Ventilatory pressure parameters impact the association between acute gastrointestinal injury and all-cause mortality in mechanically ventilated patients.

Acute gastrointestinal injury (AGI) is common in mechanically ventilated (MV) patients, but the potential association between ventilatory pressure parameters and AGI grade and their impact on mortality remains unclear. This study aimed to explore the association between ventilatory pressure parameters and AGI grade, and their interaction on all-cause mortality in MV patients. This study was a secondary analysis of a multicenter, prospective, observational study that enrolled adult patients with an expected duration of mechanical ventilation ≥ 48 h from 14 general intensive care units in Zhejiang Province between March and August 2014. The AGI grade was assessed daily on the basis of gastrointestinal symptoms, intra-abdominal pressures, and feeding intolerance in the first week of admission to the ICU. This study included 331 patients (69.2% men; mean age, 64.6 ± 18.9 years). Multivariate regression analysis showed that plateau pressure (Pplat) (OR 1.044, 95% CI 1.009-1.081, P = 0.013), serum creatinine (OR 1.003, 95% CI 1.001-1.006, P = 0.042) and APACHE II score (OR 1.035, 95% CI 1.021-1.072, P = 0.045) were independently associated with global AGI grade III/IV within 7 days of ICU admission. Moreover, global AGI grade (HR 2.228, 95% CI 1.561-3.182, P < 0.001), serum creatinine (HR 1.002, 95% CI 1.001-1.003, P = 0.012) and APACHE II score (HR 1.039, 95% CI 1.015-1.063, P = 0.001) were independently associated with 60-day mortality. In addition, there were significant (Pint ≤ 0.028) interactions of Pplat and DP with AGI grade in relation to 60-days mortality, whereas no interaction (Pint = 0.061) between PEEP and AGI grade on 60-days mortality was observed. In the presence of Pplat ≥ 19 cmH2O, the patients with AGI grade III/IV had 60-day mortality rate of 72.2%, significantly higher than those with AGI grade I/II (48.7%, P = 0.018), whereas there were no significant differences (27.9% vs. 33.7%, P = 0.39) in 60-days mortality between AGI grade I/II and III/IV among the patients with Pplat < 19 cmH2O. In comparison with Pplat, DP had a similar interaction (Pint = 0.028) with AGI grade on 60-day mortality. Ventilatory pressure parameters (Pplat and DP) are independent risk factors of AGI grade III/IV. Pplat and DP interact with AGI grade on 60-days mortality, highlighting the importance of optimizing ventilatory pressure parameters to improve gastrointestinal function and survival outcomes of MV patients.Trial registration: ChiCTR-OCS-13003824.

MicroRNA in acute kidney injury due to sepsis / 中国综合临床

Sepsis is a life-threatening clinical syndrome characterized by organ dysfunction caused by dysregulation of the body's immune response to infection, and is the primary cause of acute kidney injury in critically ill patients. Sepsis induced AKI (S-AKI) is a common clinical critical illness with a high mortality rate and is closely associated with the clinical outcome of critically ill patients. At present, the clinical diagnosis of AKI is still based on the traditional indicators such as serum creatinine and urine output, but it is easily interfered by age, gender, drugs and other factors, and cannot accurately and sensitively reflect the renal damage of patients, so that some AKI patients lose the best time for treatment. Therefore, some biomarkers with strong sensitivity and high specificity are urgently needed in the clinic to help the diagnosis of AKI, so as to take active therapeutic measures to alleviate the prognosis of AKI.Numerous studies have shown that microRNAs (miRNAs) are involved in the development of S-AKI. Therefore, miRNAs can not only be early diagnostic markers of S-AKI, but also have important potential value for the treatment and prognosis of S-AKI. In this paper, we review the potential value of miRNA for the diagnosis, prognosis and treatment of S-AKI.

Study of CT dual-low technology angiography in patients with stroke / 中国现代医生

Objective This study focused on the low voltage and low concentration contrast agent technology in vascular imaging of stroke patients.Methods Totally144 patients of ischemic stroke confirmed from January 2022 to January 2023 were enrolled.They were divided into four groups according to different imaging methods:conventional group(tube voltage 120kV,iodine concentration 370mgI/ml),low voltage group(tube voltage 80kV,iodine concentration 370mgI/ml),low concentration group(tube voltage 120kV,iodine concentration 320mgI/ml)and dual-low group(tube voltage 80kV,iodine concentration 320mgI/ml),the post-processing technology adopted ASiR algorithm for 3D reconstruction.Then to compare contrast signal-to-noise ratio(CNR)and signal-to-noise ratio(SNR)of the reconstructed image,image quality score,CT values of internal carotid artery(ICA),anterior cerebral artery(AA)A1,middle cerebral artery(MA)M1,posterior cerebral artery(PA)P1,vertebral artery(VA)and basilar artery(BA),mean iodine intake and radiation dose parameters including volume CT dose index(CTDIvol)and dose length product(DLP).Results The CNR and SNR values in dual-low group were significantly less than the other three groups(P<0.05),while image quality score and CT value of each artery were no differences among the four groups(P>0.05).What's more,CTDIvol,DLP and iodine intake volume in dual-low group were significantly less than the others(P<0.05).Conclusion The dual-low technology scanning could obtain satisfactory head and neck CT angiography for stroke patients.

Research progress on influence of PM2.5 on allergic rhinitis / 环境与职业医学

Allergic rhinitis (AR) is one of the main chronic inflammatory diseases that pose a global threat. Its symptoms persist for a long time, recur, and seriously affect the physical and mental health of the patients. Existing research has shown that the occurrence and development of AR are related to genetic and environmental factors. In recent years, the harm of air pollution to human health has received increasing attention, and fine particulate matter (PM2.5) is the main harmful component of air pollutants. Its small particle size makes it easy to absorb various harmful substances, enter the respiratory tract, damage the nasal mucosa, and participate in the occurrence and development process of AR. At present, a large number of epidemiological studies have confirmed that PM2.5 is positively related to the incidence rate and severity of symptoms of AR, but its exact mechanism is still unclear. Therefore, studying the mechanism of PM2.5 exposure on AR damage is expected to provide new clues for exploring the pathogenesis and deterioration of AR. This article reviewed the epidemiological studies and toxicological mechanisms of PM2.5 exposure and AR in recent years; discussed the potential biological mechanisms of PM2.5 induced AR occurrence and development, including nasal mucositis damage, oxidative stress, and immune damage. Furthermore, a new research direction was proposed, which suggested that neuroimmune disorders and bacterial imbalance may be involved in the progression of AR and play a certain role in the toxic effects induced by PM2.5. We aim to provide ideas and a theoretical basis for developing effective measures to prevent and treat AR.

Research progress on effects and mechanisms of short-term exposure to ambient fine particulate matter and its components on blood pressure / 环境与职业医学

Elevated blood pressure is one of the major contributors to cardiovascular disease and premature death. The exposure to ambient fine particulate matter (PM2.5) is closely associated with changes in blood pressure, and even short-term exposure to PM2.5 can lead to an increase in blood pressure. PM2.5 is a complex mixture that exerts different toxicities and triggers increased blood pressure through various mechanisms. Therefore, in this article, we provided a comprehensive review of published studies on the effects of short-term exposure to PM2.5 and its components on blood pressure, and elaborated potential mechanisms from four aspects, including oxidative stress and inflammatory response, endothelial dysfunction, autonomic nervous system disorders and hypothalamus-pituitary-adrenal axis activation, and epigenome alteration. Given the limitations of existing research, future prospective studies can be conducted on diverse populations, using more precise exposure measurement methods and multi-omics approaches, to further elucidate the mechanisms underlying the effects of PM2.5 and its various components on blood pressure. The findings would provide a theoretical foundation for effective protection of public health, particularly vulnerable groups.

CTRP6 suppresses neutrophil extracellular traps formation to ameliorate sepsis-induced lung injury through inactivation of ERK pathway

extracellular traps formation contributes to inflammatory lung injury in sepsis. C1q/tumor necrosis factor–related protein-6 (CTRP6) is a paralog of adiponectin and exerts anti- inflammatory and antioxidant properties. The role of CTRP6 in sepsis-associated inflammatory lung injury was investigated in this study. Methods: Mice were injected with lipopolysaccharides (LPS) intraperitoneally to establish the mouse sepsis model. They were first tail-vein injected with adenovirus-mediated overexpression CTRP6 (Ad-CTRP6) and then subjected to the LPS injection. Pathological changes in lungs were detected by hematoxylin and eosin staining. Inflammation cytokine levels in bronchoalveolar lavage fluid were assessed by qRT-PCR and ELISA. Flow cytometry was used to detect the number of neutrophils in bronchoalveolar lavage fluid, and immunofluorescence was performed to assess neutrophil extracellular traps. Results: Lipopolysaccharides induced pulmonary congestion, interstitial edema, and alveolar wall thickening in the lungs, as well as upregulated lung histology score and wet/dry weight ratio. CTRP6 was reduced in lung tissues of septic mice. Injection with Ad-CTRP6 ameliorated extensive histopathological changes in LPS-induced mice and decreased lung histology score and wet/dry weight ratio. Overexpression of CTRP6 reduced the levels of TNF-α, IL-6, and IL-1β in septic mice. Injection with Ad-CTRP6 also decreased the number of neutrophils and downregulated Cit-H3 and myeloperoxidase polymers in septic mice. Protein expression of p-ERK in septic mice was reduced by overexpression of CTRP6. Conclusion: CTRP6 attenuated septic lung injury, exerted anti-inflammatory effect, and suppressed neutrophil extracellular traps formation against sepsis through inactivation of extracellular signal-regulated kinase signaling (AU)

Clinical research progress of Traditional Chinese Medicine treating precancerous lesions of gastric cancer with syndrome differentiation / 国际中医中药杂志

Traditional Chinese Medicine (TCM) has certain advantages in the treatment of precancerous lesions of gastric cancer (PLGC) based on the holistic concept and the thought of syndrome differentiation. Currently, it is generally divided into 6 kinds of syndromes: liver and stomach qi stagnation syndrome, liver and stomach heat stagnation syndrome, spleen and stomach weakness syndrome (including spleen and stomach qi deficiency syndrome with coldness), spleen and stomach damp heat syndrome, stomach yin deficiency syndrome and blood stasis in stomach collateral syndrome. Clinically, the doctor should treat PLGC patients according to different syndrome types by using Chinese medicine prescription, which could improve the gastric mucosal pathological state, gastroscopy and clinical symptoms, to rehibit the development of precancerous lesions, reduce the incidence rate of gastric cancer. In the future, the doctors shouldreach the consensus of treating PLGC with TCM diagnosis, and focus on the research of TCM compounds or monomers with obvious curative effect, increase the times of follow-up, and evaluate the long-term curative effect.

Prognostic value of thromboelastography maximum amplitude and arterial blood lactate levels for sepsis in elderly patients / 中华老年医学杂志

Objective:To evaluate the prognostic value of thromboelastography maximum amplitude(MA)and arterial blood lactate levels for sepsis in elderly patients.Methods:A retrospective analysis was performed on clinical data of 63 sepsis patients(≥60 years old)admitted to the Intensive Care Unit(ICU)of Bethune Hospital of Shanxi Province from December 2018 to February 2020.MA values, white blood cell counts, lymphocyte counts, platelets, acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)scores, sequential organ failure assessment(SOFA)scores, underlying diseases, body mass index, laboratory test results and other related treatments were analyzed.The subjects were divided into the survival group and the death group according to the 28-day survival outcome.Differences in MA, APACHE Ⅱ scores, SOFA scores and laboratory test results between the two groups were analyzed, and the correlations of MA with infection parameters and age were examined.Influencing factors of survival outcomes were analyzed using multivariate Logistic regression.The receiver operating characteristic curve(ROC)was used to calculate the prognostic value of MA and arterial lactate for sepsis in elderly patients.Results:The main sources of infections were pulmonary and abdominal(79.4%, 50/63)in 63 elderly patients with sepsis.The incidences of positive blood cultures and deaths were 15.9%(10/63)and 66.7%(42/63), respectively.There existed significant differences in lymphocyte counts, arterial lactate levels, MA and lengths of stay in the ICU between the survival group and the death group( t=3.847, 2.153, 2.745, -3.574, respectively, all P<0.05).MA was correlated with arterial lactate, SOFA score and survival outcome( r=-0.498, -0.506, and -0.358, respectively, all P<0.05).Multivariate Logistic regression analysis showed that MA and arterial lactate were independent factors for the survival outcome( OR=1.626, 0.766, all P<0.05).The area under the ROC curve(AUC, 95% CI)for the combination of MA and arterial lactate was larger than that of either MA or arterial lactate alone(0.89, range: 0.763-0.846; 0.58, range: 0.574-0.730; 0.77, range: 0.521-0.832; all P<0.05). Conclusions:The combination of thromboelastography maximum amplitude and lactate in arterial blood has important clinical value in assessing the prognosis of elderly patients with sepsis.

Nontargeted lipidomic analysis of sera from sepsis patients based on ultra-high performance liquid chromatography-mass spectrometry/mass spectrometry / 中华危重病急救医学

Objective:To analyze the changes of serum lipidomics in patients with sepsis and healthy controls, search for the differences of lipid metabolites, and reveal the changes of lipidomics in the process of sepsis.Methods:A prospective observational study was conducted. From September 2019 to April 2020, morning blood samples of upper extremity superficial veins were collected from 30 patients with definite sepsis diagnosed in intensive care unit (ICU) of Shanxi Bethune Hospital and 30 age-matched healthy subjects during the same period. Serum lipid metabolites were analyzed by ultra-high performance liquid chromatography-mass spectrometry/mass spectrometry (UPLC-MS/MS), and the quality control samples were analyzed by base peak spectroscopy (BPC) and verified experimental repetition. Student t-test and fold change (FC) were used for screening significant differences in lipid metabolites and determining their expression changes. Principal component analysis (PCA) and orthogonal projectionto latent structure discriminant analysis (OPLS-DA) were used to determine the entire allocation of experimental groups apiece, access the quality of being near to the true value of model, and screen the differential lipid metabolites with variable importance of projection (VIP). Finally, Metabo Analyst platform database was used to analyze lipid molecular metabolic pathways. Results:BPC results showed that the experimental repeatability was good and the experimental data was reliable. The main parameter model interpretation rate of PCA model R 2X = 0.511, indicating that the model was reliable. The main parameter model interpretation rate of OPLS-DA model R 2Y = 0.954, Q 2 = 0.913, indicating that the model was stable and reliable. With FC > 2.0 or FC < 0.5, P < 0.05, a total of 72 differential lipid metabolites were obtained based on VIP > 1. Based on Metabo Analyst 5.0, 24 distinguishable lipid metabolites were identified including 8 phosphatidylethanolamine (PE), 7 lysophosphatidylcholine (LPC), 6 phosphatidylcholine (PC), 2 lysophosphatidylethanolamine (LPE) and 1 phosphatidylserine (PS). Compared with healthy volunteers, the lipid molecules expression proved down-regulated in most sepsis patients, including PC, LPC, LPE, and some PE, while some PE and PS were up-regulated, which was mainly related to the PE (18∶0p/20∶4), PC (16∶0/16∶0) and LPC (18∶1) metabolic pathways in glycerophospholipids. Conclusions:There are significant differences in lipid metabolites between the sera of sepsis patients and healthy volunteers. PE (18∶0p/20∶4), PC (16∶0/16∶0) and LPC (18∶1) may be new targets for sepsis prediction and intervention.

Screening of lipid biomarkers in septic patients with different survival outcome / 中国综合临床

Objective:To screen lipid biomarker in sepsis patients with different survival outcome based on ultra high performance liquid chromatography-mass spectrometry(UHPLC-MS/MS) technique.Methods:From September 2019 to April 2020, 30 septic patients admitted in Department of Intensive Care Unit and 30 cases of physical examination at the same time in Shanxi Bethune Hospital were studied. Lipid metabolite in serum were detected by UHPLC-MS/MS technique. According to the 28 day survival outcome of sepsis patients, they were divided into survival group (21 cases) and death group (9 cases). The baseline data of case group and control group, survival group and death group were compared respectively. Independent sample t-test and orthogonal partial least squares discriminant analysis (OPLS-DA) were further performed to identify lipid biomarkers related to sepsis survival outcome. Receiver operating characteristic (ROC) curve to evaluate the predictive efficacy of differential lipids on the survival outcome of biomarker sepsis patients. Results:There were 32 lipid subclasses and 1 437 differential lipid molecules in the sepsis group compared with the control group. 196 differential lipid molecules in the sepsis survival group and the death group were screened according to the OPLS-DA model (variable weight of projection (VIP)>1), which were glycerophosphingolipids (129), sphingolipids (52), glycerides (14), and sterols (1).All the original data were statistically analyzed by univariate independent sample t-test. There were statistically significant differences in 15 lipid molecules between the two groups. Combined with VIP > 1 and P < 0.01, three lipid molecules were finally screened, which were sphingomyelin (SM) lipid molecules, SM (d30∶1), SM (d32∶2), SM (d32∶1). ROC curve analysis showed that the areas under curves of the above three lipid molecular were 0.915, 0.892, 0.898, respectively. The sensitivity was 77.27%, 95.45%,72.73%. The specificity was 100.0%, 87.5%,100.0%. Further Z-test showed that there was no significant difference in the area under the ROC curve ( Z(SM (d30∶1) and SM (d32∶1)) =0.36, P=0.722; Z(SM (d30∶1) and SM (d32∶2))=0.34, P=0.732; Z(SM (d32∶1) and SM (d32∶1))=0.07, P=0.942). Conclusions:Sphingomyelin may be involved in the formation of different clinical outcomes of sepsis, and has a good predictive effect on the survival outcome of sepsis.

Effects of short-term air pollution exposure and physical activity on neural damage in the elderly / 环境与职业医学

Background Emerging evidence has shown the damage of air pollution and the benefits of physical activity to human health, and the effects of air pollution and physical activity on the nervous system need more research. Objective To explore the effects of short-term air pollution exposure and physical activity on neural damage biomarkers in healthy elderly. Methods Using a design of panel study, physically and mentally healthy retired employees were recruited from Xinxiang Medical University, and were followed up five times regularly from December 2018 to April 2019. The demographic characteristics and physical activity information were obtained by questionnaire, and the weekly physical activity level was calculated according to intensity and duration of physical activity. Biomarkers of neural damage in serum were measured, including brain-derived neurotrophic factor (BDNF), neurofilament light chain (NF-L), neuron specific enolase (NSE), protein gene product 9.5 (PGP9.5), and S100 calcium-binding protein B (S100B). Air pollution data (including PM2.5, PM10, O3, SO2, CO, and NO2) of the follow-up period were collected. Generalized estimation equation was used to analyze the association of air pollution concentration and physical activity level with the concentration of neural damage biomarkers. Results A total of 29 volunteers were included in the study, with an average age of (63.5±5.9) years; there were 11 men accounting for 37.93%; more than half of them (62.07%) received above junior middle school education; the mean physical activity level was (80.23±54.51) MET-h·week−1. The daily average concentrations of PM2.5, PM10, O3, SO2, CO, and NO2 during the study period were (68.27±60.98) μg·m−3, (130.57±58.71) μg·m−3, (36.86±13.89) μg·m−3, (17.86±10.59) μg·m−3, (4.94±1.34) mg·m−3, and (50.83±8.03) μg·m−3, respectively. The average serum concentrations of BDNF, NF-L, NSE, PGP9.5, and S100B were (139.12±46.71) μg·L−1, (402.60±183.31) ng·L−1, (11.26±10.32) ng·L−1, (14.32±13.57) ng·L−1, and (127.57±41.74) ng·L−1, respectively. The results of generalized estimation equation showed that a higher concentration of PM2.5 or O3 was associated with increased serum NSE (OR=1.359, 95%CI: 1.224-1.509, P<0.001; OR=1.286, 95%CI: 1.076-1.537, P=0.006), while a higher concentration of NO2 was associated with decreased serum NSE (OR=0.692, 95%CI: 0.549-0.873, P=0.002); a higher concentration of O3 or SO2 was related to the reduction of serum NF-L concentration (OR=0.855, 95%CI: 0.740-0.989, P=0.035; OR=0.813, 95%CI: 0.700-0.946, P=0.007); a higher concentration of NO2 was associated with decreased PGP9.5 in serum (OR=0.866, 95%CI: 0.777-0.965, P=0.009); a higher level of physical activity was associated with increased serum S100B (OR=1.038, 95%CI: 1.003-1.074, P=0.034); and no significant association of physical activity level or air pollution with BDNF (P>0.05). Conclusion Acute exposure to air pollution and high-level physical activity might affect the neural damage of elderly populations. Specifically, particulate matter (PM2.5) could increase NSE, while gaseous pollutants (O3, NO2, and SO2) could decrease NF-L and PGP9.5.

The long-term effect of hip replacement and vitamin D in the treatment of elderly osteoporotic femoral neck fractures and its effect on the level of BMP-7/25- (OH) -D-3 / 中华内分泌外科杂志

Objective:To explore the long-term effect of hip replacement and vitamin D in treatment of elderly osteoporotic femoral neck fractures and the transfection of bone morphogenetic protein-7 (BMP-7) /25 hydroxy vitamin D3[ (25- (OH) ) -D3] level.Method:Data of 108 elderly osteoporotic femoral neck fracture patients admitted from Jan. 2018 to Jan. 2020 were selected, and they were divided them into the observation group (hip replacement adjuvant vitamin D treatment) and control group (hip replacement treatment) , 54 cases in each group. All subjects were followed up for 1 year to observe the long-term treatment efficacy and SF-36 scores of the two groups of patients. Before treatment and 1, 3, 6, and 12 months after treatment, the differences in the changes in lumbar and hip bone mineral density, hip joint Harris score, BMP-7, and 25- (OH) -D3 levels were compared between the two groups.Results:12 months after treatment, the long-term treatment effect of the observation group was significantly higher than that of the control group ( P<0.05) ; 1, 3, 6, 12 months after treatment, for the lumbar and hip bone mineral density, SF-36 score, hip Harris score, BMP-7, 25- (OH) -D3 levels of the two groups of patients over time, the degree of increase was not equal, but the treatment group had the greater degree of improvement ( P<0.01) . Conclusion:Hip joint replacement and vitamin D have a good long-term effect in treatment of elderly osteoporotic femoral neck fractures, which can significantly increase bone density and improve BMP-7 and 25- (OH) -D3 levels.

Neurodegenerative lesions caused by ozone exposure in male mice / 西安交通大学学报(医学版)

【Objective】 To investigate the effects and potential mechanisms of neurodegenerative lesions in male mice caused by ozone exposure. 【Methods】 We divided 23 C57BL/6N male mice aged 8 to 9 months into control group （clean air group， 11） and ozone group （1 mg/m 3， 4h/d， 12）. After 8 weeks of continuous ozone exposure， the Morris water maze experiment was used to detect the mice’s learning and memory ability， HE dyeing to observe pathological changes in hippocampal tissue cells， and immunoprinting tests to detect the expression levels of Tau， p-Tau and α-synuclein proteins in the cerebral cortex tissue. 【Results】 After 8 weeks of ozone exposure， the mice’s spatial learning and memory ability were impaired to a certain extent， the incubation period decreased with time， and the two lines were separated， but the difference was not statistically significant. Ozone exposure caused changes in the morphology of the mice’s hippocampal tissue cells， disorders in the arrangement of hippocampal neuron， and nuclear wrinkles， and significantly increased levels of p-Tau and α-synuclein protein expressions in cerebral cortex tissues （P<0.01）， but there was no statistical significance in the total Tau expression level. 【Conclusion】 Ozone exposure leads to the loss of learning and memory in mice， changes in hippocampal neurocellular pathology， and increased expression levels of neurodegenerative variable-related proteins.

Use of X-Chromosome Inactivation Pattern to Analyze the Clonality of 14 Female Cases of Kaposi Sarcoma.

BACKGROUND: Kaposi sarcoma (KS) has features of both neoplastic growth and hyperplastic proliferation. It is the most common tumor seen in patients with HIV infection. Whether KS is a real tumor or a benign hyperplastic disease is not known. MATERIAL AND METHODS: Tissues from KS and cutaneous hemangioma lesion DNA were extracted, and then digested with methylation-sensitive restriction endonuclease HpaII. Human androgen receptor gene (HUMARA) was amplified with PCR method and the product was separated on 10% denaturing polyacrylamide gels and stained with ethylene dibromide (EB) to show the polymorphism of HUMARA. Phosphoglycerate kinase (PGK) was amplified and the product was digested by BStXI, agarose gel and EB stained to show the polymorphism of PGK. Finally, we analyzed the clonality of KS. RESULTS: In the 14 patients with KS, heterozygosity of the HUMARA gene was observed in 12 (85.7%) cases. Loss of heterozygosity of HUMARA gene on X-chromosome (without HpaII digestion there were 2 bands, after HpaII digestion there were just 1 of the bands), representing monoclonal origin, was present in 11 cases of Kaposi sarcoma. Heterozygosity of the PGK gene was observed in 5 (35.7%) cases, which all represent monoclonal origin. There was no significant difference according to country, stage, or HIV and HHV-8 (P>0.05). CONCLUSIONS: The current findings suggest that Kaposi sarcoma is a clonal neoplasm, not a reactive proliferation.

Effects of Facet Joint Arthroplasty at Different Positions under Lumbar Percutaneous Endoscopy on Range of Motion of Vertebral Bodies / 医用生物力学

Objective To evaluate the influence of facet joint arthroplasty at different positions under lumbar percutaneous endoscopy on range of motion (ROM) of vertebral bodies by using the three-dimensional (3D) finite element method. Methods The 3D finite element model of normal L3-5 segment was established, and lumbar percutaneous endoscopy was simulated by doing cylindrical excision of bone with diameter of 7.5 mm on the tip or basement of L5 facet joint, so as to obtain normal lumbar vertebra model, L5 facet joint model with shaped tip, L5 facet joint model with shaped basement, respectively. Given specific loading conditions, the ROMs of adjacent vertebral bodies for the 3 models under flexion, extension, left and right lateral flexion, left and right rotation were compared. Results When L5 facet joint tip was shaped, the ROMs of L4-5 under extension，left lateral flexion, right lateral flexion, left rotation and right rotation were obviously larger than those of the normal model, especially under left rotation. When the L5 facet joint basement was shaped, the ROMS of L4-5 under left and right rotation increased slightly compared with those of the normal model. However, the ROMs of L3-4 for both tip-shaped and basement-shaped L5 facet joint model showed no obvious changes under six different motions. Conclusions The influence of L5 facet joint with shaped tip on ROMs of L4-5 was relatively larger than that of L5 facet joint with shaped basement under lumber percutaneous endoscopy. There was no significant effect on the ROMs of L3-4 with L5 facet joint arthroplasty.

Threshold analysis of extent of resection for patients with gradeⅢgliomas using MRI / 中国医师进修杂志

Objective To evaluate the prognostic significance of extent of resection (EOR) in patients with gradeⅢglioma, and the MRI sequence best related with tumor volume. Methods Ninety-six cases were studied retrospectively who were diagnosed as glioma of grade Ⅲ gliomas at Dalian Medical University Affiliated Hospital of Dalian Municipal Central Hospital during the period from 2010 to 2015. EOR was calculated using preoperative and postoperative contrast-enhanced T1-weighted and T2-weightedfluid attenuated inversion recovery (T2Flair) MR images. Univariate and multivariate analyses were performed to evaluate the correlation between EOR and overall survival (OS). Results The results of univariate analysis showed that patients with age<50 years(P=0.032), preoperative KPS>80 scores (P<0.01), no edema (P=0.005), postoperative chemotherapy (P<0.01) and T2Flair EOR≥68% (P<0.01) had better prognosis. Cox multivariate regression analysis showed that age(P=0.008), edema (P＝0.003), postoperative chemotherapy(P=0.000) and T2Flair EOR (P=0.004) were independent factors of prognosis for grade Ⅲ glioma patients. Conclusions T2Flair-EOR is one of the most significant prognostic predictors in patients with grade Ⅲ gliomas. An important survival advantage is associated with T2Flair-EOR≥68% for patients with gradeⅢgliomas.

Correlation study between platelet function and immune parameters in septic patients / 中国综合临床

Objective To explore the correlation between platelet function and immunity index in patients with sepsis. Methods The platelet function and immune indexes of one hundred and one patients with sepsis treated in Shanxi Dayi Hospital from July 1st, 2016 to October 31st, 2017 were analyzed retrospectively. According to their shock,they were divided into shock group (34 cases) and non shock group (67 cases). Another 50 healthy people in the same period in our hospital were selected as control group. The relationship between platelet function and immune indexes was compared. Results ( 1) the incidence of maximum blood block intensity decreased in the thrombus map of the septic shock group was higher than that in the non shock group, and the difference was statistically significant ( 65. 67%( 44/67 ) vs. 23. 53%(8/34),χ2＝41. 28,P＜0. 05); (2) the CD4+T lymphocyte and C3 in the septic shock group were all lower than those in the non shock group ((47. 28%±7. 78) vs. (54. 93%±11. 26),t＝3. 554,P＜0. 05; (0. 42 ±0. 23) g/L vs. (0. 75±0. 19) g/L,t＝－3. 057,P＜0. 05),the ratio of CD4+/CD8+T lymphocyte was higher than that in non shock group ((2. 68±0. 18) vs. (2. 45±0. 07),t＝7. 18,P＜0. 001)). (3) the maximum intensity of blood clots was correlated with the percentage of CD4+T lymphocyte,CD4+/CD8+T lymphocyte ratio,complement C3,acute physiology and chronic health status score system II score,and sequential organ failure score ( r ＝ 0. 617, 0. 411, 0. 563,－ 0. 631,－ 0. 547, P＜ 0. 01, or P＜ 0. 05 ) . Conclusion Thrombocytopenia is present in septic patients,which is correlated with changes in immune indices.

Genotyping of the offsprings of Leprdb/ +mice by TaqMan probe fluorescence quantitative PCR / 中国实验动物学报

Objective To establish an efficient method of genotyping for Leprdb/ +mouse offsprings by TaqMan probe quantitative fluorescence PCR. Methods Genome DNA was extracted from tails of 228 Leprdb/ +mouse offsprings. PCR primers and TaqMan probes were designed according to the mutation sites of Lepr gene(rs1801133). Real time PCR assay was applied and SNP loci were typed with SDS software. The genotyping of 2-month old Leprdb/dbmice was validated by the phenotype and Hardy-Weinberg equilibrium test was performed. Results 228 samples were detected by the established TaqMan fluorescence quantitative PCR assay. 64 mice were of GG genotype, with a genotype frequency of 0.1929. 123 mice were of GT genotype, with a genotype frequency of 0.5395. 41 mice were of TT genotype, with a genotype frequency of 0.2807. Compared with the phenotype typing,the sensitivity of the TaqMan fluorescence quantitative PCR was 97.56% and the specificity was 99.47%. Conclusions TaqMan probe quantitative fluorescence PCR assay is a simple and efficient method,and can be used to detect the genotype of Leprdb/ +mouse offsprings.

Effects of Aerobic Exercise on the Expression of Hepatic Hepcidin, and the Level of Serum IL-6 and MCP-1 in ApoE-/-Mice / 中国运动医学杂志

Objective To observe the preventive effects of the aerobic exercise on the expression of hepatic hepcidin,and the level of serum IL-6 and MCP-1 in ApoE-/-rats with atherosclerosis (AS) and to explore the mechanism.Methods Twenty 8-week male ApoE-/-mice were randomly divided into a control group and an exercise group,each of 10.The AS model was established in both groups through feeding high-fat diet.The control group was not given exercise intervention,while the exercise group underwent 14-week progressive intensity treadmill training,5 times a week,starting at 10 n/min for 30 min for the first 5 weeks and increasing to 13 m/min for 60 min at the end.At the end of the experiment,aortic samples were fixed and treated using the hematoxylin-eosin staining and Oil Red O.Then the pathological changes of the aorta were analyzed.The hepcidin expression of liver and serum hepcidin was assessed using Western blotting,and the level of the,interleukelin-6 (IL-6) and monocyte chemotactic protein-1 (MCP-1) were detected using ABC-ELISA.Results The pathological slice showed that the vascular fiber plate and internal membrane of the aorta in the exercise group were better than that of the control group,with less ruptured vascular fibreboards,foam cell infiltration and fiber plaques.The hepcidin expression of liver and the level of serum hepcidin,the level of the serum IL-6 and MCP-1 in the exercise group were significantly lower than those of the control group (P＜0.01 and P＜0.01).Conclusion The long-term aerobic exercise can prevent AS for ApoE /-mice through lowering the expression of the hepatic hepcidin and serum hepcidin,as well as the level of serum IL-6 and MCP-1.

Effects of PM2.5 on reproductive hormone levels and pregnancy outcome in female rats / 中国实验动物学报

Objective To study the effects of PM2.5 on reproductive hormone levels and pregnancy outcome in female rats.Methods Thirty healthy 4-week old female Sprague-Dawley rats were randomly divided into the control group (normal saline), low dose of PM2.5(1.5 mg/kg) group and high dose of PM2.5 (37.5 mg/kg) group.After the blood samples were collected, the animals were exposed to PM2.5for 10 days, and then the rats were mated.On the 19th day of pregnancy, the rats were sacrificed for pregnancy outcome observation and blood samples were collected for hormone test.The blood hormone levels were detected using an ELISA kit.Results The live fetus rates in the control, low dose PM2.5 and high dose PM2.5 groups were 90.77%, 59.49% and 60.27%, respectively (P0.05), the level of FSH in the high dose group was significantly decreased (P<0.05).Conclusions PM2.5may affect pregnancy outcome through influencing the hormone levels.