Objective To investigate the relationship between high-density lipoprotein cholesterol (HDL-C) and idiopathic pulmonary embolism.Methods Clinical data of 34 patients with idiopathic pulmonary embolism from January 2005 to March 2011 were enrolled and healthy people with gender,age and basic diseasematched at the same period were selected as control.The venous blood samples of all the subjects were taken at 7:00 am after 10 hours of fasting and analyzed for total cholesterol (TC),lower-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C).Results Compared with healthy people,patients had reduced HDL-C level with a statistical significance ( ( 1.10 ± 0.28 ) mmol/L vs ( 1.49 ± 0.35 ) mmol/L,t =- 5.427,P ＜ 0.05 ).However,no statistically significant differences were found in the levels of TC and LDL- C (P ＞ 0.05 ).HDL-C was correlated with idiopathic pulmonary embolism( r =0.284,P ＜ 0.05 ).Conclusion The levels of HDL-C,but not TC or LDL-C,might be associated with the idiopathic pulmonary embolism.

Neuropathic pain and cancer pain are two difficult types of chronic pain to be controlled by currently available analgesics.Animal models can provide pivotal systems for preclinical study of pain.This article reviews some new models of chronic pain,such as those of cancer pain,central nerve pain,and the pain caused by peripheral nerve injury and disease-induced peripheral neuropathy.

Objective This paper aims to assess the clinical efficacy of pemetrexed maintenance therapy in patients with advanced non-small cell lung cancer( NSCLC) through Meta analysis.Me thods Systematic lit-erature searches were performed in Cochrane、Pubmed,Web of science, Embase and ClinicalTrials databases.The related references had been traced.We made quality assessment of qualified randomized controlled trials( RCTs) of pemetrexed maintenance therapy compared with best supportive care( BSC) in advanced NSCLC.Besides,we u-tilized stata 12.0,Revman 5.3 and GRADEpro software to evaluate the overall quality of the evidence,according to the Cochrane collaboration to perform Meta-analysis.Resutl s Three RCTs were eligible and included 1257 patients.Meta-analysis results suggested that:compared to BSC,pemetrexed maintenance therapy had a statisti-cally significant benefit in improving progression-free survival(PFS)(HR =0.55,95% CI:0.48~0.64)and overall survival(HR=0.76,95%CI:0.65~0.88).The objective response(ORR)did not reach statistical signif-icance(RR=0.97,95%CI:0.86~1.10).Conclusion Compared with BSC,pemetrexed maintenance therapy statistically significantly improve PFS and OS,but has no demonstrable impact on ORR in patients with advanced NSCLC.

In order to reconstruct a bone defect as a result of a complete excision of osteofibromatosis with pathological fracture of an extremity, free transplantation of double vascularized long fibula segments was performed in 4 cases of osteofibroas hyperplasia with fracture. After a follow up of 1～2years, the grafted fibula attained a good bony union, and the limbs regained normal length and function. This seems to be an ideal way to repair huge bone defects as a result of excision of bone tumor of extremities.

Objective To explore the image features of multilocular cystic nephroma and its correlative differential diagnosis. Methods Eight cases of multilocular cystic nephroma were retrospectively analyzed by comparing the imaging findings with surgical and pathological results. Results In all 8 cases, multilocular cystic nephromas were unilateral and circumscribed by thick capsules. These lesions ranged in diameter from 2. 5 cm to 7. 5 cm. The lesions were entirely composed of locules and septa without solid nodules. These locules did not communicate with each other. The septa of these lesions were clear in 2 cases, partly clear in 4 cases, and not very clear in 2 cases. All lesions were better detected on enhanced scans than on non-enhanced ones. Four of 8 cases also underwent MR scan, which presented low signal intensity on T1WI and high signal intensity on T2WI. The Interlocular septa was demonstrated much better with MM than with CT. Histopathology proved that the capsule and septa of the lesions were lined by cuboidal or flattened epithelial cells. Conclusion Multilocular cystic nephroma is a rare disease of the kidney. CT and MRI scanning are valuable in the diagnosis of multilocular cystic nephroma, but the imaging features are not specific enough to differentiate benign multilocular cystic nephroma from multilocular cystic renal cell carcinoma.

Objective To establish mouse allergic asthma model and observe the effect of bacterial lysates (OM-85BV) on airway inlfammation. Methods Forty-eight 4 to 6 weeks healthy male BALB/c mice were used as research subjects and randomly divided into six groups, a:control group;b:OM-85BV contral group;c:allergic asthma model;d:dexamethasone group (Dex group);e:OM-85BV A group;f:OM-85BV B group (the intervention time was prolonged 10 days than group e). BALB/c mice were sensitized and challenged with ovalbumin (OVA). Mice in groups c, d, e and f were intraperitoneally administered with antigen (OVA)-Al(OH)3 on days 1, 8 and 15, others were administered by PBS. From the 17th day to the 26th day, Mice in group f were treated with OM-85BV and others were treated with normal saline. In the next days, mice in groups c, d, e and f were intranasal given OVA for 5 consecutive days. Additionally, mice in groups b, e and f were treated with OM-85BV before challenge, while mice in the group d were administered by Dex, others were treated with normal saline at the same dose. Twenty four hours after the last intranasal administration, mice were anesthetized and dissected. Lungs were lavaged with PBS and bronchoalveolar lavage lfuid (BALF) was obtained. The total inlfammatory cells and eosinophils in BALF were counted. The total IgE levels of blood serum and IFN-γ/IL-4 levels of lavage were detected. The removed parts of lung tissue were collected for histological examination. Results Compared with groups a and b, lung tissue biopsies by HE staining from the asthma group showed obvious airway inlfammation. The situation of groups d and f was signiifcantly improved than group c, while the differences between groups e and c were not evident. Total cells and the number of eosinophils in BALF of group c (90.3±13.94×104/ml) were signiifcantly higher than that in groups a and b. Compared with the control group, levels of IL-4 in BALF (119.03±19.92 pg/ml) and IgE in serum (15.86±1.97 ng/ml) increased and levels of IFN-γin BALF (90.50±13.51 pg/ml) reduced signiifcantly. The corresponding levels of groups d, e and f were signiifcantly improved than group c (P<0.01). Conclusions Administered by OM-85BV helps regulate the balance between Th1/Th2 in asthmatic mice, reduce airway inlfammation, and prevent the occurrence and development of airway inlfammation.

Purpose To evaluate 1H proton magnetic resonance spectroscopy (1H-MRS) in detecting traumatic brain injury (TBI) and its metabolic changes during the initial two weeks after trauma using rabbit modes. Materials and Methods Fifteen Chinese rabbits were randomly divided into sham control group (n=5) and TBI group (n=10), 1H-MRS was performed 1 hour, 6 hours, 24 hours and 2 days, 7 days, 14 days after trauma, the concentration of N-acetylaspartate (NAA), creatine (Cr), choline-compound (Cho), NAA/Cr and Cho/Cr in each group was evaluated. At 6 hours, 24 hours and 168 hours after injury, 1 rabbit was slaughtered after abdominal anesthesia at each time point, the sample was ifxed with left heart catheterization perfusion after death, brain tissue was obtained, blocked, dehydrated into frozen section, HE staining was used for observation. Results Compared with the control group, NAA/Cr ratio in the trauma region decreased by 29%1 hour after trauma, with maximal reduction of 40% (at 24 hours) before increasing slightly, the NAA/Cr ratio returned to control level gradually until 168 hours later. The Cho/Cr ratio decreased by 16% 1 hour after trauma, with maximal reduction of 30%(at 6 hours) and increased gradually until finally su rpassed control level (168 hours) for 20% and then became stable. NAA/Cr ratio and Cho/Cr ratio showed statistically significant changes between each observing time point (P<0.05). Conclusion 1H-MRS can be used for dynamic detection of cerebral metabolism without injury, and is superior to MRI in detecting early abnormality of the brain, with NAA/Cr as the most sensitive parameter. Detecting the changes of NAA/Cr, Cho/Cr ratios in the trauma region can be used as a guide for assessment of the clinical treatment effectiveness of TBI.

Object To explore the relationship of 25 (OH) D levels in cord and maternal peripheral blood to understand the maternal and neonatal vitamin D status in Songjiang District of Shanghai. Methods One hundred newborns delivered at the First People’s Hospital afifliated to Shanghai Jiaotong University and 20 pregnant women during November 2010 to January 2011 in Songjiang district were enrolled in the study. The levels of 25 (OH) D in cord and maternal blood were measured by ELISA and compared. Results Mean materna1 serum levels of 25 (OH) D was (23.42±5.23) nmol/L, and cord blood 25 (OH) D was (29.77±12.51) nmol/L. Maternal serum 25 (OH) D was positively correlated with cord blood 25 (OH) D (r=0.84, P<0.001). Conclusions This study shows that the prevalence of vitamin D deifciency in pregnant women is high in Shanghai Songjiang District, which could have adverse effects on newbowns.

BACKGROUND:Nitric oxide can interfere with the function of mitochondria, and accelerate the intervertebral disc damage and degeneration by interfering with the release of inflammatory cytokines. Nitric oxide is an important inflammatory cel medium leading to degeneration of intervertebral disc induced by pressure and other external factors.
OBJECTIVE:To investigate the regulatory effect of nitric oxide and nitric oxide synthase inhibitor niacinamide on mitochondrial function and its association with biological behavior of rabbit nucleus pulposus.
METHODS:Cultured nucleus pulposus cel s of rabbit lumbar intervertebral disc were randomly divided into six groups:normal blank control group, 10μmol/L sodium nitroprusside group, 100μmol/L sodium nitroprusside group, 200μmol/L sodium nitroprusside group, 0.05 g/L nicotinamide group (100μmol/L sodium nitroprusside+0.05g/L nicotinamide), and 0.5 g/L nicotinamide group (100μmol/L sodium nitroprusside and 0.5 g/L nicotinamide). Different doses of nitric oxide donor sodium nitroprusside and nicotinamide were added in the medium of each group. Three days after intervention, cel proliferation activity, intracel ular ATP concentration, cel nitric oxide synthase activity, cel ular reactive oxygen species level, and mitochondrial membrane potential were detected respectively.
RESULTS AND CONCLUSION:(1) After 3 days of rabbit nucleus pulposus cel s intervened by different concentrations of sodium nitroprusside, intracel ular nitric oxide synthase content increased with sodium nitroprusside volume increase, and ATP concentration decreased along with sodium nitroprusside volume increase;there were significantly differences between the normal control group and sodium nitroprusside groups (P<0.01). (2) Reactive oxygen species could be increased in the sodium nitroprusside group. Niacinamide groups indicated a dose-dependent manner to improve the increase of cel ular reactive oxygen species levels with sodium nitroprusside intervention (P<0.01). (3) In the sodium nitroprusside groups, nucleus pulposus cel membrane potential decreased. In the niacinamide groups, sodium nitroprusside-induced decline in mitochondrial membrane potential was reduced (P<0.01). (4) Niacinamide groups also indicated a dose-dependent manner to improve the proliferative activity of nucleus pulposus cel s as compared with sodium nitroprusside groups (P<0.01). Significant differences were determined between the two groups (P<0.01). (5) Results suggest that the excess nitric oxide can damage mitochondrial metabolic function of rabbit nucleus pulposus cel s and cause cel energy metabolism. Niacinamide can reverse these damages by inhibiting nitric oxide synthesis, thereby contributing to the prevention against intervertebral disc degeneration.

The use of high flow nasal cannula(HFNC) therapy as a noninvasive respiratory support approach for preterm infants is rapidly increasing.HFNC is an alternative to nasal continuous positive airway pressure(nCPAP) for treating apnea of prematurity,primary respiratory support for neonates with respiratory distress,post-extubation support,facilitating nCPAP weaning in preterm infants.In this article,the proposed mechanisms of HFNC and the evidence from clinical trials of HFNC use in preterm infants were reviewed,and recommendations for evidence-based practice were established.