Sound Touch Elastography for Noninvasive Assessment of Liver Stiffness in Patients With Chronic Heart Failure.

Heart failure (HF) can damage various organs, including the liver, a phenomenon known as "cardiohepatic syndrome." The latter is characterized by liver congestion and hepatic artery hypoperfusion, which can lead to liver damage. In this study, we aimed to assess liver damage quantitatively in chronic HF (CHF) with sound touch elastography (STE). A total of 150 subjects were enrolled, including HF with reduced ejection fraction (HFrEF) groups (left ventricular ejection fraction ≤40%, n = 45), HF with mildly reduced ejection fraction (HFmrEF) groups (left ventricular ejection fraction between 41% and 49%, n = 40), and right-sided HF (RHF) groups (n = 25); normal groups (n = 40). Liver stiffness measurement (LSM) was performed in all subjects by STE. The other hepatic parameters were also measured. The LSM was 5.4 ± 1.1 kPa in normal subjects and increased slightly to 5.9 ± 0.7 kPa in patients with HFmrEF. However, the HFrEF and RHF groups had significantly higher LSMs of 8.4 ± 2.0 kPa and 10.3 ± 2.7 kPa, respectively. The LSM of HFrEF was significantly higher than that of HFmrEF, whereas the increase in LSM in patients with RHF was significant relative to HFmrEF and HFrEF. In addition, the other parameters showed abnormal values in only RHF and HFrEF. In conclusion, STE is a useful clinical technique for the noninvasive evaluation of liver stiffness associated with CHF, which could help patients with CHF manage their treatment regimens.

Cembranoids and their bioactivities in soft coral Sarcophyton glaucum / 中国中药杂志

Chemical constituents in soft coral Sarcophyton glaucum were separated and purified by various chromatographic methods. Based on the spectral data, physicochemical properties, and comparison with the data reported in the literature, nine cembranoids, including a new cembranoid named sefsarcophinolide(1) together with eight known cembranoids, namely(+)-isosarcophine(2), sarcomilitatin D(3), sarcophytonolide J(4),(1S,3E,7E,13S)-11,12-epoxycembra-3,7,15-triene-13-ol(5), sarcophytonin B(6),(-)-eunicenone(7), lobophytin B(8), and arbolide C(9), were identified. As revealed by biological activity experiment results, compounds 2-6 had weak acetylcholinesterase inhibitory activity, and compound 5 displayed weak cytotoxicity against K562 tumor cell line.

Draft Genome Assembly and Annotation for Cutaneotrichosporon dermatis NICC30027, an Oleaginous Yeast Capable of Simultaneous Glucose and Xylose Assimilation

The identification of oleaginous yeast species capable of simultaneously utilizing xylose and glucose as substrates to generate value-added biological products is an area of key economic interest. We have previously demonstrated that the Cutaneotrichosporon dermatisNICC30027 yeast strain is capable of simultaneously assimilating both xylose and glucose, resulting in considerable lipid accumulation. However, as no high-quality genome sequencing data or associated annotations for this strain are available at present, it remains challenging to study the metabolic mechanisms underlying this phenotype. Herein, we report a 39,305,439 bp draft genome assembly for C. dermatis NICC30027 comprised of 37 scaffolds, with 60.15% GC content. Within this genome, we identified 524 tRNAs, 142 sRNAs, 53 miRNAs, 28 snRNAs, and eight rRNA clusters. Moreover, repeat sequences totaling 1,032,129 bp in length were identified (2.63% of the genome), as were 14,238 unigenes that were 1,789.35 bp in length on average (64.82% of the genome). The NCBI non-redundant protein sequences (NR) database was employed to successfully annotate 11,795 of these unigenes, while 3,621 and 11,902 were annotated with the Swiss-Prot and TrEMBL databases, respectively. Unigenes were additionally subjected to pathway enrichment analyses using the Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), Cluster of Orthologous Groups of proteins (COG), Clusters of orthologous groups for eukaryotic complete genomes (KOG), and Non-supervised Orthologous Groups (eggNOG) databases.Together, these results provide a foundation for future studies aimed at clarifying the mechanistic basis for the ability of C. dermatis NICC30027 to simultaneously utilize glucose and xylose to synthesize lipids.

Hyperactivation of PI3K/AKT/mTOR signal pathway impairs TNF-α-induced autophagy in mesenchymal stem cells from patients with ankylosing spondylitis / 南方医科大学学报

OBJECTIVE@#To investigate the changes in autophagy of mesenchymal stem cells (MSCs) from patients with ankylosing spondylitis and explore the mechanism for decreased autophagy in ASMSCs.@*METHODS@#MSCs collected from 14 patients with AS (ASMSCs) and from 15 healthy donors (HDMSCs) were cultured in the absence or presence of 25 ng/mL TNF-α for 6 h. Autophagy of the cells was determined by immunofluorescence staining of GFP-LC3B, and the results were confirmed by detecting the protein expressions of autophagy markers LC3 II/LC3 I and P62. The mRNA expressions of the related genes were detected using qRT-PCR, and the protein expressions of the autophagy markers and signaling pathway-related molecules were determined with Western blotting. TG100713 was used to block the PI3K/AKT/mTOR signal pathway, and its effect on autophagy of ASMSCs was evaluated.@*RESULTS@#ASMSCs showed significantly weaker GFP-LC3B puncta staining and lower protein expression levels of LC3 II/LC3 I but higher levels of P62 protein (P < 0.05), indicating a decreased autophagy capacity as compared with HDMSCs. TNF-α-induced ASMSCs showed significantly higher protein expressions of p-PI3K/ PI3K, p-AKT/AKT and p-mTOR/mTOR than HDMSCs (P < 0.05), suggesting hyperactivation of the PI3K/AKT/mTOR signaling pathway in ASMSCs. Blocking PI3K/AKT/mTOR signaling with TG100713 eliminated the difference in TNF-α-induced autophagy between HDMSCs and ASMSCs.@*CONCLUSION@#In patients with AS, hyperactivation of the PI3K/AKT/mTOR signaling pathway results in decreased autophagy of the MSCs and potentially contributes to chronic inflammation.

Analysis of clinical characteristics and prognostic factors of patients infected with Helicobacter pylori under 30 years ol / 公共卫生与预防医学

Objective To analyze the clinical characteristics and prognostic risk factors of helicobacter pylori (Hp) infected patients under 30 years old, and to provide a theoretical basis for the eradication of Hp in young Hp-positive patients under 30 years old. Methods A total of 565 patients with upper gastrointestinal symptoms admitted to our hospital from December 2017 to December 2020 were selected. All patients were Hp positive, and all patients were treated with quadruple eradication therapy of Helicobacter pylori. According to the Hp negative status after treatment, the patients were divided into good prognosis group (Hp negative, n=374) and poor prognosis group (Hp not negative, n=191). A self-made questionnaire was used to analyze the age, gender, familial history of gastrointestinal diseases, life habits (long-term smoking, and drinking), eating habits (irregular diet, and excitant food), DOB baseline value, and treatment compliance of the two groups. Logistic regression was used to analyze the factors that may affect the prognosis of HP positive patients. Results Among the 565 Hp positive patients, 347 were males and 218 were females, with an average age of (23.49±4.29) years, 393 (69.56%) aged 18-24 years old and 172 (30.44%) aged 25-29 years old. The diagnosis results of upper gastrointestinal diseases were 54 cases of gastric cancer (9.56%), 229 cases of peptic ulcer (40.53%), 174 cases of chronic gastritis (30.80%), and 108 cases of reflux esophagitis (19.12%). There were no significant differences in age, sex, family history of gastrointestinal diseases and alcoholism between the two groups (P>0.05). There were statistically significant differences between the two groups in long-term smoking, irregular diet, preference for stimulating food, treatment compliance and baseline value of DOB (P<0.05). The results of logistic regression analysis showed that long-term smoking, poor treatment compliance and high DOB value were independent risk factors affecting the prognosis of Hp positive patients (P<0.05). Conclusion Chronic gastritis and peptic ulcer are the main upper gastrointestinal diseases in Hp-positive young patients under 30 years old. Long-term smoking, poor treatment compliance and high DOB value are independent risk factors affecting the prognosis of patients. Treatment compliance of patients should be improved, and intervention should be strengthened in patients with high DOB value and smoking.

Chemical constituents of soft coral Sarcophyton glaucum collected from Xisha and their anti-inflammatory activity / 药学学报

The crude Et2O extract of soft coral Sarcophyton glaucum, collected off the Xisha, the South China Sea, were investigated. A new cembrane-type diterpenoid, namely 15-dehydroxy-sarcophytrol D (1), together with twenty-five known compounds, namely ximaoglaucumin C (2), (11S,12S,1E,3E,7E)-11,12-epoxycembra-1,3,7-triene (3), sarcophytol W (4), cembrene (5), sarcophytol B (6), sarcophytol K (7), sarcophytol J (8), pentaene-cembrene (9), sarcophytol E (10), (+)-marasol (11), (2S)-sarcophytoninsarcophytoxide (12), (-)-17-hydroxydeepoxysarcophytoxide (13), (+)-sarcophytoxide (14), 13-acetoxysarcophytoxide (15), bophynin B (16), 16-oxosarcophytoxide E (17), sarcophinone (18), 7α-8β-dihydroxydeepoxysarcophine (19), (+)-sarcophine (20), 14-dehydroxy-sarcophytol L (21), sarcophytol L (22), 13α-hydroxy-sarcophytol L (23), trocheliophol C (24), trocheliophol E (25) and trocheliophol L (26), were isolated and purified by comprehensive chromatography methods of silica gel column, Sephadex LH-20 gel column, TLC, and semi-preparative high-performance liquid chromatography (HPLC). In anti-inflammatory bioassay, compound 4 exhibited inhibitory effects on lipopolysaccharide (LPS)-induced inflammatory responses in BV-2 microglial cells.

Factors affecting improvement of neurologic status evaluated by Quantitative Myasthenia Gravis Score for patients with thymomatous myasthenia gravis after extended thymectomy.

BACKGROUND: The length of time for clinical improvement of patients with thymomatous myasthenia gravis (MG) after extended thymectomy is not clear. The purpose of this study was to determine the length of time after thymectomy in patients with thymomatous MG to achieve a 3-point reduction of Quantitative Myasthenia Gravis Score (QMGS), and identify variables associated with a failure to achieve the reduction. METHODS: The records of patients with thymomatous MG who underwent extended thymectomy from January 2005 to December 2018 were retrospectively reviewed. The primary end point was a reduction of 3 points of QMGs and the secondary end point was another reduction of 3 points of QMGs. RESULTS: A total of 481 patients were included in the analysis, the mean age of the patients was 41.63 ± 8.55 years, and approximately 60% were male. The median time to achieve a 3 point decrease in QMGS was 6 months, and the median time to achieve another 3 point decrease was 30 months. Multivariable analysis indicated that age ≥ 42 years and Masaoka-Koga stage > I were associated with a lower probability of achieving a 3 point decrease in QMGS (HR = 0.55 and 0.65, respectively). Likewise, multivariable analysis indicated that age ≥ 42 years and Masaoka-Koga stage > I were associated with a lower probability of achieving a second 3 point decrease in QMGS (HR = 0.53 and 0.53, respectively). CONCLUSIONS: In patients with thymomatous MG who receive thymectomy, age ≥ 42 years and Masaoka-Koga stage > I are associated with a worse prognosis and failure to achieve a 3 point decrease in QMGS.

HSV-1 H129-Derived Anterograde Neural Circuit Tracers: Improvements, Production, and Applications / 神经科学通报·英文版

Anterograde viral tracers are powerful and essential tools for dissecting the output targets of a brain region of interest. They have been developed from herpes simplex virus 1 (HSV-1) strain H129 (H129), and have been successfully applied to map diverse neural circuits. Initially, the anterograde polysynaptic tracer H129-G4 was used by many groups. We then developed the first monosynaptic tracer, H129-dTK-tdT, which was highly successful, yet improvements are needed. Now, by inserting another tdTomato expression cassette into the H129-dTK-tdT genome, we have created H129-dTK-T2, an updated version of H129-dTK-tdT that has improved labeling intensity. To help scientists produce and apply our H129-derived viral tracers, here we provide the protocol describing our detailed and standardized procedures. Commonly-encountered technical problems and their solutions are also discussed in detail. Broadly, the dissemination of this protocol will greatly support scientists to apply these viral tracers on a large scale.

Study on time-toxicity relationship and mechanism of Gardeniae Fructus extract on hepatoxicity in rats based on proteomics / 中国中药杂志

To study the time-toxicity relationship and mechanism of Gardeniae Fructus extract on the hepatoxicity in rats. Rats were randomly divided into C group(0 day), D5 group(5 days), D12 group(12 days), D19 group(19 days), and D26 group(7 days recovery after 19 days of administration). The rats in normal group received normal saline through intragastric administration, and the rats in other groups received 10 g·kg~(-1 )Gardeniae Fructus extract through intragastric administration. After the final administration, the livers were collected. Hematoxylin-eosin staining was used to observe the histopathological changes in the liver tissue. Total liver proteins were extracted for proteomic analysis, detected by the Nano-ESI liquid-mass spectrometry system and identified by Protein Disco-very software. SIEVE software was used for relative quantitative and qualitative analysis of proteins. The protein-protein interaction network was constructed based on STRING. Cytoscape software was used for cluster analysis of differential proteins. Kyoto encyclopedia of genes and genomes(KEGG) database was used to perform enrichment signal pathway analysis. Pearson correlation analysis was performed for the screened differential protein expression and liver pathology degree score. The results showed that the severity of liver injury in D5, D12 and D19 groups was significantly higher than that in group C. The degree of liver damage in D5 group was slightly higher than that in D12 and D19 groups, with no significant difference between group D26 and group C. Totally 147 key differential proteins have been screened out by proteomics and mainly formed 6 clusters, involving in drug metabolism pathways, retinol metabolism pathways, proteasomes, amino acid biosynthesis pathways, and glycolysis/gluconeogenesis pathways. The results of Pearson correlation analysis indicated that differential protein expressions had a certain temporal relationship with the change of liver pathological degree. The above results indicated that the severity of liver damage caused by Gardeniae Fructus extract did not increase with time and would recover after drug with drawal. The above pathways may be related to the mechanism of liver injury induced by Gardeniae Fructus extract.

Advances of enzymes in the applications of disease treatment and drug preparation / 生物工程学报

The development of biotechnology and the in-depth research on disease mechanisms have led to increased application of enzymes in the treatment of diseases. In addition, enzymes have shown great potential in drug manufacturing, particularly in production of non-natural organic compounds, due to the advantages of mild reaction conditions, high catalytic efficiency, high specificity, high selectivity and few side reactions. Moreover, the application of genetic engineering, chemical modification of enzymes and immobilization technologies have further improved the function of enzymes. This review summarized the advances of using enzymes as drugs for disease treatment or as catalysts for drug manufacturing, followed by discussing challenges, potential solutions and future perspectives on the application of enzymes in the medical and pharmaceutical field.

Scutellarin inhibits caspase-11 activation and pyroptosis in macrophages via regulating PKA signaling

@#Inflammatory caspase-11 senses and is activated by intracellular lipopolysaccharide (LPS) leading to pyroptosis that has critical role in defensing against bacterial infection, whereas its excess activation under pathogenic circumstances may cause various inflammatory diseases. However, there are few known drugs that can control caspase-11 activation. We report here that scutellarin, a flavonoid from Erigeron breviscapus, acted as an inhibitor for caspase-11 activation in macrophages. Scutellarin dose-dependently inhibited intracellular LPS-induced release of caspase-11p26 (indicative of caspase-11 activation) and generation of N-terminal fragment of gasdermin D (GSDMD-NT), leading to reduced pyroptosis. It also suppressed the activation of non-canonical nucleotide-binding oligomerization domain-like receptor family pyrin domain containing 3 (NLRP3) inflammasome as evidenced by reduced apoptosis-associated speck-like protein containing a CARD (ASC) speck formation and decreased interleukin-1 beta (IL-1β) and caspase-1p10 secretion, whereas the NLRP3-specific inhibitor MCC950 only inhibited IL-1β and caspase-1p10 release and ASC speck formation but not pyroptosis. Scutellarin also suppressed LPS-induced caspase-11 activation and pyroptosis in RAW 264.7 cells lacking ASC expression. Moreover, scutellarin treatment increased Ser/Thr phosphorylation of caspase-11 at protein kinase A (PKA)-specific sites, and its inhibitory action on caspase-11 activation was largely abrogated by PKA inhibitor H89 or by adenylyl cyclase inhibitor MDL12330A. Collectively, our data indicate that scutellarin inhibited caspase-11 activation and pyroptosis in macrophages at least partly via regulating the PKA signaling pathway.

Application of mesh elastic gloves in the treatment of zinc oxide paste in patients with subacute eczema in the hands / 中国实用护理杂志

Objective@#To introduce the method of making mesh elastic gloves, and to explore its application effect in the treatment of zinc oxide paste in patients with subacute eczema in the hands.@*Methods@#This study was a kind of experimental study. A total of 96 patients with subacute eczema in the hands in the Dermatology Ward of the First Affiliated Hospital of Yangtze University were selected as the study subjects.They were divided into the control group (admitted from June to December in 2017) and the experimental group (admitted from June to December in 2018) according to the time of admission, 48 cases in each group. After the two procedures(apply medicine and cover with sterile gauze) of the conventional zinc oxide paste coating, the control group was fixed with "gauze bandage+ medical tape", and the experimental group was fixed with "mesh elastic gloves". The external fixed cost and time, the disassembly time, the dressing fixation, the comfort condition, the grip strength, the daily activity of the hand, and the healing effect of the skin lesions were evaluated.@*Results@#The external fixed cost and time, the disassembly time, grip strength and hand daily activities ability of the patients in the experimental group were (0.37±0.05) yuan, (26.06±2.53) s, (13.70±1.28) s, (25.96±5.83) kg, and (65.04±7.10) points, significantly better than the control group (1.63±0.21) yuan, (160.98±22.82) s, (22.36±3.50) s, (20.01±3.56) kg, (61.83±6.31) points, the difference between the two groups was statistically significant (t value was-40.931--2.340, P< 0.01 or 0.05). The total rate of comfort, the total rate of dressing loss and the total effective rate of skin lesion healing in the experimental group were respectively 100%(48/48), 0, 98% (47/48), significantly better than the control group 79% (38/48), 46% (22/48), 71% (34/48), the difference between the two groups were statistically significant (χ2 value was 11.163, 28.541, 13.353, all P<0.01).@*Conclusions@#The application of mesh elastic gloves in the treatment of zinc oxide paste in patients with subacute eczema in the hands can not only save the cost of external fixation and the time of external fixation and disassembly, but also improve dressing fixation and comfort, and improve grip and hand daily activities. At the same time, the healing effect of hand skin lesions can also be improved. In short, it meets the needs of dermatology hand coating.

Application of mesh elastic gloves in the treatment of zinc oxide paste in patients with subacute eczema in the hands / 中国实用护理杂志

Objective:To introduce the method of making mesh elastic gloves, and to explore its application effect in the treatment of zinc oxide paste in patients with subacute eczema in the hands.Methods:This study was a kind of experimental study. A total of 96 patients with subacute eczema in the hands in the Dermatology Ward of the First Affiliated Hospital of Yangtze University were selected as the study subjects.They were divided into the control group (admitted from June to December in 2017) and the experimental group (admitted from June to December in 2018) according to the time of admission, 48 cases in each group. After the two procedures(apply medicine and cover with sterile gauze) of the conventional zinc oxide paste coating, the control group was fixed with "gauze bandage+ medical tape", and the experimental group was fixed with "mesh elastic gloves". The external fixed cost and time, the disassembly time, the dressing fixation, the comfort condition, the grip strength, the daily activity of the hand, and the healing effect of the skin lesions were evaluated.Results:The external fixed cost and time, the disassembly time, grip strength and hand daily activities ability of the patients in the experimental group were (0.37±0.05) yuan, (26.06±2.53) s, (13.70±1.28) s, (25.96±5.83) kg, and (65.04±7.10) points, significantly better than the control group (1.63±0.21) yuan, (160.98±22.82) s, (22.36±3.50) s, (20.01±3.56) kg, (61.83±6.31) points, the difference between the two groups was statistically significant ( t value was-40.931--2.340, P< 0.01 or 0.05). The total rate of comfort, the total rate of dressing loss and the total effective rate of skin lesion healing in the experimental group were respectively 100%(48/48), 0, 98% (47/48), significantly better than the control group 79% (38/48), 46% (22/48), 71% (34/48), the difference between the two groups were statistically significant ( χ 2 value was 11.163, 28.541, 13.353, all P<0.01). Conclusions:The application of mesh elastic gloves in the treatment of zinc oxide paste in patients with subacute eczema in the hands can not only save the cost of external fixation and the time of external fixation and disassembly, but also improve dressing fixation and comfort, and improve grip and hand daily activities. At the same time, the healing effect of hand skin lesions can also be improved. In short, it meets the needs of dermatology hand coating.

Functional and subfoveal choroidal thickness correlation analysis before and after surgery in patients with macular epiretinal membrane / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To study the changes of choroidal thickness and the relationship between visual function and choroidal thickness before and after idiopathic epiretinal membrane surgery.<p>METHODS: From January 2016 to December 2017, 30 patients(30 eyes)with idiopathic macular membrane who underwent surgical treatment in our hospital were selected to clinical study. All patients underwent TSV25G PPV with membrane and ILM peeling, patients were followed up by best corrected visual acuity(BCVA)and subfoveal choroidal thickness(SFCT)in preoperative and postoperative 1wk, 1mo and 3mo. We performed statistical analyses using SPSS22.0, for the evaluation of BCVA and SFCT, we compared the mean differences of preoperative and postoperative measurements. On the other hand, we estimated the correction relationship between BCVA and SFCT.<p>RESULTS: The BCVA at 3mo after operation was significantly higher than that before operation(<i>P</i>=0.011). We found a significant correlation between preoperative and postoperative 3mo BCVA(<i>r</i>=0.610, <i>P</i><0.01), postoperative 1wk,1mo, 3mo showed no significant difference with preoperative SFCT(<i>P</i>=0.999). We found no significant correlation between BCVA and SFCT.<p>CONCLUSION: There was no significant change in choroid thickness after surgery, and also no significant correlation between visual function and choroid thickness.

The clinical value of platelet function changes in trauma patients for prognosis judgment / 医学研究生学报

Objective The platelet function changes are closely related to the prognosis of trauma patients and the occurrence of coagulopathy. The purpose of this paper is to investigate the clinical value of platelet function changes in trauma patients for prognosis judgment. Methods The clinical data of 94 trauma patients admitted to the Department of Critical Care Medicine, 908th Hospital from July 2017 to February 2019 were retrospectively analyzed. According to the 90-day prognosis of patients, the patients were divided into survival group (n=80) and death group (n=14) to compare the traditional coagulation function indexes, including prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), thrombin time (TT), fibrinogen degradation product (FDP), D-dimer, antithrombin II (I ATIII), thromboelastogram (TEG) index [coagulation reaction time (R), clot formation rate (K), clot formation kinetics (α angle), maximum clot strength (MA), etc.] and platelet aggregation function index [arachidonic acid (AA) platelet aggregation rate and adenosine diphosphate (ADP) Platelet aggregation rate]. The data was analyzed by receiver operating characteristic (ROC) curve analysis and Kaplan-Meier analysis. Results Compared with the survival group, the APPT, R value and K value prolonged significantly in the death group (P<0.05). However, the MA value，AA-induced and ADP-induced platelet aggregation decreased significantly in the death group (P<0.05). The ROC curve analysis showed that when the MA cut-off value was 42.05mm, the sensitivity, specificity, positive predictive value and negative predictive value were 83.8%, 71.4%, 58.3% and 94.2% respectively. When the cut-off value of AA platelet aggregation rate was 36.6%, the sensitivity, specificity, positive predictive value and negative predictive value were 57.5%, 85.7%, 75.5% and 93.8% respectively. When the cut-off value of ADP platelet aggregation rate was 29.3%, the sensitivity, specificity, positive predictive value and negative predictive value were 70%, 64.3%, 72.7% and 91.8% respectively. The death risk of patients with AA-induced aggregation rate < 36.6% was 4.37 times that of the patients with AA-induced platelet aggregation rate ≥ 36.6% (95% CI: 1.34 to 10.98). The death risk of patients with ADP-induced aggregation rate < 29.3% was 3.674 times that of the patients with ADP-induced platelet aggregation rate ≥ 29.3% (95%CI:1.385~ 12.880). The death risk of trauma patients with MA < 42.05 mm was 9.759 times that of the patients with MA ≥ 42.05 mm (95% CI: 6.674 ~ 89.87). Conclusion The platelet function of trauma patients can be significantly impaired. When the MA, AA platelet aggregation rate and ADP platelet aggregation rate are lower, the mortality rate of trauma patients becomes higher. The platelet function index of MA, AA and ADP can be used to determine the prognosis of trauma patients.

Clinical study on the diagnostic value of thrombomodulin combined with thrombin-antithrombin complex in disseminated intravascular coagulation / 医学研究生学报

Objective According to the cell-based coagulation theory, antithrombin complex (TAT) reflecting the activation of coagulation system, plasmin-α2 anti-plasmin complex (PIC) reflecting the activation of fibrinolytic system, thrombomodulin (TM) and tissue plasminogen activator-plasminogen activator inhibitor-1 complex (t-PAIC) reflecting vascular endothelial function were selected to explore their diagnostic values for disseminated intravascular coagulation. Methods A prospective study was conducted on 154 patients in the Department of Critical Care Medicine of the 908th Hospital from May to December 2018. The subjects were divided into non-overt DIC group (n=134) and overt DIC group (n=20) according to the diagnostic criteria of International Thrombus and Hemostatic Association. The differences among groups of TM, t-PAIC, TAT and PIC were compared along with statistical analysis. Results Compared with TM [10.5 (8.0~14.3) TU/mL], TAT [9.6 (4.9~21.8) ng/mL], PIC [1.253 (0.789~2.802) μg/mL] and t-PAIC [ 11.2 (7.1~22.1) ng/mL] in non-overt DIC group, TM [16.8 (11.8~21.5) TU/mL], TAT [33.6 (10.3~120.0) ng/mL], PIC [4.080 (0.814~8.651) μg/mL] and t-PAIC [19.4 (10.0~30.1)ng/mL] ) in overt DIC group were significantly increased (P<0.05). The area under the curve of TM>14.85 TU/mL combined with TAT>23.05 ng/mL as the standard diagnostic overt DIC was 0.835 (P=0.000), and the sensitivity, specificity, positive predictive value and negative predictive value were 0.85, 0.761, 0.592, 0.925 respectively. Conclusion TM combined with TAT has a higher diagnostic efficacy for overt DIC.

Coagulation dysfunction in different phases of bloodstream infection-induced sepsis: A clinical study / 医学研究生学报

Objective Bloodstream infection (BSI)-induced sepsis may cause severe coagulation dysfunction. In this study, we analyzed the characteristics of coagulation dysfunction in different phases of BSI-induced sepsis.Methods We retrospectively analyzed the clinical data on 43 cases of BSI treated in our Department of Critical Care Medicine from January 2016 to September 2018. According to the Diagnostic Criteria for Sepsis 3.0, we divided the patients into a sepsis group and a septic shock group, compared the traditional indexes of coagulation function and parameters of thromboelastography (TEG) between the two groups, and analyzed the obtained data with the ROC curves.Results Compared with the sepsis group, the septic shock group showed significantly prolonged prothrombin time (PT) (13.7 \[12.5-17.4] vs 16.7 \[15.0-20.9\] s, P0.05).Conclusion Coagulation dysfunction in BSI-induced sepsis is characterized by elevated values of DD and FDP, and in case of septic shock, it features low coagulation of clotting factors (R≥8.5 min) and fibrin function (K≥2.65 min). The patient with septic shock may experience significantly reduced PLT with basically normal platelet function.

A quasi-coaxial HV rolled pulse forming line.

A quasi-coaxial high-voltage (HV) rolled pulse forming line (rolled PFL) is researched in this paper. The PFL is rolled n circles on a support cylinder simultaneously by two layers of copper foil electrodes and two layers of insulation dielectrics. The first circle of the two electrodes are elicited in opposite directions along the axis, acting as the quasi-coaxial output structure of the PFL, and the left n - 1 circles of the PFL form a complete rolled strip line of n - 1 circles. The rolled PFL is convenient to realize HV insulation and is able to output a pulse with good quality. Characteristic parameters of the PFL are designed theoretically. Besides, the pulse discharge process of the PFL is simulated by computer simulation technology (CST) modeling, and the simulation result verifies the correctness of theory design. Furthermore, a rolled PFL with a characteristic impedance of 4.4 Ω is developed. The test characteristic impedance of the developed PFL by the incident pulse method confirms to the theory design. The discharge voltage waveform with a full width at half maximum of 57 ns of the PFL is acquired, which has a rise time of 6.8 ns. The HV test of the rolled PFL is carried out, and a discharge current pulse with an amplitude of 7 kA is acquired when the PFL is charged to 70 kV. It is calculated that the developed PFL has an energy storage density of 2.5 J/l. A Tesla generator based on 13 stages of rolled PFLs is designed, which is expected to output a 450 kV pulse with a duration of 100 ns on a 40-Ω match load. The discharge waveform of the generator is simulated by the CST software. The simulative output pulse has a rise time of 5 ns, with a flattop jitter less than 5%.

Prognostic value of thromboelastography for trauma-induced coagulopathy / 医学研究生学报

Objective Coagulation disorder is an independent risk factor of death in trauma patients. This study aimed to investigate the prognostic value of thromboelastography (TEG) for patients with trauma-induced coagulopathy.Methods This retrospective study included 124 cases of trauma-induced coagulopathy treated in our Department of Critical Care Medicine from September 2015 to July 2018. We collected the clinical data and laboratory Results of the patients within 2 hours after admission, divided the patients into a survival group (n=108) and death group (n=16) according to their 90-day prognosis after trauma, and compared the TEG parameters between the two groups. Using logistic regression analysis and ROC curves, we identified the optimal prognostic factors and compared the platelet (PLT) count and mortality rate among those with different cut-off values.Results In comparison with the survival group, the death group showed a significant increase in the clot formation time (CFT) (3.2 \[2.2-4.8\] vs 5.2 \[5.0-9.8\] min, P45.65 mm (86 \[46-114\] vs 116 \[84-171\]×109/L, P<0.05), and mortality was remarkably higher in the former than in the latter group (31.8% vs 1.2%, P<0.05).Conclusion Among the TEG parameters, MA / maximal clot strength is a valuable indicator for the prognosis of trauma-induced coagulopathy, and MA<45.65 mm indicates early PLT dysfunction and poor prognosis.

Phased Expression of Gene and Protein of NogoA and NgR in Rats with Spinal Cord Injury and Time Window of Electroacupuncture / 中国康复理论与实践

Objective To investigate the phased expression of gene and protein of NogoA and its receptor (NgR) that affects axon growth of spinal cord injury (SCI), and to explore the time window effect of electroacupuncture on SCI rats. Methods A total of 144 female Sprague-Dawley rats were randomly assigned to sham operation group (group A, n=48) and model group (n=96). In the model group, Allen's method was used to establish SCI rats model, and they were further subdivided into model control group (group B, n=48) and electroacupuncture group (group C, n=48). Group C received electroacupuncture on Dazhui (GV14), Yaoyangguan (GV3), bilateral Ciliao (BL32) and Zu-sanli (ST36) with loose-tight wave, for 20 minutes every day, one day, seven days and 14 days after modeling. The rats at every interventional therapy time were randomly subdivided into two subgroups, which accepted sev-en or 14 days of treatment. Groups A and B were killed and the injured spinal cord tissue was extracted one day, three days, seven days, 14 days and 28 days after modeling, group C at the corresponding time. The hind limb motor function was assessed with BBB score before all of rats were killed. Four samples at every time in each group were randomly selected to detect the expression of mRNA and protein of NogoA and NgR at different stage of SCI using reverse transcription real-time quantitative polymerase chain reaction (RT-qPCR) and Western blotting. Results The BBB score began to increase 14 days after modeling, and significantly increased until 28 days after model-ing (P<0.05), compared with one day, three days and seven days after modeling in group B. The BBB score in-creased in group C than in group B at all the time points (P<0.05), except 14 days after electroacupuncture one day after modeling. The BBB score was higher as electroacupuncture intervening seven days and 14 days after modeling than that at one day after modeling in group C, and no significant difference was found between seven days and 14 days of treatment at either electroacupuncture time point (P>0.05). The expression of gene and pro-tein of NogoA and NgR in group B was in the increasing tendency after SCI, and was at the peak until 21 days af-ter modeling, and was higher in group B than in group A at each time point (P<0.01). The expression of gene and protein of NogoA decreased at all the time points in group C than in group B (P<0.05), except seven days of elec-troacupuncture intervening one day after modeling in the expression of NogoA mRNA (P>0.05). The expression of gene and protein of NogoA and NgR was lower as electroacupuncture intervening 14 days after modeling than one day after modeling in group C (P<0.05). There was no significant difference in the expression of gene and protein of NogoA and NgR between electroacupuncture intervening 14 days and seven days after modeling, and seven days and one day after modeling (P>0.05); as well as between seven days and 14 days of treatment at each time point (P>0.05). Conclusion Elerctroacupuncture could improve the hind limb motor function, which may associate with the inhibition of the expression of gene and protein of NogoA and NgR in injured spinal cord of rats after SCI. Elerctroacu-puncture is effective in the treatment of SCI at the early time, however, it is much better in the recovery stage.