Importance of zinc in human immune system / 中华微生物学和免疫学杂志

Zinc is one of the essential trace elements for human. It is essential for human health. In recent decades, the distribution and transport of zinc in human body have gradually become more evident. The immunomodulatory effects of zinc on the immune system have also been elucidated. Zinc is involved in regulating the cellular signaling pathways of immune cells and affecting the development of immune organs, the physiological state and function of immune cells and the secretion of cytokines. It is an indispensable element in the immune system and plays an important role in maintaining the integrity and stability of the immune system. This article briefly introduced the distribution and transportation of zinc in the human body, with the emphasis on the relationship between zinc and the development and function of immune cells.

Effect of Modified Anshentang on Serum Inflammatory Factors, Immune Function, Bone Metabolism on Treatment of Patients with Ankylosing Spondylitis in Early and Middle Stages / 中国实验方剂学杂志

Objective:This study aims to investigate the clinical efficacy of modified Anshentang on the treatment of ankylosing spondylitis in early and middle stages with kidney deficiency and cold-governing syndrome and its effect on serum inflammatory factors， immune function， and bone metabolism indexes of patients. Method:In this study， 120 patients were randomly divided into control group and observation group， 60 cases in each group. On the basis of ethotrexate treatment， patients in control group took Bushen Shuji granule orally， while patients in observation group took modified Anshentang orally for 8 weeks. Before and after treatment， patients in two groups were observed for clinical symptoms ［ bath ankylosing spondylitis patient global score （BAS-G）， bath ankylosing spondylitis disease activity index （BASDAI）， spondyloarthritis research consortium of Canada （SPARCC）， traditional Chinese medicine symptoms （TCM symptoms）<italic> </italic>］， serum inflammatory factors ［ tumor necrosis factor-<italic>α </italic>（TNF-<italic>α</italic>）， macrophage migration inhibitory factor （MIF）， interleukin-23 （IL-23）］， immune function ［ immunoglobulin A（IgA）， immunoglobulin G（IgG）， immunoglobulin M（IgM）］， bone metabolic indicators ［osteocalcin （BGP）， bone morphogenetic protein-2 （BMP-2）， bonespecific alkaline phosphatase （BALP）］. The clinical efficacy， adverse reactions and recurrence rates of 12 months in two groups were observed. Result:During the study， 4 cases dropped out from control group and 2 cases from observation group. The total effective rate of 96.55% （56/58） in observation group was higher than 80.36% （45/56） in control group （<italic>χ</italic>²=4.827，<italic>P</italic><0.05）. The recurrence rate of 5.17% （3/58） in observation group was lower than 19.64% （11/56） in control group （<italic>χ</italic>²=5.187， <italic>P</italic><0.05）. Compare with control group after treatment， BAS-G，BASDAI， SPARCC， TCM symptoms， TNF-<italic>α</italic>， MIF and IL-23 in observation group were significantly decreased （<italic>P</italic><0.05）， while BGP， BMP-2， BALP， IgA， IgG and IgM were significantly increased （<italic>P</italic><0.05）. The incidence of adverse reactions was 12.07%（7/58） in observation group， which was lower than 32.14%（18/56） in control group （<italic>χ</italic>²=4.826，<italic>P</italic><0.05）. Conclusion:Modified Anshentang is effective in the treatment of ankylosing spondylitis in early and middle stages with kidney deficiency and cold-governing syndrome， and the incidence of adverse reactions is low.

Role of des-gamma-carboxy prothrombin in assessment of liver function and prognosis of patients with liver cirrhosis / 中华消化杂志

Objective@#To investigate the role of des-gamma-carboxy prothrombin (DCP) in assessment of liver function and prognosis of patients with liver cirrhosis. @*Methods@#From January 2013 to August 2016, a total of 137 patients with liver cirrhosis in Shanghai Changzheng Hospital were enrolled. The serum DCP level was measured, the clinical data was collected and the complication and survival situation was followed up. The 137 patients were divided into DCP negative group (DCP≤40 mAU/mL, 118 cases) and DCP positive group (DCP>40 mAU/mL, 19 cases). Forty-five patients with compensated liver cirrhosis were divided into high-level DCP group (DCP>16.5 mAU/mL, 32 cases) and low-level DCP group (DCP≤16.5 mAU/mL, 13 cases). Chi square test was used to analyze the difference in the positive rate of DCP in patients with different Child-Pugh classification. Spearman correlation test was performed to analyze the correlation between DCP and model for end-stage liver disease (MELD) scores. Kaplan-Meier survival curve was used to analyze the correlation between DCP and liver disease related mortality. @*Results@#Compared to that of DCP negative group, albumin level of patients in DCP positive group decreased (35 g/L, 20 to 57 g/L vs. 29 g/L, 17 to 42 g/L), however, total bilirubin (TBil), prothrombin time (PT), and international normalized ratio all increased (12.9 mg/L, 1.80 to 83.0 mg/L vs.22.2 mg/L, 6.4 to 169.0 mg/L; 15.5 s, 11.7 to 35.7 s vs.17.5 s, 13.9 to 33.4 s; 1.24, 0.96 to 3.72 vs.1.44, 1.09 to 3.22), and the differences were statistically significant (Z=-2.785, -2.891, -2.945 and -2.879, all P<0.01). The DCP positive (DCP>40 mAU/mL) rates of Child-Pugh A, B and C patients were 1.8% (1/55), 21.2% (11/52) and 23.3% (7/30), respectively, and the difference was statistically significant (χ2=11.246, P=0.003). The DCP levels of patients with Child-Pugh class B and C cirrhosis were significantly correlated with MELD scores (r=0.259, P=0.021). There were 16 and three patients with ascites and spontaneous bacterial peritonitis (SBP) of DCP positive group, and the incidence was higher than that of DCP negative group (55.1%, 65/118 and 1.7%, 2/118), and the differences were statistically significant (χ2=5.744 and 97.636, both P<0.05). Patients in high-level DCP group had a higher proportion of clinical decompensation than low-level DCP group (53.1% (17/32) and two cases), the difference was statistically significant (χ2=5.397, P=0.024). The overall survival rate of DCP positive group (nine survival cases) were lower than that of DCP negative group (87.9%, 87/99), and the difference was statistically significant (χ2=5.442, P=0.020). @*Conclusions@#Serum DCP level is closely related to liver function, ascites and SBP in patients with liver cirrhosis. Furthermore, it is associated with occurrence of decompensation in compensated patients and liver-related mortality in patients with liver cirrhosis. DCP may be a useful serum marker for evaluation of disease severity and prognosis in patients with liver cirrhosis in clinical practice.

Infection factors affecting the recovery of kidney function after kidney transplantation and the Countermeasures / 中华器官移植杂志

Objective To investigate the influence of infection factors on kidney transplantation after organ donation and possible countermeasures.Methods Thirty-seven cases of kidney transplantation in Organ Transplantation Center of Qianfoshan Hospital Affiliated to Shandong University from January 2014 to December 2016 were retrospectively analyzed.The patients were divided into two groups according to perioperative infection prevention programs:42 patients with postoperative routine use of cephalosporins or penicillin for 2 weeks,and 95 patients with postoperative application of carbapenems + micafungin.Postoperative infection rate,occurrence time,pathogen infection;donor age,perioperative pathogens of donor and receptor (organ preservation solution,drainage fluid,urine,sputum samples),acute rejection,delayed graft function (DGF),diabetes mellitus,and the use of immunosuppressive agents were recorded.Results The infection rate in carbapenem + micafungin group was 12.6％,and the infection rate in cephalosporin or penicillin group was 19.4％ (P＜0.05).Pathogen positive detection rate of the drainage fluid,urine and sputum was lower in carbapenems + micafungin group than that in cephalosporins or penicillin (P＜0.05).Within 2 weeks after operation,the detection rate of bacteria and fungi in the carbapenems +micafungin infection prevention group was lower than that in the control group (P＜0.05).There was no significant difference in the detection of viruses (P＞0.05).There were no significant differences in the detection of pathogens among the two weeks to six months after surgery (P＞ 0.05).Donor infection,acute rejection,DGF,and diabetes mellitus were the risk factors for postoperative infection (P＜0.05).Conclusion The application of carbapenems and micafungin can reduce the incidence of infection for the early stage of DCD kidney transplantation.Donor infection,acute rejection,DGF and diabetes mellitus are all risk factors for the postoperative infection.

Clinical analysis of mechanical perfusion in donor after cardiac death kidney transplantation / 中华器官移植杂志

Objective To observe the clinical effect of mechanical perfusion preservation kidney transplantation in donor after cardiac death (DCD),and to explore the effect of mechanical perfusion preservation of DCD on renal function recovery.Methods The clinical data of 186 patients undergoing DCD kidney transplantation from January 2012 to December 2016 were retrospectively analyzed.Sixty-eight DCD donor's kidneys were preserved by LifePortpreservation (low temperature mechanical perfusion group),118 DCD donor's kidneys were preserved by static low temperature preservation (static low temperature preservation group).The renal function recovery,the incidence of primary non-function,delayed graft function and infection,and the survival rate of patients and renal grafts were analyzed.Results There was no significant difference between the two groups in gender,age,hemodialysis ratio,dialysis time,BMI,warm ischemia time and cold ischemia time (P＞0.05).There was significant difference in creatinine value between the two groups at 1st week (P＜0.05),but there was no significant difference in creatinine at 3rd,6th,12th,24th and 36th month (P＞0.05).There was significant difference in the incidence of DGF between two groups (P＜0.05),but no significant difference in the incidence rate of PNF,AR and infection,and the survival rate of patient and renal graft between two groups (P＞0.05).There was no significant difference in 1-and 3-year survival rate of the recipients and transplanted kidney between the two groups (P＞0.05).Conclusion LifePort can significantly reduce the incidence of DGF as compared with static cold preservation.The resistance index and perfusion flow of the LifePort have important significance to assess the renal quality.

The relationship between coagulation function and birth weight and gestational age in newborn / 中国医师进修杂志

Objective To understand the relationship between coagulation function and birth weight and gestational age in newborn. Methods Five hundred premature infants in NICU from June 2015 to June 2016 were enrolled. Perinatal high-risk factors(gestational hypertension, gestational diabetes, placenta previa, spontaneous premature delivery) and general status (gestational age, sex, delivery mode, birth weight)were documented. Blood coagulation function (PT, APTT, FDP, DD, FIB, AT-Ⅲ) was detected within 6 h after birth. The premature infants were divided into three groups according to gestational age, early preterm neonate group (28-30+6 weeks, 48 cases), moderate preterm neonate group (31-33+6 weeks, 125 cases), and late preterm neonate group (34-36+6 weeks, 216 cases). And there were 111 term infants (37- 42 weeks, 111 cases). In addition , the relation between birth weight and coagulation function was analyzed. Sixty-six twins were collected and divided into tow groups according to their weight, the-lighter group and the-heavier group. The coagulation function was analyzed and compared among different gestational age groups. Results There were no differences in perinatal risk factors (P > 0.05). There were significant differences in various coagulation parameters among three groups [APTT: (93.25 ± 21.34), (82.80 ± 21.37), (78.29 ± 17.77), (62.03 ± 13.7) s;FIB: (1.95 ± 0.96), (1.67 ± 0.60), (1.51 ± 2.44), (1.40 ± 0.85) g/L; DD: (2.11 ± 0.64), (1.02 ± 0.33), (0.66 ± 0.31), (0.51 ± 0.25) mg/L;AT-Ⅲ:(25.89 ± 11.80)%, (33.86 ± 11.40)%, (36.65 ± 13.60)%, (45.18 ± 14.82)%] (P 0.05). Conclusions The coagulation function in early life in premature infants is associated with gestational age, and has no relationship with birth weight. The coagulation function of premature infants is in a changing and gradually mature process, which should be monitored dynamically.

The effect of Tongxinluo capsule combined with Jinlida sintervention on vascular ;endothelial fuction and blood glucose in the patients with Type 2 diabetes / 国际中医中药杂志

Objective To observe the effect of Tongxinluo capsule combined with Jinlidas intervention on vascular endothelial fuction and blood glucose in the patients with Type 2 diabetes. Methods A total of 100 patients with Type 2 diabetes were randomly divided into treatment and control groups with 50 patients each. Both groups were received subcutaneous injection insulin, oral admistration of Simvastatin and Aspirin. And the treatment group were received Tongxinluo capsule and Jinlida sintervention based on the standard treatment. The changes of serum levels of FPG, 2hPG, HbAlc, VEGF, NO, ET-1 were observed before and after treatement. All the patients were treated for 12 weeks. Results After the treatment, the serum of FPG (7.03 ± 2.11 mmol/L vs. 8.09 ± 2.03 mmol/L, t=1.911), 2hPG (9.27 ± 2.03 mmol/L vs. 12.06 ± 3.54 mmol/L, t=1.946), HbAlc (6.98%± 1.58%vs. 8.06% ± 2.13%, t=2.013) were decreasd (P<0.05). Besides, VEGF (684.61 ± 84.37 ng/L vs. 514.28 ± 79.52 ng/L, t=2.136), NO (43.28 ± 6.40 ng/L vs. 34.64 ± 6.70 ng/L, t=2.097) of treatment group were siginificantly higher than the control group (P<0.05), while ET-1 (53.13 ± 7.24μmol/L vs. 60.09 ± 7.18μmol/L, t=2.271) were siginificantly lower (P<0.05). Conclusion Tongxinluo capsule combined with Jinlida sintervention could decreased the level Blood glucose and improve vascular endothelial fuction in the patients with Type 2 diabetes.

The Application of We-chat Platform in Nursing Management / 医学信息学杂志

Taking the ICU We-chat platform of China Medical University Affiliated Shengjing Hospital as an example, the paper in-troduces its operation mode, analyzes its application effect, advantages and potential problems, points out that We-chat platform is ad-vantageous to improving nursing management quality, it could be a new way of nursing management.

Función renal en pacientes pediátricos con trasplante alogénico de progenitores hematopoyéticos / Renal function in pediatric patients with allogeneic hematopoietic progenitor cell transplantation

Patients with hematopoietic stem cell transplantation can develop some degree of renal failure. The aim of this descriptive study is to evaluate markers of kidney injury in pediatric patients undergoing allogeneic hematopoietic stem cell transplantation between 1991 and 2011. Patients and Method: A descriptive study of pediatric patients with allogeneic transplant of hematopoietic precursors between 1991 and 2011. The patients were between 1 month and 18 years of age at the time of the study and had at least 6 months of follow up. Clinical and nutritional history, continuous blood pressure monitoring (ABPM), urine tests, proteinuria, creatinine and renal and bladder ultrasonography imaging were evaluated. Results: During this period 65 patients were transplanted, of which 13 patients were included. 46% (n = 6) showed diverse degrees of renal compromise defined by altered renal parenchymal echogenicity, clinic or masked hypertension and/or microalbuminuria. Conclusion: In this clinical group, almost half of the patients patients had some degree of renal injury in their evolution. We consider essential to assess the renal function in the follow-up of these patients.

Introducción: Los pacientes con trasplante de progenitores hematopoyéticos pueden evolucionar con algún grado de compromiso renal. El objetivo de este estudio descriptivo fue evaluar marcadores de injuria renal en pacientes pediátricos sometidos a trasplante alogénico de progenitores hematopoyéticos entre 1991 y 2011. Pacientes y Método: Estudio descriptivo en pacientes pediátricos con Trasplante alogénico de Precursores Hematopoyéticos entre los años 1991 y 2011 con edad entre 1 mes y 18 años al momento de realizar el estudio y que tuviesen al menos 6 meses de seguimiento. Se evaluaron antecedentes clínicos, nutricionales, presión arterial por monitoreo continuo (MAPA), exámenes de orina, proteinuria, creatininuria y estudio de imágenes por ecotomografía renal y vesical. Resultados: Durante este período se trasplantaron 65 pacientes, de los cuales se incluyeron 13 pacientes. Un 46% (n = 6) presentó compromiso renal de grado variable definido por alteración en la ecogenicidad del parénquima renal, hipertensión arterial clínica o enmascarada y/o microalbuminuria. Conclusión: En la serie clínica estudiada con el 50% de los pacientes presentó algún grado de injuria renal en su evolución. Consideramos importante evaluar función renal en el seguimiento de este grupo de pacientes.

Síndrome de plaqueta pegajosa / Sticky platelet síndrome

Resumen: El síndrome de plaqueta pegajosa es una trombofilia hereditaria, de carácter autosómico dominante, caracterizada por aumento in vitro de la agregación plaquetaria en respuesta a bajas concentraciones de epinefrina y/o adenosindifosfato (ADP) que se expresa como un estado protrombótico, tanto arterial como venoso. De acuerdo con el patrón de la agregometría plaquetariacon diferentes concentraciones de epinefrina y ADP, se presentan tres formas: síndrome de plaqueta pegajosa tipo I, hiperagregación plaquetaria con epinefrina y ADP; síndrome de plaqueta pegajosa tipo II, hiperagregación plaquetaria con epinefrina sola; y, síndrome de plaqueta pegajosa tipo III, hiperagregación plaquetaria con ADP solo. Las manifestaciones clínicas están relacionadas con la predisposición a trombosis arteriales o venosas, que se expresan como isquemia coronaria o cerebral, isquemia de vasos retinianos y trastornos de la microcirculación placentaria que puede asociarse con restricción del crecimiento intrauterino del feto, preeclampsia,eclampsia y pérdidas fetales, entre otras manifestaciones. El diagnóstico del síndrome de plaqueta pegajosa se establece mediante la agregación plaquetaria al demostrar la hiperagregación de las plaquetas inducida por pequeñas dosis de epinefrina y/o ADP. El tratamiento se basa en la administración de antiagregantes plaquetarios, siendo la aspirina a baja dosis la droga ideal y el clopidogrel cuando hay resistencia a la aspirina o esta está contraindicada. El objetivo de este módulo es revisar la literatura médica mundial sobre este nuevo síndrome que debe ser tenido en cuenta en el diagnóstico y manejo de la trombofilia como una nueva opción para el paciente afectado por uno de estos síntomas.

Abstract: Sticky platelet syndrome is an autosomal dominant inherited thrombophilia, characterizedby increased in vitro platelet aggregation in response to low concentrations of epinephrine or adenosine diphosphate (ADP). It is present as a prothrombotic state, both arterial and venous. According to platelet aggregation pattern, with the different ADP and epinephrine concentrations,three types of the syndrome can be identified: sticky platelet syndrome type I, platelet hyperaggregation with both reagents; sticky platelet syndrome type II, platelet hyperaggregation with epinephrine alone; and, sticky platelet syndrome type III, platelet hyperaggregation with ADP alone. The clinical manifestations are associated with predisposition to venous and arterial thrombosis, including cardiac or cerebral ischemia, retinal vein ischemia, and placental microcirculationdisorders, associated with intrauterine growth restriction, preeclampsia, eclampsia, and fetal loss, among others. Sticky platelet syndrome is diagnosed by platelet aggregation test, where is found a platelet hyperaggregation in response to low doses of epinephrine and ADP. Treatment includes the use of platelet antiaggregation agents, being low-dose aspirin therapy the best choice and clopidogrel in the cases of resistance or contradiction for aspirin. The aim of this module is to review the medical literature about this new syndrome, which it should take into account in the diagnosis and management of thrombophilia as a possible option to a patient affected by these symptoms.

A randomized controlled study of juvenile idiopathic arthritis treated with recombinant human Ⅱ tumor necrosis factor-Fc function protein / 国际儿科学杂志

Objective Through the application of recombinant human Ⅱ tumor necrosis factor-Fc function protein (rhTNFR:Fc) in the treatment of juvenile idiopathic arthritis (JIA) with randomized control study,clinical characteristic and clinical effect were summarized.Methods According to the randomized controlled principle,124 patients with JIA were divided into control group and treatment group.The basic treatment in two groups were one antirheumatic slow-acting drug,nonsteroidal drug,adrenal cortical hormone.There were no significant differences between clinical type and basic treatment in two groups (P ＞ 0.05).Sixty-two patients of JIA treated with rhTNFR:Fc by subcutaneous injection.The doses was 0.8mg /kg per week.There were 17 cases of oligoarthritis,15 cases of polyarthritis,30 cases of systemic arthritis in the treatment group and control group respectively.The basic antirheumatic drugs,nonsteroidal anti-inflamatory drugs ( NSAIDs),adrenal cortex hormone were allowed to continued.Clinical evaluation index included ACR Pedi 30,ACR Pedi 50 and ACR Pedi 70.The adverse drug reactions were recorded.Results The remission rate of ACR Pedi 30,50,70 in 2 weeks,one month,three monthes and six monthes were different in types of JIA patients in the treatment group ( P ＜ 0.05 ).The remission rate of systemic arthritis was lower than the other two groups of arthritis ( P ＜ 0.05 ).Only 44％ ACR Pedi 50 remission was achieved after three monthes medication in systemic arthritis and 41.7％ ACR Pedi 50,29.2％ ACR Pedi 70 were achieved after six monthes.The remission rate in the types of oligoarthritis and polyarthritis at different time points (2 weeks,one month,three monthes,six monthes) of ACR Pedi 30,50,70 were similar.After six monthes,more than 80％ reached ACR Pedi 50 remission,more than half of patients reached ACR Pedi 70 remission.Three cases of macrophage activation syndrome in systemic arthritis group was effective treated with rhTNFR:Fc.In the treatment group,2 cases of systemic arthritis appeared ache and discomfort after one week treatment,3 cases appeared repeated mild upper respiratory tract infection and diarrhea during treatment,including one varicella infection.The incidence of adverse reactions in the treatment group of systemic arthritis were 16.7％,Other 2 types of patients did not show adverse reaction during rhTNFR:Fc treatment.Conclusion rhTNFR:Fc has good effect on oligoarthritis and polyarthritis of JIA.The adverse reactions of six monthes were rare.The cases of systemic arthritis could reach some clinical remission,but need to guard against infection and the occurrence of adverse reactions.To whom did not respond to conventional therapy in systemic arthritis or systemic arthritis combined with macrophage activation syndrome,it could be considered with rhTNFR:Fc.

A pulsão de morte na dinâmica transferencial / Death drive in the dynamics of transference

O autor propõe reflexões sobre o papel da pulsão de morte na transferência. Demosntra como essa pulsão age na análise,construindo um paralelo entre a formação do aparelho psíquico e o trabalho analítico. Descreve como esse trabalho está permanentemente intrincado com a questão da dualidade pulsional. Articula questões teóricas embasadas em pensamentos da psicanálise francesa contemporânea. Retoma o conceito de pulsão de morte e sua importância no edifício metapsicológico freudiano. Discute a questão referente ao que significa o estado anterior e o biologismo de Freud. Essa reflexões levam a refletir também sobre a função desobjetalizante na dinâmica da transferência e o par sujeito e na relação transferencial, será preciso considerar a forma como a separação sujeito/objeto ocorreu. Finaliza assinalando a necessidade da ligação para existir o ser psíquico.

The author proposes some reflections on the role of the death drive in transference. She demonstrates that this drive acts the analysis establishing a parallel between the creation of the psychic apparatus and the analytical work. It is shown how this work is permanently interwoven with the issue of the pulsional duality. The author approaches theoretical questions based in thoughts of the current French psychoanalytic school. Revisits the concept of death drive and its importance in the Freudian metapsychological construction. Discusses the issue concerning the meaning of the previous state and Freud's biologism. Such reflections make us think about the deobjectalization function in the dynamics of transference and the pair subject-object, considering that, to think the issue of deobjectalization in the transferential relationship, it will be necessary to consider the way by which the separation subject/object occurred. The author finalizes showing the need of bonding for the psychic being to exist.

EI autor propone reflexiones acerca del papel de muerte en la transferencia. Demuestra como esa pulsión actúa en el análisis construyendo un paralelo entre la Formación del aparato psíquico y el trabajo analítico. Describe como este trabajo está permanentemente intrincado con el tema de la dualidad pulsional. Articula aspectos teóricos basados en pensamientos del psicoanálisis francés contemporáneo. Retoma el concepto de pulsión de muerte y su importancia en el edificio metapsicológico freudiano. Discute el tema referente a lo que significa el estado anterior y el biologismo de Freud. Esas reflexiones llevan a reflexionar también sobre la función desobjetalizante en la dinámica de la transferencia y el par sujeto y objeto, considerando que, para pensar el tema de la desobjetalización en la relación transferencial, será necesario considerar la manera como ocurrió la separación sujeto/objeto. Finaliza señalando la necesidad de la ligación para que exista el ser psíquico.

Application of HRRT in delayed graft function after kidney transplantation / 中华器官移植杂志

Objective To observe the effect of hybrid renal replacement therapy (sustained lowefficiency hemodiafiltration) in recipients with delayed graft function (DGF) after kidney transplantation.Methods In 33 kidney transplant patients with DGF,there were 15 cases subject to sustained low-efficiency hemodiafiltration (SLEDF group),18 cases subject to hemodialysis (HD group).The renal function was tested,and the expression levels of complements C3,C4,and CRP,IL-1β,IL-6,TNF-α were detected before and after therapy.Results In SLEDF group,the renal function recovered in (29 ± 13) days after therapy,and in (47 ± 21) days in HD group.After therapy,the BUN and Scr in both two groups were lower than before (P＜0.01).After therapy,the levels of IL-1β,IL-6 and TNF-α were also lower than before in two groups,and the levels were lower in SLEDF group than in HD group (P＜0.05).The levels of complements C3,C4,and CRP in two groups were decreased after therapy,but there was no statistically significant difference (P＞0.05).Conclusion SLEDF can decrease the level of SCr,BUN and some cytokines in recipients effectively,and It's helpful to recovery of the renal function.SLEDF can be used by DGF recipients in transit time.

Conservative Deep Lobe Parotidectomy with Preservation of Superficial Lobe on Pleomorphic Adenoma in Deep Lobe of Parotid: a Case Report

Assessment of Left Ventricular Function after Mitral Valvular Replacement Using Multidetector Row Computed Tomography: Initial Experience

PURPOSE: To assess the usefulness of cardiac MDCT for the evaluation of cardiac function and morphology of mitral valve replacement (MVR) with or without subvalvular preservation. MATERIALS AND METHODS: Sixteen patients with (n = 10) or without (n = 6) subvalvular sparing and control subjects (n = 6) were evaluated using 16-slice MDCT (Sensation 16, Siemens, Erlangen, Germany). Images of MDCT were reconstructed for the evaluation of cardiac morphology and ventricular function. Patients were compared with respect to variables such as ejection fraction (EF), end-diastolic volume (EDV), end-systolic volume (ESV), and the diastolic-systolic left ventricular area ratio on a short-axis view at apical, mid-ventricular, and basal levels. RESULTS: The average values for cardiac function variables for control subjects and after MVR (with subvalvular preservation versus without subvalvular preservation) were, respectively, 54 +/- 8%, 54 +/- 7% and 44 +/- 6 %, for EF; 91 +/- 28 ml, 108 +/- 35 ml and 99 +/- 33 ml for EDV; 43 +/- 19 ml, 52 +/- 24 ml and, 56 +/- 21 ml for ESV. The area ratio was 2.56, 2.75, 2.09 at the apex; 2.20, 2.17, 1.56 at the mid-ventricular level; 1.90, 1.87, 1.76 at the basal level, respectively. Mid ventricular contraction for patients following subvalvular resection was significantly decreased (p < 0.05). CONCLUSION: MDCT is a useful diagnostic modality for functional and morphologic evaluation of MVR.

Pressão arterial sistêmica e diurese residual em pacientes com doença renal crônica em hemodiálise / Systemic blood pressure and residual urine output in chronic hemodialysis patients

Introdução: A função renal residual (FRR) em portadores de insuficiência renal crônica (IRC) submetidos à diálise é reconhecida como fator relevante naredução do risco relativo de morte neste grupo de pacientes. Pacientes com maiores níveis de FRR e de volume de diurese residual (VDR) tem maiorliberdade na ingestão de líquidos e melhor controle do balanço hídrico. Objetivo: Analisar transversalmente o VDR de pacientes com IRC submetidos àhemodiálise (HD) e sua relação com os níveis pressóricos sistêmicos. Pacientes e Métodos: Foram estudados 144 pacientes, divididos em dois grupos:os anúricos (A; n=80) e os não anúricos (NA; n=64). A pressão arterial sistêmica, aferida antes e após as últimas 3 sessões de hemodiálise, o ganho de peso interdialítico e o volume de ultrafiltrado eram anotados. Os pacientes foram submetidos a um questionário onde eram perguntados sobre o volume de urina eliminado no dia anterior à hemodiálise. Resultados: A pressão arterial sistólica após a sessão de hemodiálise foi maior no grupo A (130 ± 2,3versus 119 ± 4,0 mmHg, p <0,05). Em contraste, a pressão arterial diastólica do grupo A só foi maior do que aquela observada no grupo NA antes dasessão de hemodiálise (82 ± 1.6 mm/Hg versus 77 ± 1,8 mm/Hg; p<0,05). O grupo A obteve maior ganho de peso no período entre as sessões de HD (3,2 ± 1.5 versus 2.0 ± 1,8 Kg, p <0,05). O número de anti-hipertensivos usados pelo grupo A foi de 1,92 ± 0,16 unidades e pelo grupo NA foi de 1,76 ±0,17 unidades (NS, p >0,05). Conclusão: A ausência da diurese residual nos pacientes em hemodiálise associa-se a maiores valores da pressão arterial sistêmica, principalmente os níveis diastólicos. A hemodiálise reduz os valores da PAD nos indivíduos anúricos igualando-os aos dos indivíduos não anúricos. Esforços devem ser empregados para prevenção da diurese residual, visando melhor controle hídrico e pressórico dos pacientes em hemodiálise.

Introduction: The residual renal function (RRF) in patients with chronic renal failure is recognized as a relevant factor to reduce the relative risk of deathin these patients. Higher levels of RRF and residual urine output allow more flexible water intake and a better control of the volume status. Objectives: The aim of this study was to evaluate the urine output of patients with chronic renal failure under hemodialysis treatment and to analyze its relationship to the systemic blood pressures levels of patients with or without residual urine volume. Patients and Methods: One-hundred and forty-four patients comprising an anuric group (A; n= 80) and a non-anuric one (NA; n= 64). The systemic arterial blood pressure, which was verified pre- and post- the last 3 hemodialysis sessions, weight gain between sessions, and the ultrafiltration volume along the dialysis sessions were registered. The patients answered a questionnaire about the urine output the day before the hemodialysis session. Results: The systolic blood pressure level was higher in group A after hemodialysis (130 ± 2.3 versus 119 ± 4.0 mmHg, p < 0.05). In contrast, the diastolic blood pressure in group A was higher than that observed in those of group NA only beforethe dialysis session (82 ± 1.6 versus 77 ± 1.8 mmHg; p < 0.05). Group A had a larger weight gain between hemodialysis sessions (3.2 ± 1.5 versus 2.0 ± 1.8 kg, p < 0.05). The number of blood pressure drugs administered to the patients in group A was 1.92 ± 0.16 units; and to those in group NA was 1.76 ± 0.17 units (NS). Conclusion: The absence of residual urine volume in hemodialysis patients was associated with higher levels of predialysis diastolic blood pressure . Hemodialysis reduced the diastolic blood pressure values in anuric patients in a way that their values became similar to those found in non-anuric ones...

Serotonin Transporter and Pharmacotherapy / 대한정신약물학회지

The serotonin transporter (SERT) is the target site for serotonin reuptake inhibitors, which are the most widely used agents for treating various psychiatric diseases including depression. The SERT is a member of a large family of homologous integral membrane proteins. This transporter takes up 5-HT in a process that is coupled to the transmembrane movement of Na+, Cl-, and K+. The SERT may operate in at least two modes, an alternating access carrier or a channel. The function of SERT is acutely regulated by various protein kinases and phosphatases. The SERT gene is located on chromosome 17 and has several polymorphisms including 5-HTTLPR and intron 2 VNTR. Most studies involving the association between 5-HTTLPR and the response to SSRI in depression reported that l/l genotype showed better response and fewer side effects. But, it is too early to draw definite conclusion of the effects of 5-HTTLPR on anti-depressant treatment. Therefore, it is necessary to perform further studies reflecting various ethnicities and genetics of subjects as well as the environmental interactions. This review discusses recent advances in defining the structure, the action mechanism, the location, and the regulation of SERT. Furthermore, it discusses the function of SERT polymorphisms and its implications on the anti-depressant therapies.

Typical function and application of Clinical Information System(CIS) / 医疗卫生装备

Clinical Information System(CIS)is a new period of hospital information system(HIS).The construction of CIS can improve doctors and nurses' work.The traditional CIS includes doctor-workstation,PACS,LIS,RIS,etc.By establishing clinical coding system,PASS,online information gathering system and PDA,the information quality and application level of CIS can be elevated.

Application of radial basis fuction network for determination of Antongding injection / 药学实践杂志

BJECTIVE:To apply the radial basis fuction neural network for the spectrophotometric analysis of three components combined preparation.METHODS:Aminopyrine and antipyrine in Antongding injection were determined by radial basis fuction neural network UV spectrophotometry,barbitial was determined with absorbance substraction technique.RESULTS:Compared with BP network,the radial basis network was better in robustness of netwrok,training time and the forcast accuracy.CONCLUSION:The three components of Antongding injection can be determined accuratly by the radial basis fuction network spectrophotometry.

Study of exploratory eye movement and event-related potential in patients with post-stroke depression / 临床神经病学杂志

Objective To observe the cognitive fuction difference between post-stroke depression(PSD) and non-post-stroke depression(NPSD) patients.To evaluate the clinical value of exploratory eye movement(EEM) and event-related potentials(ERP) on PSD.Methods EEM and ERP test were used for 50 PSD,50 NPSD patients and 48 normal controls.The results were compared.Results The abnormal rate of EEM and ERP test in PSD group were 96%(48/50) and 92%(46/50)respectively,and the abnormal rate of EEM and ERP test in NPSD group were 86%(43/50)and 82%(41/50)respectively.The number of eye fixation(NEF)and the responsive search score(RSS)of PSD and NPSD group were significant lower and the scores of discriminant(D) were significant higher than those in the normal control group(all P