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Sepsis remains a global disease with high morbidity and mortality. The changes of immune cell metabolism are of great significance in the pathophysiology of sepsis. Hypoxia-inducible factor (HIF) is not only a major regulator of hypoxic adaptive response, but also plays an important role in metabolic pathways such as glycolysis and pentose phosphate pathway of immune cells in sepsis. Current studies have found that pattern recognition receptors, transcription factors, certain metabolic byproducts and kinases all have varying degrees of influence on HIF activity or the cell metabolism involved. This review introduces the role and regulatory mechanism of HIF pathway in the metabolic changes of sepsis immune cells, so as to develop new approaches for the diagnosis and treatment of sepsis in the future.
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Objective:Under the guidance of " Opinions on Strengthening Party Construction in Public Hospitals" enacted by the Central Committee of the Communist Party of China, the performance evaluation index system for Party-committee secretaries has been released to reflect the overall leadership responsibility of Party committees at public hospitals.Methods:By means of literature review, policy learning and the preliminary work performance of Shanghai Hospital Development Center(SHDC), the framework of the target system was constructed. Three rounds of Delphi method were conducted to score 138 indicators based on eight aspects: result, objectivity, statistics, sensitivity, accessibility, quantifiability, importance and score-oriented. The final indicators were selected and statistically weighted. SPSS 20.0 software was used for descriptive statistical analysis, and Cronbach α evaluation coefficient method and Pearson correlation coefficient were also used to analyze the reliability and validity of indicators. Results:Following three rounds of Delphi research, 18 experts finally constructed a performance evaluation index system for Party committee secretaries that is composed of 4 level-1, 13 level-2 and 25 level-3 indexes. The new index system was used to simulate the scores of 14 hospitals, which was positively correlated with the survey results of third-party patient satisfaction( r=0.897, P<0.01), and was better than the original index system. Conclusions:The index system constructed in this study proves better quantitative objectivity and stronger operability. It has a good reliability and validity among the hospitals that belongs to SSHDC, and could be used for the evaluation of performance of Party-committee secretaries at public hospitals.
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@#Objective To observe the effect of high-frequency repetitive transcranial magnetic stimulation(rTMS)on hand function in patients after stroke. Methods From June,2016 to September,2017,30 stroke patients were randomly divided into control group(n=30)and experimental group(n=30).Both groups received routine training after sham rTMS or 3 Hz rTMS.Fugl-Meyer Assessment(FMA),modified Ashworth Scale(MAS)and modified Barthel Index(MBI)were used to evaluate the hand function and the activities of daily living before and after treatment. Results Finally 27 patients completed the experiment.After treatment, the FMA score increased in both groups (Z>2.070, P<0.05), and the difference value was higher in the experimental group than in the control group (Z=-2.296,P<0.05);the MAS score improved in the experimental group(Z=-2.456,P<0.05),no difference was found in the control group(Z=-0.816,P>0.05),and the difference value was higher in the experimental group than in the control group(Z=-2.792,P<0.01);the MBI score improved in both groups(t>3.085,P<0.01),howev-er,no difference was found in the MBI score and the difference value between two groups(t<0.246,P>0.05). Conclusion High-frequency rTMS could promote the hand function in patients after stroke.
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Objective:To analyze therapeutic effect of amiodarone combined RAS inhibitors on hypertensive patients with atrial fibrillation(AF),and its influence on serum levels of uric acid(SUA)and silent information regulator 2-related enzymes 1(SIRT1).Methods:A total of 186 hypertensive patients with AF were selected from our hospital. They were randomly and equally divided into amiodarone group(group A),amiodarone + telmisartan group(A+T group)and amiodarone + ramipril group(A+ R group).Left atrial diameter(LAD),P wave dispersion(Pd),lev-els of high sensitive C reactive protein(hsCRP),brain natriuretic peptide(BNP)and SUA,SIRT1 mRNA and pro-tein expression and blood pressure variability(BPV)were observed and compared among three groups before and 45d after treatment.Results:Compared with before treatment,there were significant improvement in all index ex-cept SUA after treatment in three groups,P=0.001 all;compared with group A after treatment,there were signif-icant reductions in 24hSBPV[(0.112 ± 0.022)vs.(0.092 ± 0.020)vs.(0.091 ± 0.021)],24hDBPV[(0.143 ±0.031)vs.(0.130 ± 0.040)vs.(0.129 ± 0.039)],levels of hsCRP[(8.3 ± 0.3)mg/L vs.(5.3 ± 0.6)mg/L vs. (3.6 ± 0.4)mg/L],BNP[(64.9 ± 9.4)ng/dl vs.(61.1 ± 7.6)ng/dl vs.(58.2 ± 8.3)ng/dl]and SUA[(498.85 ± 89.54)μmol/L vs.(298.54 ± 56.12)μmol/L vs.(278.32 ± 54.09)μmol/L],SIRT1 mRNA[(2.20 ± 0.34)%vs.(1.87 ± 0.30)% vs.(1.76 ± 0.31)%]and protein[(29.54 ± 8.12)% vs.(26.31 ± 7.43)% vs.(23.21 ± 6.90)%]expression in A+T group and A+ R group,P<0.05 or <0.01. Compared with group A,there were sig-nificant rise in Pd[(39.3 ± 4.2)ms vs.(40.9 ± 4.1)ms,(41.2 ± 5.1)ms],and significant reduction in LAD [(37.8 ± 3.4)mm vs.(35.1 ± 4.6)mm,(35.7 ± 4.5)mm]in A+T group and A+R group,P<0.05 or <0.01. Conclusion:Amiodarone combined RAS inhibitors can significantly improve blood pressure variability,and reduce inflammatory factor,SUA and serum SIRT1 level in hypertensive patients with AF.
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OBJECTIVE:To provide reference for promoting rational use of essential medicines. METHODS:Combined with the actual situation of our hospital,a set of risk prevention and control system on essential medicine was constructed on the basis of relevant laws and regulations and support of information,and then implemented. RESULTS:The implementation of the system greatly promoted cognition of all medical staffs on reasonable,economical and safe use of essential drugs,standardized medication behavior and improved essential medicine use more reasonable. After the implementation of risk prevention and control system on essential medicines,medicine ratio of whole hospital decreased from 34.62% to 32.64%,inpatient medicine ratio decreased from 33.02% to 27.89%;essential medicine ratio of whole hospital rose from 31.22% to 43.34%,inpatient essential medicine ratio in-creased from 23.46%to 39.17%;the proportion of outpatient antibiotics prescriptions decreased from 15.04%to 13.46%,the utili-zation of inpatient antibiotics decreased from 62.11% to 48.47%. Various early warning were sent out 104 times in total,and 23 medical staff were punished due to irrational drug use. The prescription form and rationality of drug use were improved gradually. CONCLUSIONS:The construction of risk prevention and control system on essential medicine is one of the keys to the success of health care reform. It is suggested to make full use of thesystem+technologymeans,establish long-term mechanism for risk pre-vention and control,and constantly improve the system.
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Objective To explore the effect and the mechanism of vitamin D(Vit D) promotes proliferation and differentiation of mesenchymal stem cells (MSCs) through regulates extracts of plastrum testudinis (PTE).Methods Established the PGL3-Id1 promoter and transfered rat MSCs.PTE combined with 10-6,10-7,10-8mol/L Vit D respectively were acted on the transfected MSCs for 36 hours.The level of Id1 promoter were detected by luciferase activity measurement.1,3,30,100 pg/mL PTE combined with Vit D of 10-7 mol/L were acted on MSCs for 36 hours,3 days and 7 days,and the VDR expression were detected by RT-PCR test.Results PTE promoted the expression of Id1 in MSCs,the expression of Id1 was inhibited when PTE combined with Vit D (P ＜ 0.01),and it was significantly different among different dosis of Vit D(P ＜0.01).The expression of VDR was inhibited in different degree when PTE combined with Vit D for 36 hours,3 days and 7 days.PTE combed with large dose of Vit D for 36 hours had significant effect of inhibition,and the difference was statistically significant (P ＜ 0.05).The inhibiting effect was more obvious when PTE combined with large dose of Vit D for 3 days and 7 days.When different doses of PTE combined with Vit D for a same duration,the difference of VDR expression was statistically significant (P ＜ 0.05).Meanwhile,when same doses of PTE combined with Vit D for different durations,the difference of VDR expression at 7 days and 36 hours was statistically significant (P ＜ 0.05).Conclusion The proliferation of MSCs which promoted by PTE was inhibited by Vit D,and the nuclear receptor VDR may be one of the targets of drug action for PTE regulating proliferation and differentiation of MSCs.
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The HPLC-DAD method was established to simultaneously determine the contents of four coumaroylspermidine[ N1, N5, N10-(Z)-tri-p-coumaroylspermidine (1), N1, N5-(Z)-N10-(E)-tri-p-coumaroylspermidine (2), N1(E)-N5-(Z)-N10-(E)-tri-p-coumaroylspermidine (3), and N1, N5, N10-(E)-tri-p-coumaroyl-spermidine (4) ] in Carthamus tinctorius. The method was performed on an Eclipse XDB-C18 column (4.6 mm×250 mm, 5 μm) eluted with 47% methanol in an isocratic program. The flow rate was 1 mL•min⁻¹; the injection volume was 10 μL, and the column temperature was 30 ℃. The detective wavelength was 270, 280, 290, and 300 nm, respectively. Four coumaroylspermidine constituents showed a good linearity in the range of 0.002 1-0.041 6 (r=0.999 5), 0.002 6-0.051 2 (r=0.999 7), 0.002 7-0.054 0 (r=0.999 8) g•L⁻¹, and 0.005 0-0.100 4 (r=0.999 8) g•L⁻¹, respectively. The average recoveries of these four coumaroylspermidine constituents were in the range of 98.61%-100.9% (RSD 2.3%-3.0%). In conclusion, the method is simple, rapid, and sensitive, which could be used as a quantitative determination method for the four coumaroylspermidine components in C.tinctorius.
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<p><b>OBJECTIVE</b>To establish a method for detecting 3 common toxigenic molds (Aspergillus, Penicillium, and Fusarium) based on non-modified magnetic beads coupled with multiple real-time PCR (NMB-multiple qPCR).</p><p><b>METHODS</b>The primers and genus-specific probes were designed based on the rDNA sequences to develop a multiple real-time PCR using non-modified magnetic bead to enrichment of fungal spores. The sensitivity, specificity and repeatability of this assay were evaluated.</p><p><b>RESULTS</b>The detection limit of this assay for spiked samples was 10(4) CFU/g, demonstrating a 10-fold greater detection sensitivity of this assay than that of real-time PCR. The NMB-multiple qPCR assay also showed good specificity and reproducibility and yielded comparable results with those by traditional colony counting method for spiked samples (P>0.05).</p><p><b>CONCLUSION</b>NMB-multiple qPCR assay we established allows rapid and sensitive detection of common mycotoxigenic fungi in paprika.</p>
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Aspergillus , Capsicum , Microbiology , DNA Primers , Food Contamination , Food Microbiology , Fungi , Fusarium , Magnetic Phenomena , Penicillium , Real-Time Polymerase Chain Reaction , Methods , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
BACKGROUND:Shape memory polyurethane has good physical and chemical properties and compatibility, but there are relatively few reports on the compatibility of osteoblasts before and after the deformation-complex of the shape memory polyurethane. OBJECTIVE:To observe the compatibility of osteoblasts with shape memory polyurethane before and after the deformation-complex. METHODS: Shape memory polyurethane membranes were prepared, and its stretching-solid-complex was conducted under the experimental environment, to obtain the membrane materials after the deformation-complex. The Sprague-Dawley neonatal rat osteoblasts were inoculated on the shape memory polyurethane membranes before and after the deformation-complex. After 2 hours of culture, the number of adherent cels was counted, and cel spreading was observed; cel proliferation was determined after 1-11 days of culture. RESULTS AND CONCLUSION:The adhesion amount and proliferation activity of osteoblasts on shape memory polyurethane membranes after the deformation-complex were significantly higher than those before the deformation-complex (P < 0.05). The osteoblasts presented fusiform appearance on the shape memory polyurethane membranes after deformation-complex, and cel arrangement showed a clear orientation, but a smal spreading area; while the osteoblasts presented polygonal shape on the shape memory polyurethane membranes before deformation-complex, arranged in no particular direction, and spread largely. These findings show the shape memory polyurethane has better osteoblast compatibility after the deformation-complex.
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The paper described the professional approach of Shanghai Hospital Development Center(SHDC)in developing a professional team of public hospital directors by such means as operation and management-autonomy,fixed tenures system,performance appraisal,part-time job control and income distribution. Recommendations raised include an organic unity of management functions of investors and power of management of the directors to motivate them in their management;building a comprehensive investor management system and strict cadre management mechanism to enhance supervision of the directors.
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Objective To explore the change characteristics of physiological indexes between infants and children during living-donor liver transplantation and discuss methods of regulation and control.Method In this study,42 patients were selected and assigned into two groups according to age:infants group (＜1 year,n =25),and children group (1-16 years,n =17).The preoperative and peri-operative characteristics,intra-operative operation conditions,internal environment changes before and after re-perfusion,postoperative mechanical ventilation time,ICU time,hospital time,infection rate,additional surgery,complications and survival were analyzed.Result PELD (MELD) score,historical surgery rate and hematokrit were lower in children group than in infants group (P＜ 0.05).Serum creatinine and lactate concentrations increased significantly in children group as compared with infants group (P＜0.05).Intra-operative an-hepatic phase and cold ischemia time were shortened significantly (P ＜ 0.05),and incidence rate of re-perfusion syndrome was reduced in children group as compared with infants group (P＜0.05).As compared with pre-re-perfusion,blood lactate concentrations were significantly raised only in infants group and glucose concentrations significantly raised only in children group (P＜0.05).The blood levels of K + were decreased after reperfusion in both two groups,and those in infants group were lower than in children group (P＜ 0.05).Postoperative intensive care unit time was longer in children group than in infants group (P＜ 0.05),and there was no significant difference in survival rate between two groups.Conclusion There are many differences and change characteristics to physiological indexes between infants and children during the operation of living-donor liver transplantation.Timely management and regulation are critical for the success of surgery according to the differences.
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Objective: To evaluate the safety, feasibility and efficacy of da Vinci robot-assisted laparoscopic partial nephrectomy in treating renal tumors with PADUA score ≥10, so as to discuss its clinical potential. Methods: Between May 2012 and September 2013, da Vinci robot-assisted laparoscopic partial nephrectomy was performed for 37 renal tumors with PADUA score ≥10 by a single urologist in our institution. The information of the patients were: age 52.3±10.1(32-72) years old; body mass index 24.9±3.88(17.1-34.3) kg/m2; Charlson Co-morbidity Index (Age-weighted) 0.5±0.84(0-3); and tumor laterality (L/R) 20/17. The tumors were unilateral and solitary lesions, with a mean diameter of 4.2±1.19(2.1-7.2) cm, a PADUA score of 10.8±0.87(10-13), and a preoperative estimated glomerular filtration rate (eGFR) of 101.2±25.58 (46.6-198.7) mL/(min·1.73 m2). The renal arteries veins, and renal surroundings were isolated and the tumors were excised with or without blocking renal pedicle; all these procedures together with renorrhaphy were done by da Vinci robot-assisted laparoscopic techniques. Results: All the 37 cases were smoothly done without surgical conversion, intraoperative complications or transfusion. The mean operative time was 241±50.0 (120-330) min, estimated blood loss was 185±169.9(50-1 000) mL, and renal ischemia time was 26.7±9.90(0-50) min. The mean postoperative hospital stay was 11.4±3.44(8-19) days, with an overall complication rate of 13.5%(5/37). Pathological examination revealed no positive surgical margin, and there were 28 cases of renal clear cell carcinoma, 3 papillary cell carcinoma, and 5 different types of benign lesions. All the patients were alive during a mean follow-up of 5.9±4.64(1-12) months, with no local recurrence or distant metastasis. Nevertheless, eGFR was decreased by a mean of 8%, showing significant difference compared with that before operation(Z=-2.883, P=0.004). Conclusion: For high PADUA score renal tumors, da Vinci robot-assisted laparoscopic partial nephrectomy has the advantages of minimal invasiveness, better safety, fine manipulation, and renal function preservation, although the cancer control outcome awaits further follow-up.
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<p><b>OBJECTIVE</b>To investigate the feasibility and effect of transurethral seminal vesiculoscopy in the diagnosis and treatment of refractory or recurrent hemospermia.</p><p><b>METHODS</b>We retrospectively analyzed 162 cases of refractory or recurrent hemospermia examined and treated by transurethral seminal vesiculoscopy. The patients ranged in age from 19 to 76 years and had a hemospermia history of 3 months to 11 years, admitted due to poor therapeutic results or recurrence after 4 weeks of antibiotic medication. All the patients underwent serum PSA examination, transrectal ultrasonography, seminal vesicle ultrasonography and pelvis CT or MRI before surgery.</p><p><b>RESULTS</b>Wine- or magenta-colored colloid and inflammation were found in one or both sides of the seminal vesicle in all the cases. Pathological biopsy revealed chronic inflammatory mucosa of the seminal vesicle in all the patients, and even calculi in the ejaculatory duct or seminal vesicle in 15 cases. Postoperative follow-up averaged 21.7 (12 -29) months. Hemospermia disappeared or was alleviated in 150 (92.64%) of the cases after 1-15 ejaculations, in which 7 experienced recurrence 3 months later. Four cases failed to respond, and 1 developed acute bilateral epididymitis after surgery. No such complications as retrograde ejaculation, urinary incontinence or rectal injury were observed postoperatively.</p><p><b>CONCLUSION</b>Transurethral seminal vesiculoscopy is a safe, effective and feasible new method for the treatment of refractory or recrudescent hemospermia.</p>
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Adult , Aged , Humans , Male , Middle Aged , Young Adult , Feasibility Studies , Hemospermia , Diagnosis , General Surgery , Recurrence , Retrospective Studies , Seminal Vesicles , General Surgery , Treatment Outcome , Ureteroscopy , MethodsABSTRACT
Objective:To study effect of transcatheter occlusion and minimally invasive surgical occlusion in treating secundum atrial septal defect. Methods:Patients with secundum atrial septal defect were collected and randomly divided into observation group given transcatheter occlusion and control group received minimally invasive surgical occlusion. Then operation related index and and heart function index were observed. Results: there were no differences in operation related index between two groups(x2=1.039, P>0.05);operation success had negative correlation with age and positive correlation with LEVF (t=7.832, P0.05);in patients older than 45, the successful case, LEVF and LVEDD of observation group were significantly higher than control group(t=5.372, t=5.382;P<0.05). Conclusion:transcatheter occlusion and minimally invasive surgical occlusion can achieve ideal therapeutic efficacy;transcatheter occlusion has positive clinical value in patients over 45 years old for its advantages of small operation wound.
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Objective To evaluate the effect of Shenfu Decoction pretreatment on the function of intestinal mucosal barrier of endotoxemic rats.Methods Twenty-four adult male Sprague-Dawley rats,aged 4-6 months,weighing 180-220 g,were randomly divided into 3 groups (n =8 each):blank control group (group C),endotoxemia group (group E) and Shenfu Decoction pretreatment group (group S).Endotoxemia was induced by lipopolysaccharide 10 mg/kg injected intravenously in anesthetized rats in groups E and S.Normal saline and Shenfu Decoction 5 ml/kg were injected intraperitoneally at 30 min before the model of endotoxemia was established in groups E and S,respectively.At 2 h after the model of endotoxemia was estabhshed,blood samples were obtained from the abdominal aorta for measurement of the plasma concentrations of tumor necrosis factor-α (TNF-α),interleukin6 (IL-6),intestinal fatty acid binding protein (i-FABP) and diamine oxidase (DAO) by ELISA.The distal ileum was harvested for detection of the expression of tight junctional protein Zonula Occludens-1 (ZO-1) in the intestinal mucosa of epithelial cells by immunohistochemistry.The changes in pathological morphology of the intestinal mucosa were examined after one segment of the distal ileum was stained with haematoxylin and eosin.The pathological changes were assessed and graded according to Chiu's score.Results Compared withgroup C,the plasma TNF-α,IL-6,i-FABP and D-lac concentrations were significantly increased,Chiu's scores were increased,and the expression of ZO-1 was down-regulated in groups E and S (P ＜ 0.05).Compared with group E,the plasma TNF-α and IL-6 concentrations were significantly decreased,the plasma i-FABP and D-lac concentrations were decreased,Chiu's scores were decreased,and the expression of ZO-1 was up-regulated in group S (P ＜ 0.05).Conclusion Shenfu Decoction pretreatment can attenuate the damage to the intestinal mucosa and protect the function of intestinal mucosal barrier in endotoxemic rats and inhibition of systemic inflammatory responses is involved in the mechanism.
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Objective To evaluate the effects of unilastatin on brain injury in children undergoing aortic arch surgery under cardiopulmonary bypass (CPB).Methods Twenty ASA physical status Ⅲ or Ⅳ children of both sexes,aged 1-24 months,weighing 3-12 kg,undergoing repair of coarctation of aorta or interrupted aortic arch complicated with intracardiac malformations under CPB,were randomly divided into 2 groups (n =10 each):control group (group C) and ulinastatin group (group U).Ulinastatin 20 000 U/kg was diluted into 10 000 U/ml with normal saline and it was then injected intravenously in 3 parts (1/3 was injected via the internal jugular vein after induction of anesthesia; 1/3 at the beginning of CPB and 1/3 at 5 min before aortic unclamping).In group C the equal volume of normal saline was given instead of ulinastatin.Blood samples were taken from the radial artery after induction of anesthesia (T1),at 10 min after aortic clamping (T2),at 10 min after aortic unclamping (T3),at the end of CPB (T4),and at 6 and 24 h after termination of CPB (T5,T6) for determination of plasma S100B protein and neuron-specific enolase (NSE) concentrations.Results There was no significant difference in plasma levels of S100B protein and NSE at T1 between the two groups (P ＞ 0.05).Plasma S100B protein and NSE levels were significantly increased at T2-5 as compared to the baseline values at T1 in both groups (P ＜ 0.05).Plasma S100B protein and NSE levels were significantly lower at T2-5 in group U than in group C (P ＜ 0.05).Conclusion Ulinastatin can attenuate brain injury in children undergoing aortic arch surgery under CPB.
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Objective To investigate effects of α-crystallin on proliferation of lipopolysaccharide (LPS)-activated retinal microglia and bioactivity of iNOS.Methods The retinal microglial cells cultured in vitro were analyzed and their purity was identified by cell immunofluorescence and flow cytometry.After microglia cells being intervened using LPS and α-crystallin at various concentrations,influence of α-crystallin on activity of LPS-activated retinal microglia was detected by MTT method and level of NO was measured by RT-PCR to observe changes of iNOS expression in microglia.Results Purity of primary cultured microglial cells was 94.15％ by GSA-IB4 immunohistochemical identification and 93.34％ by CD11b flow cytometry.α-crystallin of 10-4g/L awakened activity of microglia induced by 10-6g/L LPS (P ＜ 0.01).Expressions of iNOS protein and mRNA showed significant decrease in combined treatment group (P ＜ 0.05).Conclusion In clinical condition,α-crystallin decreases the harm of microglial cells on retinal ganglial cells (RGCs) after optical nerve injury by inhibiting the microglia cells to produce NO and iNOS.
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<p><b>BACKGROUND</b>Seventeen million births occur in China each year. Neonatal mortality is the leading cause of under 5-year-old child deaths, and intrapartum-related injury accounts for much of mental retardation in young children. The Chinese Ministry of Health sought to improve infant and child survival through a nationwide initiative to have at least one person trained in neonatal resuscitation at every birth. The aim of the current study was to evaluate the impact of China Neonatal Resuscitation Program (NRP) on policy and infrastructure changes and its effectiveness in decreasing the incidence of mortality among newborn infants.</p><p><b>METHODS</b>The Chinese NRP incorporated policy change, professional education, and creation of a sustainable health system infrastructure for resuscitation. Multidisciplinary teams from all 31 provinces and municipal states disseminated NRP in a train-the-trainer cascade. The intervention targeted 20 provinces with high neonatal mortality and programs to reduce maternal mortality. Program evaluation data came from 322 representative hospitals in those provinces.</p><p><b>RESULTS</b>Changes in policy permitted midwives to initiate resuscitation and required resuscitation training for licensure. From 2004 through 2009 more than 110,659 professionals received NRP training in the 20 target provinces, with 94% of delivery facilities and 99% of counties reached. Intrapartum-related deaths in the delivery room decreased from 7.5 to 3.4 per 10,000 from 2003 to 2008, and the incidence of Apgar ≤ 7 at 1 minute decreased from 6.3% to 2.9%.</p><p><b>CONCLUSIONS</b>The Chinese NRP achieved policy changes promoting resuscitation, trained large numbers of professionals, and contributed to reduction in delivery room mortality. Improved adherence to the resuscitation algorithm, extension of training to the township level, and coverage of births now occurring outside health facilities can further increase the number of lives saved.</p>
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Humans , Infant, Newborn , Asphyxia Neonatorum , Epidemiology , Mortality , China , Clinical Competence , Infant Mortality , Resuscitation , EducationABSTRACT
Objective To investigate intraoperative changes of internal environment in infants undergoing living related liver transplantation (LRLT), and to explore appropriate treatment measures. Methods Twenty-five infants undergoing LRLT were retrospectively studied, including 12 males, 13 females, with age of (3. 4 ± 4. 6) months (ranging from 2-11 months), weight of (6. 8 ±1. 3) kg (ranging from 3. 1-8. 8 kg). Arterial blood samples were collected before the operation, at preanhepatic phase (5 min before cross-clamping), at anhepatic phase (5 min before opening inferior vena cava), 5 and 30 min after the opening inferior yena cava respectively, and at the completion of the surgery the pH value, bases excess (BE), the levels of sodium, potassium, calcium, glucose and lactate were determined. Results There were large fluctuations to the internal environment during operation. Compared with the preoperative values, the intraoperative concentrations of Na+ had no significant change; The pH value and blood level of K+ had no significant change at pre-anhepatic phase and anhepatic phase (P＞0. 05), the pH value was decreased at anhepatic phase Ⅰ (P＜0. 01 )and returned to the preoperative level at the end of the operation, and the blood level of K+ decreased at anhepatic phase and lasted till the completion of the surgery (P＜0. 01 ). The blood level of Ca2+ was decreased at pre-anhepatic phase and neohepatic phaseⅡ (P＜0. 05), and recovered at the end of the operation. Blood glucose concentration was increased significantly at preanhepatic phase to neohepatic Ⅱ, and still kept at the higher level until the end of operation. The lactate concentrations were increased significantly at pre-an.hepatic phase to neohepatic Ⅱ (P＜0. 01 ), and recovered at the end of operation. The BE was decreased at pre-anhepatic phase to neohepatic Ⅱ (P＜0. 05), and recovered at the end of the operation. Conclusion There are significant disruptions which are unique and inter-related to the internal environment parameters in infants during the operation of LRLT.Monitoring and accurate intraoperative managements for different physiological status at different phases are critical for the success of LRLT in infants.
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<p><b>OBJECTIVE</b>Erectile dysfunction (ED) is now recognized as a comorbid condition, especially in men with cardiovascular disease or diabetes mellitus. This randomized controlled trial was to examine the effect of long-term small-dose tadalafil in the treatment of ED.</p><p><b>METHODS</b>A total of 98 men older than 18 years with at least a 6-month ED history were enlisted and divided into two groups to receive once-daily treatment with tadalafil at 5 mg (n = 60) and 20 mg (n = 38), respectively, for 12 months. The effects of medication were analyzed and compared using IIEF, Global Assessment Questionnaire (GAQ) and Sexual Encounter Profile (SEP), and so were the safety and tolerance of the two doses.</p><p><b>RESULTS</b>There were no statistically significant differences in the therapeutical results between the 5 mg and 20 mg groups (P < 0.05). The IIEF-5 score was raised by 8.1 points in the former and 7.9 points in the latter; the YES answers to SEP2 in the two groups were 51.3% and 49.2% before the treatment and 82.6% and 84.9% after it. No serious adverse events were observed, except some common ones, such as rubeosis (11.9% vs 8.7%) and headache (5.3% vs 4.9%) in the 5 mg and 20 mg groups.</p><p><b>CONCLUSION</b>Oral tadalafil at 5 mg once daily is efficacious with good tolerance in the treatment of ED, and it can be an alternative to on-demand medication for some men to eliminate the inconvenience of planned intercourse within a limited timeframe.</p>