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Aryloxysulfonyl azides can be effectively activated by commercially available cobalt(II) complex of meso -tetraphenylporphyrin ([Co(TPP)]) at room temperature under neutral and nonoxidative conditions for selective radical aziridination of alkenes via metalloradical catalysis. The [Co(TPP)]-catalyzed radical aziridination system is suitable for different combinations of olefin substrates and aryloxysulfonyl azides, producing various N -aryloxysulfonyl aziridine derivatives in good to excellent yields. In addition to generating the environmentally benign N 2 as the only byproduct, this Co(II)-based metalloradical aziridination process features mild reaction conditions and operational simplicity.

In this work, we examined the effects of the surface charge of stem cell membranes and DNA/polyethyleneimine (PEI) nanocomplexes on gene transfection efficiency, because PEI was one of the most reliable and efficient carriers, and rat bone marrow mesenchymal stem cells (rBMSCs) and rat muscle-derived stem cells (rMDSCs) were one of the readily accessible and plentiful sources of stem cells. Thus, we compared the efficiency of DNA transfection in rBMSCs and rMDSCs using the PEI as a gene carrier. Transfection efficiency was evaluated on the basis of electrostatic interaction between negatively charged stem cell membranes and positively charged DNA/PEI nanocomplexes. DNA was fully complexed with PEI at negative-to-positive (NIP) charge ratios greater than 2, as confirmed by gel electrophoresis and fluorescence measurements. DNA and PEI formed spherical nanocomplexes ranging in diameter from 150 nm to 500 nm. The positive surface charge of DNA/PEI nanocomplexes increased with an increasing N/P charge ratio, as measured using dynamic light scattering and a single-walled carbon nanotube-based field-effect transistor device. rBMSCs and rMDSCs both carried a negative surface charge, with rBMSCs being more negatively charged. The transfection efficiency of rMDSCs measured using DNA/PEI nanocomplexes was very low (1%-5%) at most of the N/P charge ratios tested, whereas better efficiencies were observed with rBMSCs (1%-17%). Nanocomplexes with high NIP charge ratios were cytotoxic to both rBMSCs and rMDSCs. Collectively, the results indicate that rBMSCs were more effectively transfected with DNA/PEI nanocomplexes than were rMDSCs, reflecting the higher negative charge of rBMSC membranes that facilitate the interaction with positively charged DNA/PEI nanocomplexes.

Co(II)-based metalloradical catalysis has been, for the first time, successfully applied for asymmetric intramolecular C-H alkylation of acceptor/acceptor-substituted diazo reagents. Through the design and synthesis of a new D 2 -symmetric chiral amidoporphyrin as the supporting ligand, the Co(II)-based metalloradical system, which operates at room temperature, is capable of 1,5-C-H alkylation of α-methoxycarbonyl-α-diazosulfones with a broad range of electronic properties, providing the 5-membered sulfolane derivatives in high yields with excellent diastereoselectivity and enantioselectivity. In addition to complete chemoselectivity toward allylic and allenic C-H bonds, the Co(II)-based metalloradical catalysis for asymmetric C-H alkylation features a remarkable degree of functional group tolerance.

The Co(II) complex of a new D 2-symmetric chiral porphyrin 3,5-DiMes-QingPhyrin, [Co(P6)], can catalyze asymmetric aziridination of alkenes with bis(2,2,2-trichloroethyl)phosphoryl azide (TcepN3) as a nitrene source. This new Co(II)-based metalloradical aziridination is suitable for different aromatic olefins, producing the corresponding N-phosphorylaziridines in good to excellent yields (up to 99%) with moderate to high enantioselectivities (up to 85% ee). In addition to mild reaction conditions and generation of N2 as the only byproduct, this new metalloradical catalytic system is highlighted with a practical protocol that operates under neutral and non-oxidative conditions.

The Co(II) complex of the D 2h -symmetric amidoporphyrin 3,5-Di t Bu-IbuPhyrin, [Co( P1 )], has proven to be an effective metalloradical catalyst for intermolecular amination of C(sp 2 )-H bonds of aldehydes with fluoroaryl azides. The [Co( P1 )]-catalyzed process can employ aldehydes as the limiting reagents and operate under neutral and non-oxidative conditions, generating nitrogen gas as the only byproduct. The metalloradical aldehydic C-H amination is suitable for different combinations of aldehydes and fluoroaryl azides, producing the corresponding N -fluoroaryl amides in good to excellent yields. A series of mechanistic studies support a stepwise radical mechanism for the Co(II)-catalyzed intermolecular C-H amination.

Crigler-Najjar syndrome type I (CN-I) is the most severe type of hereditary unconjugated hyperbilirubinemia. It is caused by homozygous or compound heterozygous mutations of the UDP-glycuronosyltransferase gene (UGT1A1) on chromosome 2q37. Two patients clinically diagnosed with CN-I were examined in this paper. We sequenced five exons and their flanking sequences, specifically the promoter region of UGT1A1, of the two patients and their parents. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to determine the UGT1A1 gene copy number of one patient. In patient A, two mutations, c.239_245delCTGTGCC (p.Pro80HisfsX6; had not been reported previously) and c.1156G>T (p.Val386Phe), were identified. In patient B, we found that this patient had lost heterozygosity of the UGT1A1 gene by inheriting a deletion of one allele, and had a novel mutation c.1253delT (p.Met418ArgfsX5) in the other allele. In summary, we detected three UGT1A1 mutations in two CN-I patients: c.239_245delCTGTGCC (p.Pro80HisfsX6), c.1253delT (p.Met418ArgfsX5), and c.1156G>T (p.Val386Phe). The former two mutations are pathogenic; however, the pathogenic mechanism of c.1156G>T (p.Val386Phe) is unknown.

Background. Development of non-deqi control is still a challenge. This study aims to set up a potential approach to non-deqi control by using lidocaine anesthesia at ST36. Methods. Forty healthy volunteers were recruited and they received two fMRI scans. One was accompanied with manual acupuncture at ST36 (DQ group), and another was associated with both local anesthesia and manual acupuncture at the same acupoint (LA group). Results. Comparing to DQ group, more than 90 percent deqi sensations were reduced by local anesthesia in LA group. The mainly activated regions in DQ group were bilateral IFG, S1, primary motor cortex, IPL, thalamus, insula, claustrum, cingulate gyrus, putamen, superior temporal gyrus, and cerebellum. Surprisingly only cerebellum showed significant activation in LA group. Compared to the two groups, bilateral S1, insula, ipsilateral IFG, IPL, claustrum, and contralateral ACC were remarkably activated. Conclusions. Local anesthesia at ST36 is able to block most of the deqi feelings and inhibit brain responses to deqi, which would be developed into a potential approach for non-deqi control. Bilateral S1, insula, ipsilateral IFG, IPL, claustrum, and contralateral ACC might be the key brain regions responding to deqi.

Detection of H2O2 is important for the applications in environmental protection, pharmaceutical industries, food production, and clinical control. Current colorimetric assay of H2O2 based on enzyme or nanomaterials always needs TMB or other peroxidase substrate as coloration species. Furthermore, the corresponding response time including incubation process is in order of minute. In this study, we report on the synthesis of heavily Ti(3+)-doped TiO2 composed of spherelike nanoparticles by pulsed laser ablation method. This TiO2 can directly detect H2O2 without using TMB or any other peroxidase substrate and is free from incubation process. In addition, the detection sensitivity is compatible with or better than that of the natural enzyme or other nanomaterials. Hence, the self-doped TiO2 nanoparticles provide a novel, direct, ultrafast approach for H2O2 assay application.

Lanthanide-doped nanocrystals (NCs), which found applications in bioimaging and labeling, have recently demonstrated significant improvement in up-conversion efficiency. Here, we report the first up-conversion multicolor microcavity lasers by using NaYF4:Yb/Er@NaYF4 core-shell NCs as the gain medium. It is shown that the optical gain of the NCs, which arises from the 2- and 3-photon up-conversion processes, can be maximized via sequential pulses pumping. Amplified spontaneous emission is observed from a Fabry-Perot cavity containing the NCs dispersed in cyclohexane solution. By coating a drop of silica resin containing the NCs onto an optical fiber, a microcavity with a bottle-like geometry is fabricated. It is demonstrated that the microcavity supports lasing emission through the formation of whispering gallery modes.

Direct bandgap semiconductors, such as In2O3, Cu2O, and SnO2, have enormous applications in photochemistry, photovoltaics, and optoelectronics. Due to the same parity of conduction and valence bands, the dipole transition is silent in these direct bandgap semiconductors. The low band-to-band transition efficiency prevents them from high intensity light emission or absorption. Here, we report the fabrication of SnO2 quantum dots (QDs) with sizes less than the exciton Bohr radius by a facile "top-down" strategy based on laser fragmentation of SnO in water. The SnO2 QDs shows exciton emission at ∼300 nm with a high quantum yield of ~17%. Amplified spontaneous exciton emission is also achieved from a thin layer of SnO2 QDs dispersed in PEG400 on a quartz substrate. Therefore, we have shown that SnO2 QDs can be a potential luminescent material suitable for the realization of ultraviolet B lasing devices.

Objective: To investigate molecular characterization of streptococcus pyogenes isolates involved in an outbreak of scarlet fever in China in 2011., Methods: Seventy-four Streptococcal pyogenes involved in an outbreak of scarlet fever were isolated from pediatric patients in the areas with high incidence in China from May to August of 2011. Emm genotyping, pulsed-field gel electrophoresis (PFGE), superantigen (SAg) genes and antimicrobial susceptibility profiling were analyzed for these isolates., Results: A total of 4 different emm types were identified. Emm12 was the most prevalent type which contained four predominating PFGE patterns corresponding to four different virulence and superantigen profiles. Emm12 (79.7%) and emm1 (14.9%) accounted for approximately 94% of all the isolates. The speA gene was all negative in emm12 isolates and positive in emm1 isolates. All strains were resistant to erythromycin, and 89.4% of them were resistant to erythromycin, tracycline, and clindamycin simultaneously., Conclusion: Several highly diversified clones with a high macrolide resistance rate comprise a predominant proportion of circulating strains, though no new emm type was found in this outbreak. The data provide a baseline for further surveillance of scarlet fever, which may contribute to the explanation of the outbreak and development of a GAS vaccine in China., (Copyright © 2013 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.)

Methoxy polyethylene glycol-poly(ε-caprolactone) (MPEG-PCL; MP) diblock copolymers undergo a solution-to-gel phase transition at body temperature and serve as ideal biomaterials for drug delivery and tissue engineering. Here, we examined the potential use of a chondrocyte-loaded MP solution as an injectable, in situ-forming hydrogel for cartilage regeneration. The chondrocyte-MP solution underwent a temperature-dependent solution-to-gel phase transition in vitro, as shown by an increase in viscosity from 1 cP at 20-30 °C to 1.6 × 10 5 cP at 37 °C. The chondrocytes readily attached to and proliferated on the MP hydrogel in vitro. The chondrocyte-MP solution transitioned to a hydrogel immediately after subcutaneous injection into mice, and formed an interconnected pore structure required to support the growth, proliferation, and differentiation of the chondrocytes. The chondrocyte-MP hydrogels formed cartilage in vivo, as shown by the histological and immunohistochemical staining of glycosaminoglycans, proteoglycans, and type II collagen, the major components of cartilage. Cartilage formation increased with hydrogel implantation time, and the expression of glycosaminoglycans, and type II collagen reached maximal levels at 6 weeks post-implantation. Collectively, these data suggest that in situ-forming chondrocyte-MP hydrogels have potential as non-invasive alternatives for tissue-engineered cartilage formation.

The effectiveness of systemically administered anticancer treatments is limited by difficulties in achieving therapeutic doses within tumors, a problem that is complicated by dose-limiting side effects to normal tissue. To increase the efficacy and reduce the toxicity of systemically administered anticancer 5-fluorouracil (5-Fu) treatments in patients, intratumoral administration of an injectable hydrogel has been evaluated in the current work. The MPEG-b-(PCL-ran-PLLA) diblock copolymer (MCL) containing 5-Fu existed in an emulsion-sol state at room temperature and rapidly gelled in vivo at the body temperature. MCL acted as in vivo biodegradable drug depot over a defined experimental period. A single injection of 5-Fu-loaded MCL solution resulted in significant suppression of tumor growth, compared with repeated injection of free 5-Fu as well as saline and MCL alone. For both repeated injections of free 5-Fu and single injection of 5-Fu-loaded MCL, most of the 5-Fu was found in the tumor, indicating the maintenance of therapeutic concentrations of 5-Fu within the target tumor tissue and the prevention of systemic toxicity associated with 5-Fu in healthy normal tissues. In conclusion, this work demonstrated that intratumoral injection of 5-Fu-loaded MCL may induce significant suppression of tumor growth through effective accumulation of 5-Fu in the tumor., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

In the present study, nano-sized TiO(2)/Al(2)O(3) modified polyvinylidene fluoride (PVDF) membranes (MM) were fabricated and then utilized for oil/water emulsion separation. The results showed that, compared with PVDF membrane (OM), the contact angle of MM decreased and hydrophilicity increased. The ultrafiltration (UF) of oil in water emulsions with transmembrane pressure (TMP) increasing results in a sharp fall in relative flux with time. The cake filtration models did not always predict the performance over the complete range of filtration times very well. In the initial 30 min, all the four cake models can simulate this UF process to a certain extent, and the suitability was: cake filtration > intermediate pore blocking > standard pore blocking > complete pore blocking models. However, they were no longer adapted well with UF time extent to 60 min, but only cake filtration (R(2) = 0.9535) maintained a high adaptability. Surface and cross-sectional morphology of the membrane was investigated by SEM to make an advanced certificate of this UF mechanism.

A high temperature solution processing method was adapted to prepare durable, freestanding, submicrometer thickness films for transmission infrared spectroscopy studies of ionomer membrane. The materials retain structural integrity following cleaning and ion-exchange steps in boiling solutions, similar to a commercial fuel cell membrane. Unlike commercial membrane, which typically has thicknesses of >25 μm, the structural properties of the submicrometer thickness materials can be probed in mid-infrared spectral measurements with the use of transmission sampling. Relative to the infrared attenuated total reflection (ATR) technique, transmission measurements can sample ionomer membrane materials more uniformly and suffer less distortion from optical effects. Spectra are reported for thermally processed Nafion and related perfluoroalkyl ionomer materials containing phosphonate and phosphinate moieties substituted for the sulfonate end group on the side chain. Band assignments for complex or unexpected features are aided by density functional theory (DFT) calculations.

Background: Ischemia/reperfusion (I/R) injury is an important barrier to liver surgery and transplantation because it impairs remnant liver/reduced-size-graft regeneration. Ischemic preconditioning (IPC), as an effective measure to overcome I/R injury, has been shown to enhance the regenerative capacity of hepatocytes. However, investigations have always focused on regeneration in the late phase after reperfusion. This study aimed to investigate whether IPC enhances hepatocyte proliferation in the early phase after reperfusion and possible underlying mechanisms., Methods: A total of 90 rats were divided into three groups: hemi-hepatectomy alone (PHx group), 60 minutes of ischemia plus hemi-hepatectomy (I/R group), and a cycle of 10 minutes of alternating I/R prior to 60 minutes of ischemia plus hemi-hepatectomy (IPC group). Each group was divided into five subgroups sacrificed after 0.5, 2, 6, 12 or 24 hours (n=6/subgroup). Subsequently, serum concentrations of alanine aminotransferase (ALT), aspartate aminotransferase (AST), tumor necrosis factor-alpha (TNF-alpha), and interleukin-6 (IL-6) were measured; caspase-3 and proliferating cell nuclear antigen (PCNA) proteins were also determined by Western blotting. Furthermore, PCNA was detected by immunohistochemistry to identify the expression site., Results: Serum ALT and AST levels after 2-24 hours of reperfusion in the PHx and IPC groups were remarkably decreased compared to the I/R group, and the serum TNF-alpha was relatively lower. A significant increase of serum IL-6 levels was found in the PHx and IPC groups compared with the I/R group at each time point. Furthermore, PCNA expression was remarkably increased in the IPC group after 6-12 hours of reperfusion, and in the earlier 0.5 and 6 hours time points after reperfusion have shown the massive PCNA-positive hepatocytes. At the same time, the expression of liver p-JNK was higher in the IPC group in the early phase after reperfusion than that of the I/R group and its expression was consistent with the PCNA., Conclusion: IPC can initiate hepatocyte proliferation in the early phase after ischemia under hemi-hepatectomy, and may be associated with p-JNK expression and triggered by TNF-alpha/IL-6 signals.

The patient was a 19-year-old woman serving in the military at a remote location. She presented to a medical aid station with a chief complaint of right anterior knee pain after falling 3 hours prior from a height of 3 m and landing directly on the anterior aspect of her right knee.

This paper studies the cumulative effect of various parameters, namely anionic polyacrylamide (APAM) concentration, oil concentration, pH, trans-membrane pressure (TMP), and total dissolved solid (TDS), and obtains optimal parameters for the minimum relative flux (J/J(0)) declining in aqueous solutions with response surface methodology (RSM). In order to analyze the mutual interaction and optimal values of parameters affecting ultrafiltration, a central composite rotatable design (CCRD), one method of RSM, was employed. The analysis of variance (ANOVA) of the cubic polynomial model demonstrated that this model was highly significant and reliable. The results show that the effect of APAM and oil on J/J(0) has an inverse trend with pH value increasing. Moreover, the mutual interaction of initial APAM (oil) concentration (C(APAM(oil))) and pH (TMP) were negligible, while the mutual interaction of C(APAM) and C(oil) has an obvious effect, i.e. the effect of initial feed C(APAM) became more important at higher values of initial feed C(oil), and the J/J(0) was only about 4%. The favorable operate conditions in this ultrafiltration process were at low C(APAM), C(oil), pH, and TMP, which agreed with the conclusions of many authors, while considering water production, C(APAM) and C(oil) < 50 mg/L, pH < 4, and TMP < 0.075 MPa could be accepted., (Copyright © 2011 Elsevier B.V. All rights reserved.)

To determine the isotherm parameters and kinetic parameters of adsorption of anion polyacrylamide (APAM) from aqueous solution on PVDF ultrafiltration membrane (PM) and modified PVDF ultrafiltration membrane (MPM) is important in understanding the adsorption mechanism of ultrafiltration processes. Effect of variables including adsorption time, initial solution concentration, and temperature were investigated. The Redlich-Peterson equation of the five different isotherm models we chose was the most fitted model, and the R(2) was 0.9487, 0.9765 for PM and MPM, respectively; while, the pseudo-first-order model was the best choice among all the four kinetic models to describe the adsorption behavior of APAM onto membranes, suggesting that the adsorption mechanism was a chemical and physical combined adsorption on heterogeneous surface. The thermodynamic parameters were also calculated from the temperature dependence (Δ(r)G(m)(θ), Δ(r)H(m)(θ), Δ(r)S(m)(θ)), which showed that the process of adsorption is not spontaneous but endothermic process and high temperature favors the adsorption., (Copyright © 2011 Elsevier B.V. All rights reserved.)

Objective: To compare the different thresholds of 'moving percentile method' for outbreak detection in the China Infectious Diseases Automated-alert and Response System (CIDARS)., Methods: The thresholds of P(50), P(60), P(70), P(80) and P(90) were respectively adopted as the candidates of early warning thresholds on the moving percentile method. Aberration was detected through the reported cases of 19 notifiable infectious diseases nationwide from July 1, 2008 to June 30, 2010. Number of outbreaks and time to detection were recorded and the amount of signals acted as the indicators for determining the optimal threshold of moving percentile method in CIDARS., Results: The optimal threshold for bacillary and amebic dysentery was P(50). For non-cholera infectious diarrhea, dysentery, typhoid and paratyphoid, and epidemic mumps, it was P(60). As for hepatitis A, influenza and rubella, the threshold was P(70), but for epidemic encephalitis B it was P(80). For the following diseases as scarlet fever, typhoid and paratyphoid, hepatitis E, acute hemorrhagic conjunctivitis, malaria, epidemic hemorrhagic fever, meningococcal meningitis, leptospirosis, dengue fever, epidemic endemic typhus, hepatitis C and measles, it was P(90). When adopting the adjusted optimal threshold for 19 infectious diseases respectively, 64 840 (12.20%) signals had a decrease, comparing to the adoption of the former defaulted threshold (P(50)) during the 2 years. However, it did not reduce the number of outbreaks being detected as well as the time to detection, in the two year period., Conclusion: The optimal thresholds of moving percentile method for different kinds of diseases were different. Adoption of the right optimal threshold for a specific disease could further optimize the performance of outbreak detection for CIDARS.

Objective: To analyze the results of application on China Infectious Diseases Automated-alert and Response System (CIDARS) and for further improving the system., Methods: Amount of signal, proportion of signal responded, time to signal response, manner of signal verification and the outcome of each signal in CIDARS were descriptively analyzed from July 1, 2008 to June 30, 2010., Results: A total of 533 829 signals were generated nationwide on 28 kinds of infectious diseases in the system. 97.13% of the signals had been responded and the median time to response was 1.1 hours. Among them, 2472 signals were generated by the fixed-value detection method which involved 9 kinds of diseases after the preliminary verification, field investigation and laboratory tests. 2202 signals were excluded, and finally 246 cholera cases, 15 plague cases and 9 H5N1 cases as well as 39 outbreaks of cholera were confirmed. 531 357 signals were generated by the other method - the 'moving percentile method' which involved 19 kinds of diseases. The average amount of signal per county per week was 1.65, with 6603 signals (1.24%) preliminarily verified as suspected outbreaks and 1594 outbreaks were finally confirmed by further field investigation. For diseases in CIDARS, the proportion of signals related to suspected outbreaks to all triggered signals showed a positive correlation with the proportion of cases related to outbreaks of all the reported cases (r = 0.963, P < 0.01)., Conclusion: The signals of CIDARS were responded timely, and the signal could act as a clue for potential outbreaks, which helped enhancing the ability on outbreaks detection for local public health departments.

Objective: To analyze the pilot results of both temporal and temporal-spatial models in outbreaks detection in China Infectious Diseases Automated-alert and Response System (CIDARS) to further improve the system., Methods: The amount of signal, sensitivity, false alarm rate and time to detection regarding these two models of CIDARS, were analyzed from December 6, 2009 to December 5, 2010 in 221 pilot counties of 20 provinces., Results: The sensitivity of these two models was equal (both 98.15%). However, when comparing to the temporal model, the temporal-spatial model had a 59.86% reduction on the signals (15 702) while the false alarm rate of the temporal-spatial model (0.73%) was lower than the temporal model (1.79%), and the time to detection of the temporal-spatial model (0 day) was also 1 day shorter than the temporal model., Conclusion: Comparing to the temporal model, the temporal-spatial model of CIDARS seemed to be better performed on outbreak detection.

Background/aims: Studies have shown that kidney injury molecule-1 (KIM-1) is upregulated in damaged renal proximal tubules. In this study, we examined KIM-1 expression in glomerular epithelial cells in diabetic glomerulopathy., Methods: Renal histology, immunostaining and Western blot for protein level, and real-time PCR for mRNA expression of KIM-1 and podocyte markers were evaluated in untreated or losartan-treated Zucker lean (Fa/+) and Zucker diabetic fatty (Fa/Fa) rats., Results: The diabetic rats showed an increased glomerular expression of KIM-1. KIM-1 staining was localized primarily in the hyperplastic parietal epithelium of Bowman's capsule in the early stages of diabetes with subsequent increase in KIM-1-positive cells in the glomerular tuft in the more advanced stages. The increase in glomerular KIM-1 was associated with a decrease in podocytes in Fa/Fa rats. Antiproteinuric treatment with losartan attenuated podocytopenia and decreased renal expression of KIM-1 in treated diabetic rats. In an in vitro study, albumin overload increased KIM-1 protein in the primary cultures of rat glomerular epithelial cells., Conclusion: These results show that glomerular KIM-1 expression was increased, in proportion to the extent of proteinuria and podocytopenia in the diabetic animals, supporting that KIM-1 could be used as a potential biomarker for glomerular injury in proteinuric kidney disease., (Copyright © 2011 S. Karger AG, Basel.)

The Suzuki reactions of diboronic acid 1 and bromo-spirooxazine 2, under N(2) atmosphere and aerobic conditions, gave the dispirooxazine-substituted binaphthyl product 3 and the monospirooxazine-substituted binaphthyl derivative 4, respectively. The thermally reversible photochromic behavior of the target axially chiral spirooxazines 3 was investigated, and both the ring-opening process upon irradiation with 365 nm light and the thermally reverse ring-closing process were fast. These chiral spirooxazines were found to impart their chirality to an achiral liquid crystal host, at low doping levels, to form a self-organized photoresponsive helical superstructure.

Background: Liver transplantation is so far the most effective therapeutic modality for end-stage liver diseases, but ischemia/reperfusion (I/R) injury represents a critical barrier to liver transplantation. Primary graft dysfunction and small-for-size syndrome are closely associated with I/R injury. Ischemic preconditioning (IPC) is defined as a brief period of liver ischemia followed by reperfusion, and has demonstrated protections against a prolonged I/R injury and improved the capacity of regeneration. The article aimed to review IPC literatures for the understanding of the effects of IPC on I/R injury involving in the procurement of donor liver and protective mechanisms., Data Sources: A literature search of MEDLINE and Web of Science databases using "liver transplantation", "liver regeneration", "hepatectomy", "ischemia/reperfusion" and "ischemic preconditioning" was performed, and then a large amount of related data was collected., Results: The literature search provided a huge amount of evidence for the protective effects of IPC on I/R injury in liver transplantation, including reduction of blood loss in hepatectomy, intraoperative hemodynamic stability and its significant role in liver regeneration. The mechanism involves in balancing inflammatory cytokines, enhancing energy status and mitigating microcirculatory disturbance., Conclusion: IPC plays an essential role in hepatectomy before and after harvest of living donor liver and implantation of liver graft.

Background: Evidence has suggested that immunosuppressive drugs impact ischemia-reperfusion injury., Aims: The purpose of the present study was to evaluate the effect of sirolimus on hepatic injury and regeneration in a rat reduced-size liver ischemia-reperfusion model., Methods: Using a newly developed rat reduced-size liver ischemia-reperfusion injury model, the effects of sirolimus were evaluated by assessing liver cell apoptosis and aspartate aminotransferase, myeloperoxidase, and malondialdehyde levels. In addition, liver regeneration after sirolimus treatment was evaluated by measuring liver weight resumption and by the histological examination of bromodeoxyuridine and proliferating cell nuclear antigen expression., Results: Sirolimus significantly decreased liver cell apoptosis as well as tissue myeloperoxidase and malondialdehyde levels, but impaired postischemic liver regeneration. Ischemia-reperfusion-induced elevation of aspartate aminotransferase serum levels was significantly decreased by sirolimus., Conclusions: Despite an impairment of postischemic liver proliferation, sirolimus demonstrated beneficial amelioration of ischemia-reperfusion-induced liver injury in a reduced-size liver model in rats.

Objectives: To set a population-based cut-off value of normal adult and to determine correlations of testicular volume with body mass index (BMI), seminal profiles, and hormone levels. Testicular volume is an index of male fertility but cut-off values of normal adult has not been reported., Methods: During 54 months from January 2004, 1139 normal young men, 19-27 years old in military service were enrolled. Testicular volumes were measured by ultrasonometry. Height, body weight, and BMI were measured and semen analysis and hormone assay (follicle-stimulating hormone [FSH], luteinizing hormone [LH], and testosterone) were performed., Results: The mean age was 23.52+/-2.74. The mean testicular volume was 18.37+/-3.62 cm3 in left, and 18.13+/-3.85 cm3 in right. The mean body weight was 67.4+/-7.91 kg, the mean height was 176.2+/-6.64 cm, and mean BMI was 22.49+/-2.02 kg/m2. Testicular volumes had significant but weak correlations with height, body weight, and BMI. The semen analyses showed a mean pH of 7.63+/-0.74, volume of 2.49+/-1.12 mL, count of 68.63+/-13.62x10(6), motility of 69.93%+/-10.28%, and morphology of 68.62%+/-7.48%. Sperm counts and motility had positive correlations with testicular volume. The mean hormonal levels of FSH, LH, and testosterone were 7.31+/-2.42 mIU/mL, 7.81+/-2.49 mIU/mL, and 6.23+/-1.69 ng/mL, respectively. Testicular volume was negatively correlated with FSH and LH and positively with testosterone., Conclusions: In this population-based study, we conclude that the cut-off testicular volume in normal young adults is around 18 mL and that testicular volume is positively correlated with height, body weight, BMI, semen profile, and testosterone, and negatively correlated with FSH and LH., (Copyright (c) 2010 Elsevier Inc. All rights reserved.)

We tested the hypothesis that the basal release of nitric oxide (NO) from endothelial cells modulates contractile activity in the corpus cavernosum (CC) via inhibition of the RhoA/Rho-kinase signaling pathway. Cavernosal strips from wild-type (WT), endothelial nitric-oxide synthase knockout [eNOS(-/-)], and neuronal nitric-oxide synthase knockout [nNOS(-/-)] mice were mounted in myographs, and isometric force was recorded. mRNA and protein expression of key molecules in the RhoA/Rho-kinase pathway were analyzed by real-time polymerase chain reaction and Western blot, respectively. The cGMP levels were determined. The Rho-kinase inhibitors (R)-(+)-trans-N-(4-pyridyl)-4-(1-aminoethyl)-cyclohexanecarboxamide (Y-27632) and (S)-(+)-2-methyl-1-[(4-methyl-5-isoquinolinyl)sulfonyl] homopiperazine (H-1152) reduced cavernosal contractions evoked by phenylephrine or electrical field stimulation (EFS) in a concentration-dependent manner, although this inhibition was less effective in tissues from eNOS(-/-) mice. Y-27632 enhanced relaxations induced by sodium nitroprusside, EFS, and NO (administered as acidified NaNO2) without affecting the cGMP content of the cavernosal strips. This enhancement was less prominent in CC from eNOS(-/-). The protein expression of RhoA, Rho-guanine dissociation inhibitor, and Rho-kinase beta did not differ among the strains. However, in eNOS(-/-) CC, the protein expression of Rho-kinase alpha and both mRNA and protein expression of p115-Rho-associated guanine exchange factor (RhoGEF), PDZ-RhoGEF, and leukemia-associated RhoGEF were up-regulated. Phosphorylation of MYPT1 at Thr696 was higher in tissues from eNOS(-/-) mice. A high concentration of Y-27632 significantly enhanced NO release in CC stimulated by EFS. These results suggest a basal release of NO from endothelial cells, which inhibits contractions mediated by the RhoA/Rho-kinase pathway and modulates the expression of proteins related to this pathway in mouse CC. It indicates that endothelial integrity is essential to the maintenance of erectile function.

Microwave digestion technique was used in the decomposition of Ginkgo biloba leaves from six different trees at the same age in the same area. HNO3-H2O2 (5 : 1 v/v) was used as microwave digestion agent at a suitable temperature and time. The contents of Ca, Mg, K, Na, Cu, Zn and Zn/Cu were determined by flame atomic absorption spectrometry to study the distribution rule of metallic elements in the trees at the same age and in the same area. The recovery ratio ranged from 95.2% to 104.6%. The results showed that there were certain differences between different trees in the distribution of metallic elements. The contents of calcium were from 39 586 to 48 320 microg x g(-1), and those of magnesium from 10 076 to 12 918 microg x g(-1), of potassium from 2 004 to 5 240 microg x g(-1), of sodium from 9.05 to 35.30 microg x g(-1), and of copper from 1.50 to 3.05 microg x g(-1), while Zn/Cu values were from 2.68 to 5.93 in the leaves of 6 different trees in the same growing area. Therefore there were abounding calcium, magnesium and potassium, while the content of sodium and Zn/Cu values were lower, and the metal contents were different in the leaves. The experimental results provided useful bases for studying the distribution rule of metallic elements in Ginkgo biloba leaves, the relationship between the contents of calcium, magnesium, potassium and sodium and the Zn/Cu value in ginkgo biloba leaves and the treatment for cardio-cerebral vascular disease.

Objective: Ischemic preconditioning (IPC) has been gradually introduced into clinical liver surgery and transplantation in recent years. However, the protective effects of IPC on hepatic warm ischemia/reperfusion (I/R) injury and the potential mechanisms involved are not fully understood. We aimed to evaluate whether the reduction of apoptotic sinusoidal endothelial cells (SECs), induced by IPC, contributes to its protective effect., Methods: Male Wistar rats were randomized into three experimental groups: the continuous clamping group underwent 60 min of 70% hepatic ischemia; the IPC group received 10 min ischemia followed by 10 min reperfusion prior to ischemia, and the sham control (sham) underwent a sham operation without ischemia. Hepatocyte and SEC apoptosis, liver necrotic areas and the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), hyaluronic acid, tumor necrosis factor, myeloperoxidase (MPO) and malondialdehyde were determined. Expression of cysteine-aspartic acid protease-3 (caspase-3) in hepatocytes and SECs was also investigated. Furthermore, the hepatic leukocyte infiltration was assessed by intravital fluorescence microscopy., Results: IPC exhibited a significant alleviation of their postischemic liver function. Serum AST, ALT and tissue MPO were significantly decreased by IPC, and the degree of hepatocyte and SEC apoptosis was significantly inhibited, as shown by the decreased numbers of adherent leukocytes., Conclusions: IPC attenuates hepatic I/R injury by the reduction of leukocyte infiltration, the reduction hepatic enzymatic leakage and the depression of apoptotic cells. SECs are more sensitive to apoptosis induced by warm I/R injury compared to hepatocytes., (2010 S. Karger AG, Basel.)

To examine the semen quality of patients with uraemia and renal transplant recipients, 40 patients with uraemia and 40 renal transplant recipients were included. According to their interval of post-transplantation, renal transplant recipients were subdivided into group A (22) < or =2 years and group B (18) >2 years. A total of 40 healthy men with normal fertility were included as the controls. Semen samples from all subjects were collected and analysed. The fertility index (FI) value was calculated. The FI value of the normal fertility men was 13.02 (14.26), that of the renal transplant recipient groups A and B were 5.53 (8.30) and 9.27 (22.49) respectively, while the FI of the patients with uraemia was 0.23 (0.76). Compared with the uraemia group, the FI values of renal transplant recipient group either group A or group B were significantly better (P < 0.01). However, compared with the normal control group, the FI values of renal transplant recipient group A were lower (P < 0.01), while there was no significant difference between group B and the control group (P > 0.05). In conclusion, the FI of renal transplant recipients was recovered close to the level of healthy men with normal fertility 2 years after transplantation.

Mycophenolate mofetil (MMF) has been gradually introduced into clinical liver transplantation in recent years. However, the effects of MMF on hepatic ischemia/reperfusion (I/R) injury and the potential mechanisms involved are not totally understood. We aimed to evaluate whether MMF could attenuate hepatic I/R injury. MMF (20 mg/kg) or vehicle was administered to Wistar rats by gavage. The rats were then subjected to hepatic ischemia. Liver cell apoptosis and the levels of aspartate aminotransferase, myeloperoxidase (MPO), xanthine oxidase (XOD) and malondialdehyde (MDA) were determined. Expression of vascular cell adhesion molecule-1 (VCAM-1) and activation of mitogen-activated protein kinases (MAPKs) were also investigated. Furthermore, the hepatic microcirculation was observed by intravital fluorescence microscopy. Rats pretreated with MMF exhibited significant alleviation of their postischemic liver function. Liver cell apoptosis and the tissue MPO, XOD and MDA levels were decreased by MMF pretreatment. MMF also improved I/R-induced hemodynamic turbulence, as evidenced by reduced hepatic perfusion failure and decreased numbers of rolling and adherent leukocytes. I/R injury induced activation of the MAPKs pathway while expression of VCAM-1 was downregulated by MMF pretreatment. In summary, MMF attenuates hepatic I/R injury through suppression of the production of reactive oxygen species and amelioration of postischemic microcirculatory disturbances.

Introduction: Angiotensin II (Ang II) is the primary effector of the renin-angiotensin system (RAS). Ang II exerts its diverse physiologic actions via angiotensin type 1 and type 2 receptors. Recent evidence shows that tissue RAS exists in the penis, therefore indicating a significant role for Ang II in erectile function., Aim: To summarize the recent findings on the importance of Ang II in normal erection physiology and the pathogenesis of erectile dysfunction (ED)., Methods: This article reviews the literature that relates to the role of RAS in the regulation of erectile function., Main Outcome Measures: Evidence in the literature on the association between Ang II and the development of ED., Results: Elevated Ang II levels contribute to the development of ED in humans and different animal models. Pharmacologic therapy interrupting RAS may be beneficial for patients with ED., Conclusion: Studies have demonstrated that RAS is crucial in erectile function. Better understanding of the signaling pathways mediating Ang II physiologic actions will provide important information for the treatment of ED.

Preglomerular resistance is regulated by calcium influx- and mobilization-dependent mechanisms; however, the role of Rho-kinase in calcium sensitization in the intact kidney has not been carefully examined. Experiments were performed to test the hypothesis that Rho-kinase inhibition blunts pressure-mediated afferent arteriolar autoregulatory behavior and vasoconstrictor responses evoked by angiotensin II and P2X1 receptor activation. Rat kidneys were studied in vitro using the blood-perfused juxtamedullary nephron technique. Autoregulatory behavior was assessed before and during Rho-kinase inhibition with Y-27632 (1.0 microM; n = 5). Control diameter averaged 14.3 +/- 0.8 microm and increased to 18.1 +/- 0.9 microm (P < 0.05) during Y-27632 treatment. In the continued presence of Y-27632, reducing perfusion pressure to 65 mmHg slightly increased diameter to 18.7 +/- 1.0 microm. Subsequent pressure increases to 130 and 160 mmHg yielded afferent arteriolar diameters of 17.5 +/- 0.8 and 16.6 +/- 0.6 microm (P < 0.05). This 11% decline in diameter is significantly smaller than the 40% decrease obtained in untreated kidneys. The inhibitory effects of Y-27632 on autoregulatory behavior were concentration dependent. Angiotensin II responses were blunted by Y-27632. Angiotensin II (1.0 nM) reduced afferent diameter by 17 +/- 1% in untreated arterioles and by 6 +/- 2% during exposure to Y-27632. The P2X1 receptor agonist, alpha, beta-methylene ATP, reduced afferent arteriolar diameter by 8 +/- 1% but this response was eliminated during exposure to Y-27632. Western blot analysis confirms expression of the Rho-kinase signaling pathway. Thus, Rho-kinase may be important in pressure-mediated autoregulatory adjustments in preglomerular resistance and responsiveness to angiotensin II and autoregulatory P2X1 receptor agonists.

Panax ginseng C A Meyer (PG) is one of the most popular qi-invigorating herbal medicine and has been used to promote health, vitality, and longevity in China. Although PG has been used in traditional Chinese medicine for millennia, its qi-invigorating activities still lack convincing evidence. We investigated the effects of Panax ginseng polysaccharide (PGP) on energy metabolism and mitochondrial protection. The chronic hypoxia model was set up. Lipid peroxidation product malondialdehyde (MDA) was assayed by thiobarbituric acid (TBA) colorimetry. Mice liver mitochondria were isolated by differential centrifugation. The spectrophotometric method was used to measure the swelling of mitochondria. The levels of adenosine triphosphate (ATP), adenosine diphosphate (ADP) and adenosine monophosphate (AMP) in liver cells were determined by reversed-phase high performance liquid chromatography (RP-HPLC), adenylate energy charge (AEC), total adenylate pool (TAP), ATP/ADP and ATP/AMP ratio were calculated. The creatine kinase (CK) activities in mice skeletal muscle were determined by a commercial monitoring kit. The result showed that PGP could inhibit mitochondrial injury and swelling induced by Fe(2+)-L-Cys in a concentration-dependent manner. PGP which was administered by oral gavage daily for 10 days could inhibit the formation of MDA in mice brain, increase levels of ATP, ADP, TAP and AEC, ratio of ATP/ADP and ATP/AMP in liver cells, increase CK activities in mice skeletal muscle under chronic hypoxia condition. These results indicate that PGP protect mitochondria by inhibiting mitochondrial swelling, and improving energy metabolism. PGP functions as a preventive antioxidant by increasing CK activities. Therefore, PGP had the pharmaceutical activities of antihypoxia, antioxidation and improving energy status.

A questionnaire was designed to assess the effects of renal transplantation in men of reproductive age on marital status and fertility. The study sought to correlate recipients' marital status and fertility with the health of the recipients after the transplantation, the health of children they fathered after the procedure, and the functioning of the transplanted kidney. Male recipients (n = 243) who were single and of reproductive age before renal transplantation were selected from 2007 recipients of a renal transplant recorded in the authors' hospitals in China. Of the 243 surveyed, 185 completed the questionnaire and participated in follow-up in the clinic or by telephone. Their marital status and fertility were investigated. Of the 185 recipients, 69 got married 12-88 months (mean, 32.19 +/- 14.30 months) after renal transplantation, and 62 of 69 couples were actively attempting to become pregnant. Fifty-three patients fathered 54 children, including 1 pair of twins, 9-72 months (mean, 25.81 +/- 15.33 months) after marriage. The birth weights of the newborns ranged from 2500 to 4600 g (mean, 3395 +/- 456.80 g). These children developed well. Nine patients did not father any children, and 3 of these 9 cases were attributable to infertility in the wife. Seven patients were using contraceptives. Three recipients suffered from chronic graft rejection and resumed hemodialysis 2-11 years after they fathered children. In addition, 2 patients died after fathering 1 child: 1 from dysfunction of the transplanted kidney 9 years after birth of his child, and another in an accident 1 year after his child's birth. Our findings suggest that, like men without renal transplants, male recipients of renal transplants can get married and father children, and the transplantation procedure appears to have no significant effect on the children fathered afterwards, on the recipients' health, or on the functioning of the transplanted kidney. It is very important to indicate that, in addition to needing contraception if they do not conceive, male renal transplant recipients should expect fertility rates that are similar to those of the general population.

Objective: To explore the impregnate occasion for male renal transplant recipients., Methods: Twenty-six male renal transplant recipients were divided into 3 groups according to the post-transplantation time and the administered dose of Cyclosporine A: 7 in Group A (less than 6 months after renal transplantation and at the dose of 4.1-6 mg/[kg x d]), 11 in Group B (6-24 months and 2.1-4 mg/[kg x d]) and 8 in Group C (longer than 24 months and 1.3-2 mg/[kg x d]). The semen of the patients were detected and compared with those of 12 normal volunteers., Results: Statistically significant differences were observed in sperm motility and sperm head deformity between Group A and C (P < 0.05), but not in pH value and sperm volume, vitality and concentration among the 3 groups (P > 0.05)., Conclusion: For male renal transplant recipients, 2 years or longer after the transplantation is the most suitable time for impregnation.

Objective: To describe the occupational distribution of staff who worked on detection and reporting on public health emergency events, and to explore the effective strategies for identification and reporting on emergency events., Methods: We conducted a retrospective survey on 3275 emergent events reported through Public Health Emergency Events Surveillance System from 2005 to the first half of 2006. Data were collected by uniform self-administrated questionnaires by county Centers for Disease Control and Prevention, including information on events detection and reporting, etc., Results: Among event discoverers, 56.40% (1847/3275) were healthcare staff, 20.58% (674/3275) were teachers, and 15.15% (496/3275) were staff from the disease control systems. Among those event reporters, 56.82% (1861/3275) were healthcare staff, 21.77% (713/3275) from disease control system and 10.75% (352/ 3275) were teachers., Conclusion: Healthcare staff and teachers played the most important role in detection and reporting on events. It would be favorable to improve the ability of events detection and reporting if we could enhance the training program to the relative staff in medical facilities and school settings especially at the grass root level.

We report three crystal structures of a synthetic 5-fluoroalkylporphyrin molecule that was programmed for self-assembly. All the X-ray structures of zincated and free-base porphyrins Zn2 b, Zn5 a, and 2 b revealed rigorous pi-pi stacking and extremely hydrophobic interactions. Other the other hand, the strong aggregation of 5-fluoroalkylporphyrins in solution was also found. Interestingly, the regular nanopore formation of the 5-fluoroalkylporphyrin was visualized by atomic force microscopy (AFM). Importantly, the 5-fluoroalkylporphyrins possess liquid-crystalline properties that were confirmed by using a combination of differential scanning calorimetry (DSC) and polarizing optical microscopy (POM) techniques. By comparison, the self-assembly of non-fluorine-containing porphyrins with similar structure showed much lower aggregation ability, as investigated by NMR techniques. Additionally, no birefringent mesophase was observed for the non-fluorine-containing porphyrin.

Treatment of C70 with cycloalkylaminomethylenebisphosphonates in the presence of NaH gave corresponding C70 dimers 1 in good yield, while the methanofullerenes, C70>CH(PO3Et2) (3) and C70>C(PO3Et2)2 (4) or C60>CH(PO3Et2) (5) and C60>C(PO3Et2)2 (6), were obtained, respectively, by the reaction of C70 or C60 with tetraethyl methylenediphosphonate in the presence of NaH. Diethyl cyanomethylphosphonate reacted with C60 or C70 under similar conditions to afford C60>C(PO3Et2)CN (7) and C70>C(PO3Et2)CN (8). Furthermore, the presence of weak electronic interactions between two fullerene cages of fullerene dimers was demonstrated by cyclic voltammetry. A radical mechanism was proposed for the formation of the fullerene derivatives on the basis of the ESR studies.

[reaction: see text] Electrophilic nitration, formylation or bromination of metalated 5-fluoroalkyl-10,20-diphenylporphyrin (fluoroalkyl = CF3, ClCF2CF2, n-C6F13) proceeded with high regioselectivity, exclusively affording corresponding meso-substituted porphyrins, while the iodination reaction mainly took place at the adjacent beta site giving 2-iodo-10-fluoroalkyl-5,15-diphenylporphyrin. Suzuki, Sonogashira, and trifluoromethylation reactions of the obtained 5-bromo-15-fluoroalkyl-10,20-diphenylporphyrins or 2-iodo-10-fluoroalkyl-5,15-diphenylporphyrins could perform smoothly to give the corresponding various meso- or beta-functionalized fluoroalkylated porphyrin derivatives. Accordingly, two meso-to-meso butadiyne-bridged bisporphyrin dimers and two beta-to-beta butadiyne-linked dimeric porphyrins were prepared by the coupling reactions of 5-ethynyl-15-fluoroalkyl-10,20-diphenylporphyrins and 2-ethynyl-10-fluoroalkyl-5,15-diphenylporphyrins, respectively.

Novel carbon bridged fullerene dimers (HC60-CR2-C60H type) are obtained in high yield by the reaction of aminomethylenebis(phosphonate) anions with [60]fullerene.

Objective: To understand the changing trend on the way of delivery since 1970s and its related factors that influencing the attitude of choice on Cesarean section (C-section) in women at child-bearing age., Methods: A face-to-face interview was conducted anonymously in pregnant and lying-in women visited at the out-patient department of Gynecology and Obstetrics, Tiantan Hospital of Beijing. Totally, 415 women at child-bearing age, with a history of previous birth were interviewed on date, place and way of delivery of last birth, as well as on information that could have had impact on the choice of C-section., Results: The average rate of C-section in Tiantan Hospital had been 29% since the year of 2000, much higher than that during 1970s, 1980s and 1990s (chi(2) = 22.81, P = 0.001) which showed an increasing trend. Rate of C-section among lying-in women with native Beijing origin was 25.0%, significantly higher than 9.6% (chi(2) = 21.96, P = 0.000 002) that in the migrants. Lying-in women with education level of high school or above had higher chance to choose C-section than those with lower level of education (chi(2) = 43.64, P < 0.000 01). Workers, managerial staff or clerks had more chance to choose C-section than those with other occupations (chi(2) = 20.07, P = 0.01). As reported by the interviewees, 93% (70/75) of C-section in the hospital were performed and recommended by obstetricians., Conclusion: Rate of C-section in the hospital showed an increasing trend which suggested that intervention with health education be carried out for both pregnant women and obstetricians.

Treatment of 5,10,15,20-tetraarylporphyrins (1) with perfluoroalkyl iodides (2) in the presence of Na(2)S(2)O(4)/NaHCO(3) in DMSO-CH(2)Cl(2) at 30-40 degrees C for several hours gives the corresponding 2-perfluoroalkylporphyrins (3). Nucleophilic attack on 3 with dimethyl malonate, diethyl malonate, malonitrile, or cyano acetate (Nu) anion results in the formation of (E)-3-Nu-2-perfuoroalkyl(methylenyl)chlorins. Electrophilic substitution on 3 with NBS or NO(2) affords regioselectively the corresponding 12(or 13)-bromo- and 12,13-dibromo- or nitroporphyrins.

The clinical experience with a new fluid therapy in children with acute brain edema complicated by infectious disease is reported. The clinical data of a retrospective group of 192 patients and a prospective study of 1,302 and 2,279 patients is summarized. One method of fluid therapy for children with acute brain edema is traditional; fluid intake is restricted to less than 1,200 mL/m(2) daily (60 mL/kg daily). Another method is the new fluid therapy regimen used in our prospective study, in which dehydration and fluid replenishment are individualized. On the first day the fluid intake of patients who survived varied from 40 to 208 mL/kg daily. The mortality rate in the two prospective groups was 19.66% in 1,302 patients and 17.2% in 2,279 patients, significantly lower than the 63.5% in the retrospective group (192 patients) (P <0.001). This result indicates that a wide range of fluid intake for children with acute brain edema is allowable during the first days of treatment. The appropriate dehydration and fluid replenishment should be individualized based on close observation of the patient's condition.