Appraisal of existing evidences of competition law and policy: Bilateral legislative developments of Sino-Pak.

Developing nations use contemporary competition laws based on international models for reasons ranging from achieving international legitimacy to achieving domestic economic objectives. Although passing such laws gives these nations competition regimes more legitimacy, doing so does not guarantee that their economic goals will be met unless the laws are also effectively implemented. Comparative legal scholarship suggests that effective enforcement requires, among other things, a positive link between the passed laws and the nation's pre-existing legal systems in light of development economics. The globalization of national competition laws, particularly the application of international soft law, is responsible for the existence of modern competition law. Secondly, the competition regimes in Pakistan and China face a number of long-term difficulties, many of which are the product of globalization, which must be addressed as soon as possible. In order to examine the aims and objectives, this study employs qualitative data analysis. The results of this research suggest that for both nations to successfully implement competition law, innovation and unconventionality are required. Although the goal of competition law is to prevent anti-competitive activities and practices by promoting fair and open market competition, this goal is achieved through protecting consumers from businesses' use of unfair business practices. Because of this, the act encourages the formation of agreements that limit and restrict market dominance. In addition, the law specifies how investigations, acquisitions, mergers, penalties, leniency, and other aspects of law enforcement should be handled. As a result, this law can be seen as extremely important for regulating firms while maintaining consumer and producer welfare. It eventually supports economic growth and social justice. As a result, Voluntary adherence to competition law, rules, and regulations is essential since doing so would significantly lower the societal costs of enforcing the law.

Climate extremes drive the phenology of a dominant species in meadow steppe under gradual warming.

Plant phenology in terrestrial ecosystems, especially in the Northern Hemisphere, is expected to change owing to the projected increasing frequency and intensity of climate extremes in the context of global warming. Although such changes under mean climate change have been extensively reported in the literature, little is known about the impacts of climate extremes. In this study, climatic changes and their effects on plant phenology were characterized using long-term climatic and phenological data from the start and end of the growing season (SOS and EOS, respectively) from 2005 to 2020 for Stipa baicalensis, a dominant species in a temperate meadow steppe. The results showed that the temperature, including the mean and minimum temperatures, and extreme warm indices significantly increased; however, annual precipitation, and the frequency of extreme cold and precipitation events decreased. The SOS of S. baicalensis was initially earlier and later, whereas the EOS trended to be delayed. However, the growing season (LOS) was slightly prolonged. Compared with the indices under mean temperature, the pre-season (before SOS or EOS) minimum temperature dominantly affected SOS and EOS, whereas the mean and extreme precipitation slightly affected them. Furthermore, the findings showed that plant phenology responded to extreme temperatures quicker and stronger than mean temperatures. This study provides insight into how key extreme climatic factors could affect plant phenophases and improve and refine the phenological model. This could also be useful in enhancing grassland ecosystem management and sustainable development.

A multi-center observation of the therapeutic efficacy of Bencycloquidium bromide in the treatment of seasonal allergic rhinitis with predominant symptoms of rhinorrhea / 临床耳鼻咽喉头颈外科杂志

Objective:To observe the efficacy and safety of the M receptor antagonist Bencycloquidium bromide nasal spray in treatment of seasonal allergic rhinitis with runny nose as the main symptom. Methods:From August 2021 to September 2021, 134 patients with seasonal allergic rhinitis were enrolled in the otolaryngology Outpatient Department of Peking University Third Hospital, First Affiliated Hospital of Harbin Medical University and China-Japanese Friendship Hospital of Jilin University, including 71 males and 63 females, with a median age of 38 years. TNSS score and visual analogue scale（VAS） of total nasal symptoms were observed during 2 weeks of treatment with Bencycloquidium bromide nasal spray. Results:TNSS score decreased from （8.89±3.31） on day 0 to （3.71±2.51） on day 14（P<0.001）, VAS score of nasal symptoms decreased from （24.86±7.40） on day 0 to （6.84±5.94） on day 14（P<0.001）, VAS score of rhinorrhoea decreased from （6.88±2.06） on day 0 to （1.91±1.81） on day 14（P<0.001）. Rhinoconjunctivitis quality of life questionnaire（RQLQ） score decreased from （94.63±33.35） on day 0 to （44.95±32.28） on day 14（P<0.001）. The incidence of adverse reaction was low and no serious adverse events occurred during the whole experiment. Conclusion:Bencycloquidium bromide nasal spray has significant efficacy and good safety in the treatment of seasonal allergic rhinitis.

Application status of electrical stimulation and repetitive transcranial magnetic stimulation in postherpetic neuralgia / 中华皮肤科杂志

For the treatment of postherpetic neuralgia, drugs have always played a major but unsatisfactory role. As auxiliary or alternative therapies for postherpetic neuralgia, non-pharmacological interventions, such as electrical stimulation and repetitive transcranial magnetic stimulation, not only have shown favorable efficacy, but also can decrease adverse reactions to drugs with high safety and patient acceptance, and are benificial for management of patients with postherpetic neuralgia.

Knockdown of CXCL3-inhibited apoptosis and inflammation in lipopolysaccharide-treated BEAS-2B and HPAEC through inactivating MAPKs pathway

Background: CXCL3 (C-X-C motif chemokine ligand 3) is a member of chemokines family, which binds to the receptor to recruit neutrophils to lungs, thus participating in the pathogenesis of asthmatic lung. The role of CXCL3 in sepsis-induced acute lung injury is investigated here.Methods: Human lung epithelial cell line (BEAS-2B) and human pulmonary artery endothelial cell line (HPAEC) were treated with lipopolysaccharides (LPS). MTT and flow cytometry were performed to detect cell viability and apoptosis, respectively. Enzyme-linked immunosorbent assay (ELISA) and real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) were used to assess the levels of inflammatory factors.Results: Treatment with LPS resulted in the decrease of cell viability in BEAS-2B and HPAEC. CXCL3 was particularly upregulated in LPS-treated BEAS-2B and HPAE cells. Knockdown of CXCL3 enhanced viability and suppressed apoptosis i006E LPS-treated BEAS-2B and HPAE cells. Knockdown of CXCL3 also upregulated TNF-α, I L-1β, and IL-18 in LPS-treated BEAS-2B and HPAE cells. Moreover, knockdown of CXCL3 suppressed the activation of mitogen-activated protein kinases (MAPKs) signaling in LPS-treated BEAS-2B and HPAE cells through downregulation of p-ERK1/2, p-p38, and p-JNK. On the other hand, overexpression of CXCL3 caused completely opposite results in LPS-treated BEAS-2B and HPAE cells.Conclusion: Knockdown of CXCL3 exerted antiapoptotic and anti-inflammatory effects against LPS-treated BEAS-2B and HPAE cells, at least partially, through inactivation of MAPKs signaling, suggesting a potential strategy for the intervention of sepsis-induced acute lung injury (AU)

Preventive and therapeutic effects of common plant drugs on colon cancer and its mechanism / 国际肿瘤学杂志

It is shown that phytochemicals have a protective effect on colon cancer. Curcumin, polysaccharides (apple polysaccharides, mushroom glucans), saponins (paridis saponins, ginsenosides), resveratrol, quercetin and other plant drugs can inhibit colon cancer cell proliferation and promote cell apoptosis through different signaling pathways. In addition, it also has anti-inflammatory, antioxidant, anti-angiogenesis, reduce the toxic side effects of chemotherapy drugs, and reverse the drug resistance of tumor cells. Understan-ding the prevention and cure effect of plant medicine on colon cancer and its possible mechanism can provide more theoretical basis and therapeutic ideas for the clinical prevention and cure of colon cancer.

Association between family factors with dietary behaviors of left-behind children in rural China / 中国学校卫生

Objective@#To find out the association between family factors and left-behind children’s dietary behaviors in rural China.@*Methods@#This cross-sectional study was implemented in four counties of medium economic level were selected in Guizhou and Anhui province and four primary schools were chosen in each county and in total 16 schools were involved. Three classes from grades 5 and 6 each were selected randomly from included primary schools; all students in these classes, as well as their caregivers, were invited to participate. Self-designed questionnaire was adopted to collect intake frequencies of vegetable, fruit, meat, egg, milk, drink and fast food. Scores were calculated to evaluate these behaviors frequencies and multi-linear regression was used to explore the association between family factors and behavioral scores.@*Results@#The proportion of fruit, eggs and milk intake more than 4 times once a week in left-behind children were 44.9%, 35.1%, and 28.5%, while they were 57.2%, 38.5%, and 38.1% in non-left-behind children. It was found that statistical significant differences existed between scores of dietary behaviors of leftbehind children’s and non-left-behind children(t=-5.83, P<0.01). The results of multi-linear regression demonstrated that family cohesion (β=0.07, P=0.05) and caregivers’ behaviors (β=0.49, P<0.01) were protective factors for left-behind children’s behaviors, while taking care by single left-behind fathers was a risk factor(β=-1.21, P=0.03).@*Conclusion@#Primary caregivers play a critical role in offering guidance to children to help them develop health behaviors.

Effect of self-made traditional Chinese medicine decoction on pregnancy outcome in patients with hypertensive disorder complicating pregnancy / 中国中西医结合急救杂志

Objective To investigate the effect of self-made traditional Chinese medicine(TCM) decoction on pregnancy outcome in patients with hypertensive disorder complicating pregnancy. Methods A total of 124 pregnant hypertensive patients admitted to the Department of Critical Care of Guizhou Provincial People's Hospital from October 2016 to October 2018 were enrolled. The 62 patients who were treated with western medicine conventional method;62 patients who were treated with self-made TCM decoction on the basis of western medicine conventional method. The western medicine conventional treatment group was given magnesium sulfate combined with nicardipine; the self-made TCM treatment group was supplemented with TCM decoction on the basis of conventional western medicine treatment (composition: uncaria, raw oyster 20 g, gastrodia elata, eucommia, salvia miltiorrhiza, medlar rehmannia glutinosa each 15 g, rhizoma, mulberry parasitic, astragalus, ophiopogonis each 10 g. Severe headache and dizziness plus tortoise shell, gentian grass 15 g, anemarrhenae 10 g; severe edema plus cassia twig, aristolochiae 15 g, astragali, ginger skin 10 g), be decocted in water for oral dose, morning and evening oral, one dose a day, 1 week for a course of treatment, the two groups were continued for 4 weeks after the evaluation of clinical efficacy. The changes of blood pressure and blood coagulation parameters, placental bed arterial hemodynamics, pregnancy outcome index were observed before and after treatment; antihypertensive effects and adverse reactions after treatment were recorded. Results After treatment, the systolic blood pressure (SBP), diastolic blood pressure (DBP), Fibrinogen (Fib), placental bed arterial pulsation index (PI), end-systolic blood flow velocity and end-diastolic blood flow velocity ratio (S/D) and resistance index (RI) in both groups were lower than those before treatment, the prothrombin time (PT) and activated partial thromboplastin time (APTT) were significantly longer than before treatment, and the time-averaged flow rate (TAV) increased than that before treatment; SBP, DBP, Fib, PI, S/D and RI were significantly lower in self-made TCM treatment group than those in western medicine conventional treatment group [SBP (mmHg, 1 mmHg = 0.133 kPa): 114.26±17.07 vs. 132.72±17.64, DBP (mmHg): 82.98±6.24 vs. 90.09±6.48, Fib (g/L): 3.21±0.45 vs. 3.64±0.31, PI: 0.59±0.14 vs. 0.75±0.15, S/D: 1.70±0.21 vs. 1.93±0.25, RI: 0.43±0.08 vs. 0.54±0.12, all P < 0.05], PT, APTT, TAV in self-made TCM treatment group were significantly higher than western medicine conventional treatment group [PT (s): 12.26±0.57 vs. 11.72±0.44, APTT (s): 27.11±1.34 vs. 25.69±1.48, TAV (cm/s): 15.64±2.88 vs. 12.49±2.76, all P < 0.05]. The rate of cesarean section, postpartum hemorrhage, fetal heart abnormality and neonatal asphyxia in self-made TCM treatment group were significantly lower than those in western medicine conventional treatment group [cesarean section rate: 9.84% (6/61) vs. 27.78% (15/54), postpartum hemorrhage rate: 1.64% (1/61) to 14.81% (8/54), fetal heart abnormal rate: 3.28% (2/61) vs. 16.67% (9/54), the incidence of neonatal asphyxia: 1.64% (1/61) vs. 12.96% (7/54), all P < 0.05]. The total effective rate of the self-made TCM treatment group was significantly higher than that of western medicine conventional treatment group [98.39% (61/62) vs. 87.10% (54/62), P < 0.05]. However, there was no significant difference in the incidence of adverse reactions between the self-made TCM treatment group and western medicine conventional treatment group [16.39% (10/61) vs. 16.67% (9/54), P > 0.05]. Conclusion Self-made TCM decoction can improve the maternal and infant outcomes by improving the hypercoagulable state and placental hemodynamics in hypertensive patients with hyperthyroidism, the antihypertensive effect is remarkable and the safety is good.

The value of measuring cysC, β2-microglobulin and neutrophil gelatinase-associated lipocalin as a test panel for detection of early renal damage in lung cancer patients receiving chemotherapy / 中华老年医学杂志

Objective To compare the value of serum cystatin C (CysC),urine β2-microglobulin (β2-MG),and neutrophil gelatinase-associated lipocalin (NGAL) as a test panel with that of traditional indicators,serum Cr and urea,for detection of early renal damage in lung cancer patients after chemotherapy.Methods This prospective study collected data at our hospital on levels of serum cystatin C (CysC),urine β2-microglobulin (β2-MG),and neutrophil-gelatinase associated lipocalin (NGAL) from 63 lung cancer patients aged 60 and over.In addition,levels of traditional indicators including serum Cr and urea were also measured.Participants were divided into three groups:a prechemotherapy group,an under chemotherapy group,and a post-chemotherapy group.Results Levels of serum CysC,urine β2-MG,and NGAL in the post-chemotherapy group markedly increased,whereas levels of serum Cr and urea had no significant increase;furthermore,levels of serum CysC,urine β2-MG,and NGAL went up steadily as the time of exposure to chemotherapy drugs increased.Pearson's test showed that the sensitivity of CysC,beta 2-MG and NGAL as a panel was statistically significant for both the under chemotherapy group and the post-chemotherapy group (x2 =31.32,P=0.00;x2 =60.38,P=0.00).Conclusions Serum CysC,urine β2-MG and NGAL as a panel have good diagnostic value for early renal function damage in lung cancer patients after chemotherapy and are superior to traditional renal function indicators such as serum creatinine and urea.

Changes of white matter in LDLR knockout hypercholesterolemic rats / 国际脑血管病杂志

Objective To investigate the difference between histopathological changes of brain white matter in low-density lipoprotein receptor (LDLR) homozygous mutation rats with hypercholesterolemia and wild-type rats.Methods Thirty LDLR-/-rats and 28 wild-type rats were selected.Plasma cholesterol levels were measured by enzyme-linked immunosorbent assay at 15,18 and 26 weeks old respectively.The axonal structure of the corpus callosum area was observed by transmission electron microscopy.The myelin basic protein (MBP) of the corpus callosum area was quantitatively analyzed by Western blotting.In addition,at 26 weeks old,the myelin sheaths were stained by fast blue staining.The expression level of MBP in white matter was further detected by immunofluorescence staining,and the morphological changes of glial cells were observed.Results Compared with the wild-type rats,the plasma cholesterol concentration in LDLR-/-rats increased significantly,and it could be as high as 3.3 times at 26 weeks.The results of electron microscopy showed that the LDLR-/-rats had axonal injury at 15 weeks and aggravated gradually over time.At 26 weeks,Western blot analysis of the LDLR-/-rats showed that the MBP expression level of the corpus callosum area decreased significantly.Fast blue staining showed loosening of nerve fibers,diffuse vacuole formation,and myelinated nerve fiber loss in the corpus callosum area.In addition,it was also found that the number of oligodendrocytes in LDLR-/-rats was significantly reduced,and large numbers of astrocytes and microglia were activated.Conclusions LDLR-/-rats will have spontaneous hypercholesterolemia.Axonal injury,demyelination,decreased oligodendrocytes,as well as the abnormal activation of astrocytes and microglia are present in the early adult brain white matter area.

Effects of iron and calcium carbonate on the variation and cycling of carbon source in integrated wastewater treatments.

Iron and calcium carbonate were added in wastewater treatments as the adjusting agents to improve the contaminant removal performance and regulate the variation of carbon source in integrated treatments. At different temperatures, the addition of the adjusting agents obviously improved the nitrogen and phosphorous removals. TN and TP removals were respectively increased by 29.41% and 23.83% in AC-100 treatment under 1-day HRT. Carbon source from dead algae was supplied as green microbial carbon source and Fe2+ was supplied as carbon source surrogate. COD concentration was increased to 30mg/L and above, so the problem of the shortage of carbon source was solved. Dead algae and Fe2+ as carbon source supplement or surrogate played significant role, which was proved by microbial community analysis. According to the denitrification performance in the treatments, dead algae as green microbial carbon source combined with iron and calcium carbonate was the optimal supplement carbon source in wastewater treatment.

Evaluation of efficacy and safety of different doses Octreotide combined with Lansoprazole in the treatment of hepatocirrhosis with upper gastrointestinal bleeding / 药物评价研究

Objective To evaluate the efficacy and safety of different doses Octreotide combined with Lansoprazole in the treatment of hepatocirrhosis with upper gastrointestinal bleeding.Methods Eighty hepatocirrhosis patients with upper gastrointestinal bleeding during May.2013 to May.2016 were treated with Octreotide combined with Lansoprazole,and were divided into high dose group (40 cases) and low dose group (40 cases) according to different doses Octreotide.Before and after treatment,portalvenousmaximumvelocity (PVV) and portalveindiameter (PVD) were detected by color Doppler ultrasound respectively,and haemostatic time,blood transfusion cases and volume,rehaemorrhagia cases were recorded,and adverse reactions were observed.Results After treatment,PVV and PVD of the two groups were significantly ameliorative (P ＜ 0.05),and there were no significantly different between two groups.Haemostatic time,blood transfusiorate,blood transfusiorate volume and rehaemorrhagia rate of the high dose group were significantly less than the low dose group (P ＜ 0.05).The clinical effective rate of the high dose group was significantly higher than that of the low dose group (P ＜ 0.05).The rate of adverse reactions of the high dose group was not significantly different from that of the low dose group.Conclusions High doses Octreotide combined with Lansoprazole in the treatment of hepatocirrhosis with upper gastrointestinal bleeding have a gain on hemostatic effect,and cannot increase adverse reactions significantly.

Association between tongue coating thickness and clinical characteristics among idiopathic membranous nephropathy patients.

ETHNOPHARMACOLOGICAL RELEVANCE: Tongue coating diagnosis is a useful tool to examine the changes of a human body in Chinese Medicine. Tongue coating varies in thickness in kidney disease. However, little information exists regarding the association between clinical characters and tongue coating thickness in CKD patients. AIM OF THE STUDY: This study was carried out to determine whether there is an association between tongue coating thickness and laboratory, histological variables in idiopathic membranous nephropathy patients: one group with thin tongue coating, the other with thick tongue coating. MATERIALS AND METHODS: During July 2012-March 2014, idiopathic membranous nephropathy patients(CKD 1-2 stage) with tongue coating thickness Score ≤7, or ≥11, were enrolled as thin tongue coating group or thick tongue coating group, from Hangzhou Hospital of TCM. Laboratory variables (Hemoglobin (Hb), albumin (Alb); eGFR; alanine transferase (ALT); aspartate aminotransferase (AST); triglyceride (TG); total cholesterone (TC); high density lipoprotein (HDL); low density lipoprotein (LDL); immunoglobin A, G, M; Complement 3, 4) and renal histological data (glomerular lesions; tubular-interstitial damage) were compared, between these two groups. RESULTS: 12 idiopathic MN patients (CKD 1-2 stage) with thin tongue coating (tongue coating thickness score ≤7) and 11 with thick tongue coating (tongue coating thickness score ≥11) were enrolled in our study. We found a significant lower level of TC and LDL, a significant lower level of AST, ALT in those thick tongue coating patients, compared with thin. No significant difference was observed in pathological lesion between thick and thin tongue coating patients. CONCLUSION: Tongue coating thickness is associated with lipid metabolism in idiopathic MN patients (CKD 1-2 stages).

Late-course and concurrent radiochemotherapy for advanced esophageal carcinoma / 中国医师进修杂志

Objective To compare the efficacy and toxicity of late-course concurrent radiochemotherapy and sequential chemoradiotherapy for advanced esophageal carcinoma. Methods Eighty-two patients with advanced esophageal carcinoma were randomized into two groups: 41 cases in late-course concurrent radiochemotherapy (LCRC) group were received two cycles chemotherapy and then underwent concurrent radiochemotherapy;41 cases in sequential chemoradiotherapy (SCR) group were received four cycles chemotherapy and then underwent radiotherapy. The regimen of chemotherapy in all cases:cisplatin 25mg/m2, 1-3 d;calcium folinate (CF) 150 mg/m2, 1-5 d;fluorouracil 375 mg/m2, 1-5 d, 21 d was one cycle. All patients were received the three-dimensional conformal radiation therapy, the total dose of radiation was same as 64 Gy. Results The short-term response rate was 85.4%(35/41) in LCRC group and 65.9%(27/41) in SCR group, they had significant difference ( P0.05). The l year, 2 years, 3 years survival rate were 68.3%(28/41) and 65.9%(27/41), 56.1%(23/41) and 51.2%(21/41), 46.3%(19/41) and 36.6%(15/41) respectively,the median survival time were 30.0 months and 26.0 months, there had no significant difference ( P>0.05). Conclusion The short-term efficacy of advanced esophageal carcinoma could be improved by the late-course concurrent radiochemotherapy.

Effect of stanozolol on the nitrogen balance,grip strength and clinical outcomes of critical patients with high nutrition risk / 重庆医学

Objective To investigate the effect of stanozolol on nitrogen balance ,grip strength and clinical outcomes of criti‐cal patients with high nutrition risk .Methods We enrolled patients who were admitted to the ICU of Guizhou provincial Hospital during the time period from January 2014 to June 2014 and ,as patients with high nutrition risk .Patients ,who received same base nutritional support program ,were divided into two groups .Treatment group who were treated with stanozolol administrated with gastric or jejunal tube for 7 days by 4 mg Tid .The control group whose members underwent placebo simultaneously with the treat‐ment group .The nitrogen balance ,grip strength of both groups was measured when at admitted and 4th as well as 7th day .Prealbu‐min ,total bilirubin ,alanine aminotransferase ,and aspartate aminotransferase were measured when at the same time and before leave hospital .The duration of the mechanical ventilation ,ICU stays ,hospital stays and mortality within 28 days were recorded .Results There was no statistical significance in the differences between all the indicators of the two groups at admission(P>0 .05) .The du‐ration of mechanical ventilation ,ICU stays ,hospital stays were decreased significantly in the treatment group (P0 .05) .Nitrogen bal‐ance ,prealbumin ,grip strength and liver function parameters in the treatment group were significantly higher than they were been at admitted and control group at 4th and 7th day (all P<0 .05) .Liver function parameters of treatment group gradually decreased to the normal range before discharge .Conclusion In critically ill patients treated with anabolic steroid stanozolol ,can promote protein synthesis ,reduce muscle and other lean tissue decomposition ,improve clinical symptoms ,short the length of hospital stay and ICU stay .But we should pay more attention on liver function in critically ill patients who treated with stanozolol .

Therapeutic effect of nicorandil for treatment of patients with acute respiratory distress syndrome / 中国中西医结合急救杂志

Objective To investigate the clinical effect of nicorandil for treatment of patients with acute respiratory distress syndrome (ARDS).Methods A prospective randomized controlled trial was conducted. A total of 40 cases of patients with ARDS admitted to Department of Critical Care Medicine of Guizhou Provincial People's Hospital from October 2012 to October 2014 were enrolled, and they were randomly divided into two groups, 20 cases in each group. The two groups were treated with routine western medicine after admission. On this basis, the observation group was given nicorandil 10 mg, while the control group was given warm boiled water 10 mL, through gastric tubes 3 times a day, the therapeutic course being consecutive 5 days in both groups. The length of stay in intensive care unit (ICU), duration of mechanical ventilation after treatment, oxygenation index (OI), alveolo-arterial oxygen partial pressure difference (PA-aO2), positive end-expiratory pressure (PEEP), acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, Glasgow coma score (GCS) before and after treatment, the predicted death rate (PDR) and 28-day mortality were compared between the two groups. The predicitive factors for 28-day mortality were screened by binary logistic analysis.Results The length of stay in ICU and duration of mechanical ventilation of control group were longer than those of observation group, but the difference was not statistically significant [ICU length of stay (day): 14.55±12.71 vs. 9.15±6.00, duration of mechanical ventilation (day): 13.25±12.27 vs. 7.75±5.32, bothP > 0.05]. After treatment, the GCS was higher than that before treatment in control group and observation group (11.95±3.98 vs. 10.75±4.89, 12.95±3.67 vs. 12.20±4.56), while APACHE Ⅱ score, PDR and PEEP were all lower than those before treatment [APACHE Ⅱ: 21.05±8.58 vs. 24.90±5.63, 18.70±11.21 vs. 26.65±7.67; PDR: (47.71±29.49)% vs. (61.00±23.29)%, (36.79±18.49)% vs. (56.12±18.16)%; PEEP (cmH2O, 1 cmH2O = 0.098 kPa): 4.40±3.14 vs. 5.75±2.59, 3.80±2.55 vs. 7.55±3.32], but there were no statistically significant differences between the two groups before and after treatment (allP > 0.05). After treatment, the OI was significantly higher and the PA-aO2 was significantly lower than those before treatment in the two groups, and the degrees of improvement of the observation group were more remarkable than those of the control group [OI (mmHg, 1 mmHg = 0.133 kPa): 224.72±85.12 vs. 141.37±45.82, PA-aO2 (mmHg): 132.60±46.64 vs. 204.30±121.2, bothP 0.05). Binary logistic regression analyses showed that the PA-aO2 [odds ratio (OR) = 0.958,P = 0.013, 95% confidence interval (95%CI) = 0.927 - 0.991], APACHE Ⅱ score (OR = 0.882,P = 0.010, 95CI = 0.803 - 0.970), GCS (OR = 1.399, P = 0.004, 95%CI = 1.111 - 1.761) and PDR (OR = 0.907,P = 0.002, 95%CI = 0.853 - 0.965) after treatment were the independent predictors of 28-day mortality.Conclusion Nicorandil can significantly improve oxygenation, but cannot reduce 28-day mortality in patients with ARDS.

Protective effects of grape polyphenol on pancreatic tissues of mice with caerulein-induced acute pancreatitis / 中国病理生理杂志

AIM:To investigate the effects of grape polyphenol ( GP) on caerulein-induced acute pancreatitis (AP) in mice.METHODS:Two-month-old female mice of ICR strains (n=21) were randomly divided into 3 groups:normal control ( NC) group, AP group, and GP-treated AP group.Before AP induction, the mice in GP-treated AP group were continuously administrated with 1.5 g/kg GP aqueous solution by gavage for 7 d, while those in NC group and AP group were treated with saline as a vehicle control.On the 7th day, the mice in AP group and GP-treated AP group were in-traperitoneally injected with caerulein (50μg/kg) in 1 h interval for 7 serial injections in total.The mice in NC group were treated with saline according to the same procedure in experimental group.All the mice were sacrificed 24 h after AP induc-tion, and the pancreatic tissues and lung tissues were harvested for further investigation of the pathological changes, macro-phages infiltration, myeloperoxidase ( MPO ) activity and expression of inflammatory and oxidative stress factors.RE-SULTS:Compared with AP group, the mice in GP-treated AP group showed milder morphological changes and lower path-ological scores, including the scores of edema, inflammation and vacuolization (P<0.05), but the necrosis scores and to-tal scores showed no statistical difference between these 2 groups.Besides, the mice in GP-treated AP group had fewer macrophage infiltration, lower lung MPO activity (P<0.01), and lower expression of inflammatory factors, tumor necrosis factor α(TNF-α)and monocyte chemotactic protein 1 (MCP-1) (P<0.05), and oxidative stress factors, superoxide dis-mutase (SOD)-1, SOD-2 and NADPH oxidase 2 (NOX-2) (P<0.01).CONCLUSION:Grape polyphenol has remark-able protective effect on pancreatic tissues of mice with caerulein-induced acute pancreatitis, and the mechanisms may be related to down-regulation of inflammatory and oxidative stress factors.

Comparison of different stylet angulation and endotracheal tube camber on time to intubation with the Tosight?? / 临床麻醉学杂志

Objective To compare the effect of different stylet angulation and endotracheal tube camber on time to intubation with Tosight?? video laryngoscope.Methods One hundred and twenty patients of 18 to 55 years old,ASA Ⅰ or Ⅱ,with no difficult airway signs and history,were random-ized into three groups with different endotracheal tube bending angle:group A(angle 40°),group B (angle 60°)and group C(angle 80°).For patients in all three groups,after rapid sequence induction, the Tosight?? oral intubation were applied.The Cormack-Lehane grading,glottic exposure time, times of tracheal intubation,hemodynamic response and complications were recorded.Results Tra-cheal intubation with the Tosight were successfully completed for all three groups.The success rate of first time intubation in groups A,B and C were 37 (92.5%),39 (97.5%)and 40(100.0%),respec-tively.3 patients in group A and 1 patient in group B finished the intubation with the second try after the stylet angle was changed.The mean time to glottic exposure had no significant difference in groups A,B and C.The time to complete tracheal intubation in group C was significantly shorter than that in groups A and B (P < 0.05 ).There was no significant hemodynamic changes for all three groups,and no serious complications were detected.Conclusion When the Tosight?? is used for adult endotracheal intubation 40°,60°,80°angled stylets can all well assist endotracheal intubation.Among which 80°angled slylet has obvious advantages in intubation success rate and shortest intubation time.

Effects of intramuscular and oral mecobalamin in elderly patients with vitamin B12 deficiency / 中国综合临床

Objective To investigate the effect of intramuscular and oral mecobalamin on hematologic markers and neurologic signs in elderly patients with vitamin B12 deficiency.Methods One hundred and twenty-six patients with vitamin B12 deficiency who fulfilled the inclusion criteria were randomly divided into 3 groups,42 cases in each,including the intramuscular group (to receive mecobalamin therapy intramuscularly),the oral group ( to receive mecobalamin therapy orally) and the control group ( without mecobalamin therapy).The changes of hematologic markers including hemoglobin (Hb,g/L),mean corpuscular volume (MCV,fl),serum levels of vitamin B12 (ng/L),folate and total homocysteine (Hcy,μmol/L),and neurological signs before and after treatment were compared among these groups.Results Baseline characteristics among the three groups were similar.After a 6-month therapy,there were no differences in any markers in control group patients in comparison to baseline;for patients in the intramuscular group,the blood vitamin B12 levels increased from (139.13 ± 31.57)ng/L to (328.10 ± 42.35 )ng/L (P ＜ 0.001 ).Hcy levels decreased from (36.29 ± 16.23 )μmol/L to ( 18.23 ± 9.85 ) μmol/L ( P ＜ 0.001 ).Hb rose from ( 125.34 ± 16.21 ) g/L to ( 132.79 ± 15.98 )g/L (P =0.037).MCV reduced from (92.98 ±5.35)fl to (87.65 ±5.74)fl (P ＜0.001 ) ;For patients in the oral administration group,the blood vitamin B12 levels increased from ( 138.19 ± 29.95) ng/L to (487.79 ±32.21 ) ng/L ( P ＜ 0.001 ).Hcy levels decreased from ( 33.27 ± 11.51 ) μmol/L to ( 17.49 ± 10.13 ) μmol/L( P ＜ 0.001 ).Hb rose from ( 125.89 ± 17.65 ) g/L to ( 133.46 ± 16.26) g/L ( P =0.041 ).MCV reduced from (93.08 ± 5.10 ) fl to ( 89.29 ± 5.37 ) fl ( P =0.001 ).After the 6-month therapy,there were somewhat improvement in MMSE scores of the intramuscular ( 28.24 ± 3.89 vs.27.85 ± 3.56,P =0.633 ) and the oral groups (27.97 ± 3.77 vs.27.34 ± 3.15,P =0.408 ) compared with baseline,but the differences were not significant.The achilles tendon reflex of the intramuscular ( 1.86 ± 0.67 vs.1.56 ± 0.61,P =0.035 ) and the oral groups ( 1.79 ± 0.64 vs.1.43 ± 0.51,P =0.006 ) were enhanced compared with baseline.Foot vibration sensation of the intramuscular ( 1.35 ± 0.37 vs.1.06 ± 0.41,P =0.001 ) and the oral groups ( 1.24 ± 0.52vs.1.01 ± 0.43,P =0.03) were improved compared with baseline.After treatment,the serum VitB12 concentration in the oral group were higher than that of the intramuscular group ( P ＜ 0.001 ).There were no significant differences in other indexes between the two groups.Conclusion Mecobalamin,administered either intramuscularly or orally,may improve the hematologic markers and neurologic signs in elderly patients with vitamin B12 deficiency.