AIM: To investigate the expression of PPARγ and Nrf2/γ-GCS-h in inflammatory cells in bronchoalveolar lavage fluid(BALF) of guinea pig with bronchial asthma of acute episode, and to explore the roles of PPARγ on Nrf2/γ-GCS-h expression. METHODS: Forty adult male guinea pigs were randomly divided into 4 groups (10 guinea pigs in each group): control group (group A), asthmatic group (group B), dexamethasone treatment group (group C) and rogridone treatment group (group D). The asthmatic model was established by an ovalbumin challenge method. BALF was collected, and the total cell count and the proportion of the inflammatory cells were measured. After centrifugation, the concentrations of ROS and MDA in the clear supernatant were detected. The methods of in situ hybridization and immunohistochemistry were used for detecting the expression of PPARγ and Nrf2/γ-GCS-h at mRNA and protein levels. RESULTS: The proportion of eosinophils (EOS) in BALF in group B was significantly higher than that in groups A, C and D (P<0.01). The concentrations of ROS and MDA in BALF of group B was the highest. The difference of ROS and MDA was statistically significant (all P<0.05) as compared to the control. The results of immunohistochemistry and in situ hybridization indicated that the A value was the lowest in group B as compared to that in groups A, C and D (all P<0.01). In group B, the positive correlations were observed between PPARγ and Nrf2/γ-GCS-h, between γ-GCS-h and Nrf2. A negative correlation between the proportion of EOS in BALF and the expression of PPARγ and Nrf2/γ-GCS-h was also observed (all P<0.05). CONCLUSION: In acute asthmatic models induced by ovalbumin, the expression of PPARγ and Nrf2/γ-GCS-h is decreased, and PPARγ may up-regulate the expression of Nrf2/γ-GCS-h to inhibit the inflammatory and oxidative reactions, indicating a new way for prevention and treatment of bronchial asthma.

AIM: To explore the effects of peroxisome proliferator-activated receptor γ (PPARγ) on the activity and expression of γ-glutamylcysteine synthetase (γ-GCS), and its role in rats with chronic obstructive pulmonary disease. METHODS: COPD model was established by the method of combining fumigation and lipopolysaccharide (LPS) intra-tracheal dripping. Meanwhile, some of the COPD rats were administered with rosiglitazone (RGZ), a PPARγ activator. The pulmonary function and the pathological changes were determined. ROS content and γ-GCS activity in lung tissues were detected. The levels of PPARγ, γ-GCS mRNA and protein expression in lung tissues were measured by immunohistochemistry, Western blotting, in situ hybridization (ISH) and reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: The pulmonary function (FEV_(0.3), FEV_(0.3)/FVC%, PEF) were significantly improved in RGZ group compared to COPD group. Under light microscope, lung pathological changes in COPD group conformed to pathological features of COPD. The pathological changes of lung tissue were obviously reduced in RGZ group compared to COPD group. In RGZ group, ROS content was obviously reduced and γ-GCS activity significantly increased compared to COPD group. Protein and mRNA expressions of PPARγ and γ-GCS in COPD group significantly higher than those in control group (all P<0.01), and those in RGZ group was markedly increased compared to COPD group (all P<0.05). Linear correlation analysis showed that PPARγ protein was positively correlated with γ-GCS activity (r=0.634, P<0.01), and was no significantly correlated with ROS content (r=0.214, P>0.05). PPARγ protein was positively correlated with γ-GCS protein and mRNA (r=0.553, r=0.442, all P<0.01). CONCLUSION: PPARγ activation by RGZ reduces the extent of COPD oxidant/antioxidant imbalance, which plays an important role in the prevention and treatment of COPD. In addition, PPARγ may play an important antioxidant protection role by reducing ROS production, and increasing activity and gene expression of γ-GCS in the lung.

BACKGROUND:Poor implant anchorage in osteoporotic bone impacts its stability and requires the new solutions for the treatment. The augmentation technique with bone cements or bone substitutes is one strategy for the solutions. OBJECTIVE:To evaluate the transient stability of pedicle screw augmented using calcium sulfate cement in osteoporotic vertebral body. METHODS:Fresh calf lumbar vertebrae were selected to measure bone density, and then classified into four groups:the group by pedicle screw in normal vertebral body;the group by pedicle screw augmented using calcium sulfate cement in normal vertebral body;the group by pedicle screw in osteoporotic vertebral body;the group by pedicle screw augmented using calcium sulfate cement in osteoporotic vertebral body. Pedicle screw of equal specification was twisted into the tested pedicle of vertebral arch. The maximum axial screw pul-out strength and the maximum energy required to failure were recorded so as to assess the transient stability of pedicle screw augmented using calcium sulfate cement. RESULTS AND CONCLUSION:The maximum screw pul-out strength and the maximum energy required to failure were significantly less in osteoporotic vertebral body compared with normal vertebral body (P<0.05). The maximum screw pul-out strength and the maximum energy required to failure after augmentation using calcium sulfate cement were significantly increased (P<0.05). The maximum screw pul-out strength and the maximum energy required to failure after augmentation using calcium sulfate cement were identical between normal group and osteoporosis group. These results suggested that calcium sulfate cement could effectively increase the transient stability of pedicle screw. Calcium sulfate cement is effective in augmenting fixation in osteoporotic bone, and has potential in clinical application.

ObjectiveTo explore the childhood trauma experience and its relation to the eye emotion recognition ability in patients with schizophrenia.MethodsSeventy-one schizophrenic patients and fifty-two healthy subjects were assessed with the Childhood Trauma Questionnaire (CTQ) and the Eye Basic Emotion Discrimination Task (EBEDT).ResultsThe CTQ total score in the patients group was significantly higher than those in the control group (47.86 ± 13.26 vs 34.27 ± 7.27,P ＜ 0.01 ).The subscores in emotional abuse,physical abuse,sexual abuse,emotional neglect and physical neglect of CTQ in the patients group were also significantly higher than those in the control group.(all P＜ 0.01 ).Compared with controls,the patients had significantly lower total accuracy( (86.74 ± 6.16vs73.42 ± 11.86) ％,P ＜ 0.01 ) and longer total reaction time ( (2776.75 ± 703.42 vs 4321.40 ± 1956.83 )ms,P ＜ 0.01 )of EBEDT.The significant difference were also found on the accuracy and reaction time of the EBEDT six basic emotion between the two groups ( all P ＜ 0.01 ).Correlation analysis indicated that CTQ total score were negatively correlated with the EBEDT total accuracy ( r=-0.390,P＜0.01 ),and its sub-accuracy of happiness,surprise,sadness,and anger ( respectively r =- 0.419,r =- 0.451,r =- 0.391,r =- 0.344,P ＜ 0.01 ) in the patients group.The correlation between CTQ total score and EBEDT total accuracy was also found in the control group.ConclusionChildhood trauma is related to eye basic emotion recognition in schizophrenia patients,suggesting that the trauma during childhood can affect the social recognition ability.

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Objective To summarize the assessment standards of organ donation after cardiac death (DCD) donor lungs application and donor lung function maintenance experience.Method From Jan.2013 to June 2015,139 cases of DCD donors were subjected to rigorous assessment and effective donor lung function maintenance,and 11 donor lungs for lung transplantation were obtained.The donor lung cold ischemia time was (526.8-± 12.6) min (312 to 675 min).Double lung transplantation was performed on 9 cases,and 2 cases received single lung transplantation.Result Perioperatively,1 lung transplant recipient died of pulmonary infection.The survived 10 recipients had no rejection after operation,and obtained good quality of life during discharge to the final follow-up.Condusion The effect of donor lung transplantation using organ donation is satisfactory.The assessment standards and functional maintenance of donor lung are important factors to guarantee the success of lung transplantation.

Objective To discuss the clinical efficacy of balloon occlusion technique in treating pernicious placenta previa.Methods Between January 2015 and March 2016,a total of 16 matcrnal patients with pernicious placenta previa,who were admitted to the Interventional Department of Qujing Municipal First People's Hospital,received balloon occlusion management to assist obstetrician in dealing with placenta previa.Central type of placenta previa with highly suspected placenta implantation were diagnosed in 15 patients by color ultrasound or MRI.Balloon catheters were placed in bilateral internal iliac arteries before cesarean section was carried out,and immediately after the fetus was taken out the balloons were inflated to temporary occlude the targeted arteries.Based on the hemostatic status the balloon catheters were timely retrieved.One patient received emergency temporary balloon occlusion of abdominal aorta,and laparotomy revealed that the placenta had penetrated to the subserosa of uterine anterior wall,and total hysterectomy had to be carried out.Results Successful balloon occlusion was achieved in all 16 patients.The mean blocking time of the artery was 15 minutes and the amount of blood loss was 300-1200 ml.Conclusion In treating pernicious placenta previa,balloon occlusion treatment before cesarean section is safe and reliable,it can significantly reduce the amount of blood loss during surgery,make quick and effective hemostasis,provide a clear surgical field for the performance of cesarean section,and,more important,save the maternal life.This effective technique has fully showed the necessity of multidisciplinary collaboration,including obstetrics,interventional radiology,etc.

Objective To investigate the prevalence and risk factors of chronic kidney disease (CKD) in middle-aged and older adult population in Shanghai Pudong New District.Methods Two thousand residents aged 45 years and above were randomly selected for questionnaire survey and health check-up in Shanghai Pudong New District from July 2006 to October 2010.The laboratory examinations were also performed including the urine routine,urinary protein to creatinine ratio,serum creatinine,blood glucose and lipids.The glomerular filtration rate (eGFR) was estimated by simplified Chinese MDRD (modification of Diet in Renal Disease) equation.SPSS 13.0 statistical software was used for statistical analysis.Results Among 1905 residents who completed survey and examinations,the adjusted prevalence of albuminuria was 12.0％ (95％ CI:0.105-0.135) and of eGFR less than 60 ml · min-1 · 1.73 m-2 was 1.9％ (95 ％ CI: 0.172-0.213).The prevalence of CKD was 12.6％ (95 ％ CI: 0.112-0.142).Logistic regression analysis revealed that age (OR =1.043),hypertension (OR =2.272),diabetes mellitus (OR =1.233)and hyperuricemia (OR =1.003)were independently associated with CKD.Conclusions The prevalence of CKD in adult residents (≥45 years) from Shanghai Pudong New District is high.It is necessary to carry out early screening and to intervene risk factors of CKD in middle-aged and older residents.

Objective:To investigate the efficacy of two-way needle suture technique (TNST) in the minimally invasive repair of acute closed Achilles tendon rupture.Methods:From June 2019 to June 2021, 26 patients with acute closed Achilles tendon rupture were treated at Zhengzhou Orthopedic Hospital. They were 20 males and 6 females, with a mean age of 28 (23, 31) years. The rupture end was (4.2±1.3) cm away from the calcaneal insertion, and the interval from injury to operation 4.3 (2.0, 5.0) d. Preoperative MRI examinations revealed in all the patients closed Achilles tendon rupture which was to be repaired by TNST. The operation time, incision length, incidence of complications, ankle dorsiflexion and plantar flexion were recorded. The Arner-Lindholm scoring was used to evaluate the clinical efficacy.Results:The operation time was (20.0±5.0) min and the incision length (2.5±0.4) cm. Postoperatively, all incisions healed by the first stage, with no complications like incision infection, skin edge necrosis, deep vein thrombosis at lower limbs, injury to the sural nerve, or re-rupture of the Achilles tendon. All patients were followed up for (12.0±6.0) months. At the last follow-up, the patients walked normally, their incisions healed well, the continuity of the Achilles tendon was good by palpation, their heel lift was strong, and all their activities were restored to the levels before rupture of the Achilles tendon. The ankle dorsiflexion was 22.6°±3.7° and the plantar flexion 25.3°±3.7°, According to the Arner-Lindholm evaluation, the clinical efficacy was rated as excellent in 25 cases and as good in 1 case, giving an excellent and good rate of 100% (26/26).Conclusion:In the minimally invasive repair of acute closed Achilles tendon rupture, TNST shows the advantages of limited surgical invasion, a low incidence of postoperative complications, and reliable curative effects.

Objective To discuss the clinical application of ultrasound-guided temporary balloon occlusion in performing cesarean section for patients with pernicious placenta previa.Methods At Qujing Municipal First People's Hospital,the Interventional Department and Ultrasonography Department assisted the Obstetrics Department to accomplished cesarean section for 13 patients with pernicious placenta previa.The diagnosis of central placenta previa was confirmed by both color ultrasound and MRI in all the 13 patients.Before cesarean section,the balloons were placed in bilateral common iliac arteries or in abdominal aorta,and the balloons were inflated at the same time when the fetus was delivered so as to temporarily obstruct the target vessels.Based on the hemostatic condition,the balloon was timely withdrawn.Results Among the 13 patients,temporary abdominal aorta occlusion was employed in one and temporary bilateral common iliac artery occlusion in 12.Ultrasound-guided occlusion was successfully accomplished in 12 patients,and the average blocking time was ＜15 min.The amount of intraoperative blood loss was 800-1500 ml.Conclusion Ultrasound-guided temporary balloon occlusion before cesarean section is safe with reliable effect in treating pernicious placenta previa,it can remarkably reduce the amount of intraoperative blood loos,and it has no X-ray radiation damage,therefore,this technique is worthy of clinical application.