SummaryThe aim of the present study was to evaluate the effects of hypertonic saline solution (C-HSS) with high dose furosemide on hospitalization time, readmission, and mortality in patients with New York Heart Association (NYHA) class III heart failure.Decompensated heart failure patients (NYHA III) with chronic ischemic or nonischemic cardiomyopathy and ejection fraction < 40% were divided into 2 groups in an open-label random manner: the first group received a 1-hour intravenous infusion of furosemide (100 mg) plus compound C-HSS (100 mL) twice daily and underwent serious water restriction (500 mL/day); the second group received furosemide intravenous bolus (100 mg) twice a day and water restriction (500 mL/day), without C-HSS. Both groups had normal sodium (120 mmol sodium) intake. After discharge, the two groups continued to receive 120 mmol Na/day and 500-1000 mL water/day.The first group (132 C-HSS patients) had an increase in urination, a reduction in hospitalization time (4 ± 2 versus 7 ± 2 days, P < 0.01), and a reduction in hospitalization costs (2210 RMB versus 3506 RMB, P < 0.01) compared with the second group (132 without C-HSS patients). During the follow-up period (36 ± 12 months), the first group had a significantly higher average readmission time (31.84 ± 7.58 months versus 15.60 ± 6.25 months, P < 0.01) and lower mortality rate (16.5% versus 31.9%, P < 0.01).The results suggest that periodical C-HSS administration, combined with serious water restriction and a normal sodium diet, significantly reduces the hospitalization time, readmission rate, and mortality in patients with NYHA class III HF. (Int Heart J 2017; 58: 601-607)

Exposure to lead (Pb) can induce kidney injury and our recent studies have found that Salvia miltiorrhiza (SM) injection, a traditional Chinese medicine, could protect against the organ injury induced by iron overload. This study was designed to investigate the protective effects of SM injection on nephrotoxicity induced by Pb acetate in mice and to elucidate the potential mechanism(s). Healthy male mice were randomly divided into four groups: control, Pb, low-dose Salvia miltiorrhiza (L-SM), and high-dose Salvia miltiorrhiza (H-SM). SM injection dose dependently reduced the Pb accumulation in the kidney, decreased kidney coefficients, and ameliorated renal structure and function from the morphology analysis. Meanwhile, SM administration downregulated serum levels of blood urea nitrogen (BUN) and creatinine (CR), decreased malondialdehyde (MAD) content, and increased activities of super oxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in the kidney homogenate. Moreover, SM injection reduced the level of renal apoptosis by immunohistochemical staining analysis. Our findings implicate the therapeutic potential of SM injection for Pb-induced nephrotoxicity, which were at least partly due to the decrease of Pb accumulation, inhibition of lipid peroxidation, and suppression of renal apoptosis. These results provided preliminary experimental support for Danshen as a therapeutic drug for Pb poisoning diseases.

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In order to prevent collision of complex structure well, accurate measurement of the distance of adjacent wells must be required during the development of the unconventional reservoir. The precision of the traditional survey tools and scanning software is not accurate enough. Based on the electromagnetic anticollision measuring calculation method, the electromagnetic anticollision detection tool was designed and simulation experiments were carried out. The influence of different position relations between sensor and casing on magnetic field strength detected by the sensor was analyzed. When the sensor and the casing were parallel and the distance of them was 0.5 m∼3 m, the tool could calculate accurately the distance and orientation of the adjoining well. When the angle between the sensor and the casing was within 50°, the calculation result was accurate. This research result validated the accuracy of the principle of the electromagnetic anticollision tool while drilling cluster well, and it could provide theoretical support for the development of electromagnetic detection tools.

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Background Informal learning refers to learners-sponsored, monitored and regulated learning method, which lays the foundation for medical life-long education of residents with sustainable self-learning ability and permanent learning behaviors. In this article the authors explore the academic value and significance in informal learning to improve the effectiveness for the standardized residency training in the context of “Internet plus” which combines technology with education to promote reforms for learning patterns. Standardized residency training started relatively late in China and there are less empirical studies targeted for the medical students in this phase. Based on it, this study aims to explore online informal learning behavior of medical students in residency training.Methods An empirical study was performed at the Fourth Hospital of Hebei Medical University in China where postgraduate medical education is being conducted. The study was implemented by questionnaire of the following aspects related to informal learning of residents as learning attitude, motivation, behavior and utilization of learning resources. Learning efficiency before and during COVID-19 is specifically surveyed and analyzed. 451 valid samples were collected to understand the situation of informal learning in the context of “Internet plus” and to find out interconnections among variables. The data from questionnaire has been analyzed through descriptive analysis, difference analysis and correlation regression analysis.Results Informal learning attitudes of residents in standardized training are of high recognition and strong learning belief but need better self-management; The intervention between informal learning motivation and behavior among the levels of self-control, learning target and utilization of online resources resulting in great influence of environmental and individual factors on self-efficacy. Relative weak ability appears in choosing, screening and utilizing effective information online without effective guidance from teachers.Conclusions In this study we innovatively propose appropriate and practical suggestions for researching methods in informal learning of postgraduate medical education in clinical setting during intensive online learning during COVID-19 period. The findings of this research have great significance in guiding learning paths, effects and development for informal learning of residents and put forward effective measures for the development of positive and sustainable informal learning in future career of the doctors-to-be.