Early prediction of post-endoscopic retrograde cholangiopancreatography pancreatitis via dynamic changes of leukocyte: A retrospective study.

BACKGROUND: Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) remains a major concern for clinicians. Hence early identification of PEP is meaningful to minimize medical risks. AIMS: This study aims to explore the value of dynamic leukocyte changes for early prediction of PEP. METHODS: Patients from January 2017 to December 2018 (training set) and January 2019 to December 2022 (test set) were retrospectively reviewed. The dynamic changes of leukocyte, neutrophil, and lymphocyte were examined to evaluate the diagnostic value of PEP. RESULTS: A total of 498 patients (36 PEP cases) in training set and 948 patients (71 PEP cases) in test set were analyzed. Four predictors were finally identified in training set containing margin and ratio of 3h-post ERCP leukocyte count (Po Leu) to pre-ERCP leukocyte count (Pr Leu), 3h post-ERCP neutrophil-to-lymphocyte ratio (NLR) and pre-ERCP fibrinogen levels. ROC analysis revealed the optimal thresholds were 2.3 (x109/L), 1.6, 4.8 and 3.1 (g/L), respectively. The sensitivity and specificity of Po Leu - Pr Leu and Po Leu/Pr Leu were 71.0%, 82.7%, 66.1% and 86.3% to diagnosis PEP in patients with hyperamylasemia. CONCLUSIONS: For early identification of PEP, the elevation of amylase and lipase still exhibits the highest sensitivity, while the dynamic changes of leukocyte would be helpful for the different diagnosis of hyperamylasemia.

Formation mechanism and characterization of black silicon surface by a single-step wet-chemical process.

We report a simple single-step etching method for formation of black surface on silicon wafer by using HAuCl4-HF-H2O2 etching solution, in which catalytic Au particles were deposited in situ. The black surface suppresses the reflectivity in a wide spectral region. The formation mechanism involved has been discussed.

[Domestic imipenem cilastatin sodium for the treatment of severe aspiration pneumonia, a curative effect observation].

OBJECTIVE: To evaluate the efficacy and safety of domestic imipenem cilastatin sodium for the treatments of severe aspiration pneumonia. METHODS: A randomize, open, parallel-controlled trial was conducted. Sixty-eight patients with severe aspiration pneumonia were divided into trial group (n=36) and control group (n=32) by random distribution method. The application of trial group domestic imipenem cilastatin sodium was 1.0 g intravenous drip, every 6-8 hours for 7-14 days. The control group application with imported injection imipenem cilastatin sodium was 1.0 g intravenous drip, every 6-8 hours for 7-14 days. The highest daily temperature (T), heart rate (HR), breathing rate (RR), pulse blood oxygen saturation (SpO(2)), blood oxygen partial pressure (PaO(2)), inhaled oxygen concentration (FiO(2)), oxygenation index (PaO(2)/FiO(2)), airway peak pressure (Paw), minute ventilation (MV) and white blood count (WBC), pro calcitonin (PCT), high-sensitivity C-reactive protein (hs-CRP) index before and 1, 3, 7 days after treatment, and liver and kidney function, chest X-rays, and sputum cultures of drug sensitive test were conducted. And the effectiveness and safety were determined according to the standards. RESULTS: After treatment indexes of the two groups were obviously improved, i. e. T, HR, RR, Paw, MV, the WBC, PCT, CRP were gradually declined, PaO(2)/FiO(2) was gradually raised. There were statistical significance before and 3 days after treatment in the trial and the control group [T: 37.35±0.91 centigrade vs. 38.43±1.06 centigrade, 37.28±0.88 centigrade vs. 38.35±1.11 centigrade; HR: 90.25±10.60 bpm vs. 118.94±15.46 bpm, 89.31±11.17 bpm vs. 124.34±17.87 bpm; RR: 25.14±3.17 bpm vs. 32.28±4.49 bpm, 24.81±2.43 bpm vs. 33.13±4.17 bpm; Paw: 23.03±3.04 cm H(2)O vs. 33.22±4.59 cm H(2)O, 22.75±3.22 cm H(2)O vs. 33.63±4.79 cm H(2)O; MV: 8.67±1.26 L/min vs. 11.80±2.01 L/min, 8.88±1.45 L/min vs. 13.21±2.90 L/min; WBC: 11.26±1.96 ×10(9)/L vs. 14.57±3.10 ×10(9)/L, 12.28±3.38 ×10(9)/L vs. 15.25±4.93 ×10(9)/L; PCT: 6.90±5.46 µg/L vs. 16.97±7.93 µg/L, 6.17±6.13 µg/L vs. 21.26±11.54 µg/L; CRP: 85.50±37.91 mg/L vs. 120.17±45.47 mg/L, 94.31±38.51 mg/L vs. 142.34±53.57 mg/L; PaO(2)/ FiO(2): 182.06±40.88 mm Hg vs. 98.67±20.62 mm Hg, 184.09±43.78 mm Hg vs. 96.22±22.59 mm Hg, all P<0.05]. There was no significant change in SpO(2) before and after treatment in two groups. And the total clinical effective rate in trial and control group were 83.4% and 81.2%, adverse reaction rate were 13.9% and 9.4%, bacterial removal rate were 90.3% and 87.0% respectively, and there was no significant difference between the two groups (all P>0.05). CONCLUSION: Domestic imipenem cilastatin sodium can effectively control severe aspiration pneumonia, and it is safe and effective antibiotics.

Incidence, prognosis, and risk factors of sepsis-induced cardiomyopathy.

BACKGROUND: At present, large-scale studies on the clinical characteristics of sepsis-induced cardiomyopathy (SIC) are lacking. AIM: To investigate the clinical characteristics of SIC. METHODS: Based on the analysis of the MIMIC-III public database, we performed a large-scale retrospective study involving sepsis patients who were admitted to the intensive care unit (ICU) and had no concomitant cardiac disease. We used propensity score matching analysis and multivariate logistic regression to ensure the robustness of the results. The primary outcome was hospital mortality, and the secondary outcomes included the number of patients who received mechanical ventilation or renal replacement therapy during their hospital stay, the number of patients administered with vasopressors, the length of ICU stay, and the length of hospital stay. RESULTS: In the present study, after screening 38605 patients, 3530 patients with sepsis were included. A total of 997 patients met the SIC diagnostic criteria, and the incidence of SIC was 28.20% (95% confidence interval [CI]: 26.80%-29.70%). Compared to patients in the non-SIC group, patients in the SIC group were of older age and had a higher Simplified Acute Physiology Score (SAPS)-I score, SAPS-II score, and Elixhauser comorbidity index (ECI). A total of 367 (36.8%) of 997 patients in the SIC group and 818 (32.3%) of 2533 patients in the non-SIC group died in the hospital, which resulted in a significant between-group difference (odds ratios = 1.22, 95%CI: 1.05-1.42; P = 0.011). For the secondary outcomes, more patients in the SIC group received mechanical ventilation and vasopressors. Multivariate logistic regression analysis showed that age, male sex, ECI, hemoglobin level, diabetes, and mechanical ventilation use on the first day of ICU admission were risk factors for SIC. CONCLUSION: Compared with non-SIC patients, hospital mortality is higher in SIC patients.

[The effects of the plasma levels of serotonin and neuropeptide on ventilated patients with Yitongshu acupuncture points injection].

OBJECTIVE: To evaluate the change in the plasma levels of serotonin (5-hydroxytryptamine) and neuropeptide (beta-endorphin, beta-EP) after injection of Yitongshu into Zusanli points in patients under mechanical ventilation. METHODS: Twenty-eight patients undergoing mechanical ventilation were randomly divided into two groups: midazolam combined with fentanyl group (control group, n=14) and midazolam combined with fentanyl and Yitongshu group (Yitongshu group, n=14). The drugs were given to the patients continuously intravenously with an injection pump in an even rate, with the dosage adjusted to reach the sedative target of visual analog score (VAS)< or =3-4 and Ramsay 2-4. Yitongshu injection (4 ml) was injected into the Zusanli point on both sides 11 hours or 23 hours after administration of the durgs in Yitongshu group. The hemodynamic and respiratory parameters, including mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR), pulse oxygen saturation (SpO(2)), oxygenation index (PaO(2)/FiO(2)) and pressure airway (Paw), were recorded, and the sedation levels (VAS and Ramsay) were evaluated before sedation and 1, 12, 24 hours after sedation in these patients. The plasma levels of 5-hydroxytryptamine and beta-EP were examined before sedation, 12 hours and 24 hours after sedation. RESULTS: Compared with that before sedation, HR and VAS score were significantly lower, and Ramsay score was significantly higher in both groups. MAP was significantly lower at 1 hour, and RR at 12 hours and 24 hours , as well as the Paw at 24 hours, and the PaO(2)/FiO(2) was significantly higher at 24 hours. The level of 5-hydroxytryptamine at 12 hours and 24 hours in Yitongshu group [(101.45+/-14.67) ng/L, (104.86+/-11.74) ng/L] was significantly higher than that in control group [(61.57+/-10.62) ng/L, (59.86+/-8.64) ng/L, both P<0.05]. But the level of beta-EP showed no difference between two groups [control group: (162.72+/-38.44) ng/L at 12 hours, (151.83+/-24.54) ng/L at 24 hours; Yitongshu group: (169.35+/-28.10) ng/L at 12 hours, (159.41+/-15.89) ng/L at 24 hours, both P>0.05]. CONCLUSION: Yitongshu injection can reduce the plasma level of 5-hydroxytryptamine in ventilated patients, but with no effect on beta-EP.

[Progress on the treatment of adolescent idiopathic scoliosis].

Adolescent idiopathic scoliosis (AIS) is a common disease with the age of 10 to 18 years, the Cobb angle more than 10 ° on the coronal plane and combined with the rotation of the vertebral body without other organic lesions. The disease can lead to deformity, pain and even damage of cardiopulmonary function, which seriously affects the physical and mental health and quality of life of patients. For mild to moderate AIS patients, regular observation, braces and other conservative treatment methods can effectively delay the progress of scoliosis. For AIS patients whose conservative treatment is ineffective and reaches the surgical threshold, surgery is recommended. Currently, the prevalent surgical method is posterior vertebral body fusion represented by the pedicle screw internal fixation system, which can often achieve good clinical efficacy. In recent years, Physical Therapeutic Scoliosis Specific Exercise (PSSE) has become more and more popular because of its safety and effectiveness. At present, the specific indications for the treatment of AIS patients are gradually improving, the concept and technology of treatment are constantly updated, and the clinical efficacy is constantly improved. This article will start from two aspects of conservative treatment and surgical treatment, mainly describes the commonly used treatment methods in clinical progress and application as well as the problems faced, in order to provide a reference for the selection of clinical treatment.

TGF-beta1 induces human bronchial epithelial cell-to-mesenchymal transition in vitro.

The subepithelial fibrosis component of airway remodeling in asthma is mediated through induction of transforming growth factor-beta1 (TGF-beta1) expression with consequent activation of myofibroblasts to produce extracellular matrix proteins. The number of myofibroblasts is increased in the asthmatic airway and is significantly correlated with the thickness of lamina reticularis. However, much is still unknown regarding the origin of bronchial myofibroblasts. Emerging evidence suggests that myofibroblasts can derive from epithelial cells by an epithelial-to-mesenchymal transition (EMT). In this study we investigated whether TGF-beta1 could induce bronchial epithelial EMT in the human bronchial epithelial cell. Cultured human bronchial epithelial cells, 16HBE-14o, were stimulated with 10 ng/ml TGF-beta1. Morphologic changes were observed and stress fiber by actin reorganization was detected by indirect immunostaining. The expression of alpha-SMA (alpha-smooth muscle actin) and the epithelial cell marker E-cadherin were detected in those 16HBE-14o cells after TGF-beta1 stimulation for 72 h, using immunostaining and RT-PCR. The contents of collagen I were determined by radioimmunoassay, and the levels of endogenous TGF-beta1 were measured with ELISA. Human bronchial epithelial cells stimulated with TGF-beta1 were converted from a "cobblestone" epithelial structure into an elongated fibroblast-like shape. Incubation of human bronchial epithelial cells with TGF-beta1 induced de novo expression of alpha-SMA, increased formation of stress fiber by F-actin reorganization, and loss of epithelial marker E-cadherin. Moreover, a significant increase in the levels of collagen I and endogenous TGF-beta1 released from bronchial epithelial cells stimulated with TGF-beta1 were observed. These results suggested that human bronchial epithelial cells, under stimulation of TGF-beta1, underwent transdifferentiation into myofibroblasts.

[Changes in expressions of the myocardial Toll-like receptor 4, tumor necrosis factor-alpha and interleukin-6 mRNA in rat with sepsis].

OBJECTIVE: To investigate the relationship between apoptosis of myocardial cell in the rats with sepsis and the expressions of Toll-like receptor 4 (TLR4), tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) mRNA, and the protective effect of glutamine (Gln) against apoptosis of myocardial cell. METHODS: Rat model of sepsis was reproduced by peritoneal injection with lipopolysaccharide (LPS), and the animals were divided into control group, LPS group and Gln group. Rats in each group were further divided into four subgroups, 0, 6, 12 and 24 hours ( n =6). Apoptosis of myocardial cells was surveyed, and TLR4, TNF-alpha and IL-6 mRNA expressions were assessed with reverse transcription-polymerase chain reaction (RT-PCR). The pathological changes in myocardial cells were observed. RESULTS: Myocardial apoptosis rate in LPS group was higher. Compared with the control group, expressions of TLR4 mRNA, TNF-alpha mRNA and IL-6 mRNA were significantly higher at all time points after LPS administration in the LPS group and the Gln group (all P<0.05). Compared with the LPS group, the rate of myocardial apoptosis in Gln group was lower, and expression of TLR4 mRNA in the Gln group was significantly lower at 12 hours and 24 hours; the expression of TNF-alpha mRNA was obviously lower at 6 hours and 24 hours; the expression of IL-6 mRNA in the Gln group was significantly lower at 12 hours (all P<0.05). CONCLUSION: TLR4, TNF-alpha and IL-6 gene expressions play extremely important role in apoptosis of myocardial cell in the rat with sepsis. Gln can affect apoptosis-related gene expressions, thus alleviating the apoptosis of myocardial cell.

[Photoluminescence investigation of InAs bimodal self-assembled quantum dots state filling].

Self-assembled InAs quantum dots were prepared on GaAs(100) substrate in a solid source molecular beam epitaxy system. The distribution and topographic images of uncapped dots were studied by atomic force microscope. The statistical result shows that the quantum dots are bimodal distribution. The photoluminescence spectrum results shows that the intensity of small size quantum dots dominated, which may be due to: (1) the state density of large quantum dots lower than that of small quantum dots; (2) the carriers capture rate of large size quantum dots is small relative to that of small ones; (3) there is a large strain barrier between large quantum dots and capping layer, and the large strain is likely to produce the defect and dislocation, resulting in a probability of carriers transferring from large quantum dots to small dots that is very small with temperature increasing.

Effect of glutamine on caspase-3 mRNA and protein expression in the myocardium of rats with sepsis.

: Apoptosis and caspase-3 play an important role in the pathogenesis of sepsis. In this study, the authors monitored myocardial apoptosis and investigated caspase-3 protein expression change in rats with sepsis. In addition, we investigated the protective effect of glutamine (Gln) on myocardial injury in septic rats. A rat model of sepsis was established by intraperitoneal injection of lipopolysaccharide (LPS). Rats were divided into control group, endotoxin (LPS) group and LPS + Gln group, which were further divided into 4 subset groups (0, 6, 12 and 24 hour subgroups; n = 6). The rate of myocardial apoptosis, caspase-3 mRNA expression and caspase-3 protein expression were examined. Data were analyzed using the F-test or linear correlation test. The results revealed that the rate of myocardial apoptosis in the LPS group was significantly higher than that in the control group (P < 0.05). Compared with the control group, LPS group has an upregulated caspase-3 mRNA expression level. However, the caspase-3 protein was low expressed (P < 0.05). The LPS + Gln group has significant lower myocardial apoptosis rate compared with the LPS group (P < 0.05). In addition, caspase-3 mRNA expression levels and caspase-3 protein expression levels were lower in the LPS + Gln group (P < 0.05). We found that Gln reduces the extent of myocardial apoptotic cell death by decreasing the gene and protein expression of caspase-3. Therefore, Gln may be used to prevent the onset of sepsis at an early stage.

Metalorganic chemical vapor deposition growth of InAs/GaSb type II superlattices with controllable AsxSb1-x interfaces.

InAs/GaSb type II superlattices were grown on (100) GaSb substrates by metalorganic chemical vapor deposition (MOCVD). A plane of mixed As and Sb atoms connecting the InAs and GaSb layers was introduced to compensate the tensile strain created by the InAs layer in the SL. Characterizations of the samples by atomic force microscopy and high-resolution X-ray diffraction demonstrate flat surface morphology and good crystalline quality. The lattice mismatch of approximately 0.18% between the SL and GaSb substrate is small compared to the MOCVD-grown supperlattice samples reported to date in the literature. Considerable optical absorption in 2- to 8-µm infrared region has been realized.PACS: 78.67.Pt; 81.15.Gh; 63.22.Np; 81.05.Ea.

Observation of strong anisotropic forbidden transitions in (001) InGaAs/GaAs single-quantum well by reflectance-difference spectroscopy and its behavior under uniaxial strain.

The strong anisotropic forbidden transition has been observed in a series of InGaAs/GaAs single-quantum well with well width ranging between 3 nm and 7 nm at 80 K. Numerical calculations within the envelope function framework have been performed to analyze the origin of the optical anisotropic forbidden transition. It is found that the optical anisotropy of this transition can be mainly attributed to indium segregation effect. The effect of uniaxial strain on in-plane optical anisotropy (IPOA) is also investigated. The IPOA of the forbidden transition changes little with strain, while that of the allowed transition shows a linear dependence on strain.PACS 78.66.Fd, 78.20.Bh, 78.20.Fm.