 1.3) d,(10.4 ± 2.4) d](P ＜ 0.01). The postoperative using analgesics rate in group A was lower than that in group B [34.2%(27/79) vs. 66.7%(58/87)] (P ＜ 0.01), and abdominal scar was not obvious. Conclusion Lifting laparoscopic surgery treatment of uterus myoma is superior to the open surgery treatment.

The effects of urapidil on myocardial perfusion and cardiac function in acute myocardial infarction / 中国综合临床

Objective To evaluate the effect of urapidil on myocardial reperfusion and cardiac function during primary percutenons coronary intervention (PCI) in acute myocardial infarction (AMI) patients.Methods 54 AMI patients undergoing primary PCI were randomized to intracoronary urapidil (n=27) and nitroglycerin (n=27) group.When blood flow grade TIMI-l or more appeared in the infarct related artery (IRA) before or after percutenous transluminal coronary angioplasty (PTCA),urapidil (12.5 mg) or nitroglycerin (0.2 mg) was given intracoronary and then stents were implanted as needed.TIMI blood flow,no reflow/slow floW,corrected TIMl frame count (cTFC),myocardial blush grade (MBG),ST resolution (STR) on ECG, peak of creatine kinase (CK),cardiac troponin T (cTnT) were observed before and after PCI.Left ventricular ejection fraction (LVEF) was measured 24 hours and 30 days after PCI and MACE including death,reinfartion,revascularization in hospital were observed. Resuits Urapidil group compared to the nitroglycerin group,cTFC (18.38±3.30 vs.21.44±4.26,P=0.005) decreased and MBG (P=0.040) improved.STR in the urapidil group improved significantly compred to the nitroglycerin group (93% vs.70%,P=0.038).LVEF of 24 hours and 30 days after PCI in the urapidil group was higher than that ofthe nitroglycerin group (0.55±0.05 vs.0.52±0.06,P=0.021 and 0.58±0.06 vs 0.54±0.06,P=O.041,respectively).Peak CK (1895.26±1239.02 vs.1269.96±515.84,P=0.021) and peak TnT (5.81±5.27 vs 3.64±2.35,P=0.050) in the urapidil group decreased more significantly than that of the nitroglycerin group.No difference of MACE was found in the two groups.Conclusion Intracoronary urapidil administration adjunct to primary PCI in AMI ameliorates coronary blood flow and myocardial perfusion, improves ventricular function,and reduce the infarct size and does not incllase the incidence of complications during hospitalization.

Study on Pharmacokinetics and Bioequivalence of Simvastatin Sustained Release Tablets in Beagle Dogs / 中国药房

OBJECTIVE:To study pharmacokinetics and bioequivalence of Simvastatin sustained release tablets in healthy beagle dogs.METHODS:6 beagle dogs were randomized into two groups.They received oral single dose of Simvastatin sustained release tablets 20 mg(test tablet) or Simvastatin tablets for sale(reference tablet).Plasma samples were collected at different time points.Plasma concentration of simvastatin acid was determined by LC-MS/MS and pharmacokinetic parameters were calculated.RESULTS:The pharmacokinetic parameters of reference tablet vs.test tablet were as follows:Cmax:(23.461?6.043) ng?mL-1 vs.(13.942?3.236) ng?mL-1;tmax:(2.158?0.396) h vs.(4.116?1.145 3) h;t1/2:(4.564?0.645) h vs.(8.143?0.679) h;AUC0～24 h:(118.647?31.989) ng?h?mL-1 vs.(129.977?29.853) ng?h?mL-1.CONCLUSIONS:The absorption rate of test tablet is different from that of reference tablet.The two kinds of tablets are not bioequivalent.

Absorption Kinetics of Simvastatin in Rats / 中国药房

0.025 63 h-1).A linear relation between absorption and concentration was noted for simvastatin at a concentration of 1.0～20.0 ?g?mL-1;and within a pH value of 5.0～7.4,the absorption of simvastatin was not affected.CONCLUSION:Simvastatin showed absorption behavior in the whole section of intestine.The absorption of the drug conforms to the passive transport mechanism and first-order kinetics.The results indicate that simvastatin can be formulated and prepared into sustained-release drug delivery system.

Analyzing of the evolutionary trend of clinical features and therapy in 68 cases of infective endocarditis / 中国实用内科杂志

Objective To analyze the evolutionary trend of clinical features in infective endocarditis.Methods The study enrolled 68 patients who were diagnosed as having infective endocarditis from July 1987 to July 2007.The patients were divided into two groups:group Ⅰ included patients from 1987 to 1997,group Ⅱ included patients from 1997 to 2007.All clinic data were compared.Results In both groups,61 patients(89.7%) had basic heart diseases,67 patients(98.5%) had fever and 62 patients(91.2%)had cardiac murmur;41 patients(60.3%) had positive results in the blood culture.Vegetations were found in 57 cases(83.8%) by echocardiography.The rate of surgical treatment was 19.1%,the total cure rate was 66.7%.Comparing the data between the two groups,age of onset changed from (36.7?12.7)years to (44.4?18.6)years(P

Early-phase changes of parameters related to myocardial fibrosis in acute myocardial infarction / 中国病理生理杂志

AIM:To investigate the changes in parameters related to myocardial fibrosis of H2 relaxin (H2RLX) and procollagen type I C-terminal peptide (PICP),transforming growth factor-?1 (TGF-?1) level in the plasma after acute anterior myocardial infarction. METHODS:Forty-one patients with anterior myocardial infarction (MI) and 10 controls with normal coronary vessels were selected. Plasma H2RLX,PICP,and TGF-?1 levels were determined by enzyme linked immunosorbent assay (ELISA) in 10 control subjects and 41 post-MI patients at day 3 and 7 post-MI. RESULTS:(1) H2RLX level at day 3 post-infarct had no difference between the patients and the controls. No marked change in H2RLX at day 3 versus day 7 post-infarct was observed. (2)The level of PICP at day 3 post-infarct was markedly increased followed by a fall at day 7 post-infarct,but was still higher than that in control. (3) TGF-?1 level,which was similar at day 3 and 7 post-infarct,was higher than that in control. (4) At day 7 post-infarct,the level of H2RLX was positively correlated with the fasting blood glucose in MI group. CONCLUSION:In early period of acute MI,profibrotic factors such as TGF-?1 expression and collagen expression increase. However,antifibrotic relaxin has no change.