Relationship between omentin-1,AQP4,and VILIP-1 levels and vascular recanalization after emergency endovascular treatment in patients with acute large vessel occlusion stroke / 中国医科大学学报

Objective To investigate the relationship between omentin-1,aquaporin 4(AQP4),and visinin-like protein 1(VILIP-1)levels and vascular recanalization after emergency endovascular treatment in patients with acute large vessel occlusion stroke(ALVOS)and their combined predictive efficacy.Methods In total,110 patients with ALVOS undergoing emergency endovascular treatment were categorized into a non-reopening group(23 patients)and a reopening group(87 patients)based on whether the blood vessels were re-opened after surgery.Clinical data and omentin-1,AQP4,and VILIP-1 levels were compared between the two groups.Factors influencing postoperative blood vessel reopening were analyzed,and nomograms were drawn to evaluate their predictive performance and calibration.Results Significant differences were observed in the proportion of patients with hypertension;preoperative NIHSS scores;emergency blood glucose;AQP4,VILIP-1,omentin-1,and platelet levels;time from onset to endovascular treatment;preoperative ASPECTS;and proportion of patients undergoing intravenous thrombolysis between the two groups(P＜0.05).Preoperative ASPECTS and omentin-1 levels were independent protective factors associated with postoperative vascular recanalization,whereas the time from onset to endovas-cular treatment,preoperative NIHSS scores,and AQP4 and VILIP-1 levels were independent risk factors associated with postoperative vascular recanalization(P＜0.05).The C-index of the nomogram for predicting postoperative vascular recanalization was 0.994,and the AUC of the nomogram for predicting postoperative vascular recanalization was 0.994,with a calibration degree of 0.975.Conclusion Omentin-1,AQP4,and VILIP-1 levels are important factors affecting vascular recanalization in patients with ALVOS after emergency endovascular treatment.Clinically,monitoring these levels may help to predict and evaluate early vascular recanalization fol-lowing treatment.

Application of Acapella positive expiratory pressure therapy combined with high-frequency chest wall oscillation sputum expulsion in the treatment of severe pneumonia in children / 中国中西医结合急救杂志

Objective To analyze the application value of Acapella positive expiratory pressure therapy combined with high-frequency chest wall oscillation sputum expulsion in children with severe pneumonia,and provide theoretical reference for the formulation of treatment plans for severe pneumonia.Methods From April 2022 to April 2023,120 children with severe pneumonia were selected from the Children's Respiratory Department of the Second Affiliated Hospital of Wenzhou Medical University.According to different treatment plans,the children were divided into traditional airway clearance group,Acapella positive expiratory pressure therapy group,high-frequency chest wall oscillation treatment group,and Acapella positive expiratory pressure therapy combined with high-frequency chest wall oscillation treatment group,with 30 cases in each group.The duration of pneumonia symptom remission and hospitalization,as well as the difference of pulmonary function index and inflammatory factors before and after treatment were compared.Results Compared with traditional airway clearance group,Acapella positive expiratory pressure therapy group,high-frequency chest wall oscillation treatment group,the disappearance time of pulmonary rales,the recovery time of body temperature,the time of cough relief and the length of stay of children in the Acapella positive expiratory pressure therapy combined with high-frequency chest wall oscillation treatment group were significantly shortened[the disappearance time of pulmonary rales(days):4.85±0.78 vs.8.47±2.36,5.22±2.12,5.38±1.56,the recovery time of body temperature(days):3.51±1.04 vs.7.84±2.34,4.45±1.92,4.76±1.59,the time of cough relief(days):7.45±2.15 vs.13.59±4.08,8.88±3.35,8.72±2.59,the length of stay(days):3.78±0.63 vs.8.29±2.07,5.02±1.44,4.96±1.25,all P<0.05].The disappearance time of pulmonary rales,the recovery time of body temperature,the time of cough relief,and the length of stay in Acapella positive expiratory pressure therapy group and high-frequency chest wall oscillation treatment group were shorter than those in traditional airway clearance group(all P<0.05).Forced expiratory volume in one second(FEV1),forced vital capacity(FVC)and FEV1/FVC after treatment were significantly higher than before treatment,and the inflammatory factors tumor necrosis fact-α(TNF-α),hypersensitive C-reactive protein(hs-CRP)and white blood cell count(WBC)were significantly lower than before treatment.After treatment,FEV1,FCV and FEV1/FVC in the Acapella positive expiratory pressure therapy combined with high-frequency chest wall oscillation treatment group were significantly higher than those in the traditional airway clearance group,Acapella positive expiratory pressure therapy group and high-frequency chest wall oscillation treatment group[FEV1(L):3.65±1.33 vs.2.28±0.45,2.94±0.63,2.99±0.72,FVC(L):4.56±1.84 vs.2.94±0.83,3.46±1.28,3.65±1.34,FEV1/FVC:(72.36±8.84)％ vs.(59.84±4.05)％,(62.35±5.22)％,(64.59±5.58)％,all P<0.05].The pulmonary function indexes of children in Acapella positive expiratory pressure therapy group and high-frequency chest wall oscillation treatment group were higher than those in traditional airway clearance group(all P<0.05).After treatment,the levels of serum inflammatory factors in the Acapella positive expiratory pressure therapy combined with high-frequency chest wall oscillation treatment group were significantly lower than those in the traditional airway clearance group,Acapella positive expiratory pressure therapy group,high-frequency chest wall oscillation treatment group[TNF-α(ng/L):14.62±4.55 vs.29.44±6.13,18.09±5.33,17.52±4.42,hs-CRP(mg/L):21.41±3.65 vs.48.67±8.39,40.24±6.42,37.24±5.12,WBC(×109/L):13.42±3.67 vs.19.29±6.45,15.43±5.34,14.22±4.14,all P<0.05],the serum inflammatory factor indexes of Acapella positive expiratory pressure therapy group,high-frequency chest wall oscillation treatment group were lower than those of traditional airway clearance group(all P<0.05).Conclusion Acapella positive expiratory pressure therapy combined with high-frequency chest wall oscillation sputum expulsion is effective in the treatment of severe pneumonia in children,which can shorten the time of sputum improvement and hospital stay,reduce the level of inflammatory factors,improve the pulmonary function of the children,and promote the rehabilitation process of the children.

Construction of Rat Model of Migraine with Hyperactivity of Liver-Yang and Blood Stagnation Based on"Combination of Disease and Syndrome" / 世界科学技术-中医药现代化

Objective To study the characteristics of a rat model of migraine with hyperactivity of liver-yang and blood stagnation,which was established by Fuzi Decoction combined with electrical stimulation of the trigeminal ganglion.Methods The 30 SD rats were divided into normal group,model group,and Zhengtian pill group(1.6 g·kg-1),with 10 rats in each group.Rats in the model group and Zhengtian pill group were fed with aconite decoction(2.00 g·kg-1)once a day for 28 day to establish the hyperthermia model;On the 15 day of intragastric administration,rats in the Zhengtai pill group were simultaneously given Zhengtai pill solution once a day for 14 day;At 29 day,the trigeminal ganglion was stimulated to create the migraine model of hyperliver and stasis.After 30 min of the last dose,the macroscopic signs and behaviors were observed,and the blood rheology was detected by blood visticometer.Positive substance P(SP)expression,mRNA and relative protein expression in the trigeminal cervical pulp complex(TCC)in rat mice by immunohistochemistry,RT-qPCR and Western blot analysis.Results Compared with the normal group,the model group has macro signs such as red eyes,irritability,cage fighting,dark tongue and stasis points;regular head positioning and frequent hair management;increased distance in the central area(P<0.05).The relative viscosity of whole blood,plasma viscosity,red blood cell aggregation index all increased(P<0.05),and the red blood cell variant index decreased(P<0.05);SP positive expression,mRNA and the relative protein expression increased in TCC(P<0.05).Compared with model group,Zhengtian pill group can improve macro representation and behavior significantly;can significantly reduce central distance(P<0.05);can reduce plasma viscosity,high-shear relative viscosity of whole blood,and red blood cell aggregation index(P<0.05);increase the Red blood cell variant index significantly(P<0.05);down-regulate SP positive expression,mRNA and relative protein expression in TCC(P<0.05,P<0.01).Conclusion SD rats were used for 4 weeks to construct a migraine model of hyperhepatic hyperactivity and stasis,which was basically consistent with the clinical manifestations.

Analysis of anticipatory grief and its influencing factors among the main caregivers of maintenance hemodialysis patients / 中国实用护理杂志

Objective:To investigate the status of anticipatory grief among the main caregivers of maintenance hemodialysis patients, and to analyze its influencing factors.Methods:From April 2021 to July 2021, the main caregivers of 180 patients undergoing maintenance hemodialysis in Xiangdong Hospital Affiliated to Hunan Normal University and Liling Traditional Chinese Medicine Hospital in Hunan Province, were selected by convenience sampling method for the research object. The survey was carried out using the General Information Questionnaire, the Anticipatory Grief Scale and the Zarit Caregiver Burden Interview, multiple linear regression was used to analyze the influencing factors of anticipatory grief in the main caregivers of maintenance hemodialysis patients.Results:The total score of Anticipatory Grief Scale in the main caregivers of maintenance hemodialysis patients was 84.43±12.02, and the total score of Zarit Caregiver Burden Interview was 24.92 ± 7.98, which were positively correlated ( r = 0.557, P<0.01).In the multiple linear regression analysis, the caregiver ′s education level, age, gender, care burden and per capita monthly income and the patient ′s age were the influencing factors of anticipatory grief for the main caregivers of maintenance hemodialysis patients ( t values were -5.54-8.75, all P<0.05), which could explain 54.1% of the total variance. Conclusions:The anticipatory grief of the main caregivers of maintenance hemodialysis patients is at a relatively serious level. Medical care should pay more attention to the caregivers and their sadness in their communication, so as to detect problems in time, so as to take targeted measures to the current situation, which is effective to improve their level of grief and improve the quality of care.

The mechanism of effective fractions from Xiongma decoction in the treatment of migraine model rats with hyperactivity of liver-yang and blood stasis / 中国药房

OBJECTIVE To expl ore the mechanism of effe ctive fractions from Xiongma decoction in the treatment of migraine with hyperactivity of liver-yang and blood stasis. METHODS Totally 70 male SD rats were randomly divided into normal group ， model group ，positive control group （Flunarizine hydrochloride capsules 0.9 mg/kg），low-dose and high-dose groups of Xiongma decoction effective fractions （ethyl acetate extract 0.87，3.46 g/kg，n-butanol extract 1.80，7.20 g/kg）. Except for normal group ， rats in other groups were given aconite decoction （2 g/kg），once a day ，for 4 consecutive weeks to establish the hyperactivity model of liver-yang. On the 15th day of modeling ，all administration groups were given corresponding drugs intragastrically at the same time ，once a day ，for 2 consecutive weeks. On the 29th day of modeling ，rats trigeminal ganglion was stimulated to establish the migraine model with hyperactivity of liver-yang and blood stasis ，then the medication was maintained for another time according to the above method. The macroscopic signs and behavior of the rats were observed ；positive expression ，mRNA and protein expression of transient receptor potential vanilloid 1 （TRPV1），calcitonin generelated peptide （CGRP），calcitonin receptor-like receptor （CRLR） and receptor-associated membrane proteins 1 （RAMP1） in trigeminal cervical spinal complex （TCC） were detected by immunohistochemistry ，RT-qPCR and Western blot assay. RESULTS Rats in model group showed macrophysical signs and behaviora l manifestations related to migraine with hyperactivity of liver-yang and blood stasis. Thirty minutes after last administration ，the above conditions of rats in Xiongma decoction effective fraction groups were improved significantly. Compared with normal group ， positive expression，mRNA and protein expression of TRPV 1，CGRP， CRLR and RAMP 1 in TCC of rats in the model group were significantly increased （P＜0.05）. Compared with model zengguirong@hnse.org group， most of above indicators in Xiongma decoction effective fraction groups were significantly decreased （P＜0.05）. CONCLUSIONS The mechanism of Xiongma decoction in preventing and treating migraine with hyperactivity of liver-yang and blood stasis may be related to inhibit the activity of TRPV1-CGRP/CGRP receptor signaling pathway in TCC.

Determination of individualized PEEP during lung-protective ventilation in patients undergoing general anesthesia: comparison of pulmonary electrical impedance tomography and dynamic lung compliance / 中华麻醉学杂志

Objective:To compare the efficacy of individualized PEEP determined by lung electrical impedance tomography (EIT) and dynamic lung compliance (Cdyn) during lung-protective ventilation strategies in the patients undergoing general anesthesia.Methods:Sixty patients of both sexes, aged 18-64 yr, of American Society of Anesthesiologists physical status Ⅰor Ⅱ, with body mass index of 18.5-28.0 kg/m 2, undergoing elective surgery with general anesthesia and endotracheal intubation in the Second Affiliated Hospital of Soochow University, were selected.Lung-protective ventilation strategy was applied in supine position after general anesthesia.The peak value of PEEP did not exceed 10 cmH 2O, with an increment/decrement of 2 cmH 2O for titration.The corresponding Cdyn value and lung EIT data were collected during titration.The patients were divided into 2 groups ( n=30 each) using a random number table method: titration first increased and then decreased group (group A) and titration first decreased and then increased group (group B). The determination method of individualized PEEP: Cdyn method was the PEEP corresponding to the maximum Cdyn value; EIT method was obtained through PV500 PC software analysis.The level and success rate of individualized PEEP determined by the Cdyn and EIT methods were compared, and the ICC consistency analysis of the determined individualized PEEP was performed. Results:Compared with the Cdyn method, the success rate of individualized PEEP determined by EIT method was significantly increased, and the level of individualized PEEP was decreased in the two group ( P<0.05). In group A, the individualized PEEP titrated by the EIT and Cdyn methods showed good agreement (the ICC value of the increment-Cdyn and increment-EIT methods was 0.761, P<0.05; the ICC value of the decrement-Cdyn and decrement-EIT methods was 0.763, P<0.05). In group B, the individualized PEEP titrated by the EIT and Cdyn methods showed good agreement (the ICC value of the increment-Cdyn and increment-EIT methods was 0.809, P<0.05; the ICC value of the decrement-Cdyn and decrement-EIT methods was 0.797, P<0.05). Conclusion:The agreement between the individualized PEEP determined by lung EIT method and Cdyn method during lung-protective ventilation is good in the patients undergoing general anesthesia, and the success rate of EIT method is higher, and the level of individualized PEEP is lower.

Muscular pathological features and morphological analysis of facioscapulohumeral muscular dystrophy / 中国医师杂志

Objective:To analyze the pathological features of facioscapulohumeral muscular dystrophy (FSHD). For better characterization of inflammatory response in FSHD, we performed histochemical morphological analysis for FSHD and polymyositis (PM) muscle biopsies.In order to provide a reference for guide targeted therapeutic interventions.Methods:The clinical and myopathological data of 30 patients with FSHD from January 2006 to January 2019 in the Sixth Hospital of Shanxi Medical University and the first hospital of Jilin University were retrospectively analyzed. The patients were divided into non-inflammatory infiltration group (16 cases) and inflammatory infiltration group (14 cases) according to the presence or absence of inflammatory cell infiltration. For better characterization of inflammatory response in FSHD, we performed histochemical morphological analysis for two groups of muscles: FSHD and PM muscle biopsies, using Image-Pro plus bioanalytical software.Results:In 30 cases of FSHD, 14 cases showed intramuscular and interstitial inflammatory cell infiltration, especially around the blood vessels. Immunohistochemical staining confirmed that the infiltration of inflammatory cells was mainly CD4 + T lymphocytes. Morphometric analysis showed that there were no significant differences in muscle fiber surface area, density, diameter, inflammatory cell infiltration, regeneration and necrosis between FSHD patients and PM patients ( P>0.05). The total area of myointerstitium in FSHD group was significantly larger than that in PM group ( P=0.03). Conclusions:The pathological morphometric analysis showed that the proliferation of interstitial connective tissue in FSHD inflammatory cell infiltration group was significantly more than that in PM group. Clinicians can identify the two from pathology and provide help for clinical practice.

Negative result of susceptibility vessel sign in predicting large artery atherosclerosis acute middle cerebral artery occlusion / 中华神经医学杂志

Objective:To investigate the predictive value of negative result of susceptibility vessel sign (SVS) in etiology types of large vessel occlusion (LVO) stroke.Methods:Sixty-three LVO stroke patients admitted to our hospital from December 2015 to October 2019 were chosen in our study. The clinical data of 63 patients with negative SVS and positive SVS were compared to clarify the independent factors influencing the SVS negative/positive results. The SVS negative rate in large artery atherosclerosis (LAA) patients and non-LAA patients were compared, and the sensitivity, specificity and accuracy of SVS in predicting LAA acute middle cerebral artery occlusion were evaluated.Results:Of the 63 patients, 32 (50.8%) had negative SVS, and 31 had positive SVS; as compared with the positive SVS group, the negative SVS group had significantly higher incidence of hyperlipidemia, lower baseline NIHSS scores, and lower incidence of atrial fibrillation ( P<0.05). Multivariate Logistic regression analysis showed that hyperlipidemia and baseline NIHSS scores were independent factors influencing SVS in patients with LVO stoke. Among the 41 LAA patients, 25 had negative SVS, with a negative rate of 61.0%; among the 22 non-LAA patients, 7 had negative SVS, with a negative rate of 31.8%; significant difference in negative rate was noted between the two groups ( χ2=4.870, P=0.027). The sensitivity, specificity, positive and negative predictive values, and accuracy of negative SVS in predicting LAA stroke was 60.98% ( 95%CI: 44.50%-75.80%), 68.18% ( 95%CI:45.13%-86.14%), 78.12%, 48.39% and 63.49%, respectively. Conclusion:Negative result of susceptibility vessel sign has a high predictive value in acute middle cerebral artery occlusion.

Preliminary establishment of reference interval for non-fasting serum triglycerides among healthy middle-aged and elderly people in some communities Beijing / 中华检验医学杂志

Objective:To establish the reference interval of serum triglyceride (TG) for 4 hours after meal in healthy middle and old people of Beijing community, and to provide the diagnostic basis for the judgment of dyslipidemia after meal.Methods:Selected 369 elderly people from January to October 2018 in the health examination of Guang′anmen Hospital of the Chinese Academy of Traditional Chinese Medicine. The subjects collected fasting venous blood samples in the morning the next day after fasting for 12 hours, then ate a standard breakfast that conformed to the local dietary habits, and collected venous blood samples again 4 hours after eating. Serum TG levels were measured 4 h after meal using AU5822 fully automatic biochemical analyzer and matching reagents. The comparison of postprandial TG between different age and sex groups was statistically significant using the nonparametric test of two independent samples, and the comparison between postprandial and fasting TG using the nonparametric test of two paired samples with P<0.05 as the difference. The 95% confidence interval was calculated using a nonparametric method according to the relevant requirements of the CLSI EP28-A3c file, and the reference interval was expressed as P2.5, P97.5. Results:The median 4-hour post-prandial TG of the middle-aged and elderly aged 45-59 years and those aged ≥ 60 years at health checkups were 1.65 (1.25, 2.13) mmol/L and 1.58 (1.25, 2.00) mmol/L, there was no significant difference between the two groups ( Z=-1.040, P>0.05). There was no statistical difference between males 1.69 (1.22, 2.31) mmol/L and females 1.63 (1.26, 2.12) mmol/L at 4 hours postprandial TG levels in the 45-59 year-old group ( Z=-0.179, P>0.05),there was also no statistical difference between 1.64 (1.22, 2.06) mmol/L for men and 1.53 (1.28, 1.99) mmol/L for women aged 60 years or older ( Z=-0.256, P>0.05).Compared with the median fasting TG of 1.05 (0.87, 1.29) mmol/L, the median serum TG of 1.61 (1.25, 2.09) mmol/L at 4 hours after meal was significantly increased ( Z=-16.449, P<0.01). The difference between postprandial and fasting was 0.52 (0.30, 0.85) mmol/L.The reference range of serum TG at 4 hours after meal was 0.82 to 3.02 mmol/L. Conclusion:In this study, the reference range of serum triglycerides for 4 hours after meal was established in some healthy elderly population groups in Beijing.

Acute encephalopathy with biphasic seizures and late reduced diffusion / 中华实用儿科临床杂志

Acute encephalopathy is a common childhood disease,especially in the nervous system of infants and young children. Recently,a new subtype of childhood acute encephalopathy named acute encephalopathy with bi-phasic seizures and late reduced diffusion (AESD)has been reported. The patients present with persistent febrile sei-zures,long - term cognitive impairment and local brain atrophy. Acute infantile encephalopathy predominantly affecting the frontal lobes is a special type of AESD,which mainly impair the frontal lobe the improvement of understanding and early diagnosis of acute encephalopathy in children is particularly important.

Curative effect of nursing intervention in the treatment of children with bronchial pneumonia and its effects on pulmonary function / 中国基层医药

Objective To observe the curative effect of nursing intervention in the treatment of children with bronchial pneumonia and its effects on pulmonary function.Methods 100 children with bronchial pneumonia were selected as the research subjects,they were randomly divided into control group (50 cases) and observation group (50 cases) according to the digital table.The control group received routine nursing,the observation group received high quality nursing.The pulmonary function indicators (FVC,FEV1,PEF),the adverse reactions and the clinical curative effect were observed in the two groups after treatment.Results After treatment,the FVC,FEV1,PEF of the observation group were (3.96 ± 0.80) L,(3.15 ± 0.80) L,(6.32 ± 2.01) L/s,respectively,which were better than those of the control group [(2.85 ±0.91)L,(2.43 ±0.63)L,(4.90 ± 1.35)L/s] (t =6.478,P=0.000;t =5.000,P =0.000;t =4.147,P =0.000).The incidence rate of adverse reactions of the observation group was 14.00％ (7/50),which was lower than 38.00％ (19/50) of the control group (x2 =7.484,P =0.006).The total effective rate of the observation group was 98.00％ (49/50),which was higher than 80.00％ (40/50) of the control group (x2 =8.274,P =0.004).Conclusion To give children symptomatic treatment of infantile bronchial pneumonia at the same time,take the high quality nursing intervention can effectively improve lung function in children,reduce the incidence of complications,it is conducive to prognosis and can improve the therapeutic efficacy.

Establishment and evaluation on the clinical reportable rang of serum alanine aminotransferase / 国际检验医学杂志

Objective To explore the functional sensitivity ,maximum allowable dilution ,analytical measurement range and clin‐ical reportable rang of the serum alanine aminotransferase (ALT ) detected by Beckman Dxc800 automatic analyzer with the DiaSys diagnostic biochemistry reagent kits .Methods According to the EP6‐A document published in 2004 by American Clinical and La‐boratory Standards Institution (CLSI) ,these samples with equal interval ,proportional prepared with the low levels serum and the high levels serum and their concentration exceeding the range claimed by manufacture ,were detected twice each .The results were registered and analyzed by the SPSS19 .0 statistic software with polynomial regression analysis to determine the analytical measure ‐ment range .Five samples at the low concentration ,which were prepared previously ,were detected repeat at day interval .And the functional sensitivity was determined with combining the coefficient of variation and the average value .Three samples ,diluted to different dilution ratio with physiological saline ,were detected .The dilution recovery rate ,which was required in the range of 90%- 110% ,was calculated to establish the clinical reportable rang by combining the Functional Sensitivity .Results The analytical measurement range of the serum ALT detected by Beckman Dxc800 analyzer was 5 .50 - 847 .50 U /L ,the runctional sensitivity was 3 .698 U /L ,the maximum allowable dilution was 1 ∶ 8 and the clinical reportable rang was 3 .698 - 6 780 .0 U /L .Conclusion The analytical measurement range of the serum ALT detected by Beckman Dxc800 analyzer with the DiaSys diagnostic biochemistry rea‐gent kits ,was wider than that of being claimed by manufacture ,the clinical reportable rang could meet the need of clinic .

Liquid phase coprecipitation of gemcitabine magnetic-targeting nanoparticles / 国际药学研究杂志

Objective To use the liquid phase coprecipitation method for preparing gemcitabine magnetic nanoparticles to the pouch,and explore the preparation process in a number of conditions. Methods The effect of different stirring speeds,Fe3+/Fe2+ratio,pH,temperature of Fe3O4 powder and emulsification condition,ultrasonic time,curing temperature on the preparation of target?ed magnetic nanoparticles were observed. Results The preparation of Fe3O4 nanoparticles was as follows:800 r/ min of stirring speed,1.7∶1 Fe3+/Fe2+ratio,pH=9,the reaction temperature of 60℃,and the 5∶40 water/oil compared,ultrasonic time of 10 min, 100℃curing temperature. Conclusion Fe3O4 powder with small particle size,high purity,and no agglomeration are prepared,the stability of the gemcitabine magnetic nanoparticles capsule is good.

Clinical application value of point-of-care combined detection of cardiac markers for diagnosing acute myocardial infarction / 国际检验医学杂志

Objective To investigate the clinical application value of point-of-care combined detection of cTnI,MYO and CK-MB in the patients with acute myocardial infarction (AMI).Methods 74 cases of coronary syndrome were collected as the patients group,including 36 cases of AMI and 38 cases of unstable angina pectoris(UAP),and 40 individuals with healthy physical examina-tion were selected as the control group.The concentrations of cardiac marker cTnI,MYO and CK-MB in blood at different times were detected by using the point-of-care rapid immune quantitative method.Then the sensitivity and specificity for diagnosing AMI were compared for determining the best time of single detection and combined detection.Results The positive rates of cTnI,MYO and CK-MB within onset 2-12 h with the symptoms in the AMI group were higher than those in the control group and the UAP group,the difference had statistical significance (P <0.01).The combined detection of cTnI,MYO and CK-MB within onset 6-12 h with symptoms had the higher sensitivity and higher specificity for diagnosing AMI.The combined detection of cTnI and CK-MB within onset 12-24 h with symptoms could reach the optimal sensitivity and optimal specificity for the diagnosis.The sensitivity and specificity of cTnI within onset 24-72 h with symptoms for diagnosing AMI were 100.0% and 100.0% respectively.Conclu-sion The point-of-care combined detection of cTnI,MYO and CK-MB can conveniently and rapidly diagnose AMI.The sensitivty and specificity of various indexes in different time periods are different.Their combined detection can increase the diagnostic rate for AMI.

Expression of nuclear factor kappa B1 and tissue factor in femoral venous endothelial tissue of the rat deep vein thrombosis model / 中国组织工程研究

BACKGROUND: At present, the basic underlying molecular mechanism regulating the interactions among venous endothelial cells, platelets, leukocytes, and promoting local deep vein thrombosis microenvironment formation, still remains unclear, and there is no ideal method for early diagnosis of deep vein thrombosis. OBJECTIVE: To study the underlying role of nuclear factor kappa B1 and tissue factor in rats with deep vein thrombosis. METHODS: A total of 67 Sprague-Dawley rats were randomly divided into control group (n=10) and model group (n=57). Deep vein thrombosis model was established by a clamping and sewing method in femoral vein combined with cast fixation. The incidence and serious degree of thrombus were observed by dissecting rat femoral vein in different time points (2.5 and 25 hours after modeling). The model group was further divided into pre-thrombogenesis group (2.5 hours after modeling), thrombogenesis group (25 hours after modeling) and non-thrombogenesis group (25 hours after modeling). Then total RNA was extracted from the localized femoral venous endothelial tissue. The candidate genes, associated inflammation and thrombosis, were screened by a special gene chip. Then the gene expression of nuclear factor kappa B1 and tissue factor was further identified by real-time polymerase chain reaction. RESULTS AND CONCLUSION: Pre-thrombogenesis group had no thrombogenesis, while thrombogenesis group have 23 cases with thrombosis and non-thrombogenesis group have 22 cases without thrombosis. The results of gene chip hybridization analysis and real-time PCR found that the mRNA expression of nuclear factor kappa B1 and tissue factor in rat femoral vein endothelial tissue were significantly up-regulated at 2.5 hours after modeling (pre-thrombogenesis group was higher than control group) (P < 0.05), and continued up-regulating at 25 hours after modeling (thrombogenesis group was higher than the pre-thrombogenesis group, non-thrombogenesis group and control group) (P < 0.05). The results from present study indicate that up-regulating expressions of nuclear factor kappa B1 and tissue factor in local femoral venous endothelial tissue of rat deep vein thrombosis models may play a key role in initiating venous thrombosis.

Effects of oxidative stress and Rac1/2 on venous wall and their roles in traumatic deep vein thrombosis / 中国组织工程研究

BACKGROUND: The molecular mechanism and core regulatory network of deep vein thrombosis are not fully clarified yet.OBJECTIVE: To explore the roles of oxidative stress and Rac1/2 in rat deep vein thrombosis.METHODS: Deep vein thrombosis model in SD rats was established by a champing method femoral veins clamping combinedwith fixation of the lower extremity with plaster. The incidence and serious degree of thrombus were observed by dissecting ratfemoral vein at different time points (2.5 and 25 hours after modeling). The model rats were divided into pre-thrombogenesisgroup (2.5 hours after modeling), thrombogenesis group (25 hours after modeling) and non-thrombogenesis group (25 hours aftermodeling). Then total RNA and protein were extracted from the femoral venous wall tissues.RESULTS AND CONCLUSION: Colorimetry results showed that compared with the non-thrombogenesis group, theconcentration of malondiadehyde in rat femoral vein wall tissues of the thrombogenesis group was the highest (P < 0.05), followedby that of the pre-thrombogenesis group (P < 0.05). The concentrations of total superoxide dismutase and glutathione reductasein the thrombogenesis group were the lowest, followed by those in the pre-thrombogenesis group (P < 0.05). The results of genechip hybridization analysis and real-time PCR showed that compared with the non-thrombogenesis group, the expressions ofRac1 and Rac2 in rat femoral vein wall tissues of thrombogenesis group increased the most, followed by that of thepre-thrombogenesis group (P < 0.05). These findings indicate that the up-regulation of malondialdehyde and Rac1/2 as well asthe activity decrease of total superoxide dismutase and glutathione reductase may lead to the formation of deep venousthrombosis.

Nuclear factor-κB signaling pathway and autophagy in inhaled sevoflurane-produced delayed myocardial protection in rats / 中华麻醉学杂志

Objective To evaluate nuclear factor (NF)-κB signaling pathway and autophagy in inhaled sevoflurane-produced delayed myocardial protection in rats.Methods Ninety-six adult male Sprague-Dawley rats,weighing 270-350 g,were randomly assigned into 6 groups (n =16 each):sham operation group (group S),ischemia-reperfusion (I/R) group,sevoflurane group (SEVO group),specific NF-κB inhibitor parthenolide (PTN)group,dimethyl sulfoxide (DMSO) group and PTN + sevoflurane group (PTN + SEVO group).The animals were anesthetized with intraperitoneal pentobarbital 50 mg/kg,intubated and mechanically ventilated.Myocardial I/R was induced by 30 min of occlusion of the left anterior descending branch of coronary artery followed by 2 h of reperfusion.In group I/R,33％ oxygen was inhaled for 2 h.In group SEVO,2.5％ sevoflurane was inhaled for 2 h.In groups PTN and DMSO,PTN 500 μg/kg and DMSO were administered intraperitoneally 15 min before oxygen inhalation respectively.In group PTN + SEVO,PTN 500 μg/kg was administered intraperitoneally 15 min before exposure to sevoflurane.Myocardial I/R was induced 24 h after intraperitoneal administration.Eight animals in each group were sacrificed immediately before ischemia and the hearts were removed to detect the NF-κB activity and expression of LC3-Ⅱ and cathepsin B.The left animals in each group were sacrificed at 2 h of reperfusion and the hearts were removed to determine the myocardial infarct size (by TTC staining).Results Compared with group S,the myocardial infarct size was significantly increased at 2 h of reperfusion in the other groups,and the NF-κB activity was significantly increased and the expression of LC3-Ⅱ and cathepsin B was up-regulated immediately before ischemia in group SEVO (P ＜ 0.05).Compared with group I/R,the NF-κB activity was significantly increased and the expression of LC3-Ⅱ and cathepsin B was up-regulated immediately before ischemia,and the myocardial infarct size was significantly reduced at 2 h of reperfusion in group SEVO (P ＜ 0.05).Compared with group SEVO,the NF-κB activity was significantly decreased and the expression of LC3-Ⅱ and cathepsin B was down-regulated immediately before ischemia,and the myocardial infarct size was significantly increased at 2 h of reperfusion in DMSO,PTN and PTN + SEVO groups (P ＜ 0.05).Conclusion NF-κB signaling pathway and autophagy are involved in inhaled sevoflurane-produced delayed nyocardial protection in rats.

Application of glucose-6-phosphate isomerase and auto-antibodies in diagnosis of rheumatoid arthritis / 中华全科医师杂志

Blood samples were collected from 90 patients with confirmed rheumatoid arthritis (RA), 73 patients with other rheumatic diseases and 50 normal controls. Serum glucose-6-phosphate isomerase (GPI) and anti-cyclic citrullinated peptide (CCP) were detected with ELISA method, rheumatoid factor IgM( RF IgM)was measured with turbidimetric immunoassay and antikeratin antibody (AKA) was determined with indirect immunofluorescence assay. The serum GPI levels of RA group[1.73 (0. 43 -4. 40)mg/L]were significantly higher than those of rheumatic disease[0. 14 (0. 10 -0. 18 )mg/L]and normal controls[0. 12 (0. 09 - 0. 15 ) mg/L], ( H = 18. 13, P ＜ 0. 01 ). The sensitivities of GPI, anti-CCP,RF-IgM, AKA, GPI + CCP, GPI + RF-IgM were 80% (72/90), 57% (51/90), 68% (61/90), 29% (26/90) ,92% (83/90) and 96% (86/90), respectively; the specificities were 97% (119/123) ,95% ( 117/123 ) ,77% (95/123) ,95% ( 117/123 ), 93% ( 115/123 ) and 76% ( 93/123 ), respectively. GP1 level was significantly correlated with CCP and RF-IgM ( r = 0. 674 and 0. 533, P ＜ 0. 01 ), but not correlated with AKA ( r = 0. 12, P ＞ 0. 05 ). The results suggest that serum glucose-6-phosphate isomerase level is a valuable indicator for early diagnosis of rheumatoid arthritis.

Study of percutaneous 125Ⅰ seeds implantation guided by CT in elderly patients of stage Ⅰ peripheral non-small cell lung cancer / 中华放射肿瘤学杂志

ObjectiveTo evaluate the efficacy, feasibility and safety of CT guided percutaneous 125Ⅰ seeds implantation in elderly patients of stage Ⅰperipheral non-small cell lung cancer ( NSCLC ).MethodsClinical data of 16 elderly peripheral stage Ⅰ NSCLC patients ( 10 squamous carcinoma and 6adenocarcinoma;13 stage ⅠA and 3 stage ⅠB ) who received radioactive 125Ⅰ seeds implantation because of refusal or being unsuited to operation or external radiotherapy were retrospectively analyzed. Prescribed dose was 140 - 160 Gy. Under CT guidance, 125Ⅰ seeds were implanted percutaneously into tumors for interstitial radiotherapy according to treatment plan system. ResultsMean number of 125Ⅰ seeds each patient received was21.1. 12 complete response (CR) and 4 partial response (PR) were achieved. Total response rate ( CR + PR) was 100％. 100％ patients completed 10 to 56 months of follow-up, 15, 13, 8 and 6 patients completed 1-, 2-, 3-and 4-years'follow-up, respectively. The median local progression free time was 14months. The 1-,2-,3-and 4-year overall survival rate were 60％, 54％, 50％ and 33％, respectively (median:14 months). 7 cases died of non-tumor disease and 5 died of metastasis. No severe complications were observed. ConclusionsCT guided 125Ⅰ seeds implantation is a safe, reliable and effective radical treatment method for elderly stage Ⅰ peripheral NSCLC patients, who refuse to or are unsuitable to operation or external radiotherapy.

Effect of sevoflurane preconditioning on cardiomyocyte apoptosis following myocardial ischemia/reperfusion in rats / 中华麻醉学杂志

Objective To investigate the effect of sevoflurane (Sero) preconditioning (Precon) on cardiomyocyte apoptosis following myocardial ischemia-reperfusion (I/R) in rats. Methods Sixty-four adult male SD rats weighing 270-350 g were randomly divided into 4 groups ( n = 16 each): group Ⅰ sham operation (group S); group Ⅱ myocardial I/R; group Ⅲ Sero and group Ⅳ Sevo-Precon + myocardial I/R. The animals were anesthetized with intraperitoneal pentobarbital 50 mg/kg, intubated and mechanically ventilated. PET CO2 was maintained at 35-45 mm Hg. Myocardial I/R was induced by 30 min occlusion of the left anterior descending branch of coronary artery followed by 2 h reperfusion in group Ⅱ and Ⅳ . In group Ⅲ the animals inhaled 2.5 % sevoflurane for 30 min while in group Ⅳ the animals inhaled 2.5% sevoflurane for 30 min at 15 min before myocardial I/R. Eight animals were killed at the end of 2 h reperfusion in each group. The hearts were removed for determination of myocardial infarct size (IS) as a percentage of area at risk (AAR) (IS/AAR) by triphenyl tetrazolium chloride staining. Myocardial apoptosis was detected using TUNEL and apoptosis index (AI) was calculated. Another 4 animals were killed before ischemia and at the end of 2 h reperfusion for determining the expression of Bcl-2 and caspase-3 protein in myocardium by Western blot. Results Sevoflurane preconditioning significantly decreased infarct size and AI in group Ⅳ as compared with group Ⅱ (group I/R). Bcl-2 protein expression was significantly decreased and caspase-3 protein expression was significantly increased after 2 h reperfusion as compared with the expression before ischemia in group I/R (group Ⅱ ). Sevoflurane preconditioning significantly reversed the I/R-induced changes in Bcl-2 and caspase-3 protein expression. Conclusion Sevoflurane preconditioning can attenuate myocardial I/R injury by decreasing myocardial apoptosis.