Objective To investigate the clinic application significance of hand control high frequency continuous positive airway pressure treatment with self-inflating bags(SIB) fitted with positive end expiratory pressure (PEEP) valves on the neonatal transport of severe neonatal congenital diaphragmatic hemia (CDH).Methods Clinical data of a total of 28 infants with severe CDH transported by the pre-hospital emergency care team of our department were analyzed.The 28 patients were divided into treatment group (n =16) and control group (n =12).Hand control high frequency continuous positive airway pressure of SIB and PEEP valve were administered in the treatment group,while only hand control SIB positive airway pressure were given in the control group during the transportation.The exacerbation,complication and blood gas indicators at different time before and after treatment in two groups were monitored and compared.Results In the treatment group,no case aggravated,no case complicated with gas leakage,pulmonary hemorrhage,persistent pulmonary hypertension,intracranial hemorrhage; 2 cases died for multiple organ failure before operation (12.5％),5 cases died after operation (31.3％).In the control group,8 cases aggravated (66.7％),cases complicated with gas leakage,pulmonary hemorrhage,persistent pulmonary hypertension,intracranial hemorrhage were 5 (41.7 ％),3 (25.0％),1 (8.3 ％),respectively; 4 cases died for multiple organ failure before operation (41.7％),5 cases died after operation (33.3％).The indexes of pH,PaO2,PaCO2 and PaO2/FiO2 at different time before and after treatment between the treatment group and the control group or in each separate group all showed statistical significance (P ＜ 0.05).Conclusion Early accurate diagnosis during transportation with hand control high frequency continuous positive airway pressure of SIB fitted with PEEP valves for CDH is a safe and effective ventilation method which can reduce complications and increase successful transfer and survival rate.

BACKGROUND:More than 10 kinds of lipid metabolism-related genes have been found, and endocrine dysfunction mediated by these genes is an important pathological basis for the occurrence and development of insulin resistance. OBJECTIVE:To investigate the effects of metformin on serum lipid profiles and the expression levels of various genes associated with insulin resistance, as well as the histopathological changes of the liver and pancreas in rats with type 2 diabetes melitus. METHODS:A type 2 diabetes mellitus rat model was established by feeding a high-fat diet to the rats for 4 weeks, combined with the intraperitoneal injection of streptozotocin (35 mg/kg). In the meanwhile, metformin was administered orally (400 mg/kg?d) (model group) or nothing (control group). Semi-quantitative RT-PCR, histopathological and biochemical examinations were then performed. RESULTS AND CONCLUSION:Metformin improved the symptoms of insulin resistance by normalizing the serum lipid profiles in the diabetic rats. Furthermore, metformin upregulated the expression levels of insulin receptors and genes associated with lipid metabolism, including acyl-CoA oxidase, carnitine palmitoyl transferase-1 and peroxisome proliferator activated receptor-α. In addition, metformin downregulated the expression levels of fetuin-A and retinol binding protein-4, and improved the expression of perilipin that had been reduced in the type 2 diabetes mellitus rats. Metformin was shown to induce positive signaling for insulin and the regeneration of pancreaticβcells in the pancreas. These results suggest that metformin ameliorates the insulin resistance induced by type 2 diabetes mellitus via regulating the expression levels of fetuin-A, retinol binding protein-4, perilipin and various genes associated with lipid metabolism.

BACKGROUND:Some scholars have prepared zein/chitosan composite membrane based on blending methods, and preliminary evaluation ofitsphysical and chemical properties showsthat chitosan partly improvesthe mechanical properties and hydrophilic properties of zein. Therefore, zein/chitosan composite membrane presumably has good cytocompati bility, which is beneficial to osteogenic differentiation of bone marrow mesenchymal stem cels.
OBJECTIVE:To explore the effect of zein/chitosan composite membrane on the differentiation of bone marrow mesenchymal stem cels into osteoblasts and its feasibility asabone tissue-engineered material.
METHODS:With 60% acetic acid as solvent, zein/chitosan composite membrane was prepared by blending and casting method. The structure and physicochemical properties of the composite membrane were investigated by Fourier transform infrared spectroscopy, tensile testing, water absorption testing and scanning electron microscopy. And the cytocompatibility of the membrane was evaluated byin vitrocel cufture. Besides,bone marrow mesenchymal stem celsfrom Sprague-Dawley ratwere isolatedvia adherence screening method, andthe effects of thecompositemembrane on theosteogenic differentiation ofthese celswere observedby scanning electron microscopy, fluorescent labeling and alkaline phosphatase assay.
RESULTS AND CONCLUSION:The tensile strength, water absorption and hydrophilicity of the films were improved with the chitosan increased; chitosan could promote cel proliferation indicating the good cytocompatibility of the composite films. Moreover, osteogenic induction occurredin bone marrow mesenchymal stem cels cultured on the compositem embrane, and with an increase of chitosan, the induction was promoted. In conclusion, zein/chitosan composite membrane can be applied widely in the field of bone tissue engineering.

BACKGROUND: Bone morphogenetic protein in combination with hol ow porous titanium al oy can improve the affinity with surrounding bone tissues. OBJECTIVE: To observe the effects of bone morphogenetic protein 2 on growth and osteogenic differentiation of bone marrow mesenchymal stem cel s cuftured on a hol ow porous metal prosthesis scaffold. METHODS: Passage 3 Sprague-Dawley rat bone marrow mesenchymal stem cel s were directly inoculated onto a hol ow porous metal prosthesis, and then the scaffold was cultured in DMEM medium containing 0, 0.001, 0.01, 0.06 and 0.1 g/L bone morphogenetic protein 2, respectively. At 6, 12, 24 and 48 hours after inoculation, cel adhesion was detected by MTT assay. Cel osteogenic differentiation was detected by alizarin red staining at 18 days. Besides, Transwel culture was put on the scaffold, and 5x108/L bone marrow mesenchymal stem cel s were added into the upper chamber, and DMEM medium containing 0, 0.001, 0.01, 0.06 and 0.1 g/L bone morphogenetic protein 2 were added into the lower chamber to observe cel migration capability after 0, 6, 12, 24 and 48 hours culture. RESULTS AND CONCLUSION: After 6-48 hours of inoculation, different mass concentrations of bone morphogenetic protein 2 promoted adhesion of bone marrow mesenchymal stem cells in a time-dependent manner. After 18 days of inoculation, bone marrow mesenchymal stem cells induced by different mass concentrations of bone morphogenetic protein 2 changed from fusiform to polygon, and arranged in a multilayer and overlapped form. Numerous calcified nodules could be found, which were stained red by alizarin red. Additionally, within 6-48 hours of culture, bone morphogenetic protein 2 could promote the migration of bone marrow mesenchymal stem cells in a concentration-and time-dependent manner. In conclusion, bone morphogenetic protein 2 can enhance the adhesion, osteogenic differentiation and migration of bone marrow mesenchymal stem cells cultured on the hollow porous metal prosthesis.

ObjectiveTo investigate the diagnosis and correlative factors of suspected severe acute respiratory synd rome (SARS) cases, and finally, complete the diagnosis and treatment.MethodsTo analyze the clinical, laboratory data,chest radiog raph and treatment of 100 suspected SARS cases.ResultsAmong 100 suspected SARS cases,66 were diagnosed as SARS,4 were mycoplasma l pneumonia, 2 were pulmonary tuberculosis,the others were general bacteria pne umonia.Conclusions SARS hasn't characteristic clin ical manifestation.Because there is not a gold diagnosis standard up to now, the disinfection and isolation of suspected SARS cases should be treated as SARS c ases. In order to prevent missed and misdiagnosis, the diagnosis and treatment s hould be synthetically thought.

Objectiye To evaluate the value of intraoperative bile leakage test during liver resection in preventing postoperation bile leakage. Methods Eighty-one cases were randomly divided into two groups,in the test group (41 cases) white fat emulsion(sterilized) was injected into common bile tract through cyst bile duct,the leakage points on the transect surface were observed and disposed. In the control group (40 cases) the transect surface were disposed by regular methods. The rate of postoperation bile leakage in the two groups were analyzed. Results The rate of postoperation bile leakage in the test group was 2. 4% (n=1), and the rate of postoperation bile leakage in the control group was 15% (n = 6). There was significant difference between the two groups (x2=4.04, P＜0.05). Conclusion The white bile leakage test is effective in preventing the postoperation bile leakage during liver resection and does not increase other complications.

Objective To analyze the characteristics of opportunistic infection (OI) in patients with HIV/AIDS in Guangdong and the relationship between OI and the change in blood CD4+ T lymphocyte count (CD4+ ).Methods Seven hundred and sixty two patients with HIV/AIDS admitted were analyzed. Results Among all the 762 patients, 704 (92.39% ) had more than one kind of OI, with 1428 episodes totally.Etiologically, fungus infection (38.38% ) was most common, followed by bacteria (36.20% ), and virus (7.77% ) infection. Most OI occurred in the lungs (33.05% ), mouth (26.89% ), skin (10.29% ) and gastro-intestine (8.96% ).Septicemia and other systemic disseminated diseases accounted for 6.58% and 9.94% respectively.The incidence of OI in patients with CD4+= 200/μ1 (103/136, 75.74%) was significantly lower than that in patients with CD4+ <200/μ1 (601/626, 96.01%), P<0.01.All the AIDS defining OI were found in patients with CD4+ <200/μ1 Among them, 81.97% of patients with pneumonia carinii pneumonia (PCP), 71.43% of patients with cytomegalovirus retinitis and all the patients with cryptococcal meningitis, disseminated cryptococosis, disseminated histoplasmosis, mycobacterium avium intracellular complex (MAC), disseminated penicilliosis mameffei and toxoplasma cerebritis had the CD4+ less than 50/ μ1.Conclusions The most common OI in patients with AIDS in Guangdong area are fungi, bacterial and viral infections.Lung, mouth, skin, gastro-intestine and systemic disseminated infections are the most prevalent infections.As the CD4+ decreased, the incidence of OI especially AIDS defining OI increased. Dynamic detection of CD4+ will be of great help for the prediction, prevention, early diagnosis and treatment of OI in patients with AIDS.

Objective To investigate the effect of Bcl-2 gene expression on the proliferation and apoptosis of human pancreatic cancer SW1990 cells.Methods Bcl-2 short guide RNA (Bcl-2-sgRNA) was designed and synthesized,and it was combined with CRISPR-Cas 9.After confirmation by gene sequencing,it was transfected into human pancreatic cancer cell line SW1990,then the cells with stable Bcl-2 gene knock-out were selected,and wild type SW1990 cells were used as control.The cell growth curve was determined by CCK-8 method.The number of clone formation was measured.Flow cytometry was used to measure cell cycle and apoptosis.Results Human pancreatic cancer cell line SW1990 with Bcl-2 gene knock-out was successful constructed.Compared with wild type SW1990 cells,the growth of SW1990 cells with Bcl-2 gene knock-out was inhibited,the number of clone formation was significantly decreased [(160.7 ± 10.0) vs (285.3 ± 14.2)],the proportion of G1 cells was significandy increased [(84.51 ± 0.97) ％ vs (57.49 ± 1.08) ％],the proportion of S phase cells significantly decreased [(12.82 ± 0.99) ％ vs (27.56 ± 1.65) ％],and apoptosis rate was remarkably increased [(12.67 ± 0.59) ％ vs (0.37 ± 0.35) ％],and the difference between the two groups was statistically significant (P ＜ 0.01).Conclusions Knock-out of Bcl-2 gene can inhibit the growth of human pancreatic cancer cell line SW1990,decrease the ability of clone formation,block the cell in G1 phase and greatly increase cell apoptosis rate.

Objective To study the compatibility of TCM prescriptions of TCM practitioners of all dynasties of Alzheimer disease (AD). Methods Amnesia, forgetting, dementia, and idiot were set as search words to retrieve relevant literature in Encyclopadia of Traditional Chinese Medicine. Prescription information was screened and standardized to build database. Frequency analysis and association rules were used to mine TCM prescriptions and compatibility rules. Results Totally 449 AD related prescriptions were selected, involving 682 Chinese medicinal herbs. The individual herb with the highest frequency was Ginseng Radix Rhizoma (192);the herbal pair with the highest frequency was Ginseng Radix Rhizoma-Polyhalae Radix (182);the herbal combination with 3 Chinese medicinal herbs with the highest frequency was Poria with Hostwood-Ginseng Radix Rhizoma-Polyhalae Radix (79);the herbal combination with 4 Chinese medicinal herbs with the highest frequency was Polyhalae Radix-Ginseng Radix Rhizoma-Poria with Hostwood-Glycyrrhizae Radix et Rhizoma (37). The results of association rules showed that Ginseng Radix Rhizoma-Polyhalae Radix, Ginseng Radix Rhizoma-Glycyrrhizae Radix et Rhizoma, and Ginseng Radix Rhizoma-Poria with Hostwood were commonly used compatibilities in AD related prescriptions. Conclusion Treatment of TCM practitioners in all dynasties for AD mainly chooses Chinese medicinal herbs with the efficacy of tonifying qi and soothing nerves. The compatibilities and combinations are reasonable and with certain representativeness.