Objective To investigate the effectiveness of entropy in measuring the level of sedation during target controlled infusion (TCI) of propofol in patients of different ages. Methods Twenty-nine ASA Ⅰ-Ⅱ patients undergoing elective surgery under general anesthesia were divided into two age groups: Ⅰ adult group (20-64 yr) (n = 16) and Ⅱ the aged group (65-85 yr) ( n = 13). The patients were unpremedicated. The level of sedation was assessed using OAA/S scale. Propofol was given by TCI. The effect-site concentration (Ce) of propofol was set first at 1 ?g?ml-1 and then increased step by step by 0.5 ?g?ml-1 every 60 seconds until Ce reached 6 ?g?ml-1. Response entropy ( RE), state entropy ( SE), BP, HR, SpO2 were monitored and recorded at each Ce, before intubation, and immediately and 1, 2, 3, 4, 5, 10 min after intubation. The predictive performance of entropy was evaluated by prediction probability (Pk) .Results The two groups were comparable with respect to sex (M/F ratio), body weight and body weight index (kg?m-2). The RE and SE values decreased as Ce increased. The difference between RE and SE was also reduced. In adult group when Ce reached 2.0 ?g?ml-1, the RE and SE values were lower than the baseline values ( P

ObjectiveTo detect the expression levels of macrophage migration inhibitory factor (MIF) in peripheral blood mononuclear cells (PBMCs),sera and skin tissue fluid from patients with vitiligo vulgaris,and to investigate their clinical significance.MethodsThirty-nine patients with vitiligo vulgaris and 31 age- and sex-matched normal human controls were recruited in this study.Real-time reverse transcription-PCR was employed to assess the expressions of MIF mRNA in PBMCs,enzyme-linked immunosorbent assay (ELISA) to detect the concentrations of MIF in sera and skin tissue fluid from these subjects.ResultsPatients with vitiligo vulgaris showed a significantly higher level of MIF mRNA in PBMCs (6.70 (2.64 - 8.65) vs.1.67 (1.24 - 2.45),Z=5.895,P＜ 0.05),MIF protein in sera (32.76 (10.67 - 40.98) μg/L vs.7.89 (6.13 - 9.54) μg/L,Z=5.936,P ＜ 0.05 ) and skin tissue fluid ( 167.80 ( 107.40 - 219.60) μg/L vs.42.44 (32.29 - 49.74) μg/L,Z =4.715,P ＜ 0.05) compared with the normal human controls.The expression levels of MIF mRNA in PBMCs,and MIF protein in sera and skin tissue fluid were also higher in patients with progressive vitiligo than in those with stable vitiligo (7.89 (3.89 - 9.12) vs.5.62 (2.23 - 7.29),Z=2.213,P＜ 0.05; 37.80 (29.50 - 45.70) μg/L vs.22.70 (9.36 - 37.78) μg/L,Z=2.141,P＜ 0.05; 211.50 (131.70 - 248.75) μg/L vs.144.65 (89.13 - 167.30) μg/L,Z =2.100,P ＜ 0.05).In addition,the vitiligo area severity index (VASI) score was positively correlated with the expression levels of MIF mRNA in PBMCs (r =0.486,P ＜ 0.05)and MIF protein in sera (r =0.453,P ＜ 0.05).ConclusionMIF might play a certain role in the pathogenesis of vitiligo vulgaris.

Objective:To investigate the efficacy of nourishing feeding in patients with acute respiratory failure.Methods:One hundred patients with acute respiratory failure who received treatment in the First Affiliated Hospital of Wenzhou Medical University, China from December 2018 to March 2020 were included in this study. They were randomly divided into a control group and an observation group ( n = 50/group). After admission, all patients were actively treated and given enteral nutritional support. The gastric tube was indwelled. The head of the bed was elevated by 30-40°. The control group was given enteral nutrition which could reach the target dose within 2 days. The observation group was given nourishing feeding. Before and after 7 days of treatment, serum levels of hemoglobin (Hb), albumin (ALB) and total plasma protein as well as white blood cell and lymphocyte counts were determined. Intestinal tolerance was monitored during the treatment period. Mechanical ventilation time, length of intensive care unit stay, total hospital stay, and infection were compared between the control and observation groups. The number of deaths within 60 days after admission was recorded. Results:After treatment, serum levels of ALB, Hb and total plasma protein in the observation group were (49.86 ± 2.41) g/L, (134.96 ± 9.23) g/L, (54.18 ± 3.96) g/L, respectively, which were significantly higher than those in the control group [(42.34 ± 2.29) g/L, (127.49 ± 6.11) g/L, (42.86 ± 2.88) g/L, ( t = 15.99, 4.77, 16.35, all P < 0.01). After treatment, serum levels of ALB, Hb and total plasma protein in each group were significantly increased compared with before treatment (all P < 0.05). After treatment, white cell count in the observation group was significantly lower than that in the control group [(7.96 ± 1.06) × 10 9/L vs. (10.27 ± 2.35) × 10 9/L, t = 6.34, P < 0.01]. Lymphocyte count in the observation group was significantly higher than that in the control group [(1.19 ± 0.47) × 10 9/L vs. (1.02 ± 0.34) × 10 9/L, t = 2.07, P = 0.04]. After treatment, white cell count in each group was significantly decreased, and lymphocyte count in each group was significantly increased compared with before treatment (both P < 0.05). Intestinal intolerance rate in the observation group was significantly lower than that in the control group (22.0% vs. 52.0%, χ2 = 9.65, P < 0.01). The duration of mechanical ventilation, intensive care unit stay and total hospital stay in the observation group were (14.75 ± 5.36) d, (15.81 ± 6.28) d and (24.94 ± 7.18) d, respectively, which were significantly shorter than those in the control group [(18.69 ± 8.64) d, (27.96 ± 8.44) d and (29.84 ± 8.65) d, t = 2.74, 8.17 and 3.08, all P < 0.01]. The infection rate in the observation group was significantly lower than that in the control group (24.0% vs. 44.0%, χ2 = 4.46, P = 0.03). Conclusion:Nourishing feeding for enteral nutrition in patients with acute respiratory failure can better improve the nutritional status, reduce the level of systemic inflammation, improve the immune function, can be tolerated by the intestine, avoid infection, and promote the rehabilitation of patients with acute respiratory failure.

Objective To detect the expressions of miR-155,T helper type 17 (Thl7) cells,and Th17 cellspecific transcription factor RORγt and effector cytokine interleukin (IL)-17 in peripheral blood and skin lesions from,and to evaluate their relationship in,patients with atopic dermatitis (AD).Methods Peripheral blood was obtained from 37 patients with AD and 33 age-and sex-matched healthy controls,and biopsy specimens from the lesional and perilesional skin of five patients with severe AD as well as from the normal skin of five healthy human controls.Real-time fluorescence-based reverse transcription (RT)-PCR was employed to measure the mRNA expression levels of miR-155,RORγt and IL-17 in peripheral blood mononuclear cells (PBMCs) and skin specimens,flow cytometry to detect the percentage of Th17 cells in PBMCs,enzyme-linked immunosorbent assay (ELISA) to determine the plasma concentration of IL-17.Statistical analysis was done using independent sample's t test,one-way analysis of variance followed by the least significant difference test,and linear correlation analysis.Results Compared with the healthy controls,the patients with AD showed a significant increase in Th17 cell percentage (1.78％ ± 0.52％ vs.0.47％ ± 0.15％,P＜ 0.01),mRNA expression levels of miR-155 (5.78 ± 1.78 vs.1.82 ± 0.46,P＜ 0.01),RORγt (6.08 ± 1.04 vs.1.64 ± 0.52,P＜ 0.01) and IL-17 (7.09 ± 1.75 vs.1.71 ± 0.46,P＜ 0.01),as well as in the plasma concentration of IL-17 ((2.51 ± 6.15) pg/ml vs.(11.80 ± 2.24) pg/ml,P＜ 0.01).There was a sequential decrease in the expression levels of miR-155,RORγt and IL-17 mRNA from lesional skin,perilesional skin to normal skin (F =41.803,17.040 and 37.064 respectively,all P ＜ 0.01).The miR-155 mRNA expression level in PBMCs was positively correlated with the SCORing Atopic Dermatitis (SCORAD) index,Th17 cell percentage,RORγt and IL-17 mRNA expression levels as well as IL-17 plasma concentration (r =0.405,0.426,0.402,0.410 and 0.408 respectively,all P ＜ 0.05).Similarly,the miR-155 expression level was positively correlated with RORγt and IL-17 mRNA expression levels in lesional and paralesional specimens (r =0.428 and 0.435 respectively,both P ＜ 0.05).Conclusion The up-regulated expression of miR-155,Th17 cells and their effector cytokine IL-17 may be associated with the development of AD.

Objective To develop a scale of social adaptation degrees of special service personnel (referred to as scale) applying Traditional Chinese Medicine and psychological theory and to assess its reliability and validity. Methods By literature review, job analysis, inventory survey, topics interview, this scale was determined in dimensions, items and items pool based on theoretical model. Results After specialist important analysis and combining the different results of statistical analysis, including Cronbach's α coefficient, resolution factor, correlation analysis and confirmatory factor analysis, 6 dimensions, 14 factors and 40 items were finally kept in the scale. The dimensions were psychological characteristics, physical condition, intelligence level, interpersonal relationships, environmental factors and moral character. The factors were self-control, self-esteem character bias, self-confidence, physiological function, learning intelligence, creating intelligence, leadership intelligence, gregariousness, cooperative, confidence feeling, natural environment, social environment and moral character. Conclusion This scale was made on the basis of general international principle, it had good reliability and validity meeting measurement standard of traditional Chinese medicine and psychological theory, and it is an effective and practical evaluation tool of social adaptation degrees of special service personnel.