Explore the Mechanism of Jiawei Shengji Yuhong Ointment in Promoting Wound Healing after Anal Fistula of Damp-heat Type Based on NF-κB/VEGF Signaling Pathway / 浙江中医药大学学报

[Objective]To discuss the effect of Jiawei Shengji Yuhong Ointment on wound healing of rat model after anal fistula operation and its internal mechanism.[Methods]Seventy SD rats were randomly divided into blank group,Vaseline group(model group),Kangfuxin liquor group(control group),Jiawei Shengji Yuhong Ointment group(experimental group),ammonium pyrrolidine dithiocarbamate(PDTC)+vaseline group(PDTC+model group),PDTC+Kangfuxin liquid group(PDTC+control group),PDTC+Jiawei Shengji Yuhong Ointment group(PDTC+experimental group).The damp-heat wound model of rats after anal fistula operation was established and treated with different drugs.At the same time,PDTC intervention group was given intraperitoneal injection of nuclear factor-κB(NF-κB)signaling pathway inhibitor PDTC for 5 consecutive days on the basis of drug intervention.The wound healing of rats in each group was recorded,and the wound healing rate of rats in each group was calculated.On the 3rd,7th and 14th days,the granulation tissues of rats in each group were taken for Western blot and immunohistochemistry to detect the protein expression of NF-κB p65.The expression of interleukin-1β(IL-1β)and vascular endothelial growth factor(VEGF)was detected by enzyme-linked immunosorbent assay(ELISA).Hematoxylin-eosin(HE)staining was used for histomorphological observation.[Results]Compared with other groups,the experimental group and PDTC+experimental group could significantly shorten the wound healing time,and the wound healing rates of PDTC+experimental group and experimental group were higher(P＜0.05).HE staining results also confirmed that PDTC+experimental group can effectively promote the rapid growth of granulation tissue.The results of immunohistochemistry and Western blot showed that was inhibited significantly in experimental group and PDTC+experimental group the protein expression of NF-κB p65 in rat wound tissue,and the difference was statistically significant compared with the other groups(P＜0.05).The results of ELISA showed that the content of IL-1 β in each group decreased gradually at 3,7 and 14 d after treatment,and the content of IL-1[3 in PDTC+experimental group was the lowest(P＜0.05).The content of VEGF in each group increased gradually,and the content of VEGF in PDTC+experimental group and experimental group was the highest(P＜0.05).[Conclusion]Jiawei Shengji Yuhong Ointment can inhibit the expression of NF-κB p65 and IL-1 β protein and up-regulate the expression of VEGF protein through NF-κB signaling pathway,thereby promoting the angiogenesis of vascular endothelial cells,reducing inflammation,and promoting the wound healing after anal fistula surgery.

Break the domestic public hospital clinical research evaluation system under the background of"five only" / 现代医院

Objective The purpose of this article is to summarize and review the current status of the construction of clinical research evaluation systems in domestic public hospitals,identify existing problems in the evaluation system,and propose development strategies and suggestions.Methods Retrieved relevant articles,dissertations and policies from the past five years(2018-2022),screened the titles,viewed the full texts of 52 selected papers and their references,and summarized them.Results The"five-only"indicators have long been an important indicator for evaluating clinical research in public hospitals,but in today's scientific research environment and policy environment,the"five-only"evaluation system has revealed its utilitarian draw-backs and gradually evolved into a hindrance to scientific research.It is urgent to break through the"five-only"orientation and establish a clinical research evaluation system oriented towards"transforming and applying transformation of scientific research achievements".Conclusion The evaluation system for clinical research should break the previous"five-only"evaluation model based on quantity-oriented scientific research evaluation.We can draw on the framework of the research output,influence,and environment indicators in the UK's REF Excellence Framework model,combine the American APT system and the Chinese STEM indicator dimensions,explore multi-outcome evaluation,integrate developmental indicators,and continuously improve the indica-tor system and application methods in practice to promote the development of clinical research in public hospitals.

Characteristics of plasma Epstein-Barr virus DNA in children with primary infection / 中华儿科杂志

Objective: To explore the characteristics of plasma Epstein-Barr virus (EBV) DNA in primary infection in pediatric cases. Methods: The laboratory and clinical data of 571 children diagnosed with EBV primary infection in Children's Hospital of Fudan University during September 1st, 2017 to September 30th, 2018 were retrospectively analyzed. According to the results of plasma EBV DNA, they were divided into positive group and negative group. According to the EBV DNA, they were devided into high plasma virol load group and low plasma virol load group. The Chi-square test, Wilcoxon rank sum test were used to compare the differences between groups. Results: Among the 571 children with EBV primary infection, 334 were males and 237 were females. The age of first diagnosis was 3.8 (2.2, 5.7) years. There were 255 cases in positive group and 316 cases in negative group. The percentage of cases with fever,hepatomegaly and (or) splenomegaly, elevated transaminase in the positive group were higher than those in the negative group (235 cases (92.2%) vs. 255 cases (80.7%), χ2=15.22, P<0.001; 169 cases (66.3%) vs. 85 cases (26.9%), χ2=96.80, P<0.001; and 144 cases (56.5%) vs. 120 cases (38.0%), χ2=18.27, P<0.001; respectively).In the positive group, 70 cases were followed up for 46 (27, 106) days, 68 cases (97.1%) turned negative within 28 days, with the exception of 2 cases (2.9%) developed chronic active EBV infection by follow-up revision.There were 218 cases in high plasma viral DNA copies group and 37 cases in low copies group. More cases presented with elevated transaminases in the high plasma viral DNA copies group than those in the low group (75.7% (28/37) vs. 56.0%(116/207), χ2=5.00, P=0.025).Both the positive rate of EBV DNA in peripheral blood leukocytes (84.2% (266/316) vs. 44.7% (255/571), χ2=76.26, P<0.001) and the copies of EBV DNA (7.0×107 (1.3×107, 3.0×108) vs. 3.1×106 (1.6×106, 6.1×106) copies /L, Z=15.23, P<0.001) were higher than that of plasma. Conclusions: In immunocompetent pediatric cases diagnosed as EBV primary infection, cases with positive plasma EBV DNA were prone to have fever, hepatomegaly and (or) splenomegaly, and elevated transaminase than those with negative plasma viral DNA. The plasma EBV DNA usually turns negative within 28 days after initial diagnosis.Most cases with high viral load in plasma showed elevated aminotransferase.

Association Analysis Between Methylation of SCARB1 Gene Promoter and Coronary Heart Disease / 中国医学科学院学报

Objective To explore the relationship between scavenger receptor class B member 1 (SCARB1) gene promoter methylation and the pathogenesis of coronary artery disease. Methods A total of 120 patients with coronary heart disease treated in Renji Hospital affiliated to Shanghai Jiao Tong University School of Medicine from December 2018 to May 2020 were selected as the case group,while 140 gender and age matched healthy participants were randomly selected as the control group for a case-control study.The methylation status was detected by high-throughput target sequencing after bisulfite converting,and the methylation of CpG sites in the promoter region of SCARB1 gene was compared between the two groups. Results The case group showed higher methylation level of SCARB1+67 and lower methylation level of SCARB1+134 than the control group (both P<0.001),and the differences remained statistically significant in men (both P<0.001) and women (both P<0.001).The overall methylation level in the case group was lower than that in the control group [(80.27±2.14)% vs.(81.11±1.27)%;P=0.006],while this trend was statistically significant only in men (P=0.002). Conclusion The methylation of SCARB1 gene promotor is associated with the pathogenesis and may participate in the occurrence and development of coronary heart disease.

The role of cAMP /Epac / Rap1 signaling pathway regulate the secretion of IL-1 β, TNF-α, BDNF from NG2 cell and the effect of Jujuboside A / 安徽医科大学学报

Objective@#To investigate whether the cyclic adenosine monophosphate (cAMP) / exchange proteins directly activated by cAMP (Epac) / ras-related protein 1 ( Rap1 ) signalling pathway is involved in the intervening mechanisms of interleukin-1 β (IL-1 β) ，tumor necrosis factor-α (TNF-α) ，brain-derived neurotrophic factor (BDNF) and Jujuboside A(JuA) secretion by NG2 cells． @*Methods@#NG2 cells were cultured in vitro and the experiment was divided into control group ，pertussis toxin ( PTX) group ，ESI-09 group，JuA group and positive drug group．The effect of different concentrations of JuA on the survival rate of NG2 cells was detected by CCK-8 method，and the expression of IL-1 β , TNF-α , BDNF，cAMP，Epac，Rap1 mRNA and protein in each group was detected by RT-PCR and Western blot. @*Results@#Compared with the control group，the PTX group decreased the expression of IL-1 β and TNF-α mRNA and protein (P＜0. 01) and increased the expression of cAMP and BDNF mRNA and protein (P＜0. 01) ; the ESI-09 group increased the expression of IL-1 β and TNF-α mRNA and protein (P < 0. 05) and decreased the expression of BDNF，Epac and Rap1 mRNA and protein expression (P＜0. 01) ; the JuA group and positive drug group increased IL-1 β , TNF-α , BDNF，cAMP，Epac，Rap1 mRNA and protein expression (P＜0. 01) ．@*Conclusion @#The cAMP / Epac / Rap1 signaling pathway is involved in the secretion of IL-1 β , TNF- α , and BDNF by NG2 cells．JuA may act on cAMP / Epac / Rap1 signaling pathway to affect the secretion of BDNF by NG2 cells.

Recent advance in transradial approach in neurointerventional diagnosis and treatment / 中华神经医学杂志

In recent years, with the development of neurointerventional techniques, transradial approach (TRA) has been able to meet most needs of neurointerventional procedures. Compared with tranfemoral approach (TFA), TRA can obviously reduce access-site complications, shorten hospital stays and improve patient satisfaction. However, due to the long learning curve, lack of radial-specific catheters, small artery diameter and specific vascular access-site complications, TRA development is relatively slow, and relevant domestic and foreign studies are still at initial stage. Therefore, this article mainly focuses on the anatomy, advantages and limitations, approaches of radial artery, and discuss the safety and feasibility of TRA in neurointerventional diagnosis and treatment, in order to provide more references for neurointerventionalists.

Effect of GIV on neuroinflammatory response in a model of cerebral ischemia/reperfusion inj ury / 安徽医科大学学报

Objective@#To investigate whether GIV , a coiled helix structural domain protein containing 88A , has an effect on the neuroinflammatory response in a model of cerebral ischemia⁃reperfusion injury.@*Methods@# A middle cerebral artery embolization⁃reperfusion model (MACO/R) and an oxygen glucose deprivation/reoxygenation model ( OGD 6 h + R 24 h) of BV2 microglia were constructed in C57BL/6 mice , and the area of cerebral infarction was detected by TTC staining; the Longa neurobiological score was used to evaluate the degree of neurological deficit in mice ; ELISA was used to detect the release of IL⁃6 and TNF⁃α in the supernatant of peripheral blood and cell cultures , and Western blot was used to detect the protein expression of GIV , TREM2 and TLR4 in the cortical area around the infarct foci in mice ; different concentrations of lipopolysaccharide (LPS , 1 , 5 , 10 μg/ml) were used to stimulate BV2 cells for 24 h to establish a neuroinflammation model , qRT⁃PCR was performed to detect the mRNA levels of IL⁃6 , TNF⁃α and IL⁃1β , and Western blot was used to detect the expression of GIV ; OGD/R culture treatment was performed after knocking down the expression of GIV gene using siRNA interference technique ;ELISA was performed to detect the release concentration of IL⁃6 and TNF⁃α in cell culture medium supernatant;protein immunoblotting was performed to detect the knockdown efficiency of GIV.@*Results @#Both the successfully constructed MCAO/R and OGD/R models activated the neuroinflammatory response and induced a decrease in protein expression of GIV ; MCAO/R induced increased concentrations of IL⁃6 and TNF⁃α release in peripheral blood of mice and promoted the protein expression of TREM2 and TLR4 ; LPS activated IL⁃6 , IL⁃1β and TNF⁃α expression in BV2 cells , but did not affect GIV expression ; siRNA interference with GIV gene expression further in creased the expression of inflammatory factors IL⁃6 and TNF⁃α .@*Conclusion@#The GIV gene may be characteristically involved in regulating the neuroinflammatory response induced by cerebral ischemia⁃reperfusion injury , and it may be a potential therapeutic target for cerebral ischemia⁃reperfusion injury.

Determination of methyl isobutyl ketone in urine by headspace coupled with gas chromatography-mass spectrometry / 中华劳动卫生职业病杂志

Objective: To establish a method for the determination of methyl isobutyl ketone (MIBK) in urine samples by headspace-gas chromatography-mass spectrometry. Methods: Automatic headspace sampling technique was adopted to optimize the headspace conditions (headspace bottle heating temperature and equilibration time) and gas chromatographic conditions. A total of 5 ml samples were taken and added with 3.0 g ammonium sulfate into a 20 ml headspace bottle. After heated at 60 ℃ for 30 mins, gas from the upper part of headspace bottle was injected into gas chromatography with an injection volume of 100 μl. The target was separated by HP-5MS UI (30 m×0.25 mm×0.25 μm) capillary column and then detected by mass spectrometry detector. The retention time and external standard method were used for qualitative and quantitative analysis of MIBK in samples, respectively. Results: The standard curve of MIBK showed significant linearity between 20.0-1 000.0 μg/L. The standard curve was y=62.9x-652.5, and the correlation coefficient r=0.9998. The detection limit of MIBK was 5.0 μg/L and the quantification limit of MIBK was 16.0 μg/L. The average recovery rate was 95.3%~100.2% at three spiked concentrations of low (50.0 μg/L) , medium (200.0 μg/L) and high (500.0 μg/L) . The intra-day and inter-day precisions were 1.7%~3.8% (n=6) and 1.2%~4.0% (n=6) respectively. This method was stable for the determination of MIBK, and the urine could be kept 14 d at -20 ℃ without significantly loss. Conclusion: This method is proved to be simple, practical and highly sensitive. It can satisfy the request for the determination of urine samples of workers exposed to MIBK.

Meta-analysis on the contents of trace elements in workers with occupational exposure to lead / 中华劳动卫生职业病杂志

Objective: To quantitatively evaluate the content differences of trace elements in workers with occupational exposure to lead. Methods: In January 2021, relevant literatures on the contents of trace elements in workers with occupational exposure to lead published from 1990 to 2020 were searched through CNKI, Wanfang, VIP, PubMed, web of science and Embase. Screened and extracted the literatures, and evaluated the quality of the included literatures with Newcastle Ottawa Scale. Meta analysis was performed with Review Manager 5.3 software, and standardized mean difference (SMD) and its 95% confidence interval were used as effect indicators. Results: A total of 20 literatures were included, and the quality scores were 5-7. The results of Meta-analysis showed that compared with the control group, the contents of blood zinc (SMD=-1.01, 95%CI: -1.53, -0.49) , hair zinc (SMD=-0.17, 95%CI: -0.33, -0.01) , hair copper (SMD=-0.50, 95%CI: -1.01, 0) , hair iron (SMD=-3.91, 95%CI: -5.80, -2.03) and hair manganese (SMD=-1.09, 95%CI: -2.02, -0.15) in occupational lead exposure group were significantly lower (P<0.05) . Compared with the control group, the content of cobalt in hair of occupational lead exposure group (SMD=1.41, 95%CI: 0.72, 2.10) was higher, and the difference was statistically significant (P<0.05) . There was no significant difference in the contents of blood chromium, blood copper, blood iron, blood manganese, blood selenium and hair nickel between the two groups (P>0.05) . Conclusion: Workers with occupational exposure to lead have abnormal trace elements.

Comparative analysis between chest pain center management model and emergency green channel in pre-hospital treatment of patients with acute ST-segment elevation myocardial infarction / 中国医师杂志

Objective:To observe the effect of chest pain center management model and emergency green channel on pre-hospital rescue rate of patients with acute ST-segment elevation myocardial infarction (STEMI).Methods:Patients with STEMI admitted in Yunnan Provincial Emergency Center between January 2017 and June 2019 were selected as the study subjects. 522 patients with STEMI sent by emergency center were included in the observation group (chest pain center management model of first-aid), while 326 patients with STEMI who came to the hospital by themselves were included in the control group (emergency green channel for first-aid). The pre-hospital and nosocomial first-aid related indexes, cardiac function (assessed by Killip grade), rescue rate, hospital stay and incidence of complications were compared between the two groups.Results:The response time of visit, time of initial electrocardiogram (ECG) completion and total time of first-aid in observation group [(1.04±0.11)min, (1.56±0.25)min, (10.63±2.26)min] were significantly shorter than those in control group [(2.82±0.26)min, (5.99±1.06)min, (18.65±2.98)min, P<0.05]. The grade of cardiac function in observation group was significantly better than that in control group ( P<0.05). Compared with the control group, the observation group had higher successful rescue rate, shorter hospital stay , lower total incidence of complications [94.25% vs 42.02%, (6.09±1.02)d vs (8.92±1.65)d, 13.01% vs 32.12%, P<0.05]. Conclusions:Compared with emergency green channel, chest pain center management model can not only shorten first-aid related time of STEMI patients, but also improve their successful rescue rate, reduce incidence of complications and improve prognosis.

A multi-center investigation of breast-conserving surgery based on data from the Chinese Society of Breast Surgery (CSBrS-005) / 中华医学杂志(英文版)

BACKGROUND@#Although breast-conserving surgery is one of the standard treatments for breast cancer, few studies have assessed its recent implementation in China. We aimed to clarify the current real-world status of breast-conserving surgery in China.@*METHODS@#This cross-sectional survey relied on data collected by the Chinese Society of Breast Surgery (CSBrS) to examine patients who underwent this surgery between January 2018 and December 2018. The survey was conducted using a uniform electronic questionnaire to collect information, including clinical and pathological data on these patients.@*RESULTS@#Overall, 4459 breast-conserving surgeries were performed in 34 member units of CSBrS, accounting for 14.6% of all breast cancer surgeries performed in these units during the study period. In patients who underwent breast-conserving surgery with information on tumor size available, more than half (61.2%) of the tumors were smaller than 2 cm in diameter, and only 87 (3.2%) tumors were larger than 4 cm in diameter. Among patients who underwent breast-conserving surgeries, 457 (10.2%) patients received neoadjuvant therapy before the surgery. Among patients with a reported margin width, 34 (2.0%) patients had a margin of ≤2 mm, and 1530 (88.2%) of them had a margin of >5 mm.@*CONCLUSIONS@#This study demonstrated the rates of breast-conserving surgery in member units of the CSBrS, and introduced the characteristics and surgical margins of patients who underwent this surgery. This information helps describe the real-world status of breast-conserving surgery in China.@*TRIAL REGISTRATION@#chictr.org.cn, ChiCTR1900026841; http://www.chictr.org.cn/showproj.aspx?proj=42783.

Protective effect of the Potentilla anserina polysaccharide on high altitude cerebral edema and high altitude pulmonary edema in rats / 国际药学研究杂志

Objective: To test the anti-plateau hypoxia effect of Potentilla anserina polysaccharide(PAP), Cynomorium songarieum Rupr. polysaccharide(SCRP), Sphallerocarpus gracilis polysaccharide(SGP)and Lilium brownii polysaccharide(LP), and then investigate the protective effect of most effective polysaccharide on the high altitude cerebral edema(HACE)and high altitude pulmonary edema(HAPE)in rats. Methods: PAP, CSRP, SGP and LP were prepared by the water extraction-alcohol precipitation method. The normobaric hypoxia test and acute hypoxia test were performed to find out the polysaccharide with the best anti-hypoxia effect and the related dose-dependent effect in mice. A large hypobaric hypoxia chamber stimulating 8000 m altitude was used to investigate pathological changes and water contents in rat brain and lung tissue before and after hypoxia, and the concerned oxidative stress and inflammation related parameters were also measured. The protective effect of PAP on the high altitude cerebral and pulmonary edema was evaluated by the rat model experiments. Results: PAP showed the best and dose-dependent anti-hypoxia effect among the four polysaccharides. The water content in brain and lung tissues of rats increased obviously in the hypoxia model(HM)group, and the brain tissue cell hierarchical fuzzy, lung tissue congestion and edema as well as the heavy inflammatory cell infiltration, widening of alveolar interval and thickening of alveolar wall were also found in the HM group. The enzymatic activity of SOD was notablely depressed, while both the MDA and IL-1β contents in brain and lung tissues remarkably increased(P<0.01)in the HM group. Com- pared with the HM group, the water content in the rat brain and lung tissues significantly decreased in each of the different dose PAP groups(P<0.05 or P<0.01), and the inflammatory cell infiltration, alveolar interval, and thickness of alveolar wall all notabely decreased in the HM group. Furthermore, the enzymatic activity of SOD increased, while both the MDA and IL-1β contents decreased, all significantly in the PAP groups than in the HM group(P<0.05 or P<0.01). Conclusion: PAP showed a good anti-hypoxia effect and effectively inhibited HACE and HAPE to exert a certain protective effect in a rat model.

Clinical and laboratory characteristics of primary Epstein-Barr virus infection in children / 中华传染病杂志

Objective:To understand the clinical and laboratory characteristics of primary Epstein-Barr virus (EBV) infection in children.Methods:Totally 210 cases with primary EBV infection from September 2016 to March 2017 in Department of Infectious Diseases, Children′s Hospital of Fudan University in Shanghai were retrospectively collected. The clinical information (fever, rash, etc), and laboratory data such as liver function, EBV test (serological test, polymerase chain reaction (PCR)-DNA) were analyzed.Results:The age of children with primary EBV infection was (4.2±2.4) years. Numbers of patients with fever, tonsil and/or pharynx exudation, cervical lymphadenopathy, eyelid edema and rash were 187 (89.0%), 130 (61.9%), 204 (97.1%), 95 (45.2%) and 21 (10.0%), respectively. A total of 120 cases (57.1%) presented with typical triplets of infectious mononucleosis. Absolute lymphocyte count ≥5.0×10 9/L was found in 177 cases (84.3%), and abnormal lymphocyte ratio≥0.10 was found in 184 cases (87.6%). Elevated transaminase level was found in 96 cases (45.6%), and 72 cases were followed until transaminase level back to normal, in whom 97.2% (70/72) patient returned to normal within six weeks. Epstein-Barr viral capsid antigen (EBV-VCA)-IgM was positive in 192 cases (91.4%). EBV-VCA-IgG and Epstein-Barr viral early antigen (EBV-EA)-IgG positive were presented in 182 cases (86.7%) and 62 cases (29.5%), respectively. Epstein-Barr viral nuclear antigen (EBV-NA)-IgG was negative in all cases. EBV DNA test was carried in 199 cases, of which 122 cases (61.3%) were positive. Conclusions:Pediatric primary EBV infection mainly occurs in preschoolers. Most patients are presented with enlarged cervical lymph nodes, fever, and positive EBV serological markers. Transient transaminase elevation is observed in some cases.

Research progress on radioprotective effects of bee products / 中华放射医学与防护杂志

Radiation exposure is an ongoing and serious threat in military and public health concern, and there is an unmet need for effective preventative or mitigative treatment against radiation-induced injuries. The handful of FDA approved radiation protection agents cannot be widely used due to their side effects. Some natural non-toxic compounds such as bee products have been reported to prevent and treat radiation-induced injuries of oral mucosa, esophagus, skin, liver, intestine and hemopoietic system by reducing radiation-induced oxidative stress, apoptosis and DNA damage, indicating that they may be potential options of safe radioprotective agents. In this paper, the experimental and clinical studies on prevention and treatment of radiation injury by bee products were reviewed.

Correlation between the Depth of the Left-Sided Double-Lumen Tube and Specific Body Landmarks / 中国医科大学学报

Objective To investigate the correlation between the insertion depth of the left-sided double-lumen tube (DLT) and some specific body landmarks in order to guide left-sided DLT intubation. Methods Ninety-five adult patients who underwent thoracic surgery were chosen, and the age (A), sex (S), height (H), weight (W), distance between the cricothyroid membrane and upper notch of the sternum angle (L), size of the left-sided DLT (F), and predicted depth of intubation (y) were recorded. After anesthesia induction, the final corrected insertion depth of the left-sided DLT (Y) were recorded using fiberoptic bronchoscopy. The Y and y were compared.Linear regression and Pearson's correlation analysis were used to analyze the data. Results There was no difference between the Y and y (P＞ 0.05). The Y was significantly correlated with H, W, and L (P ＜ 0.01), and was not correlated with A (P＞ 0.05). Three linear regression equations for H, L, and Y were obtained. H and L were linearly dependent on Y, and the determination coefficients R2 were 0.43 (Y=7.285+0.128 H) and 0.41 (Y=19.305+0.866 L), respectively. Using both H and L as the independent variables, the determination coefficient R2 was 0.56 (Y=8.127+0.087 H+0.559 L). Conclusion The linear regression equation Y=8.127+0.559 H+0.087 L could be used as a rapid method to assess the insertion depth of the left-sided DLT. However, the ideal insertion depth of the left-sided DLT still needs to be confirmed using fiberoptic bronchoscopy.

Updates in timing of initiation of renal replacement therapy in patients with acute kidney injury / 解放军医学杂志

Acute kidney injury (AKI) is one of the most common serious complications in Intensive Care Unit (ICU),and also an independent risk factor for death.It is associated with a substantial increase in morbidity and mortality.AKI occurs in about 13 million people per year,and the mortality of AKI was 13.1％.A meta analysis showed that the incidence of AK1 was 0.99％-11.6％ in China.Renal replacement therapy (RRT) has become one of the conventional treatments for AKI patients,however the timing of RRT initiation in patients with AKI has not yet been defined.In this article,based on the two recent large randomized controlled trials (RCT),the timing to start or terminate the treatment are reviewed.

Effect of ω-3 polyunsaturated fatty acid on oxidative stress production and apoptosis in hippocampus of neonatal rats with brain injury induced by lipopolysaccharide / 新乡医学院学报

Objective To investigate the effects of ω-3 polyunsaturated fatty acid(PUFA)on oxidative stress produc-tion and apoptosis in hippocampus of neonatal rats with brain injury induced by lipopolysaccharide(LPS). Methods Forty-eight neonatal Sprague Dawley rats(3 days)were randomly divided into control group,LPS group,ω-3 PUFA group and ω-6 PUFA group,with 12 rats in each group. The rats in the LPS group,ω-3 PUFA group and ω-6 PUFA group were given 0. 6 mg·kg - 1 LPS via intraperitoneal injection,then equal volume of saline,ω-3 PUFA and ω-6 PUFA was immediately given via intraperitoneal injection respectively;while the rats in the control group were all given equal volume of saline. The rats in each group were sacrificed at 24 hours after intraperitoneal injection with saline or fat emulsions to obtain the hippocampus. The levels of superoxide dismutase(SOD)and malondialdehyde(MDA),reduced glutathion(GSH),oxidized glutathione(GSSG) were detected and GSSG/ GSH was calculated. The apoptotic index was measured by terminal deoxynucleotidyl transferase-me-diated dUTP nick end labeling. Results Compared with the control group,the levels of SOD and GSH in hippocampus of rats in the LPS group,ω-6 PUFA group and ω-3 PUFA group were significantly decreased(P < 0. 05),and the levels of MDA, GSSG and the ratio of GSSG/ GSH were significantly increased(P < 0. 05). Compared with the LPS group,the levels of SOD and GSH in hippocampus of rats in ω-6 PUFA group were significantly decreased(P < 0. 05),the levels of MDA,GSSG and the ratio of GSSG/ GSH were significantly increased(P < 0. 05);the levels of SOD and GSH in hippocampus of rats in ω-3 PU-FA group were significantly increased(P < 0. 05),the levels of MDA,GSSG and the ratio of GSSG/ GSH were significantly de-creased(P < 0. 05). Compared with the ω-6 PUFA group,the levels of SOD and GSH in hippocampus of rats in ω-3 PUFA group were significantly decreased(P < 0. 05),the levels of MDA,GSSG and the ratio of GSSG/ GSH were significantly in-creased(P < 0. 05). The apoptotic index in the LPS group,ω-6 PUFA group and ω-3 PUFA group was higher than that in the control group(P < 0. 05). The apoptotic index in the ω-6 PUFA group was higher than that in the LPS group(P < 0. 05). The apoptotic index in the ω-3 PUFA group was lower than that in the LPS group and ω-6 PUFA group(P < 0. 05). Conclusion ω-3 PUFA can alleviate the oxidative stress,and decrease the apoptosis of hippocampus in neonatal rats with brain injury in-duced by LPS. So it has a neuroprotective effect in brain injury induced by LPS.

Diagnostic Value of Nasopharyngeal Aspirates in Children with Lower Respiratory Tract Infections / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The accuracy of nasopharyngeal aspirate (NPA) specimens in detecting lower respiratory pathogens remains controversial. The objective of this study was to evaluate the diagnostic accuracy of aspirates (NPAs) specimen in lower respiratory tract infections (LRTIs) in children.</p><p><b>METHODS</b>The prospective study was designed to collect the data of paired NPAs and bronchoalveolar lavage fluids from children with acute LRTIs from January 2013 to December 2015. All specimens were subjected to pathogen detection: bacterial detection by culture, Mycoplasma pneumoniae (Mp) detection by polymerase chain reaction assay and virus (influenza A and B viruses, parainfluenza virus [PIV] Types 1 and 3, respiratory syncytial virus, and adenovirus) detection by immunofluorescence assay. The diagnostic accuracy analysis of NPAs was stratified by age ≤3 years (n = 194) and >3 years (n = 294).</p><p><b>RESULTS</b>We collected paired specimens from 488 children. The positive rate of pathogen was 61.6%. For Streptococcus pneumoniae, NPA culture had the specificity of 89.9% and negative predictive value of 100% in age ≤3 years, the specificity of 97.2% and negative predictive value of 98.9% in age >3 years. For Mp, the positive predictive values of NPA was 77.4% in children ≤3 years, and 89.1% in children >3 years. For PIV III, NPA specimen had the specificity of 99.8% and negative predictive value of 96.5% in children ≤3 years. For adenovirus, NPA had the specificity of 97.8% and negative predictive value of 98.4% in age ≤3 years, the specificity of 98.9% and negative predictive value of 99.3% in age >3 years.</p><p><b>CONCLUSIONS</b>NPAs are less invasive diagnostic respiratory specimens, a negative NPA result is helpful in "rule out" lower airway infection; however, a positive result does not reliably "rule in" the presence of pathogens.</p>

Application of new markers in genetic analysis for hair stem without follicles / 复旦学报（医学版）

Objective To solve the problems of low success rate in detecting complete DNA typing of biological samples,such as naturally fallen hair,severely degraded bones and teeth which is difficult in forensic identification.Methods We applyed a specific retrotransposon (RE) DNA sequences in identification,with DNA fragment length of 60-125 bp.A RE combined with 21 loci were used in individual discrimination to compute the likelihood (LR) values and combined paternity index (CPI)values in phylogenetic identification.Results This research obtained high success rate in detection of hair stem without follicles and severely degraded biological samples.We found that most of the LR values were 108-1012,which met the requirement of identity establishing.Through the CPI values,it was difficult to support the assumptions,with most of the CPI values less than 10 000.Conclusions The RE with 21 loci can be used for individual discrimination,but more loci are need for applying in phylogenetic identification.

Mitochondrial abnormality in major depressive disorder: Research advances / 国际药学研究杂志

Majordepressive disorder(MDD)is an important public health problem affecting 350 million people worldwide. With the increasing pressure in life and work, the morbidity of MDD has risen year by year, which is estimated to reach 10% of the total population in 2020. MDD will become the world's second top common disease. Due to the unclear mechanism and multiple signaling pathways, the MDD treatments have reached an impass. Only 30% of the MDD patients have received effective treatments. In order to provide new ideas for depression research, this paper reviews the recent achievements on the relationship between mitochondrial abnormalities and depression, including mitochondrial dysfunction, mitochondrial oxidative damage, and mitochondrial defects.