Objective To analyze the application effect and safety of streamlined liner of the pharynx airway (SLIPA) anesthesia in painless fiberoptic bronchoscopy (FB).Methods Two hundred and eighty-two patients who undorwent FB examination in Kaifeng Second People's Hospital from January 2015 to January 2017 were selected and divided into observation group and control group,with 141 patients in each group.The patients in observation group were given SLIPA assisted anesthesia;the patients in control group were given endoscopic mask assisted anesthesia.The oxygen saturation (SpO2),systolic blood pressure (SBP),diastolic pressure (DBP) and heart rate (HR) of patients in the two groups were monitored.The changes of SBP,DBP and HR,the incidence of adverse reactions and the satisfaction of patient to the anesthesia were compared between the two groups.Results The fluctuation of HR,SBP and DBP of patients in the observation group was (3.52 ± 2.92) times · min-1,(7.04 ±5.30) mmHg(1 mmHg =0.133 kPa),(1.52 ± 1.63) mmHg respectively and in the control group was (5.52 ± 1.89) times · min-1,(30.12 ± 8.88) mmHg,(4.06 ± 5.78) mmHg respectively;the fluctuations of HR,SBP and DBP of patients in the observation group were significantly less than those in the control group(P ＜ 0.05).In the observation group,12 patients with cough,8 patients with abdominal distension,6 patients with pharyngeal pain,2 patients with SpO2 ≤90％,4 patients with SpO2 ＜ 85％;in the control group,57 patients with cough,32 patients with abdominal distension,47 patients with pharyngeal pain,28 patients with SpO2 ≤90％,19 patients with SpO2 ＜ 85％.The incidence of adverse reactions of patients in the observation group was significantly lower than that in the control group (x2 =27.10,61.82,41.59,72.46,87.75;P ＜0.05).The anesthesia satisfaction of patients in the observation group(97.87％) was significantly higher than that in the control group(82.98％) (x2 =29.97,P ＜ 0.05).Conclusion SLIPA assisted anesthesia has good clinical effect and safety in patients with painless FB.

Alveolar Bone Loss ; prevention & control ; Alveolar Process ; surgery ; Bone Regeneration ; Dental Implantation, Endosseous ; Dental Prosthesis, Implant-Supported ; Guided Tissue Regeneration, Periodontal ; methods ; Humans ; Immediate Dental Implant Loading ; Male ; Middle Aged ; Periodontitis ; surgery ; Tooth Extraction ; adverse effects ; Wound Healing

Objective: To investigate the mechanism of liver and lung injury in mouse septic models. [Methods: Twenty-four male Kunming mice were subjected to cecal ligation and puncture (CLP) or sham operation. The permeability of microvasculature, water contents, activities of myeloperoxidase (MPO) and the apoptosis of microvascular endothelial cells in lung microvasculature and liver sinus were examined 3 h and 12 h after operation. Results: Both the liver and lung showed a significant increase in microvessel permeability at 12 h in CLP group compared with sham operation group. MPO activity and water content in CLP group were obviously higher than those in the sham operation group. The apoptosis of lung microvascular endothelial cells at 12 h in CLP group (5.03 ± 0.92)% was significantly higher than that of control group (3.48 ± 1.21)% (P< 0.01). Conclusion: Sepsis can lead to severe injury to the liver and lung. Apoptosis in lung microvascular endothelial cells might cause alteration of microvascular permeability, finally resulting in the injury of lung.

Objective To investigate the expression of procalcitonin (PCT) and C-reactive protein (CRP),and endotoxin in bloodstream infection with different microorganisms,so as to assess the value of these inflammatory cytokines in early diagnosis of sepsis in bloodstream infections patients.Methods Data of 152 septic bloodstream infected patients with 90 male and 62 female aged from 62 to 102 years and 79.2 ± 16.3 years in average admitted from January 2012 to December 2013 were analyzed retrospectively.According to the results of blood culture,the microorganisms could be categorized into gram-negative bacteria,gram-positive bacteria and fungus groups,and the levels of serum CRP,PCT,and endotoxin were compared among these groups of bloodstream infections patients within 24 hours after admission.Results (1) A total of 152 strains of microorganisms were surveyed including 92 gram-negative strains (61.18％),43 gram-positive strains (28.29％),and 16 fungal strains (10.53％).In the gram-negative strains,Klebsiella pneumoniae (n =29),Acinetobacter baumannii (n =24),Escherichia coli (n =23),Burkholderia cepacia (n =9) and Pseudomonas aeruginosa (n =4) were the most common isolates.In the Gram-positive strains,13 strains of Staphylococcus aureus were isolated.(2) In the gram-negative bacterial bloodstream infections group,there were 60 (64.52％) patients with endotoxin positive,and there were no endotoxin positive cases with detected gram-positive bacteria and fungal bloodstream infections.The median levels of PCT were significantly different among the three groups [gram-negative strains group:7.760 (3.365,28.585) ng/mL,gram-positive strains group:0.705 (0.265,3.225) ng/mL,fungal infection group:1.245 (0.543,1.998) ng/mL].In the fungal bloodstream infection group,the mean level of CRP was higher than that in other two groups [gram-negative strains group:(126.01 ± 66.53) mg/L,gram-positive strains group:(77.58 ±54.21) mg/L,fungal infection group:(140.14 ±71.21) mg/L].(3) The receiver operating characteristic (ROC) curve of inflammatory cytokines was made for the diagnostic value in bloodstream infections.ROC curve used to distinguish between gram-positive bacterial bloodstream infections group and fungal group showed that AUCPCT+CRP =0.791.When PCT cut-off value was 0.92 ng/mL,and CRP cut-off value was 68.00 mg/L,the sensitivity was 50％ and the specificity was 95.5％.ROC curve used to distinguish between the gram-negative bacterial bloodstream infections group and fungal group showed that AUCPCT+CRP+LPS =0.947.When PCT cut-off value was 2.16 ng/mL and CRP cutoff value was 94.10 mg/L,and endotoxin was positive,the sensitivity was 82.8％ and the specificity was 100％.ROC curve used to distinguish between gram-negative bacterial bloodstream infections group and gram-positive bacterial group showed that AUCPCT+CRP+LPS =0.947.When PCT cut-off value was 2.68 ng/ mL,CRP cut-off value was 106.5 mg/L,endotoxin was positive,the sensitivity was 74.2％ and the specificity was 97.7％.Conclusions Gram-negative bacteria were the most common microorganisms in bloodstream infections in ICU patients.Compared with single inflammatory cytokine,the serum concentrations of PCT,CRP and endotoxin used together could provide more sensitivity and specificity for the early diagnosis of bloodstream infection with different microorganisms.

Objective:To investigate the value of anti-hexokinase1 antibodies (anti-HK-1) and anti-kelch-like 1 antibodies (anti-KLHL12) antibody in evaluating ursodeoxycholic acid (UDCA) response in patients with primary biliary cholangitis (PBC).Methods:112 PBC patients who had been treated with UDCA for more than 12 months with relatively complete clinical data were analyzed. Serum was collected and the expression of anti-mitochondrial antibody (AMA), anti-HK-1 and anti-KLHL12 antibodies were detected by ELISA. The response to UDCA was based on Paris standard. According to the expression of new antibodies, the patients were divided into the new antibody positive group and negative group. In addition, PBC related baseline indicators were collected, and Spearman correlation analysis was used to study the correlation between antibody expression and baseline indicators in PBC patients.Results:Positivity of anti-HK1 and anti-KLHL12 antibody in AMA-positive PBC patients were 44.7% and 41.2% respectively. Positivity of anti-HK1 and anti-KLHL12 antibodies in AMA negative PBC patients were 33.3% and 22.2%. Anti-HK1 positive patients had higher serum levels of Alaninetransaminase (ALP), aspartate aminotransferase, (AST), γ-glutamyl transpeptidase (γ-GT) and total bilirubin (TBIL) compared with anti-HK1 negative patients, with statistical significant differences ( P<0.05). Notably, correlation analysis showed significantly positive correlation between anti-HK1 antibody expression and ALP, γ-GT and TBIL serum levels ( r=0.735, P<0.05; r=0.332, P<0.05; r=0.491, ( r=0.466, P<0.05). The UDCA response rate in anti-HK-1 antibody positive group was lower than that of the negative group (36.2% vs 60%; P<0.05). Conclusion:Anti-HK-1 and anti-KLHL12 antibody can help to diagnose PBC, and the expression of anti-HK-1 antibody is correlated with the severity of PBC, which could help to predict the reaction of PBC patients to UDCA.

OBJECTIVE: To investigate the quantity and species distribution of diatoms in Chuanyang River of Pudong new area of Shanghai and provide references for the invesitigation of water body in forensic practice. METHODS: The water samples collected from 15 areas in Chuanyang River of Pudong new area in September 2012 were examined by microscope to identify the species of diatoms. RESULTS: Cyclotella and Pinnularia were found to be the dominant species within the 12 species of diatoms in Chuanyang River, which showed differences in species among the sections of Huangpu River, the center and the East China Sea. CONCLUSION The differences in subsectional distribution of diatom species in Chuanyang River may provide a new foundation for forensic identification in drowning cases especially in the determination of falling location.
China ; Diatoms ; Drowning ; Forensic Medicine ; Fresh Water ; Rivers

Objective:To investigate the mechanism of liver and lung injury in mouse septic models.Methods:Twenty-four male Kunming mice were subjected to cecal ligation and puncture(CLP)or sham operation.The permeability of microvasculature,water contents,activities of myeloperoxidase(MPO)and the apoptosis of microvascular endothelial cells in lung microvasculature and liver sinus were examined 3 h and 12 h after operation.Results:Both the liver and lung showed a significant increase in microvessel permeability at 12 h in CLP group compared with sham operation group.MPO activity and water content in CLP group were obviously higher than those in the sham operation group.The apoptosis of lung microvascular endothelial cells at 12 h in CLP group(5.03?0.92)% was significantly higher than that of control group(3.48?1.21)%(P

Objective To discuss the differences of inflammatory parameters such as procalcitonin ( PCT ), C-reactive protein ( CRP ), endotoxin, white blood cell ( WBC ), neutrophil ratio ( Neut%) in blood of septic patients caused by bacterial bloodstream infection, and their correlation with the severity of disease. Methods 292 septic patients with positive blood culture were enrolled in Beijing Shijitan Hospital Affiliated to Capital Medical University from February 2012 to March 2015, and their gender, age, acute physiology and chronic health evaluation Ⅱ( APACHEⅡ) score, bacterial species and other general information were retrospectively collected. The differences in inflammatory parameters ( PCT, CRP, endotoxin, WBC, Neut%) in septic patients caused by bacterial bloodstream infection were compared, their correlations with APACHEⅡ scores within 24 hours were analyzed, and their diagnostic efficacies were also analyzed. Results ①It was shown by Pearson correlation coefficients that positively statistical correlation was found between PCT ( r=0.638 ), CRP ( r=0.620 ), endotoxin ( r=0.284 ), WBC ( r=0.209 ) and APACHEⅡscore ( all P=0.000 ) in bacterial bloodstream infective patients ( n=292 ), and positively statistical correlation was found between PCT ( r=0.626 ), CRP ( r=0.616 ), Neut%( r=0.297 ) and APACHEⅡscore ( all P<0.01 ) in Gram positive bacterial ( G+) group ( n = 86 ), and positively statistical correlation was shown between PCT ( r=0.631 ), CRP ( r=0.616 ), endotoxin ( r=0.301 ), WBC ( r=0.226 ) and APACHEⅡscore ( all P<0.01 ) in Gram negative bacterial ( G-) group ( n=206 ).②It was shown that PCT and CRP of both G+/G-bacterial severe sepsis and septic shock subgroup were significantly higher than those of sepsis subgroup, respectively [ G+ group: PCT (μg/L ):0.92 ( 0.38, 4.75 ) vs. 0.43 ( 0.22, 1.00 ), CRP ( mg/L ):118.45±62.60 vs. 57.97±32.41;G-group:PCT (μg/L ):6.92 ( 1.94, 25.90 ) vs. 1.28 ( 0.27, 4.12 ), CRP ( mg/L ):130.99±60.18 vs. 49.18±26.87, all P<0.01 ], and the endotoxin and WBC in G-bacterial severe sepsis and septic shock subgroup were significantly higher than those of sepsis subgroup [ endotoxin ( ng/L ): 19.40 ( 9.62, 33.87 ) vs. 10.00 ( 5.00, 18.52 ), WBC ( ×109/L ): 12.13±6.72 vs. 9.61±5.01, both P<0.01 ]. The PCT and endotoxin in G-bacterial severe sepsis and septic shock subgroup were significantly higher than those in G+severe sepsis and septic shock subgroup [ PCT (μg/L ):6.92 ( 1.94, 25.90 ) vs. 0.92 ( 0.38, 4.75 ), endotoxin ( ng/L ):19.40 ( 9.62, 33.87 ) vs. 2.56 ( 1.11, 4.01 ), both P<0.01 ].③The diagnostic efficacy of inflammatory parameters for severe sepsis and septic shock subgroup were: PCT area under receiver operating characteristic ( ROC ) curve ( AUC ) = 0.683, the cut-off point = 0.55 μg/L, sensitivity 63.2%, specificity 69.0%; CRP AUC = 0.802, the cut-off point = 92.25 mg/L, sensitivity 73.7%, specificity 86.2%; WBC AUC = 0.614, the cut-off point = 7.35×109/L, sensitivity 75.4%, specificity 48.3%; Neut% AUC = 0.622, the cut-off point = 0.882, sensitivity 43.9%, specificity 79.3%in G+group. At the same time, it was shown that PCT AUC=0.780, the cut-off point=6.80μg/L, sensitivity 51.0%, specificity 93.9%; CRP AUC = 0.907, the cut-off point = 90.10 mg/L, sensitivity 73.2%, specificity 95.9%;endotoxin AUC=0.694, the cut-off point=17.54 ng/L, sensitivity 57.3%, specificity 75.5%;WBC AUC=0.611, the cut-off point = 10.54×109/L, sensitivity 54.1%, specificity 69.4%; Neut% AUC = 0.621, the cut-off point = 0.843, sensitivity 65.6%, specificity 61.2%in G-group. Conclusions The plasma PCT and CRP have the best correlation between inflammatory parameters and severity of disease in bloodstream infective sepsis patients. CRP has the best diagnostic effect in severe sepsis/septic shock patients with bloodstream infection.

Objective To investigate the cross-talk between extracellular signal-regulated kinase (ERK) and nuclear factor κB (NF-κB) signal transduction pathways in A375 human melanoma cells.Methods Cultured A375 cells were randomly divided into 5 groups:control group receiving no treatment,two U0126 (a selective inhibitor of the ERK signaling pathway) groups treated with U0126 of 10 and 5 μmol/L,and two BMS-345541 groups treated with BMS-345541 of 10 and 5 μmol/L.After 24-hour treatment,Western blot and reverse transcription PCR were performed to measure the protein expressions of NF-κB P65,phosphorylated IκBα (p-IκBα),ERK1/2,as well as p-ERK1/2,and the mRNA expressions of NF-κB P65 and ERK1,respectively.One-way analysis of variance and least significant difference (LSD)-t test were carried out for statistical analysis.Results After 24 hours of treatment with U0126 of 10 and 5 μmol/L,a significant decrease was noted in the relative expression level of NF-κB p65 protein (0.60 ± 0.04 and 0.56 ± 0.06 vs.1.54 ± 0.15,both P＜ 0.01) and mRNA (0.79 ± 0.05 and 0.75 ± 0.04 vs.0.86 ± 0.05,both P ＜ 0.01),but a statistical increase in that of p-IκBα protein (0.90 ± 0.05 and 0.70 ± 0.02 vs.0.61 ± 0.03,both P ＜ 0.01) in the two U0126 groups compared with the control group; significant differences were observed in the expression level of p-IκBo protein (P ＜ 0.01) but not in that of NF-κB p65 protein (P ＞ 0.01) between the two U0126 groups.The relative expression levels of ERK1/2 and p-ERK1/2 proteins as well as ERK1 mRNA were significantly higher in the control A375 cells than those in the cells treated with BMS-345541 of 10 μmol/L (0.73 ± 0.07,0.75 ± 0.09,1.51 ± 0.02,all P ＜ 0.01),but similar to those treated with BMS-345541 of 5 μmol/L (0.94 ± 0.11,0.99 ± 0.04,1.62 ± 0.03,all P ＞ 0.05).Conclusion There is a cross-talk between ERK and NF-κB signal transduction pathways in A375 melanoma cells.

Objective To evaluate the effect of combination therapy with milrinone and esmolol on hemodynamics and cardiac function in patients with septic myocardial depression. Methods From October 2010 to October 2013,after the hemodynamics and cardiac function were evaluated by pulse indicator continuous cardiac output (PICCO),74 sepsispatients withCI < 2.2 L/min · m2 after fluid resuscitation were enrolled in the study and were divided into group A with intravenous injection of dobutamine hydrochloride ,and group B with intravenous injection of milrinone and esmolol,with 37 cases in each group. The patients'PICCO indicators, echocardiography and cardiac biomarker(CK,CK-MB,MYO,cTnI and ProBNP)in two groups were compared before and after 3-day treatment. Results (1)CI and GEF were significantly increased in group B after 3-day treatment when compared with those in group A.(2)Compared with those in group A,early diastolic mitral flow velocity/end diastolic mitral velocity (E/A) and right ventricular diastolic diameter(RVD) in group B had statistical significance.(3) CK-MB,cTnI and ProBNP decreased significantly in group B when compared with those in group A. Conclusion Combination therapy with milrinone and esmolol can increase cardiac ejection function,slow down the heart rate,reduce the heart blood and vascular preload,lessen the injury of myocardial and improve heart function.