Objective To investigate the changes and significance of I?B kinase-?(I?K-?) in the lung tissues of rabbits with hemorrhagic shock.Methods The expressions of I?K-? and NF-?B in the lung tissues and the concentration of tumor necrosis factor-?(TNF-?) in the plasma were measured by in situ hybridization(ISH),immunohitochemistry and enzyme linked immune adsorbent analysis(ELISA), respectively. And the pathological changes were examined with light microscope in lung tissues.Results In hemorrhagic shock group,the expressions of I?K-?(0 1685?0 0164)and NF-?B( 0 1469?0 0083)in lung tissues , the level of TNF-?(636 72?100 23) in the plasma were obviously higher than those of normal group [I?K-?(0 0427?0 0241),NF-?B(0 0358?0 0048),TNF-?(199 51?35 69)ng/L](all P

Objective To investigate the preventive mechanism of Anisodamine (654-2) on multiple organ dysfunction syndrome (MODS) of rabbits. Methods Rabbit model of MODS induced by hemorrhagic shock and endotoxin was used in this study. Twenty-four rabbits were randomly divided into the control group (C group) , hemorrhagic shock plus endotoxin group (M group) and 654-2 treatment group (T group). The expression of IKK-? of pulmonary alveolar macrophage (PAM) and kuffer cell(KC), the NF-?B activity of nuclear protein extracted from PAM and KC and the concentration of tumor necrosis factor-? (TNF-?) in the culture supernatant were measured by in situ hybridization (ISH), electrophoretic mobility shift assay (EMSA) and enzyme linked immune absorbent analysis(ELISA), respectively. Then the blood air, biochemical and pathological changes in visceral organs were examined in each groups. Results In PAM and KC of M group, The expression of IKK-? mRNA [(0 15?0 03);(0 17?0 04)], the activity of NF-?B [(1 49?0 30);(1 72?0 36)] and the secretion level of TNF-? [( 279 74?25 91);(300 05?30 86)ng/L] were significantly higher than those of control group (P

Objective To discuss the value of hypotonic-MRCP combined with LAVA dynamic contrast-enhanced scan in diagnosis of duodenal tumor.Methods Five patients with duodenal adenocarcinomas confirmed by pathology were involved in this study.All cases underwent plain MRI and hypotonic-MRCP and LAVA dynamic contrast-enhanced scans.Results 4 of 5 cases were correctly diagnosed with MR imaging.Imaging signs included:the cavum of descending duodenum appeared as asymmetrical stenosis,masses with soft tissue signal intensity connecting the intestinal wall with wide base,the intestinal wall stiff,the intestinal mucosa destruction.The lesions would be slightly-moderately enhanced at LAVA dynamic enhancement scanning.Conclusion Hypotonic-MRCP combined with LAVA dynamic contrast-enhanced scan can display the direct and indirect sign of duodenal tumors,which was effective in identifying the circumscription of the tumor and its extension.

Objective To analyze the epidemic characteristics of mushroom poisoning incident in order to find the regularity of outbreak and provide the fundamental guidelines of prophylaxis,control,diagnosis and treatment.Methods According to the reported information from the Management Information System of Public Health Emergency in China mainland,the area-time distribution of mushroom poisoning incidents from 2004 to 2014 was analyzed,and the descriptive analysis of mushrooms poisoning incidents including causes,places,occupation of victims and incidents identification were made from 2010 to 2014.Results In China (excluding Hong Kong,Macao and Taiwan),the top five provinces of mushroom poisoning incidents were Yunnan,Guizhou,Sichuan,Guangxi and Hunan.The epidemic peak was reached in summer-autumn season.The major and significant incidents accounted for 76.56％ of overall mushroom poisoning incidents,and the fatality rate of 3 701 patients accounted for 21.24％ (786 deaths).The causes were mistaking poisonous mushrooms as edible mushrooms or purchasing poisonous mushrooms in the market by accident.About 87.50％ incidents happened at home.Farmers,workers,children and students were easily subjected to mushroom poisoning because of their large range of activities,strong curiosity and lacking related ability for distinguishing edible mushroom from poisonous mushrooms.No identification was done in 200 mushroom poisoning incidents from 2010 to 2014,which accounted for 92.59％ of mushroom poisoning incidents in the corresponding period.Standard species identification was carried out only in two poisonous mushroom incidents.Conclusions Mushroom poisoning incident was one of the most important causes of death in per-oral poisoning incidents.It should to cope with surveillance and meticulous management during high prevalence season and in high-risk provinces.At the same time,it should be strengthened to train doctors and health professionals with the knowledge of identification of mushroom poisoning in key areas as well as to develop the health promotion of mushrooms poisoning prevention.

Objective To study the effects of propofol used alone and in combined with opioids in gastroscopy,in order to select the more suitable anesthesia protocol.Methods A total of 285 pa-tients undergoing gastroscopy were selected in April ,201 5 in our hospital,including 105 males,180 females,ranging from 18 to 65 years old,weighing 40-90 kg,falling the category of ASA Ⅰ or Ⅱ. According to random number table,subjects were divided into four groups:dezocine group(group D, n =76),fentanyl group (group F,n =87),oxycodone group (group O,n = 71 )and control group (group C,n =5 1).Each group was implemented the corresponding anesthesia.SBP,DBP,HR,SpO 2 in baseline(T0 ),1(T1 ),3(T2 ),5(T3 )min after entering gastroscope were recorded.Choking cough, body movement,extra propofol,awakening time and inspecting time were observed.Results Among four groups,there was no statistical significance in age,gender,weight,blood pressure,heart rate and oxygen saturation and other general information.There were more cases given extra propofol in group C than in the other three groups (P <0.01 ).While for the experimental groups,there were more cases needing extra propofol in group O than in group D and group F (P < 0.01 ).The incidences of body movement and choking cough in group C were higher than those in the other three groups (P <0.01 ).Compared with the group C,dosage of propofol ,awakening time in the three groups,especially in group D,were much lower (P < 0.01 ).Conclusion Propofol in combination with opioids for sedation during painless gastroscopy can alleviate adverse reaction caused by propofol used alone.The more suitable anesthesia protocol is propofol with dezocine.

Objective To compare the effects of ephedrine and phenylephrine on hemodynamics in the patients undergoing surgery in prone position under general anesthesia.Methods Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients, aged 20-60 yr, with body mass index of 18.5-2:5.0 kg/m2, scheduled for elective posterior lumbar interbody fusion under general anesthesia, were randomized to ephedrine group (group E, n =30) or phenylephrine group (group P, n =30).When hypotension [decrease in systolic blood pressure (SBP) ＞20％ of the baseline value, T0] occurred in supine position, SBP, diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), cardiac output (CO), cardiac index (CI) and central venous pressure (CVP) were recorded, and ephedrine 0.1 mg/kg (group E) or phenylephrine 1 μg/kg (group P) was injected via the central veins.The parameters mentioned above were recorded within 10 min after administration (T1-T10).Results Both ephedrine and phenylephrine could maintain the parameters of hemodynamics at the normal level.Compared with the baseline values at T0 , SBP, DBP, MAP and HR at T1-T10 and CO and CI at T2-T10 were significantly increased, and no significant change was found in CVP at each time point after administration in group E, and SBP and MAP at T1-T6, DBP at T1-T5, CVP at T2 and T3, and CO and CI at T1-T3 were significantly increased, and HR was decreased at T2 and T3 in group P.Compared with group P, SBP was significantly decreased at T1, and increased at T2-T10, DBP and MAP were decreased at T1, and increased at T3-T10, HR was increased at T1-T10, CO and CI were increased at T2-T10, and CVP was decreased at T1-T3 in group E.Conclusion Compared with phenylephrine, although ephedrine provides no significant effect on hemodynamics clinically, it can increase cardiac output to some extent in the patients undergoing surgery in prone position under general anesthesia.

Abstract Research has shown that occupational stress is closely related to the occurrence and progression of atherosclerosis, with immune dysregulation serving as a mediating factor. Occupational stress triggers immune dysregulation in the body, ultimately leading to atherosclerosis through mechanisms such as the activation of immune cells and inflammatory mediators, endothelial dysfunction, and lipid metabolism disorders. This article reviews the primary mechanisms by which immune dysregulation plays a role in atherosclerosis caused by occupational stress, providing the reference for the prevention and intervention of atherosclerosis.

Objective To study the effect of genetic polymorphism of leukotriene C4 synthase (LTC4S) and 5-lipoxy-genase (ALOX5) on efifcacy of leukotriene receptor antagonist (LTRA) in children with moderate persistent asthma. Methods Seventy-two children with moderate persistent asthma who visited the out-patient clinic of Shanghai Children’s Medical. Center from June 2011 to June 2013 were divided into two groups, each of which ifrst had ICS or LTRA+ICS for twelve weeks and then had the other for another twelve weeks. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to assess the genetic polymorphism of LTC4S RS730012 and ALOX5 RS2115819. Pulmonary function, clinical symptoms and C-ACT score were evaluated before and after treatment. Results After the treatment with LTRA, 75%forced expiratory lfow (FEF75) was improved more signiifcantly in patients with A/C or C/C genotype at LTC4S (RS730012) locus than in patients with A/A genotype. After the treatment with LTRA+ICS, there was no difference of pulmonary function among patients with different genotypes at ALOX5 (RS2115819). Conclusions The SNP of LTC4S (RS730012) is associated with the efifcacy of montelukast in asthmatic patients because of the improvement of small airway function.

Objective To compare the pressor responses to ephedrine during general anesthesia with different drugs.Methods Sixty ASA physical status Ⅰ or Ⅱ patients,scheduled for elective gastrointestinal tumor resection under general anesthesia,aged 20-64 yr,weighing 45-90 kg,were included in this study.The patients were randomized to receive dexmedetomidine + remifentanil + sevoflurane (group Ⅰ,n =20),propofol + remifentanil + sevoflurane (group Ⅱ,n =20),or dexmedetomidine + propofol + remifentanil + sevoflurane (group Ⅲ,n =20) to maintain the depth of anesthesia.Ephedrine 0.1 mg/kg was injected intravenously when the systolic blood pressure (SBP) was decreased to about 90 mm Hg during anesthesia.Blood pressure was monitored and recorded at 1-min intervals for 10 min after the injection.The onset time (TSBP,TDBP,TMAP) for ephedrine to raise the SBP,diastolic blood pressure (DBP) and mean arterial pressure (MAP) and the maximal amplitude (△SBP,△DBP,△MAP) were also recorded.Results Compared with Ⅱ group,TSBP,TDBP and TMAP were significantly shortened,and △SBP,△DBP and △MAP were increased in Ⅰ and Ⅲ groups (P ＜ 0.05).Conclusion Compared with propofol + remifentanil + sevoflurane combined anesthesia,dexmedetomidine + remifentanil + sevoflurane combined anesthesia and dexmedetomidine + propofol + remifentanil + sevoflurane combined anesthesia augment the pressor responses to ephedrine in patients.

Objective To explore the effect of emergency rescue in whole-course integrated of abdominal injury with multitrauma. Methods Two hundred and eleven cases of abdominal injury with multitrauma from January 2004 to December 2006,before the emergency rescue in whole-course integrated, treating severe trauma 102 cases (group A),from January 2007 to December 2009,after the emergency rescue in whole-course integrated, treating severe trauma 109 cases (group B) .retrospectively analyzing and comparing the clinical effect between the two groups. Results In group A,injury severity score (ISS) was (24.7 ± 6.2) scores, 14 cases died, the mortality was 13.7% ,the time in emergency room and the time to operation room averaged (1.8 ± 0.2), (2.3 ± 0.3) h. While in group B, ISS was (26.6 ± 7.4) scores,6 cases died, the mortality was 5.5%, the time in emergency room and the time to operation room averaged (1.1 ± 0.1), (1.5 ± 0.2 ) h. ISS indicated no significant difference between the two groups ( P > 0.05 ), the mortality, the time in emergency room and the time to operation room indicated significant difference between the two groups (P < 0.05 ).Conclusion Emergency rescue in whole-course integrated of abdominal injury with multitrauma is an effective way to improve the curative rate.