Objective To investigate the concentration change of indoxyl sulfate (IS) in blood and the renal expression of renal fibrosis-related factors (transforming growth factor-beta 1, TGF-β1;fibronectin, FN) after administration of mutagenic lactobacilli by oral.Methods A total of 60 male Sprague-Dawley (SD) rats aged 6 weeks was divided randomly into 3 groups.The normal control group (Sham group, n =20) received Sham operation of just incision of skin without kidney removed.The other two groups of rats were renal failure models selected from survivals of the other 40 rats who received real operation with 5/6 of kidney removed.Finally, 35 survived renal-failure rats were divided randomly into 2 groups : pathological control group(Model group, n =17) who were administrated of 2ml sterile saline solution once a day by gavage, and experimental group (lactobacillus bulgaricus (LB) group, n =18) who were administrated of 2 ml mutagenic lactobacilli (1.5 × 108 cfu/ml) once a day by gavage.Eight weeks later, blood specimens were taken to test the concentration of IS with high performance liquid chromatography-fluorescence detection (HPLC-FLU), and urea and creatinine by automatic biochemical analyzer;moreover, the rats were killed to get kidney tissues for pathological examination.Results The levels of serum IS, urea, and creatinine were statistically significantly different between two groups (P ＜ 0.05).Both the levels of renal tubular damage and renal interstitial fibrosis were both lessen in the experimental group compared to the model group (P ＜0.05).TGF-β1 and FN expressions in renal tissues were significantly decreased (P ＜0.05).Conclusions Mutagenic lactobacilli not only reduces serum concentration of IS, urea and creatinine in renal failure rats but lowers the expressions of TGF-β1 and FN in renal tissues.

Objective To investigate the carotid plaque conditions and clinical commonly used test events in patients with type 2 diabetes mellitus (T2DM) and to explore the risk factors affecting the stability of plaques in carotid artery.Methods According to the results of cervical vascular color Doppler ultrasound examination, 125 patients with type 2 diabetes mellitus were divided into unstable plaque group (n=21), stable plaque group (n =54), and non-plaque group (n =50).Analysis related results including age, gender, systolic blood pressure (SBP), diastolic blood pressure (DBP), intima-media thickness (IMT), fasting blood glucose (FBG), triglycerides (TG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), uric acid (UA), fibrinogen (Fbg), D-dimer (D-D), free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH) were analyzed.Results Age, gender, SBP, DBP, TG, HDL, D-D, and TSH were without significant differences among groups.Glucose and Fbg were significant different (P ＜ 0.05) between unstable plague group and stable plaque group/no plaque group.No significance difference was found between stable and no plaque groups.IMT, TC, LDL, and FT4 were significant different (P ＜ 0.05) between unstable and stable plaque groups, and between stable and no plaque groups.Logistic multiple regression analysis suggested that IMT and TC might be independent risk factors for the stability of plaques in carotid artery of patients with type 2 diabetes mellitus (P ＜ 0.05).Conclusions The factors affecting formation of plaques in carotid artery include glucose level, TC, and LDL in patients with type 2 diabetes mellitus.The factors affecting its stability include thickness of IMT, TC, LDL, and FT4.IMT and TC were the independent risk factors for the stability of plaques in carotid artery.

Objective To investigate the dynamic changes of endoplasmic reticulum stress-related molecules including glucose regulated protein (GRP78), C/EBP homologous protein (CHOP), and caspase-12 in sciatic nerve of diabetic rats and explore its mechanisms.Methods Rats were randomly divided into normal control group (NC) and diabetes mellitus group (DM) that were induced by intraperitoneal injection of Streptozocin after 4 weeks of high-fat chow feeding.Sciatic nerves were isolated for three times at 4 weeks, 8 weeks and 12 weeks after induction of diabetes.The expressions of GRP78, CHOP,and caspase-12 were detected with quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot analyses.The morphology of sciatic nerve was investigated with electron microscope.Results With the extension of the course, demyelinating and axonal injury appeared in sciatic nerve of diabetic rats.The expressions of GRP78 mRNA and protein in DM group were significantly higher than NC group at 4 weeks and 8 weeks after induction of diabetes(P ＜0.05, P ＜0.01).The expressions of CHOP mRNA and protein in DM group were significantly higher than NC group at 8 weeks and 12 weeks after induction of diabetes (P ＜ 0.05).The expressions of caspase-12 mRNA and protein in DM group were significantly higher than NC group at 8 weeks after induction of diabetes(P ＜ 0.05, P ＜ 0.01).Conclusions Endoplasmic reticulum stress-related molecules (GRP78, CHOP, and caspase-12) contributed to the peripheral nerve injury of diabetic rats, and displayed dynamic changes.

Objective To investigate the effect of fluvastatin on the expressions of caspase-12,CCAAT/enhancer-binding protein homologous protein(CHOP), and c-Jun N-terminal kinases (JNK) in ischemia-reperfusion brain injury in rats.Methods Forty two rats were randomly divided into sham operation group (6 rats), ischemia-reperfusion (I/R) group (18 rats), and fluvastatin (Flu) group (18 rats).The rats of I/R and Flu groups were molded by modified Longa intraluminal thread, then put to death at 2 h occlusion and 24 h reperfusion point.Expressions of caspase-12, CHOP, and JNK were detected with immunohistochemistry and Western blot.Results Immunohistochemistry and Western blot showed that the expressions of caspase-12, CHOP, and JNK were increased at 24 h reperfusion.Compared to I/R group, the expressions of caspase-12 and CHOP in Flu group were decreased significantly (all P ＜0.01);and the expression of JNK had no difference between I/R and Flu groups(P ＞ 0.05).Conclusions The increased expression of caspase-12, CHOP, and JNK showed that endoplasmic reticulum stress was involved in the pathological process of ischemia-reperfusion brain injury.Fluvastatin could inhibit the expression of caspase12 and CHOP, and could delete endoplasmic reticulum stress (ERS) in ischemia-reperfusion brain injury.

Objective To investigate influence of different usage of dyclonine hydrochloride mucilage on hemodynamics and postoperative throat pain of laryngeal mask anesthesia patients.Methods Sixty patients in flexible ureteroscopic holmium laser lithotripsy with laryngeal mask anesthesia were randomly divided into three groups according to different usage of dyclonine hydrochloride mucilage (n =20).Group A was coated laryngeal mask with paraffin oil.Group B was coated laryngeal mask with dyclonine hydrochloride mucilage.Group C was coated laryngeal mask with dyclonine hydrochloride mucilage and dyclonine hydrochloride mucilage gargle.The indwelling time of laryngeal mask, postoperative recovery time of spontaneous breathing, time of hearing the call to open eyes, and the time of pulling out the laryngeal mask were recorded.Heart rate (HR), mean blood pressure (MBP) index at T1 (pre-anesthesia induction), T2 (1 min before pulling out the laryngeal mask), T3 (pulling out the laryngeal mask), T4 (5 min after removing the laryngeal mask), and T5 (10 min after removing the laryngeal mask) were recorded.The complications of throat after removing laryngeal mask were observed.The pain degree of sore-throat at the time of 30 minutes after removing the laryngeal mask was observed.The adverse reactions of the usage of dyclonine hydrochloride were observed in three groups.Results There were no statistically significant differences in indwelling time of laryngeal mask, postoperative recovery time of spontaneous breathing, time of hearing the call to open eyes, and the time of pulling out the laryngeal mask among three groups (P ＞ 0.05).There were no statistically significant differences in HR, MBP at T1 , and T5 (P ＞ 0.05).HR and MBP were higher in group A than in groups B and C at T2 ～ T4, and HR and MBP were higher in group B than in group C at T2 ～ T4, with statistically significant difference (P ＜ 0.05).The incidences of sore throat and swallowing discomfort were significantly lower in groups B and C than in group A (P ＜ 0.05).The incidences of sore throat and swallowing discomfort were significantly lower in group C than in group B (P ＜0.05).No statistically significant difference were found in incidence of hoarseness among three groups (P＞ 0.05).The pain degree of sore-throat in group C were significantly lower than in group B, and the pain degree of sore-throat in groups B and C was significantly lower than in group A (P ＜ 0.05).There were no allergic reactions and local anesthetic poisoning for three groups.Conclusions Dyclonine hydrochloride mucilage can reduce hemodynamic fluctuations during recovery period, and prevent or relieve effectively the patient's throat pain after laryngeal mask anesthesia.At the same time, dyclonine hydrochloride mucilage can improve the patient's postoperative physical comfort without adverse reactions, especially coated laryngeal mask with dyclonine hydrochloride mucilage and dyclonine hydrochloride mucilage gargle.

Objective To investigate effects of different sedation methods on the mechanical ventilation patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods A total of 101 patients with mechanical ventilation in our hospital was randomly divided into observation (58 cases) and control (43 cases) groups.The observation group was given to strengthen psychological care during the day, and the night was given to the patients with AECOPD.The control group was treated with continuous analgesia and sedation, and the daily morning was executed to wake up the plan 1 ～ 2 hours.A set of indexes were observed, including white cell count, C-reactive protein, oxygen index, B-type natriuretic peptide, delirium occurred rate, unexpectedly drawn tube rate, and duration of mechanical ventilation.Results White blood cell number, C reactive protein, and oxygen index group in the observation group were significantly better than the control group [(10.1 ± 2.4) × 109/L vs (11.2 ± 2.8) × 109/L,(40.6 ± 11.6) mg/L vs (45.8 ± 12.2) mg/L, and (285.6 ±45.1) vs (268.2 ±42.6)] (P ＜0.05).The incidence of delirium rate in the observation group was significantly lower than the control group [30/58(51.7％) vs 31/43(72.1％)] (P ＜0.05).The mechanical ventilation time in the observation group was significantly shorter than the control group [(8.41 ± 3.96) d vs (10.35 ± 5.57) d] (P ＜ 0.05).There was no significant difference between B type natriuretic peptide and accidental extubation rate (P ＞ 0.05).Conclusions The night program sedation program can significantly improve AECOPD mechanical ventilation in patients with inflammatory index and oxygen index, reduces the incidence of delirium in patients with acute exacerbation of chronic obstructive pulmonary disease, does not increase the accidental extubation rate, and significantly shortens the AECOPD patients with mechanical ventilation duration of mechanical ventilation, as a mechanical ventilation in AECOPD patients who killed one of the options.

Objective To investigate the natural rotation of the fetal head during labor when it was engaged by occiput transverse (OT) or occiput posterior(OP) positions.Methods A total of 1 013 parturients was included who had a singleton term gestation, vertex presentation, OT or OP position with cervical dilatation of ≤ 3 cm, and vaginal delivery.All parturients were delivered in Xiamen Hospital of Traditional Chinese Medicine during April 1 to December 31,2014.Cervical dilation, station, and fetal position of every delivery were systematically recorded.Main outcome was the cervical dilation and station of anterior rotation from OT or OP position.They were Stratified by cervical dilation every 2 cm since 4 cm into 4 ～ 5 cm, 6 ～7 cm, 8 ～9 cm, 10 cm;or were stratified by fetal head station every 1 cm since-2 (S-2) into S-1 , S0, S+1 , S+2 , S+3.The differences in anterior rotation rate, dilatation, and head station between OT and OP were analyzed.Results There were 850 OT and 407 OP with cervical dilatation of ≤≤ 3 cm.The rate of anterior rotation was 82.5 ％ (701/850) and 76.7 ％ (312/407), respectively.The constituent ratio of OT rotating into occiput anterior position (OA) at different dilatation was different with that of OP (x2 =260.93, P ＜ 0.01).The constituent ratio of OT rotating into OA at different fetal head station was different with that of OP (x2 =133.18, P ＜0.01).The cervical dilatation and fetal head station that make it easy for OT 's anterior rotation were 6 ～7 cm (OR =5.81 , 95％ CI :3.81 ～8.87), 8 ～9 cm(OR =4.99 ,95％ CI:3.19 ～7.83), and S+1(OR =3.01, 95％ CI: 1.99 ～4.54), S+2(OR =5.43, 95％ CI:3.53 ～ 8.35).The cervical dilatation and fetal head station that make it easy for OP 's anterior rotation were 6～7 cm(OR =4.11,95％ CI :2.24 ～7.89), 8 ～9 cm(OR =27.31, 95％ CI :15.12 ～49.34), 10 cm(OR =27.76 , 95％ CI :14.87 ～51.82), S+2(OR =4.84 , 95％ CI :3.03 ～7.73).Conclusions The anterior rotation time of OT is different from OP.It's easy for OT to rotate into OA when cervix dilate into 6 ～9 cm and fetal head station is at S+1 ～ S+2.When cervix dilate into 6 ～ 10 cm and fetal head station is at S+2, it's easy for OP to rotate into OA.

Objective To investigate the levels of cystatin C (CC) with the H&Y scale and duration of Pakinson's disease(PD)patients.Methods The study consists of 432 PD patients and 513 control subjects.PD patients were divided into 3 subgroups according to their H&Y scale.The levels of CC and Scr were measured.The statistics analysis was used to evaluate their associations.Results In PD and control groups, CC concentrations were significantly different (P ＜ 0.05), and Scr concentrations in two study groups were not significantly different(P ＞ 0.05).PD in each subgroup, CC concentrations in the medium group were significantly higher than the early and control groups, and CC in the late group was significantly higher than the other two subgroups.Rank correlation analysis and comparison of CC concentration and duration and H&Y score showed that CC concentration was positively correlated with the duration of PD(r =0.209, P ＜0.01), and that CC concentration and H&Y score were significantly positively correlated (r =0.618, P ＜0.01).Conclusions There was a certain correlation between CC levels and PD, and CC levels of PD patients were significantly higher.There was no significant increased CC in the initial stages of the disease, perhaps CC was not necessary cause of the onset of PD.However, the level of CC with H&Y stage and duration were positively correlated, perhaps CC may be involved in the process of disease progression, because high level of CC may increase PD patient's condition.

Pancreatic cancer (PC) is one of the deadliest solid malignancies.Although surgery remains the only curative treatment,more than 80％ of patients suffer relapse after resection.More and more data evidence that PC is a systemic disease suggests systemic therapy plays crucial roles in the multidisciplinary treatment.Thus,new treatments are urgently needed for PC patients.Recently,a growing number of novel and promising drugs are being evaluated in preclinical and clinical settings.Herein,we reviewed the progress in the new cytotoxic and targeted therapy for metastatic PC.

Objective To investigate the characteristics of common causes of acute pancreatitis (AP) in China and to evaluate the association of the aetiology with the severity of disease.Methods The relevant literature was searched from the China National Knowledge Infrastructure (CNKI) database (1989.1-2015.3),WANFANG database (1999.1-2015.3),VIP database (1994.1-2015.3),and China Academic Journal Network Publishing Database (CAJD).To collect related literature about aetiology and the severity of acute pancreatitis,Meta analysis was performed for gallstone,alcohol,hyperlipidemia and other AP from the aspects of the severity of disease in the literature which reaches the criteria.Results The Meta analysis included 24 clinical articles which were accordance with the criteria,totally 17359 patients,including 8673 cases of biliary AP [6690 cases of mild acute pancreatitis (MAP),1983 cases of acute necrotizing pancreatitis (ANP)],1408 cases of alcoholic AP (1022 cases of MAP,386 cases of ANP),1753 cases of hyperlipidemia AP (1107 cases of MAP,646 cases of ANP),and 5525 cases of other aetiology (4179 cases of MAP,1346 cases of ANP).The Meta analysis showed that among the common causes which was developed to AP,there was significant difference between biliary AP and alcohol AP (OR =0.65,95％ CI:0.45 ～0.93,P ＜ 0.05).There was significant difference between biliary AP and hyperlipidemia AP (OR =0.51,95％ CI:0.33 ～0.79,P ＜0.05).However,there was no significant difference between alcoholic AP with hyperlipidemia AP (OR =0.70,OR =0.70,95％ CI:0.46 ～ 1.05,P ＞ 0.05).Conclusions There is difference in the severity of AP caused by different reasons in China.There is more likely that hyperlipidemia AP and alcohol AP easily developed into ANP than biliary AP.However,further investigation and large-scale clinical trials will be needed to confirm this conclusion.