Objective To investigate the clinical value of butylphthalide in patients with acute cerebral infarction.Methods 120 patients with acute cerebral infarction were randomly divided into study group and control group according to the method of random number table,60 cases in each group.The study group used butylphthalide on the basis of routine treatment,while the control group only received routine treatment.Main outcome measures included the National Institutes of Health Stroke Scale (NIHSS)table,activities of daily living Barthel index,blood viscosity,clinical curative effect and health related quality of life (HRQL)score.Results There was no significant difference in NIHSS score,Barthel score,blood viscosity and HRQL between the two groups on admission (P >0.05 ).When compared with the control group after 3 months,NIHSS score of the study group decreased significantly [(948 ±3.84)points vs.(14.38 ±3.29)points,t=5.395,P=0.000],Barthel score increased significantly[(84.44 ± 10.59)points vs.(75.89 ±8.39)points,t=3.854,P=0.015];blood viscosity decreased significantly[(5.09 ± 0.64)mPa.s vs.(648 ±0.71 )mPa.s,t =7.493,P=0.000];HRQL scores increased significantly [(80.47 ± 1 5.39)pointsvs.(69.58 ±14.39)points,t=4.395,P=0.002];clinical curative effect in the study group was significantly higher than control group (χ2 =6.122,P=0.013).Conclusion Butylphthalide is helpful to improve the prognosis and quality of life in patients with acute cerebral infarction.

Objective To investigate the efficacy and safety of the postoperative analgesia after thoracotomy with different patient-controlled intravenous analgesia (PCIA)medication.Methods One hundred and twenty ASA Ⅰ or Ⅱ patients scheduled for elective thoracic surgery were randomly di-vided into four groups according to different PCIA formula:group S received sufentanil 3 μg/kg;group SD received sufentanil 1.5 μg/kg plus dezocine 0.3 mg/kg;group SF received sufentanil 1.5μg/kg plus flurbiprofen axetil 3 mg/kg;group DF received dezocine 0.3 mg/kg plus flurbiprofen ax-etil 3 mg/kg.For all four goups,the applied medicine was diluted with 0.9% saline to 300 ml,and was infused at 5 ml/h with a bolus dose of 3 ml.The lockout time was set at 1 5 min.The VAS and Ramsay sedation scale were recorded 2,4,8,24,48 h after surgery,respectively.Total pressing times and the side effects were also recorded for the 24 h period after the surgery.Results There were no significant differences of the VAS score at the time 2,4,8,24 and 48 h post surgery of press num-bers within 24 h postoperatively among all groups.The Ramsay sedation scale was significantly high-er at the time 2,4,8,24 h after surgery in group S than those in other three groups (P <0.05).The side effects were more in group S than those in other three groups (P <0.05).Conclusion Compared with sufentanil alone,combination therapy is safer and more effective for analgesia after thoracic sur-gery.With good outcomes and less side effects,it deserves more consideration in clinics.

Objective To explore the effect of Lycium barbarum polysaccharide (LBP) on adiponectin (APN) expression and the mechanism of lowering blood-lipid and anti-inflammation in atherosclerotic (AS) mice.Methods C57BL/6J mice with normal feed were chosen as control group.Thirty-two ApoE-/-mice with high cholesterol diet were successfully established as AS models,and then the mice were randomly divided into model group and three LBP groups,which were feed with high,medium,and low dose of LBP.After feeding for four weeks,aortic blood and tissues were collected.Blood-lipid,inflammatory factors,endothelin-1 (ET-1),APN,AdipoR1,and AMPK pathway related protein expression were detected.Differentiated 3T3-L1 cells were divided into control group,LBP group,and LBP + BML-275 group.Triglyceride (TG),inflammatory factors,APN,AdipoR1,and AMPK pathway related protein expression was investigated.Results In mice,compared with the control group,typical AS pathomorphologic changes were found in aorta and the levels of TG,total cholesterol (TC),nitric oxide (NO),ET-1,interleukin-6 (IL-6),and tumor necrosis factor (TNF-α) in the model group were significantly increased,while the protein expression of HDL-C,APN,AdipoR1,PPARα,AMPKα,and p-AMPK-α and Acyl-CoA oxidase (ACO) mRNA expression was reduced.Compared with the model group,AS pathomorphologic state was obviously improved in aorta and the amount of TG,TC,NO,ET-1,IL-6,and TNF-α in LBP groups were markedly decreased,while the protein expression of HDL-C,APN,AdipoR1,PPARα,AMPKα,p-AMPKα,and ACO mRNA expression was up-regulated.These changes were all in a dose-dependent manner.In differentiated 3T3-L1 fat cells,compared with control group,LBP enhanced the expression of APN,AdipoR1,PPARα,AMPKα,p-AMPKα,and ACO,but decreased the amount of TG,IL-6,and TNF-α.Compared with LBP group,the levels of TG,IL-6 and TNF-α was notably increased in BML-275 group.Conclusion LBP up-regulates the expression of APN and AdipoR1,activates APN/AMPK pathway,plays a role in lowering blood-lipid and anti-inflammation,and thus relieves AS in mice.

AIM:To explore the influences of semaphorin 3A (Sema 3A) on hydrogen peroxide (H2O2)-induced injury in human umbilical vein endothelial cells (HUVECs).METHODS:Sema 3A over-expression vectors were constructed and transfected into the HUVECs by Lipofectamine 2000, and the over-expression effect was verified by qPCR and Western blot.The HUVECs in different groups were treated with or without 200 μmol/L H2O2 for 4 h.The levels of inflammatory cytokines were measured by qPCR.The levels of lactic dehydrogenase (LDH), superoxide dismutase (SOD) and malondialdehyde (MDA) were detected by corresponding colorimetry.The cell viability was measured by MTT assay.The cell apoptosis was analyzed by flow cytometry.The levels of apoptosis-related proteins cleaved caspase-3 and Bcl-2 were determined by Western blot.RESULTS:H2O2 induced inflammatory cytokine secretion, increased the levels of LDH and MDA, decreased SOD activity and cell viability, and increased cell apoptosis in the HUVECs.Over-expression of Sema 3A enhanced the above processes.No injury effect of Sema 3A over-expression on HUVECs without H2O2 treatment was observed, indicating that the injury effects of Sema 3A on HUVECs depended on H2O2.CONCLUSION:Sema 3A markedly enhances H2O2-induced injury in the HUVECs, which depends on H2O2.Sema 3A may promote oxidative stress-caused endothelial cell injury.

OBJECTIVE:To study the mechanism of Aurantii fructus immaturus(AFI)and its main active ingredients in pro-moting gastrointestinal motility of model rats with spleen deficiency. METHODS:170 rats were randomly divided into blank group (10 rats) and modeling group (160 rats),rats in modeling group was induced models with spleen deficiency by bitter cold diar-rhea+irregular diet. After modeling, rats were randomly divided into model group, naringin (NA) low-dose, medium-lose, high-dose groups(3.267,6.535,13.070 mg/mL),neohesperidin(NE)low-dose,medium-lose,high-dose groups(3.865,7.730, 15.460 mg/mL),synephrine(SY)low-dose,medium-lose,high-dose groups(0.252,0.504,1.008 mg/mL),compatibility groups with 3 monomer ingredients (NA-NE-SY) low-dose,medium-lose,high-dose and AFI water decoction low-dose,medium-lose, high-dose groups(0.104,0.208,0.416 g/mL,calculated by crude drug),ig,once a day,10 mL/kg,for 7 d. After the last admin-istration,gastrin (GAS) in serum,and acetylcholine (ACh),motilin (MTL),substance P (SP),vasoactive intestinal peptide (VIP)levels in plasma were detected. RESULTS:Compared with blank group,GAS level in serum and ACh,MTL,SP levels in plasma in model group were reduced(P<0.01),VIP level in plasma was increased(P<0.05). Compared with model group,ex-cept for the GAS level in serum showed no obvious change in NA high-dose group and SY doses groups,other medicine groups were obviously increased (P<0.05 or P<0.01);the ACh levels in serum were obviouly increased in NE high-dose group,SY high-dose group and AFI water decoction low-dose group(P<0.01). MTL levels in plasma were obviously increased in NE medi-um-dose,high-dose groups,SY high-dose group,compatibility low-dose,medium-dose groups and AFI water decoction medi-um-dose,high-lose groups (P<0.05);SP levels in plasma were obviously increased in NA low-dose,medium-dose groups and NE doses groups(P<0.05 or P<0.01);VIP levels were reduced in NA low-dose group,SY high-dose group and AFI water decoc-tion low-dose,medium-lose groups(P<0.05). CONCLUSIONS:AFI may promote the gastrointestinal motility of model rats with spleen deficiency by promoting the secretion of GAS,ACh,MTL,and inhibiting the secretion of VIP;there are differences be-tween AFI and the 3 monomer ingredients in regulation of gastrointestinal hormones.

Objective To assess the risk factors of carbapenem -resistant Acinetobacter baumannii (CRAB) infection.Methods Clinical data of patients with positive bacterial culture in Tianjin Medical University General Hospital during January 2011 and December 2015 were retrospectively analyzed, including 68 patients with carbapenem resistant Acinetobacter baumannii (CRAB) bacteremia, 68 patients with carbapenem sensitive Acinetobacter baumannii ( CSAB) bacteremia, and 68 patients with positive culture of other bacteria (control group).The risk factors of Acinetobacter baumannii infection were analyzed by univatiate and multivariate Logistic regression analyses .Results Univariate analysis showed that bacteremia /sepsis,use of carbapenems,β-lactamase inhibitor compound,tigecycline,combined antibiotics, glucocorticoids,surgery within one month, mechanical ventilation, central venous catheters ( CVCs ), arteriopuncture,indwelling catheter≥3 days and indwelling gastric tube were risk factors of CRAB infection (CRAB vs.control: χ2 =4.96,15.56,7.64,9.22,5.89,6.80,17.00,11.83,18.22,8.24,25.24 and 7.70, P <0.05 or P <0.01, respectively); while use of third-generation cephalosporin,CVCs,length of hospital stay were risk factors of CSAB infection (CSAB vs.control: χ2 =11.93 and 6.94,U =1555, P <0.05).Multivariate logistic analysis showed that bacteremia /sepsis (OR =4.01, 95%CI:1.13 ~14.20), use of carbapenems (OR =4.17, 95%CI :1.79 ~9.73), CVCs (OR =2.93, 95% CI: 1.22 ~7.08), indwelling catheter≥3 days (OR =6.08,95%CI:2.39 ~15.46) were independent risk factors of CRAB infection; use of third-generation cephalosporin (OR =3.98, 95% CI :1.88 ~8.43 ),CVCs(OR =3.40, 95% CI:1.48 ~7.81) were independent risk factors of CSAB infection .Conclusions Long-term use of carbapenems and invasive procedures are associated with CRAB infection , strict control of invasive procedures and rational use of antibiotics may reduce CRAB infection .

Objective To evaluate the clinical application of the whole blood interferon γ(IFN-γ) release assay of QuantiFERON TB Gold in tube (QFT-GIT) in diagnosis of tuberculosis. Methods From October 2014 to October 2015, 109 patients with tuberculosis (45 cases of confirmed patients and 64 cases of clinically diagnosed patients) and 70 patients with non-tuberculosis were enrolled in Tianjin Medical University General Hospital. In order to evaluate diagnosis value between two kinds of tests, and to compare the differences between two groups, QFT-GIT test and colloidal gold anti tuberculosis antibody (TB-Ab) were employed to detect in two groups of patients. The ROC curve of IFN-γrelease quantity was analyzed in two groups. Results The sensitivity and specificity of QFT-GIT were 93.58% and 85.71% respectively. The positive rate was significantly higher in QFT-GIT than that of TB-Ab (χ2=43.68,P<0.01). The sensitivity of combined detection of the two methods decreased to 52.3% (57/109), but the specificity increased to 90.0% (63/70). The release quantity of IFN-γwas significantly higher in tuberculosis group than that in the non-tuberculosis group (U=330,P<0.05). The area under the ROC curve of IFN-γrelease quantity was 0.913 (95%CI:0.864-0.963). Conclusion The whole blood IFN-γrelease assay of QFT-GIT is a sensitive and specific assay for detecting tuberculosis infection. The combination QFT-GIT with TB-Ab can improve the specificity further, which could be a useful tool for the diagnosis of tuberculosis .

OBJECTIVE: This study aimed to investigate the relationship between CD14 gene rs2569192(C/G), rs3138078 (--1359G/T) and allergic rhinitis (AR) in Xinjiang Uygur and Han populations as well as to determine characteristics of polymorphisms. METHOD: A total of 300 AR and 300 healthy controls subjects were included. The frequencies of genotypes and alleles were detected as well as the levels of tIgE in different genotypes were compared. RESULT: (1) The distribution of genotypes or alleles of CD14 gene rs2569192 (C/G), rs3138078 (--1359G/T) had no differences between the Xinjiang Uygurs and Hans (P > 0.05). The highest frequency of alleles was C, G. (2) The frequencies of genotypes and alleles were not different between the AR and control group in Uygur and Han (P > 0.05). The frequencies of genotypes and alleles of rs2569192 were different between the Uygur AR and Han AR group (P < 0.05). (3) The distribution of genotype frequencies and allele of rs 2569192 in the Xinjiang Uygur and Han population were quite different from Chinese Beijing Han populations, Japanese, European and African (P < 0.05). (4) The serum total IgE level in AR group was higher than that in healthy control group (P < 0.05). CONCLUSION (1) rs2569192 (C/G), rs3138078 (--1359G/T) polymorphisms were not different between the Chinese Xinjiang Uygur and Han population. The major allele were both C and G. rs2569192 of CD14 in Xinjiang populations was different from that in the other populations. (2) No relationship between rs2569192, rs3138078 and AR was found. (3) The serum total IgE level in AR group was higher than that in healthy control group. No relationship between CD14 two SNP and serum total IgE level was found.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Alleles ; Case-Control Studies ; Child ; Child, Preschool ; China ; epidemiology ; Ethnic Groups ; genetics ; Female ; Gene Frequency ; Genotype ; Humans ; Hypersensitivity ; epidemiology ; genetics ; Lipopolysaccharide Receptors ; genetics ; Male ; Middle Aged ; Polymorphism, Single Nucleotide ; Rhinitis ; epidemiology ; genetics ; Young Adult

Objective:To explore the teaching effect and novel ideas of online teaching applied in skill operation course.Methods:One hundred and fifty-one students studying in Sichuan University taking the First Aid in the Life: Basic Knowledge and Skills as an elective course in the autumn semester of 2019 and spring semester of 2020 were included as the research subjects in this study. Among them, 77 students in the spring semester of 2020 were selected as the experimental group and 74 students in the autumn semester of 2019 were selected as the control group. The students in the experimental group studied the first aid course by online platform, and the others in the control group studied through traditional teaching mode. The teaching effect of the two groups was compared and the teaching satisfaction of the two groups weas analyzed. SPSS 23.0 was used for Chi-square test and t-test. Results:There was no significant difference between the control group and the experimental group in the assessment scores of cardiopulmonary resuscitation, hemostatic bandaging, and fracture fixation [(8.65±0.81 vs 8.69±0.90, P=0.750); (8.10±0.50 vs 8.12±0.61, P=0.880); (8.21±0.89 vs 8.16±0.78, P=0.710)]. Among the students participating in the questionnaire survey in the experimental group, 59 (95.16%) students thought that this course was helpful in dealing with first aid in daily life, and 38 (61.29%) students did not want to change the traditional teaching method to online teaching. Conclusion:The application of online teaching in first-aid skill operation course is feasible and can achieve the similar teaching effect, which provides a novel idea for exploring the online teaching of first aid skills.

Objective To explore the CTV to PTV external expansion boundary and the effect of the dose of normal lung tissue under different fixed modes by a comparative analysis of combined body position and thermoplastic film fixed set-up error of radiation therapy for lung cancer. Methods From October 2016 to March 2018, the patients who received chest radiology at the Tangshan people's hospital were enrolled as subjects retrospectively divided into two groups, including 50 patients with lung cancer radiotherapy with combined body position fixation, and 40 patients with lung cancer with thermoplastic film fixation. The two groups of patients drew the target areas in accordance with the unified standard, and the set-up error of left and right, up and down, front and rear ( x, y, z axis) were recorded respectively after 1 time/week cone CT( CBCT) matched with the planned CT image and analyzed by t test. According to the MPTV =2. 5Σ+0. 7δ, CTV to PTV external expansion boundary in the combined body position group were calculated. And the V5、V20 and V30 of two groups of patients were calculated and analyzed by TPS system. Results The set-up error of the combined body position group and thermoplastic film group were respectively (1. 00 ± 0. 58) mm and (3. 28 ± 0. 43) mm on the x axis, (1. 42 ± 0. 28) mm on the y axis and (4. 03 ± 0. 41) mm, (1. 06 ± 0. 44) mm and (3. 18 ± 0. 34) mm on the z axis. The set-up errors of the two groups were statistically significant on x, y and z axis( t= -20. 740, -35. 596, -25. 015,P<0. 05). There was no significant difference in set-up errors between the central and peripheral lung cancer patients and between left and right lung cancer patients(P>0. 05). Through the MPTV =2. 5Σ+0. 7δ, CTV to PTV external expansion boundary in the combined body position fixation group was 2. 906 , 3. 746 and 2. 958 mm on x, y and z axis respectively. The comparison between group A and B showed that the mean values of V5 , V20 and V30 in group B were reduced by 1. 5％, 3. 1％ and 4. 8％ respectively compared with group A. Conclusions The combined body position technique can improve the accuracy of lung cancer patients after radiation therapy,and further reduce the boundary of CTV to PTV, which is of certain value to reduce the occurrence of radiation pneumonitis.