Objective: To improve the understanding of pulmonaryStrongyloides stercoralis. Methods: Two paients were diagnosed with severe infection with pulmonaryStrongyloides stercoralis by respiratory ICU of Xiangya Hospital. The clinical manifestations, laboratory tests, imaging and pathological data were analyzed. Another 87 cases in the literature were reviewed from 1973 to 2013. Results: In the 2 cases, digestive symptoms were the ifrst symptom andStrongyloides stercoralis was found in the lungs. Eosinophils was detected in the 13 death cases by blood routine examination, with 10 cases≤0.05×109/L. Conclusion: The farmers were the main infected people. Patients with basic diseases or with immunosuppression due to long-term glucocorticoid treatment tend to infect and even die atfer the infection withStrongyloides stercoralis. Eosinophil granulocyte reduction shows poor prognosis, which needs early diagnosis and treatment.

AIM: To determine the HPLC fingerprint of ultramicro decoction piece of Fructus gardeniae. METHODS: Chromatographic conditions were as follows: column: Hypersil BDS C_ 18 (4.6 mm?200 mm,5 ?m), mobile phase: acetonitrile-water (10∶90), column tempemture: 25 ℃,flow rate: 1 mL?min -1 , wavelength: 238 nm, and inject volume: 10 ?L. RESULTS: The fingerprint of ultramicro Fructus gardeniae was established and 7 common peaks in the fingerprint were indicated. CONCLUSION: It can nearly completely reflect intrinsic quality of ultramicro decoction piece of Fructus gardenian.

AIM: To observe the effect of myocyte enhancer factor 2C (MEF2C) on the expression of substance P (Sub P) and neurofilament triplet L (NFL) in rat dorsal root ganglion cells (DRGn cells). METHODS: DRG neurons were dissociated and cultured, and then exposed to different concentrations of nerve growth factor (NGF, 10 μg/L, 30 μg/L, 100 μg/L or 200 μg/L) for 24 h. The neurons cultured in media with the lowest concentration of NGF (10 μg/L) served as control. Real time PCR was used for detecting the mRNA of substance P and NFL in the DRGn cells. Three MEF2C-siRNAs were transfected into PC 12 cell line by the way of chemical mediation. The best siRNA with the highest interference ratio was determined by real time PCR. The DRGn cells knocked out MEF2C gene were also transfected with siRNA, and the expressions of substance P and NFL were measured by real time PCR after stimulated with high concentration of NGF. RESULTS: The expressions of substance P and NFL increased in primary cultured rat DRG neurons in a dose-dependent manner of NGF stimulation. The expression level of MEF2C in experimental group was lower by 50% than that in control group. No change of cyclic AMP response element-binding protein (CREB) was observed. The substance P decreased by 41% in experimental group than that in control group at the same time point. The NFL was decreased by 61%. CONCLUSION: NGF may promote the synthesis of substance P and NFL in rat DRGn cells. MEF2C regulates the expression of substance P and NFL in DRGn cells in rat embryo and MEF2C may be a critical transcriptional factor involved in the airway hyperresponsiveness.

Objective To elucidate intracellular transcription factor activation of C_7～T_5 dorsal root ganglia in rats recurrently infected with respiratory syncytial virus (RSV). Methods Eighty 1～2 weeks old Sprague-Dawley rats were randomly divided into 2 groups: a control group and a RSV-infection group. The rats in the RSV-infection group were infected with 5 ×10~5 U/mL RSV once a week and the rats in the control group were treated with culture medium without RSV. Airway response was measured after 8 weeks. Lung tissue was submitted for HE staining and in situ hybridization. The C_7～T_5 dorsal root ganglia were obtained for the preliminary screening of the intracellular transcription factors by TranSignal~(TM) protein/DNA combo array. Nuclear protein of C_7～T_5 dorsal root ganglia were extracted and submitted to Western blot. Results Airway response in the RSV-infection group was higher than that in the control group (P＜0.05). HE staining showed inflammatory cell infiltration, and in situ hybridization demonstrated positive RSV RNA in the RSV-infection rat lung which was not present in the control group, thus validating the efficacy of our model. TranSignalTM protein/DNA combo array screening showed that 55 transcription factors increased by at least 2 folds in the C_7～T_5 DRG cells of the RSV-infection group. The transcription factors Smad and interferon regulatory factor (1 or 2) were the 2 most upregulated transcription factors identified by combo array screening (59 and 43 fold increase compared with the control, respectively). Western blot confirmed Smad(1/2/3) and IRF-1 upregulate while IRF-2 remained unchanged. Conclusion Respiratory syncytial virus infection results in airway hyperresponsiveness and transcription factor activation in C7～T5 spinal adorsal root ganglia in rats, which may contribute to airway nerve network dysfunction and airway hyperresponsiveness.

Objective:To study on the effect of ultrasound-guided thoracic paravertebral nerve (TPVB) block on quality of recovery from general anesthesia in tuberculosis patients with fiberboard exfoliation in post anesthesia recovery unit (PACU).Methods:From May 2018 to December 2019, 40 tuberculosis patients in Changsha Central Hospital with pulmonary fibreboard exfoliation and focal abscess lesions cleaning were randomly divided into two groups, with 20 patients in each group. The patients in group A received endobronchial general anesthesia and in group B received ultrasound-guided TPVB combined with endobronchial general anesthesia. Patients in the two groups were maintained under anesthesia by propofol, and the bispectral index (BIS) was maintained within the range of 40-50. The dosage of propofol and sufentanil was adjusted according to changes in BIS and hemodynamics. The mean arterial pressure (MAP), heart rate (HR) in two groups of patients were recorded at before anesthesia induction (T 0), before cutting leather (T 1), cut skin after (T 2), the end of operation (T 3), extubation time (T 4), and T 5 (time of leaving PACU). The visual analogue scale (VAS) of all patients in resting and cough state was recorded at 5, 30 min after extubation and the time of leaving PACU. The dosage of propofol and sufentanil in the operation and the additional dosage of sufentanil in PACU were recorded in both two groups. And the respiratory recovery time, consciousness recovery time, extubation time and sedation agitation scale(SAS) were observed. The adverse reactions such as nausea, vomiting, drowsiness and hypotension were observed in PACU. Results:Compared with group A, MAP and HR of patients at T 2, T 3, T 4, T 5 in group B were more stable during anesthesia, and VAS of patients in group B were lower than that in group A at each time point after extubation ( P<0.05). The dosage of sufentanil and propofol in group B were (35.92±8.12)μg and (749.56±95.30)mg respectively, which were significantly lower than those in group A [(45.74±4.42)μg and (862.83±105.34)mg, P<0.05]; the dosage of sufentanil in postoperative anesthesia recovery room of group B was (5.26±2.10)μg, significantly less than that of group A (10.35±5.86)μg ( P<0.05). The respiratory recovery time, consciousness recovery time and extubation time in group B were (12.92±5.12) min, (20.56±5.10) min and (26.87 ± 6.16) min, which were shorter than those in group A [(15.74±4.72)min, (25.83±5.34)min and (35.35±5.80)min, P<0.05]. The incidence of postoperative nausea, vomiting, lethargy and hypotension in group B were 10%, 10%, 35% and 20%, which were significantly lower than those in group A (30%, 20%, 75% and 45%, P<0.05). Conclusions:Ultrasound-guided paravertebral nerve block may significantly reduce the dosage of opioid analgesics for general anesthesia in tuberculosis patients with fiberboard exfoliation, accelerate the speed of anesthesia recovery, reduce the agitation during recovery, and improve the quality of anesthesia recovery.

OBJECTIVE: To explore the effect of nerve growth factor(NGF) and interferon regulatory factor-1(IRF-1) on sodium current change of sensory neuron in rat pheochromocytoma cells. METHODS: Sensory neuron rat pheochromocytoma cells were stimulated by different concentrations of NGF(0-200 ng/mL), the IRF-1 mRNA levels were examined by real-time PCR, and the activation of IRF-1 was examined by Western blot. The sodium current change was recorded by patch clamp. RESULTS: Low concentration of NGF improved the sodium current, which was concentration dependent. When exposed to high concentration of NGF, the expression of IRF-1 mRNA in PC-12 was improved. Low concentration of NGF resulted in IRF-1 intronuclear transporting, and the expression was not affected. Sodium current did not occur in PC-12 cells when IRF-1 was blocked. CONCLUSION NGF can improve the sodium current in PC-12 cells concentration-dependently, and the improvement is regulated by IRF-1.
Animals ; Interferon Regulatory Factor-1 ; genetics ; metabolism ; Nerve Growth Factor ; pharmacology ; PC12 Cells ; RNA, Messenger ; genetics ; metabolism ; Rats ; Real-Time Polymerase Chain Reaction ; Sodium Channels ; drug effects

The clinical data of patients with chlamydia psitsiti pneumonia confirmed by metagenomic next-generation sequencing (mNGS) who were admitted to the Huizhou Municipal Central Hospital from January 2020 to November 2021 were retrospectively analyzed. Among 21 patients, the serum creatine kinase (CK) was elevated in 10 cases, and 5 cases was complicated with rhabdomyolysis (RM). The symptoms of patients with Chlamydia psittaci pneumonia-induced RM were severe, including high fever, dyspnoea, headache and myalgia; 2 case were complicated by acute kidney injury (AKI) and neurological symptoms. Laboratory testing showed a marked increase in CK, myoglobin (Mb), high sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6) and D-dimer levels in all 5 patients. The chest CT revealed large areas of pulmonary consolidation, ground-glass opacity in 1 case and a small amount of pleural effusion in 2 cases. One patient died from multiple organ failure, and the other 4 patients were discharged with considerable improvement. Patients with psittacosis pneumonia are prone to developing rhabdomyolysis, early detection and early treatment can effectively improve the prognosis of patients.

Objective:To analyze the clinical characteristics of Chlamydia psittaci pneumonia and to investigate the correlation between serum inflammatory biomarkers and severity of the disease. Methods:Sixteen patients with Chlamydia psittaci pneumonia admitted to the Huizhou Municipal Central Hospital from January 2020 to July 2021 were selected as the study subjects, including 10 severe cases and 6 mild cases. Clinical data were collected and analyzed, such as baseline characteristics, clinical symptoms, laboratory inspection and chest imaging manifestations. Results:① Thirteen Chlamydia psittaci pneumonia were associated with a definite bird or poultry contact history. Common symptoms included high fever, chill, cough, fatigue, and anorexia (16 cases), dyspnoea (12 cases), and other systemic symptoms. ② Laboratory test results showed normal white blood cell count (WBC, 10 cases), decreased lymphocyte count (LYM, 13 cases), increased high sensitive C-reactive protein (hs-CRP, 16 cases), D-dimer (15 cases), lactate dehydrogenase (LDH, 13 cases), aspartate aminotransferase (AST, 16 cases) and alanine aminotransferase (ALT, 12 cases) levels, however, the albumin (Alb, 15 cases) lever was decreased. The numbers of CD3 + T cells and CD4 + T cells decreased in 10 patients. ③ The levels of D-dimer, interleukins (IL-2, IL-6, IL-10) in severe Chlamydia psittaci pneumonia were significantly higher than those in mild Chlamydia psittaci pneumonia [D-dimer (μg/L): 10 257±4 203 vs. 1 085±642, IL-2 (ng/L): 1.1 (0.8, 1.7) vs. 0.3 (0.1, 0.7), IL-6 (ng/L): 315 (182, 505) vs. 75 (18, 131), IL-10 (ng/L): 7.0±4.1 vs. 2.3±0.7], but the LYM was lower (×10 9/L: 0.4±0.1 vs. 1.1±0.4), with significant differences (all P < 0.05). ④ Chest imaging manifestations were exudative lesions and large consolidation of lungs. Large consolidation of both lungs can occur in some critically ill patients. Conclusions:Chlamydia psittaci pneumonia is mainly associated with a bird or poultry contact history. The clinical manifestations usually present high fever, dyspnea, normal or slightly increased leucocytes, and lung consolidation. The levels of LYM, D-dimer, IL-2, IL-6 and IL-10 in serum are expected to predict the severity of the Chlamydia psittaci pneumonia.

Objective: Shortage of kidney allografts is a major barrier to end-stage renal disease patients receiving kidney transplantation, and it is necessary to enlarge the donor pool and find better ways of using available allografts. The global incidence of nephrolithiasis is increasing, nephrolithiasis affects approximately 10％ of adults worldwide, and it also affects the kidney donors. However, there is little information about the use of cadaveric kidney allografts with nephrolithiasis. This study aims to evaluate the safety and outcome of kidney transplantation with allografts from the deceased donors with nephrolithiasis. Methods: A total of 520 deceased donors who was at least 10 years old, and 945 adult recipients with single kidney transplantation at the Department of Kidney Transplantation, the Second Xiangya Hospital from 2016 to 2020 were included in this study. The donors were divided into 2 groups according to nephrolithiasis diagnoses: The donors with nephrolithiasis (D+) and the donors without nephrolithiasis (D?). The recipients were assigned into 3 groups according to their donors and the allografts they received: The allografts from donors without nephrolithiasis (D?K?), the allografts without nephrolithiasis from donors with nephrolithiasis (D+K?), and the allografts with nephrolithiasis (D+K+). The demographic and clinical data of enrolled subjects were retrospectively analyzed. The allograft discard ratio between different donors were analyzed. The one-year survival of allografts and recipients, as well as the allograft function and the complications of kidney transplantation were compared. Results: Fifty out of 520 donors had nephrolithiasis, and the nephrolithiasis incidence was 9.6％. We recovered 1040 kidneys, and total discard rate was 4.4％ (46/1040). The D+ group had a rate of 7％ discard. The donors with kidney discard accounted for 12％ in the D+ group, and this was higher than that of donors in the D? group (5.1％, P<0.05). The total incidence of delayed graft function (DGF) was 7.5％, and there were no significant differences in the incidence of DGF in recipients among the D?K?, D+K?, and D+K+ group (7.5％ vs 6.5％ vs 8.2％, P>0.05). During the one-year follow-up, 8 allografts lost function and 19 recipients died with a functional allograft. Recipients in the D?K?, D+K?, and D+K+ groups also had no significant difference between a one-year allograft and patient survival rate (P>0.05). However, recipients in the D+K+ group had a higher level of serum creatinine [(139.2±62.46) μmol/L vs (117.19±51.22) μmol/L, P<0.05] and lower estimated glomerular filtration rate [eGFR; (56.67±23.31) mL/(min·1.73 m?2) vs (66.86±21.90) mL/(min·1.73 m?2), P<0.05] compared with recipients in the D?K? group at 12 months after transplantation. During the first year after transplantation, 4 recipients developed urolithiasis, and recipients who received allografts from the D+ group donors had a higher incidence of urolithiasis than those who received allografts from the D? group donors (2.2％ vs 0.2％, P<0.05). There were no significant differences in the incidence of urinary tract infections and ureteral strictures at 1 year between recipients of D+ and D? donors (both P>0.05).Conclusion: The cadaveric kidney allografts with nephrolithiasis could be safely used for transplantation, and the short-term outcome is acceptable. However, nephrolithiasis in donors may increase the rate of kidney discard, disturb the short-term function of allografts, and increase the risk of urolithiasis in recipients. Further research with a long-term study is needed to verify the long-term outcome of kidney transplantation using cadaveric kidney allografts with nephrolithiasis.

To examine the association between serum copper concentration and the prevalence of hypertension in patients with knee osteoarthritis (OA).
 Methods: A total of 935 patients who were aged ≥40 years and underwent routine checkups from October 2013 to November 2014 at the Health Management Center of Xiangya Hospital, Central South University were included. They were diagnosed as knee OA by weight-bearing bilateral anteroposterior radiography. Serum copper concentration was measured using the chemiluminescence method. Blood pressure was measured by an electronic sphygmomanometer. The association between serum copper concentration and hypertension was evaluated by conducting multivariable adjusted logistic regression.
 Results: Compared with the lowest quintile, the multivariable-adjusted odds ratio (OR) and related 95% confidence interval (95% CI) of hypertension were 1.46 (95% CI 1.02 to 2.09, P for trend=0.035) and 1.47 (95% CI 0.77 to 2.78, P for trend=0.032) in the total population and female subgroup of the highestest quintile, respectively. There was no significant association between serum copper and hypertension in male subgroup among OA patients (OR=1.21, 95% CI 0.76 to 1.93, P for trend=0.354).
 Conclusion: The serum copper concentration was significantly associated with the prevalence of hypertension in total population and female subgroup, but may not in male subgroup among patients with knee OA.
Adult ; Copper ; Cross-Sectional Studies ; Female ; Humans ; Hypertension ; complications ; Male ; Odds Ratio ; Osteoarthritis, Knee ; complications ; Risk Factors