Exploring the collision, acoustic and thermal energy dissipation distribution of discrete mass.

This research delves into the transfer and loss of energy in a discrete mass when subjected to forced vibration. Using discrete element method (DEM), we analyzed the dynamic behavior of regular spherical granular assemblies and the energy distribution characteristics under different excitation frequencies and reduced accelerations. Moreover, the energy transfer and dissipation process of granular assemblies under different vibration states are studied using an experimental method. The results show that the granular assemblies will produce collision energy dissipation, thermal energy dissipation, acoustic energy dissipation and other forms of energy dissipation in the forced vibration state and the proportion of different energy dissipation under different excitation is given. The collision and friction of granular assemblies are the key to affecting other forms of energy dissipation. When the excitation increases, the energy dissipation forms are generated inside the granular assemblies, and the proportion of collision energy dissipation of the granular assemblies increases. The acoustic energy above 20 kHz occupies the main part of the acoustic energy dissipation. Thermal energy consumption always exists, which takes a long time to play a role. The granular also have other forms of energy loss, which is hard to be measured, including Rayleigh waves generated by granular collision. In this study, the relationship between the forced vibration state of the granular assemblies and the energy loss distribution is established. Various types of energy transfer and conversion distribution which further enriches the energy dissipation of discrete element calculation of the granular assemblies is discussed and provides a reference for the energy loss analysis of the granular assemblies.

Clinical analysis of different cases with abnormal signals of bilateral pontine brachium on magnetic resonance imaging / 中华神经科杂志

Objective To investigate the clinical manifestations and diagnosis of patients with abnormal signal of bilateral pontine brachium on magnetic resonance imaging (MRI),in order to improve the understanding of diseases involving bilateral middle cerebellar peduncles.Methods Combined with auxiliary examination,we compared the clinical manifestations of five patients and analyzed the characteristics of diseases involving bilateral middle cerebellar peduncles.Results MRI was similar in all five patients.Symmetrical T2-weighted,FLAIR-weighted images of bilateral middle cerebellar peduncles were seen on MRI,with corresponding hypointensity on T1 WI of all five patients.No obvious enhancement has been showed.But there were different clinical manifestations and diagnosis of them.The first patient manifested as dizziness,visual rotation,slurred speech and inactivity of right limb.She was diagnosed with acute cerebral infarction.The second patient only manifested as dizziness.Combined with the history of cerebral infarction,he was diagnosed as Wallerian degeneration.The third patient manifested as blindness in the left eye,vision blurred in right eye and numbness of limbs.She was diagnosed with neuromyelitis optica.The forth patient manifested as lisp,walking instability,talk rubbish and hyperspaamia.She took heroin for dozens of times,and was diagnosed with heroin encephalopathy finally.The final patient manifested as ataxia,slurred speech,choking,dysphagia,less facial expression and urinary retention.He was diagnosed with olivopontocerebellar atrophy.Conclusions The etiology of bilateral pontine brachium lesion is complex.Cerebrovascular diseases,demyelinating diseases,infectious and toxic diseases,and neurodegenerative diseases can be involved.The mechanism of bilateral pontine brachium lesions is not very clear and needs to be further explored.

Research on Policy Factors Affecting Private TCM Institutions Organized by Social Capital / 中国中医药信息杂志

In order to further promote the development of the TCM industry, promote and encourage social capital to organize TCM institutions, according to the national policy and system regulations on private TCM institutions, this article analyzed and studied policies factors affecting private Chinese medical institutions, concluded the advantaging policies for the development of private TCM institutions, teased out the unreasonable regulations to hinder and restrict the private TCM institutions, and finally proposed relevant suggestions and advice, with a purpose to promote the attention of government in the process of promoting private TCM institutions policy.

Research on the effectiveness between high flow nasal oxygen cannula and non-rebreather oxygen face mask in post-extubation patients / 中华急诊医学杂志

Objective To compare the clinical effects of high flow nasal cannula (HFNC) and non-rebreathing oxygen face mask (NRB) in post-extubation patients.Methods 88 critically ill patients with machinery ventilations were divided into HFNC group and NRB group randomly.Blood gas analysis and hemodynamic parameters were assessed 1 hour prior to extubation and 6 hours after extubation.The primary clinical outcomes measured were ventilation-free days,re-intubation patient numbers,length of stay in ICU (Intensive Care Unite),total duration of hospitalization and mortality.The scant of breath degree and comfortableness of patient were recorded according to the Visual analogue scale.The measurement data were described by mean ± standard deviation ((x) ± s) and analyzed with t test,enumeration data were described by number of cases and composition ratio and analyzed with X2test,P ＜ 0.05 was considered to have statistical difference.Results There was no significant difference in clinical features between the two groups,The oxygenation index of HFNC group is significantly higher than that of NRB group after extubation [(251.4 ±43.9) vs.(201.7 ±60.7),P =0.037)].There were more ventilator-free days in the HFNC group than NRB group [(4.2 ± 2.1) vs.(3.4 ± 2.8),P =0.037)] and fewer patients required reintubation (P =0.028).The rate of ventilator associated pneumonia is also lower than NRB group (P =0.024).The patients' scant of breath feeling were obviously allevated comparing with the NRB group [(2.9 ± 1.1) vs.(3.7 ± 1.8),P =0.042)].The oxygenation index of NRB group significantly decreased after extubation [(242.9 ±68.4vs.201.7 ±60.7 P =0.048)].The two groups demonstrated similar hemodynamic patterns before and after extubation.And there were no statistically significant clinical differences in PaCO2,length of ICU stay,total duration of hospitalization or mortality.Conclusions Compared with NRB,HFNC is a more safe and effective clinical tool in the prevention and treatment of critical adult patients with extubation failure.

Safety and efficacy of transcatheter arterial angiography and embolization for endoscopic refractory gastrointestinal bleeding / 中国介入影像与治疗学

Objective To evaluate the diagnostic and therapeutic value and safety of transcatheter arterial angiography and embolization in patients with endoscopic refractory gastrointestinal bleeding.Methods Thirty-one cases of endoscopic refractory gastrointestinal bleeding were performed DSA and treated with transcatheter arterial angiography and embolization.The safty and efficacy was evaluated.Results Angiographic positive rate of bleeding was 80.65％ (25/31);28 cases was treated with embolization.The success rate of first embolization was 75.00％ (21/28),and the total success rate was 82.14 ％ (23/28) by the second embolization.Seven patients received surgical resection after interventional therapy,including 2 cases of jejunal stromal tumors and 5 cases of gastric malignant tumors.Four cases of gastric cancer patients underwent rebleeding within 30 days after interventional therapy,of which 2 died of heart or lung function failure due to basic diseases.Except for 1 patient of anastomotic bleeding after gastrointestinal anastomosis occurred anastomotic fistula after embolization,who recovery with the support treatment,no other cases occurred serious gastrointestinal ischemic necrosis.Conclusion Interventional diagnosis and treatment for gastrointestinal bleeding hemostasis is effective and safety,and also can achieve good results especially for malignant gastric tumor hemorrhage,which can be used for endoscopic refractory gastrointestinal bleeding patients.

Role of growth factors in acute lung injury induced by paraquat in a rat model.

Paraquat (PQ) can cause acute lung injury in humans and experimental animals. However, the role of growth factors in the progression of injury has not been clearly established. We developed an animal model of PQ-induced lung injury using Wistar rats. One milliliter of PQ solution (30, 60, and 120 mg/kg) was applied through the lavage, while the same amount of vehicle was applied to control rats. Based on histopathology, the lungs of some animals exposed to PQ showed acute fulmination, resulting in death, while others showed a more protracted injury, resulting in typical pulmonary fibrosis at 21 days. Using this PQ-poisoned rat model, we examined the intrapulmonary gene expression and circulatory level of cytokines and growth factors at 8 hours, 24 hours, 3 days, 7 days, 14 days, and 21 days after PQ administration. Semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) analysis demonstrated that the gene expression levels of interleukin-1 beta and interleukin-6 were significantly increased at 21 days after PQ challenge compared with the controls. The mRNA expression of tumor necrosis factor-alpha was also significantly increased except on days 14 and 21 after PQ treatment. Moreover, PQ-treated rats showed enhanced gene expression of growth factors such as platelet-derived growth factor-A and insulin-like growth factor-1 at 21 days and transforming growth factor-beta 1 at 14 days. ELISA results showed the circulatory level of cytokines and growth factors coincided with intrapulmonary gene expression. The synergistic effects of these molecules are presumed to cause pulmonary damage due to PQ challenge and may become targets of treatment.

Continuous versus intermittent hemofiltration in patients with severe acute pancreatitis / 中华肝胆外科杂志

Objective To compare the therapeutic effects of continuous veno-venous hemofiltration (CVVH) versus repeated intermittent veno-venous hemofiltration (RIVVH) on patients with severe acute pancreatitis (SAP).Methods Fifty-six patients with SAP were randomly divided into the CVVH group (n =28) and the RIVVH group (n =28).The clinical symptoms and signs,the APACHE Ⅱ and MODS scores,the result of biochemistry including amylase and lipase,and the plasma levels of TNF-α,IL-6,IL8 before and after treatment,the duration of mechanical ventilation,boosting drug application time,the length of stay in ICU,the surgical intervention rate and the mortality were compared between the two groups.Results The clinical symptoms improved in the two groups after treatment (P ＜ 0.05).The APACHE Ⅱ and MODS scores were all reduced in the two groups after treatment (P ＜ 0.05).When compared with the RIVVH group,the result of biochemistry including amylase and lipase,and the plasma levels of TNF-α,IL6,IL-8 were significantly decreased (P ＜ 0.05).The duration of mechanical ventilation,the length of stay in ICU and the mortality were also significantly decreased in the CVVH group (P ＜ 0.05).Conclusions CVVH was more efficacious than RIVVH in the treatment of SAP.

Effect of modified early goal directed therapy on the prognosis of patients with septic shock / 重庆医学

Objective To evaluate the effects of modified early goal directed therapy (EGDT )on the prognosis of patients with septic shock .Methods Clinical data of 116 patients with septic shock admitted to ICU during January 2011 to March 2013 were retrospectively analyzed .Patients were divided into modified early goal‐directed therapy group (n=57) and traditional early goal‐di‐rected therapy group (n=59) according to different methods of treatment ,the patients′28‐day survival rates of these 2 groups were compared .Modified early goal‐directed therapy are divided into survival group (n=46) and non‐survival group (n=11) according to 28‐day prognosis .Acute physiology and chronic health evaluation Ⅱ (APACHEⅡ ) score ,sequential organ failure assessment (SOFA) ,multiple organ dysfunction syndrome (MODS) score and other relevant indicators of survival group and non‐survival group were compared .Results The 28‐day survival rate in modified early goal‐directed therapy group had increased approximately 18 .9% higher than that of the traditional early goal‐directed therapy group(P< 0 .05) .The APACH Ⅱ score ,SOFA score and MODS score in non‐survivors were significantly higher than those of survivors in modified EGDT group ,which were[(29 .36 ± 1 .57)d vs .(24 .30 ± 3 .27)d] ,[(13 .45 ± 0 .52)d vs .(12 .78 ± 1 .33)d] ,[(9 .00 ± 0 .00)d vs .(4 .04 ± 1 .94)d]separately .And vaso‐pressors time and mechanical ventilation time was significantly longer in non‐survivors than survivors(P<0 .05) .Conclusion Mod‐ified early goal directed therapy could improve 28‐day survival rate ,and it show s beneficial effects on outcome of critical patients w ith septic shock .

Species distribution of pathogens and prognostic factors of catheter-related bloodstream infections in Intensive Care Unit / 重庆医学

Objective To investigate the incidence and the species distribution of catheter‐related bloodstream infection(CRBSI) in the intensive care unit(ICU) at our hospital ,and analyze the risk factors for CRBSI .Methods The hospitalized patients microbi‐ologically diagnosed as CRBSl were included in this study from January 2012 to June 2013 .Data were collected retrospectively and analyzed by software SPSS 19 .0 .Results There were 67 patients were diagnosed as nosocomial CRBSI of 987 cases ,in which 24 cases (35 .8% )died in the hospital .Eighty one strains were detected from 67 cases of CRBSI ,including 42 Gram‐positive(G+ ) bac‐teria(51 .9% ) ,36 Gram‐negative(G-)bacteria (44 .4% ) ,and 3 fungi(3 .7% ) .Staphylococcus epidermidis was predominant patho‐genic G+ bacteria ,and Acinetobacter baumannii was predominant G - bacteria .With multiple logistic regressions ,age≥65 ,high A‐PACHEⅡ score and polymicrobial CRBSI were independent predictors of worse outcome .Conclusion Within the latest 18 months , the prevalence of pathogens infection are Staphylococcus epidermidis and Acinetobacter baumannii in CRBSI in ICU .Advanced age , disease severity and polymicrobial CRBSI should be regarded as significant independent risk factor of the CRBSI patients in ICU for mortality .

Effect of continuous blood purification in the treatment of cardiorenal syndrome type Ⅰ / 中华老年医学杂志

Objective To evaluate the effect of continuous blood purification (CBP) on cardiorenal syndrome (CRS) type Ⅰ.Methods Clinical data of 42 patients with CRS type [at our hospital were collected from January 2012 to June 2014.We observed and compared changes in mean arterial pressure (MAP),heart rate,respiration rate,acute physiology and chronic health evaluation (APACHE) Ⅱ score,and urinary volume before and 5 days after CBP.Meanwhile,levels of serum creatinine (Scr),cysteine proteinase inhibitor Cystatin C (CysC),serum creatinine (cTn) and B-type natriuretic peptid (BNP) were monitored.In addition,dynamic changes in cardiac index (CI),intrathoracic blood volume index (ITBI),global end-diastolic volume index (GEDI),central venous pressure (CVP),and extravascular lung water index (ELVWI) were monitored using the pulse induced contour cardic output plus monitoring system (PiCCO plus),and changes in left ventricular ejection fraction (LVEF) before and 5 days after CBP was measured by color Doppler ultrasound.Results There was no significant difference in MAP in patients with CRS type Ⅰ before and 5 days after CBP (P=0.08).Tacbycardia and tachypnea improved,while urine volume increased and the APACHE Ⅱ score decreased significantly,5 days after CBP(allP＜0.05).Plasma levels of Scr,CysC,cTn and BNP after treatment were lower than those before treatment [(126.8±68.3) μmol/L vs.(413.6±126.1) μmol/L,(1.1±0.8) g/L vs.(4.1±1.1) g/L,(2.6±0.4) μg/L vs.(3.5± 0.7) μg/L,(807.6±427.7) ng/L vs.(3300.3±567.6) ng/L,all P＜0.05)].Myocardial contractility,cardiac preload and lung related parameters also significantly improved after CBP (allP ＜0.05).Conclusions CBP can alleviate clinical symptoms of CRS type Ⅰ,improve cardiac and renal function,and is promising as an important auxiliary measure for the treatment of patients with cardiorenal syndrome type Ⅰ.

Effect of hemoperfusion plus hemofiltration in patients with hyperlipidemic pancreatitis / 中华肝胆外科杂志

Objective To evaluate the effect of different blood purification modes on patients with hyperlipidemic pancreatitis (HLP).Methods 28 patients with HLP in our department were enrolled into this study from January 2010 to June 2013.The patients were randomly divided into the HP/CVVH group (15 patients) and CVVH group (13 patients).The clinical symptoms and signs of the two groups were observed.The plasma levels of TNF-α,IL-6,IL-8,blood triglyceride and APACHE Ⅱ score before and after treatment were compared between the two groups.The duration of mechanical ventilation,ICU stay and mortality rate were compared between the two groups.Results The clinical symptoms improved in the two groups after treatment.The plasma levels of TNF-α,IL-6,IL-8,blood triglyceride and APACHE Ⅱ score were all reduced.However,the plasma levels of TNF-o,IL-6,IL-8,blood triglyceride and APACHE Ⅱ score in the HP/CVVH group were lower than the CVVH group at the same time points,showing significant differences (P ＜ 0.05).The duration of mechanical ventilation,ICU stay and mortality rate decreased in the HP/CVVH group (P ＜ 0.05).Conclusions HP/CVVH was more efficacious in the treatment of HLP.

Therapeutic effect of 4-1BB monoclonal antibodies and glucocorticosteroid on immune hepatitis induced by ConA / 中华风湿病学杂志

Objective To investigate the therapeutic effect of 4-1BB monoclonal antibodies (4-1BBmAb) and glucocorticosteroid and the affect of the expression of CD4+CD25+T lymphocytes on the mouse hepatitis induced by ConA.Methods Mouse model of hepatic injury was induced by the application of ConA and checked by hepatic function tests and hepatic pathology.Mter the animal models were constructed,the mice in the group of therapeutic alliance were treated with glucocorticosteroid and 4-1BBmAb.In contrast,mice in the control group were treated with 4-1BBmAb or glucocorticosteroid alone.The groups were then compared.After blood was collected respectively from the control group,the model group and the therapy group,flow cytometry was used to examine CD4+CD25+T lymphocytes.Chi-square test and t-test were used for statistical analysis.Results Compared with the control group,the conditions of the mice were improved after being disposed with 4-1BBmAb.The conditions became even better when 4-1BBmAb were used combined with glucocorticosteroid.ALT and AST of the control group were (140±22) U/L and (131±16) U/L respectively,that of 4-1BBmAb group were (98±14) U/L and (89±11) U/L respectively.The ALT and AST of the glucocorticosteroid treatment group were (76±11) U/L and (71±10) U/L respectively,ALT was (61±8) U/L and AST was (55±7) U/L in the combination treatment group.Differences among groups was statistically significant (P＜0.01).The expression of CD4+CD25+T lymphocytes was (3.0±0.8)％ in the control group,(8.5±2.9)％ in the gluco-corticosteroid treatment group,(8.4±3.5)％ in the 4-1BBmAb treatment group and was (11.2±3.5)％ in the combination treatment group.The difference was significant among the groups (P＜0.05).Conclusion 4-1BB-mAb have therapeutic effect for hepatic injury.The effectiveness will become even more evident when 4-1BB monoclonal antibodies are used together with glucocorticosteroid.During the course of treatment,4-1BBmAb and glucocorticosteroid can impact the expressions of CD4+CD25+T lymphocytes and this is the mechanism for the effectiveness in treating immune-mediated hepatic injury.

The relevance between single nucleotide polymorphism in the downstream of Toll-like receptor signal transduction pathway and rheumatoid arthritis susceptible genes / 中华风湿病学杂志

Objective To study the correlation between single nucleotide polymorphism (SNP) of downstream mononucleotide in signal transduction of Toll-like receptors and predisposing genes of rheumatoid arthritis (RA).Methods One hundred and sixty-two RA patients were selected from northern part of Han people in China,and 188 healthy subjects were enrolled as normal controls.Rs7744 of Myd88,rs5030445 of TRAF6,rs11265618 and rs4845626 of IL-6R were analyzed.The data of genotypic frequency and allele genotypic frequency were statistical analyzed by x2 test between the two groups.Results The difference of allele frequency of TRAF6 rs5030445 between the two groups were remarkable (x2=5.716,P＜0.05),and so did the IL-6R rs11265618 (x2=5.704,P＜0.05).But the difference of genotypic frequency was not statistically significant for locus of Myd88 rs7744,TRAF6 rs5030445 and IL-6R rs11265618 (P＞0.05).And the differenceof allele frequency and genotypic frequency between the two groups had no statistical significance in locus of Myd88 rs7744 and IL-6R rs4845626 (P＞0.05).Conclusion There is significant correlation between single nucleotide polymorphism and predisposing genes of RA.The G allele of TRAF6 rs5030445 gene locus is a possible predisposing gene for RA.The T allele of IL-6R rs11265618 is a possible predisposing gene of RA.

Meta-analysts on relationship between mycoplasma infection and rheumatoid arthritis / 中华风湿病学杂志

Objective To systematically review the relationship between mycoplasma infection and rheumatoid arthritis (RA).Methods Articles on case-control studies about the relation between mycoplasma infection and RA were collected by literature searching according to the selection criteria.Meta-analyses were performed for the included studies using RevMan 4.3.2 software.The odds ratio (OR) and its corresponding 95％ confidence interval (95％CI) were calculated by Meta-analysis.Results Seventeen casecontrol studies involving 729 RA patients and 1191non-RA controls,such as osteoarthritis (OA),reactive arthritis (ReA),gouty arthritis (GA),healthy controls were included.The results of Meta-analyses showed that there was a significant difference in the infection ratio of mycoplasma between patients with RA and non-RA (OR=4.40,95％CI 2.26 to 8.56,P＜0.01),and sensitivity analysis according to different published date and detection methods showed no difference.There were also significant differences between RA patients and OA patients (OR=11.29,95％CI 5.55 to 22.97,P＜0.01) and healthy controls (OR=6.80,95％CI 3.96 to 11.67,P＜0.01).Conclusion Mycoplasma infection is associated with RA.More evidence are needed to prove whether mycoplasma has played an equal role in RA and ReA,as well as the significant difference of mycoplasma infection between RA and GA groups.

Meta-analysis of association between peptidylarginine deiminase Ⅳ gene and rheumatoid arthritis / 中华风湿病学杂志

Objective To systematically analyze and evaluate the association between the peptidylarginine deiminaseⅣ(PADI4) gene and rheumatoid arthritis (RA) based on the published data,and to provide evidence for the pathogenesis of RA.Methods By selecting five SNPs in PADI4 (rs11203366,rs11203367,rs874881,rs2240340,rs1748033) which had been extensively examined.Meta-analysis on each SNP was performed step by step according to Hugenet manual to investigate the association of the polymorphisms of the PADI4 gene with RA.Results This Meta-analysis enrolled 15 659 RA patients and 22 019 healthy controls from 21 studies worldwide.It demonstrated that rs11203366,rs11203367,rs2240340 and rs 1748033 confered susceptibility to RA in Asian ethnicity (P＜0.01,0.03,＜0.01,＜0.01),while rsl1203366,rsl1203367 and rs874881 confered susceptibility to RA in Caucasian of European ancestry (P=0.0002,0.004,0.03).It also shown that no significant association between rs874881 and RA in the Asian ethnicity populations (P=0.2),or rs2240340,rs1748033 and RA in Caucasian of European ancestry (P=0.18,0.1 ).A linkage disequilibrium study was also performed.The LD study showed that rs11203366,rs11203367,rs874881,rs2240340 and rs1748033 were in linkage disequilibrium both in the Asian ethnicity and Caucasian,which was basically inconsistent with the results of Meta-analysis.The conflicting results should be explained by many aspects such as bias in sample selection,genotyping,and the stratification.Conclusion The PADI4 genotype is partially associated with RA,and the underling mechanisms need further study.Haplotype based research and Metaanalysis would be valuable.

The alteration of gray matter volume in children with mental retardation: the differences between the patients presented with operation deficit predominantly and those presented with language deficit mainly / 中华放射学杂志

Objective To detect the differences of grey matter volume between the patients with mental retardation (MR) presented clinically as operation deficit (OD) or as language deficit (LD) and the children with typical normal development using optimal VBM.The developmental connections between brain gray matter and language or operation skills were examined.Methods Magnetic resonance imaging was obtained from 9 children with mental retardation presented as OD predominantly and 11 children with mental retardation presented as LD mainly,as well as the age-matched control group (11 and 14 normal children,respectively) on a 1.5 T scanner.Voxel-based morphometry analysis with an optimization of spatial segmentation and normalization procedures was applied to compare the volume of grey matter between the two groups (OD VS.control; LD VS.control).Statistically,the total and local gray matter volumes were compared between the two groups with t test.Results The total gray matter volume of OD group was [(1.030 ± 0.078) × 106 mm3].Compared to that of controls [(0.984 ± 0.058) × 106 mm3],it was increased significantly (t =-2.6,P ＜ 0.05).And the gray matter volume in the posterior cingulated gyrus,left superior prefrontal gyrus,left cuneus,left middle prefrontal gyrus and the body of left caudate nucleus showed significantly increased.Meanwhile,the total gray matter volume of the MR children presented as LD [(1.002 ± 0.068) × 106 mm3] showed significantly increased(t =-3.0,P ＜ 0.05) compared with that of control group [(0.957 ±0.057) × 106 mm3].The gray matter volume in bilateral thalami,the left inferior temporal gyrus,the left inferior frontal gyrus,and the left cerebellum of the LD group was more than that of normal children.Conclusion As revealed by VBM,there are differences in alterations of gray matter volume between MR children presented with OD and with LD relative to control.

The expression of uPA and uPAR in patients with systemic inflammatory response syndrome / 中华急诊医学杂志

Objective To test plasma levels of uPA,uPAR,D-dimer,IL-6 and TNF-α,and observe the relationships between uPA,uPAR and D-dimer,IL-6,TNF-αin patients with SIRS.Methods A prospective,clinical case-control study was adopted.Cases were collected from our hospital in January 2008 to January 2010,and all were ＞ 55 years of age.Venous blood samples were collected via routine venipuncture.Eighty-five patients were divided into two groups according to diagnostic criteria of SIRS:SIRS group collected from Intensive Care Unit ( n =50) and non SIRS group collected from medical ward ( n =35).The control group comprised 30 unrelated healthy blood donors who visited the General Health Checkup Division at our hospital.Patients with (1) pregnant women; (2) cancer; (3) died after admitted into ICU in 7 days; (4) after cardiopulmonary resuscitation ; ( 5 ) with previous blood system diseases; (6) patients with SIRS before admitted into ICU were excluded from the study.uPA,uPAR,D-D,IL-6 and TNF-α in blood were detected by commercial enzyme-linked immunosorbent assay (ELISA) kits.The data was analyzed using SPSS version17.0.Data accorded with normal distribution of measurement was expressed as mean ± standard,and analyzed by independent-samples t test; non-normal distribution of measurement data,expressed by median,was analyzed with Mann-Whitney test.Relationships between plasma levels of uPA,uPAR and D-dimer,IL-6 TNF-α were analyzed using Spearman rank correlation test.To compare with blood level of uPA,uPAR,IL-6 and TNF-α in SIRS patients in the application of diagnostic value of MODS,we constructed the receiver operating characteristic curve ( ROC curve) for blood levels of uPA,uPAR,IL-6 and TNF-α in 24 h.Results The plasma levels of uPA,uPAR,D-dimer,IL-6 and TNF-αin patients of SIRS were obviously higher compared with non-SIRS and normal controls ( all P ＜ 0.01 ).Correlation analysis showed that there was positive correlation between uPAR level and IL-6 level (r =0.395,P =0.004) ; there was positive correlation between uPAR level and TNF-αlevel ( r =0.606,P ＜0.01 ).There was no correlation between uPAR levd and D-dimer level ( r =- 0.069,P =0.632).There was no correlation between uPA level and D-dimer,IL-6 or TNF-α ( all p ＞ 0.05).There ROC curve were made based on the abilities of uPAR,D-dimer,IL-6 and TNF-αlevels in 24 hours to diagnose MODS,and the ROC areas under the curves were 0.76,0.58,0.86,0.83 respectively.Conclusions These results demonstrate that uPA and uPAR play a major contributory role in patients with SIRS in the process of coagulation disorders,but the mechanism in SIRS is not the same.uPAR may play a central rolein the development of SIRS to MODS.

Characteristics of hippocampal 3-dimensional magnetic resonance imaging in amnestic mild cognitive impairment / 中华神经科杂志

Objective To identify the characteristics of hippocampal 3-dimensional MRI in patients diagnosed as having subtypes of amnestic mild cognitive impairment(aMCI)using hippocampal surfacebased analytic technique.Methods Fifry aMCI patients and 16 healthy controls who were equivalent in age and education(NC)were recruited.Every subiect carried out a 3-dimensional MRI scan.After the imaging data were acquired.the borders of the hippocampus were manually traced in coronal vlew using the software of InsightSNAP1.4.1. Hippocampal volume was computed automatically and statistically analysed.Hippocampal 3-dimension MRI were transformed into 3-dimension parametric surface mesh models of 400×200 prids.Hippocampal radial distance measures which was the distance from the surface point to the central axis were statistically compared between two groups.The radial atrophy significance maps were acquired and adjusted for multiple comparisons.Hippocampal morphological difference maps of aMCI in contrast with NC were acquired.Results The average normalized volume of left hippocampus were(3247.5±600.2)mm3 in aMCI patients and(3467.9±451.3)mm3 in NC subjects.The average normalized volume of right hippocampus were(3416.8±699.1)mm3 in aMCI patients and(3469.1±358.9)mm3 in NC subjects.Comparison of hippocampal volume did not differ significantly between aMCI patients and NC subjects(t=1.161,P=0.255;U=0.178,P=0.859).By using hippocampal surface-based morphologic analytic technique,3-dimension hippocampal morphological difference maps between two groups were acquired,showing significant atrophy on the lateral and inferior hippocampal surface which corresponded to CA1 and subiculum hippocampal subfields bilaterally in aMCI patients compared with NC subjects. Conclusions aMCI patients do not have significant volume loss in the hippocampus. Through hippocampal surface-based morphologic analyses, partial regional atrophy of hippocampus at some degree is found, mainly localizing in the lateral and inferior hippocampal regions which correspond to CA1 and subiculum hippocampal subfields bilaterally in aMCI compared with NC. These results may reflect the early image marker in aMCI.

Clinical evaluation of linezolid in 15 cases of severe lung infections caused by methicillin-resistant Staphylococcus aureus / 中国感染与化疗杂志

Objective To evaluate the efficacy and safety of linezolid in the treatment of severe lung infections caused by methicillin-resistant Staphylococcus aureus (MRSA).Methods Fifteen patients admitted to ICU due to severe lung infection caused by MRSA received linezolid treatment. WBC, lactic acid (LAC), IL-1β, IL-6, and TNF-α levels were measured before and after treatment. Results Clinical efficacy rate was 73.3%. The level of WBC, LAC and inflammatory cytokines decreased significantly after linezolid treatment (P<0.01).Conclusions Linezolid shows good efficacy in the treatment of severe lung infections caused by MRSA.

Expression of RECK in peripheral blood mononuclear cells and correlation with matrix metalloproteinase-9 in systemic lupus erythematosus / 中华微生物学和免疫学杂志

Objective To investigate the expression of RECK(reversion-inducing eysteine-rich protein with kazal motif) in peripheral blood mononuclear cell (PBMC) of systemic lupus erytbematosus (SLE) patients and the relationship between RECK and matrix metalloproteinase-9 (MMP-9) in SLE. Methods PBMC were isolated from 69 SLE patients and 23 healthy donors. The protein and mRNA levels of RECK in PBMC were determined by Western blot and RT-PCR, respectively, and the MMP-9 mRNA level was tested too. After cultured for 24 h with phytohemagglutinin(PHA) stimulation, these levels and the secretion of MMP-9 were observed. Results Compared with healthy donors, RECK protein and mRNA lev-els decreased in SLE patients, and MMP-9 mRNA level increased, and the secretion level of MMP-9 was higher. After PHA stimulation, compared with blank control, the expression of RECK protein and mRNA were lower, but the MMP-9 mRNA level increased and the secretion of MMP-9 increased significantly. The protein levels of RECK were inversely associated with MMP-9 secretion but no association between RECK protein level and MMP-9 mRNA level was found. Conclusion RECK might play an important role in SLE pathogenesis through inhibiting the secretion of MMP-9. Regulation of RECK expression would be prospec-tive in SLE treatment.