A safety evaluation of profound hypothermia-induced suspended animation for delayed resuscitation at 90 or 120min

Background: The successful treatment of military combat casualties with penetrating injuries is significantly dependent on the time needed to get the patient to an adequate treatment facility. Profound hypothermia induced suspended animation for delayed resuscitation(SADR) is a novel approach for inducing cardiac arrest and buying additional time for such injuries. However, the time used to safely administer circulatory arrest(CA) is controversial. The goal of this study was to evaluate the safety of hypothermia-induced SADR over 90 and 120 min time intervals.Methods: Sixteen male BAMA minipigs were randomized into two groups: CA90 group(90 min, n =8) and CA120 group(120 min, n =8). Cannulation of the right common carotid arteries and internal jugular veins was performed to establish cardiopulmonary bypass for each animal. Through the perfusion of cold organ preservation solution(OPS), cardioplegia and profound hypothermia(15℃) were induced. After CA, cardiopumonary bypass(CPB) was restarted, and the animals were gradually re-warmed and resuscitated. The animals were assisted with ventilators until spontaneous breathing was achieved. The index of hemodynamic perioperative serum chemistry values [alanine transaminase(ALT), aspartate aminotransferase(AST), creatinine(CR), lactic dehydrogenase(LDH) and troponin T(TnT)] and survival were observed from pre-operation to 7 days post-operation.Results: Fifteen animals were enrolled in the experiment, while 1 animal in CA120 group died from surgical error. All 8 animals in CA90 group recovered, with only 1 animal displaying mild disability. However, in CA120 group, only 2 animals survived with severe disability, and the other 5 animals died after 2 days post-operation. In CA90 group, the perioperative serum chemistry values increased at 1 day post-operation(ALT 84.43±18.65 U/L; AST 88.99±23.19 U/L; Cr 87.90±24.49μmol/L; LDH 1894.13±322.26 U/L; TnT 0.849±0.135 ng/ml) but decreased to normal or almost normal levels at 7 days post-operation(ALT 52.48±9.04 U/L; AST 75.23±21.46 U/L; Cr 82.69±18.41μmol/L; LDH 944.67±834.32 U/L; TnT 0.336±0.076 ng/ml).Conclusion: Profound hypothermia-induced SADR is an effective method for inducing cardiac arrest. Our results indicate that inducing CA for 90 min(at 15℃) is safer than doing so for 120 min. Our results indicate that 120 min of CA at 15℃ is dangerous and can result in high mortality and severe neurological complications. Further experimentation is needed to determine whether 120 min of CA at temperatures lower than 15℃ can lead to safe recovery.

PROfound研究——前列腺癌精准治疗新希望

转移性去势抵抗性前列腺癌(metastatic castrate-resistant prostate cancer,mCRPC)是前列腺癌发展的终末阶段。患者生存预后很差。尽管不断地有新的治疗手段出现,比如新型内分泌治疗以及紫杉醇类化疗,mCRPC患者的生存期依然很有限。奥拉帕利是一款聚腺苷酸二磷酸核糖基聚合酶(poly ADP-ribose polymerase,PARP)抑制剂,PARP酶在DNA修复中扮演着重要的角色。奥拉帕利已经获批用于卵巢癌和乳腺癌的治疗。目前,奥拉帕利用于mCRPC治疗的Ⅲ期临床研究PROfound的结果在2019年的欧洲肿瘤内科学会(ESMO)年会与2020年的美国临床肿瘤学会-泌尿生殖系统肿瘤研讨会(ASCO-GU)已经发布。本文将带来PROfound研究的结果以及最新的结果更新。

Otolithic organ function in patients with profound sensorineural hearing loss

Profound sensorineural hearing loss (PSHL) is not uncommonly encountered in otology. In clinics, there is a high incidence of otolithic damage in patients with PSHL, but relevant reports are few. Sharing a continuous membranous structure and similar receptor cell ultrastructures, the cochlea and vestibule may be susceptible to the same harmful factors. Disorders of the inner ear may result in a variety of manifestations, including vertigo, spatial disorientation, blurred vision, impaired articulation, and hearing impairment. Considering the diversity of clinical symptoms associated with PSHL with otolithic dysfunction, it may be frequently misdiagnosed, and objective means of testing the function of otolithic organs should be recommended for hearing-impaired patients. Vestibular-evoked myogenic potentials (VEMPs) via air-conducted sound are of great importance for the diagnosis of otolithic function. Hearing devices such as cochlear implants are commonly accepted treatments for PSHL, and early identification and treatment of vestibular disorders may increase the success rate of cochlear implantation. Therefore, it is necessary to increase awareness of otolithic functional states in patients with PSHL.

The Significant and Profound Impacts of Chou’s 5-Steps Rule

In this short review paper, the significant and profound impacts of the 5-steps rule have been briefly recalled with crystal clear convincingness.

The Significant and Profound Impacts of Chou’s Invariance Theorem

In this short review paper, the significant and profound impacts of the Chou’s “invariance theorem” have been briefly presented with crystal clear convincingness.

The Significant and Profound Impacts of Chou’s Pseudo Amino Acid Composition or PseAAC

In this short review paper, the significant and profound impacts of the Pseudo Amino Acid Composition or PseAAC have been briefly presented with crystal clear convincingness.

PSYCHOLOGICAL DEVELOPMENT OF CHILDREN AFTER CARDIAC SURGERY WITH PROFOUND HYPOTHERMIA AND CIRCULATORY ARREST

Fifty-three patients with congenital heart disease were follwed up 14 to 57months after cardiac surgery with profound hypothermia and circulatory arrest.Meanintelligence quotient(IQ)was 88.6±16.1The incidence of psychological underdevelopedwas 13.2(7/53),higher than normal children population,The high incidence may be attri-buted to poor preoperative intellecutual development.The circulatory arrest time weremore than 60 minutes in 9 cases,41-60 minutes in 32 cases and less than 40 minutes inanother 12 cases.The IQ of these three groups were 84.8±11.9,86.2±15.7and 95.3±19.2respctively and incidence of psychological underdeveloped were 11.1%,15.6% and 8.5%respectively,No significant difference existed between groups.The time of circulatory ar-rest also had no obvious correlation with IQ.

Reconstruction of the Global Economic Governance System and China’s Role under the Profound Changes

The world today is undergoing profound changes unseen in a century.In particular,under the impact of the COVID-19 pandemic and the Ukraine crisis,the global political and economic landscape has undergone unprecedentedly profound changes,and the current global economic governance system is facing multiple crises,such as the lack of legitimacy,effectiveness,and common values.Hence,promoting the reform of the global governance system is becoming the prevailing trend.

Research and Analysis on the Profound Implication of Holland Still Life Images

The 17th century Holland still life drawing mostly all is through the extremely rigorous science manner, concentrates on completely to carry on the description to some lifeless goods. Such as flowers, shells, fruit and other things and of this style is the product of the Dutch culture, which represented by observing depict static objects, record the many realistic scene of eternal charm. Precise visual science and prosperity in the Netherlands, some of the new invention made evidence for its science and technology, such as microscope and camera, like the golden age of fine painting. It has some aspect research also to take compared to the vision, for example the botany, explains the showing plant flowers and plants with the science method in the different growh stage significance. In the philosophy domain, in the visual optics and under the technical development, the epistemology obtained the further development. The Dutch painters also recorded the world in a more detailed and vivid way through their methods.

The Most Profound Fables(1)

狐狸和山羊 一天，一只狐狸掉进了一口深井，怎么也爬不上来。一直口渴的山羊，来到井边喝水，看到井底的狐狸，就像它问井水好不好喝。狐狸极力掩饰自己的窘境，装出一副开心的样子，对井水的甘甜赞不绝口，还说这是天下第一井.

Effects of hemodilution on neurological injury and cerebral amino acid content after circulatory arrest during profound hypothermia in rats

To investigate the effects of different degrees of hemodilution on neurological injury and amino acid content in different brain areas after deep hypothermic circulatory arrest (DHCA).Methods Forty-eight male adult SD rats weighing 400～450 g were randomly divided into 4 groups (n=12 each):group Ⅰ Hct 10%(H1);group Ⅱ Hct 20% (H2);group Ⅲ Hct 30%(H3) and control group (C).All animals except those in control group underwent DHCA at 18℃ for 90 min (includinhg cooling and rewarming) under general anesthesia with fentanyl,ketamine and droperidol.Different degrees of hemodilution were accomplised by changing the composition and volume of priming solution used in cardiopulmonary bypass (CPB).Hct was determined before,at the initiation of CPB and beginning of rewarming.PaO2,pH and blood lactate of arterial blood and SO2 of venous blood from internal jugular vein (SjvO2) were determined at the beginning and end of cooling and rewarming.The animals were killed and brains removed after recovery of circulatory function for the count of injured neurons and detemination of glutamate (Glu),aspartate (Asp),glycine (Gly),γ-aminobutyric acid (GABA) and taurine (Tau) contents in cortex,hippocampus and thalamus.Results The number of injured neurons in hippocampus and parietal cortex were significantly smaller in Hct 30% group than in the other two groups (P<0.05).The contents of the five amino acids in hippocampus and parietal cortex were all increased after DHCA.The Glu,Asp and Gly contents in hippocampus and parietal cortex were significantly lower in Hct 30% group than in the other 2 groups (P<0.05).There was no significant difference in GABA and Tau contents among the 3 groups.Conclusion Hemodilution at Hct 30% attenuates the neuronal injury after DHCA.The inhibition of the release of the excitatory amino acids in the brain may be involved in the mechanism of neuronal protection.13 refs,1 fig,3 tabs.

The Profound Revelation of Human Social Relations and the Profound Realization of Information Right of Citizens——The social significance of network technique advancement in the perspective of “Entity Cube”

The R＆D group of relationship searching in Microsoft Asia Research Institute explains ＂Entity Cube＂ launched in 2008 as follows：

何以必然 何以可能:中国式现代化是走和平发展道路的现代化

审视中国式现代化走和平发展道路的必然性和可能性,既是诠释中国式现代化内在意蕴的应有之义,也能为回答人类未来何去何从的“世界之问”提供重要参考。这条和平发展道路是在传承中华优秀传统文化中开辟的,蕴含了爱好和平的民族精神;是在以西方现代化道路为镜鉴中开辟的,蕴含了自立自强的奋斗精神;是在以马克思主义为价值引领中开辟的,蕴含了不负使命的担当精神;是在进行伟大斗争中开辟的,蕴含了捍卫国家和人类安全的天下情怀。面对“百年未有之大变局”中的新问题与新挑战,这条和平发展道路必将展现出更为深刻的价值。

Profoundly Commanding the Rich Connotation and Construction Path for a Mankind Community of Shared future

To build a mankind community of shared future is an important concept and initiative put forward by the Communist Party of China Central Committee(CPCCC)with Comrade Xi Jinping as the core to co-ordinate domestic situation and international situation,and is an important part of the CPCCC‘s

International Taxation and the BRITACOM:A Study from the Perspective of“Profound Changes Unseen in a Century”

The world is undergoing"profound changes unseen in a century",which is crucial for current development of international taxation.The trends of"world multi-polarization,economic globalization,IT application and cultural diversity"are surging forward.New driving forces are replacing the old ones.Balance among different countries is also changing rapidly.A global governance system is thus reshaping.Based on all these changes,this paper analyzes their impacts on international taxation,and particularly the Belt and Road Initiative Tax Administration Cooperation Mechanism(BRITACOM).

The Profound Changes Unseen in a Century: The Perspective of Overlapping Effect of Technological Revolution Cycle and Political & Economic Thought Cycle

The waves of technological revolution can lead to great differences in the economic and social structures of countries and have a destructive impact. The choice of political and economic thoughts can amplify or inhibit such differentiation and impact. Over the past 100 years, humankind has undergone three technological revolutions, and the mainstream political and economic thoughts have experienced a cycle from classical liberalism to various types of anti-liberalism and finally to neoliberalism. In the two liberal periods, the overlap of liberalism and a technological revolution caused sharp contradictions between the rich and the poor, leading to profound economic adjustment and great political and social turmoil worldwide. In the non-liberal period, however, the overlapping effects were relatively mild. Currently, the world is facing similar trends and risks as during 1914-1940. Whether humankind will repeat the same mistakes merits attention and vigilance. This study argues that it is necessary to oppose unilateralism, uphold multilateralism, and advance globalization and free trade under the concept of collaborative development and shared prosperity, as well as explore comprehensive and sustainable development. These are of great significance for human society to prevent risks, obtain advantages and avoid disadvantages, and maintain world peace and development.

双侧极重度感音神经性聋患儿人工耳蜗植入效果分析

目的分析双侧极重度感音神经性聋患儿人工耳蜗植入效果。方法选取2018年2月~2022年2月本院接诊的80例双侧极重度感音神经性聋患儿,将40例非对称性听力损失患儿纳入对照组,行单侧人工耳蜗植入;将40例对称性听力损失患儿纳入观察组,行双侧人工耳蜗植入;分析两组开机前和干预6、12、36个月后的听觉行为分级(CAP)、言语可懂度分级(SIR),并建立多因素logistic模型,分析双侧人工耳蜗植入后影响CAP、SIR评分的独立危险因素。结果观察组干预后12、36个月CAP、SIR评分显著高于对照组(P<0.05)。多因素logistic分析显示,年龄>3岁、术前未使用助听器、植入时间<1年、内耳畸形是影响双侧人工耳蜗植入儿童CAP、SIR评分的独立危险因素(P<0.05)。结论双侧人工耳蜗植入是极重度感音神经性聋患儿听觉补偿的有效手段,年龄、植入时间、内耳畸形等因素可能影响患儿的听觉、言语功能康复,尽早为患儿植入双侧人工耳蜗,加强相关干预,才能有效促使患儿听觉言语功能康复。

“元亨利贞”与《周易》春夏秋冬的四时结构模式

《周易》以“元亨利贞”一句开篇,而“元亨利贞”是与春夏秋冬四时相呼应的,是四时观念的总结升华。农耕文明的生产方式决定了中国文化对时间的敏感,“食哉,惟时”是早期中国的重要思想理论,《周易》特别强调“时义大矣哉”的思想。先秦经典文本存在以四时为基础的文本结构形式,《周易》与《尚书》《诗经》《周礼》《吕氏春秋》等经典文献一样,都存在一个以春夏秋冬为中心线索的文本结构形态。《周易》以元亨利贞的四时观念为文本总纲,以“雷以动之”的意象为中心而结构文本,《屯》《豫》《革》《复》四卦是春夏秋冬四时运转的具体象征形式,《周易》的四时结构体现着时之动、物之象、礼之成、义之合的基本原则。