Objective:To investigate the effect of recombinant Elafin on A549 apoptosis induced by paraquat and the underlying mechanism.Methods:pEGFP-C1-Elafin was transformed into A549 competent cells by electroporation.Transformed A549 was cultured for additional 24 h before Elafin mRNA was detected by RT-PCR and cocultured with or without various concentration of paraquat( PQ ) for different duration.A549 apoptosis percentage and reactive oxygen species ( ROS ) content were tested by flow cytometry .Nuclear factor erythroid like-2(Nrf2) heme oxygenase-1(HO-1) were examed by Western blot .Results:Elafin expressed successfully in A549 after transformation.PQ caused A549 apoptosis in a concentration dependent manner and leaded to ROS content increasing and Nrf2 and HO-1 decreasing.However,elafin could inhibit ROS production and A549 apoptosis,upregulate Nrf2 and HO-1.Conclusion:Elafin could restrict A549 apoptosis to some extent and the possible mechanism lied in its ability to upregulate Nrf2 ex-pression.

Objective To investigate the effect of ginkgolide B(BN52021) on the NF-?B expression in pulmonary tissue of mice with LPS-induced acute lung injury.Methods Fifty Kunming mice were divided into 2 groups at random: LPS group(L group) and BN52021 pretreated group(B group),and then each group was subsequently divided into 5 subgroups according to different time point(0,1,3,9 and 12 h).The mice from corresponding groups received an intraperitoneal injection of normal saline or 20 mg/kg BN52021 followed by an injection of 15 mg/kg LPS 5 min later.The mice were sacrificed in 0,1,3,9 and 12 h after LPS injection.The wet/dry ratio(W/D) was recorded for pulmonary function and the pathological changes of lung tissues stained by HE were examined by light microscopy.The expression of NF-?B p65 was detected by Western blotting,and the levels of tumor necrosis factor-?(TNF-?) and interleukin-10(IL-10) were determined by ELISA.Results The significant increase of W/D was found after LPS injection in L group,which indicated the existence of pulmonary edema;while the W/D in B group was lower(P

Objective To investigate the effect of vaccum-assisted closure(VAC)on the expression of C-ski and Smad3 in the human wound margin tissue and to explore their significance in triggering the wound healing.MethodsFourteen patients,9 males and 5 females with chronic wound admitted in our department from April 2007 to April 2009 were enrolled into the study after signed an informed consent,and the full-thickness skin defects were collected before treatment,and 1,4 or 7 d after treatment.Immunohistochemistry(IHC)was carried out to detect the expressions of C-ski and Smad3,and RT-PCR was used to determine their mRNA expressions of C-ski and Smad3.ResultsIHC results showed that there existed little C-ski in the wound margin tissue before treatment,and after treatment,it were gradually increased.Compared with before treatment group,the differences in 4 and 7 d after treatment were markedly significant(P0.05).Compared with above groups,the differences in 4 and 7 d after treatment groups were markedly significant(P

Objective To investigate the size and diversification of peripheral nerve measured by high frequency ultrasound in di-abetic peripheral neuropathy patient .Methods The endings of the medial branch of deep peripheral nerves(DPN) were interrogated by high frequency ultrasound and nerve electrophysiology ,and the nerve conduction characters were studied in a cohort of 150 clini-cally diagnosed diabetic peripheral neuropathy patients and a control group of 100 healthy volunteers .At the sametime these cases underwent electrophysiological examination .Results Distinct echoic appearances were consistently detected between the DPN nerves of diabetic peripheral neuropathy patients and healthy volunteers .The sensitivity rate of high frequency ultrasound and nerve electrophysiological examination in diagnosis of diabetic peripheral neuropathy were 91 .33% and 74 .67% ,and the specificity rate were 91% and 82% .Conclusion High frequency ultrasound may play a role in the diagnosis of diabetic peripheral neuropathy .

Wasp sting is a common emergency in mountainous areas of China, with rapid onset and progression, high mortality rate, and serious harm to public health. Wasp sting can cause mild local reactions in mild cases, and Anaphylaxis or even multiple organ dysfunction in severe cases, of which Acute kidney injury (AKI) is the most common and serious. Blood purification treatment is commonly used for wasp sting patients to maintain renal function, eliminate toxins, and maintain Internal environment stability. The commonly used clinical methods are Hemoperfusion (HP), plasma exchange (PE), and continuous renal replacement therapy (CRRT). At present, there is no clear recommendation for the blood purification treatment mode of wasp sting in China, and there is no clear guidance for its combined treatment mode. This article will review the single and combined use of blood purification treatment models for wasp stings, based on the latest clinical research.

Objective To explore the value of the ratio of hemoglobin to red blood cell distribution width(HRR)in predicting the hospitalization risk of the patients in emergency internal medicine outpatient.Methods The clinical data of the patients in the emergency internal medicine outpatient of this hospital from May to September 2022 were collected;the univariate and multivariate binary logistic regression analysis was used to identify the risk factors for the patients hospitalization.The receive operating characteristics(ROC)curve was drawn,and the area under the curve(AUC)was calculated.Then the restrictive cubic spline(RCS)chart of HRR and the hospitalization risk was drawn and the relationship between HRR and the hospitaliza-tion risk was analyzed.Finally,the patients were divided into the low HRR group and the high HRR group ac-cording to the optimal cut-off value of HRR,the propensity score matching(PSM)was performed based on HRR grouping,and the hospitalization rates after matching were compared between the two groups by using x2 test.Results A total of 2 320 patients were included in this study,in which 791 cases were hospitalized,with an hospitalization rate of 34.1％;the multivariate logistic regression analysis suggested that HRR was an independent influence factor for hospitalization of the patients in the emergency internal medicine department(OR=0.68,95％CI:0.59-0.78,P＜0.05);when the optimal cutoff value of HRR was 9.43,AUC was 0.65;the RCS chart indicated that when HRR≤10.39,the lower the HRR level,the higher the hospitaliza-tion risk for the patients,and the two basically showed the linearly negative correlation.After PSM,the hospi-talization rate in the low HRR group was significantly higher than that in the high HRR group(P＜0.01).Conclusion HRR could be used to predict the hospitalization risk of adult patients in emergency internal med-icine department.The lower the HRR,the higher the hospitalization risk;HRR may be used as a marker to as-sess the disease severity in clinical work.

Objective:To investigate the clinical characteristics of first-episode and recurrent acute hypertriglyceridemic pancreatitis (HTGP).Methods:The retrospective cohort study was con-ducted. The clinical data of 313 patients with HTGP admitted to 26 medical centers in China in the Chinese Acute Pancreatitis Clinical Research Group (CAPCTG)-PERFORM database from November 2020 to December 2021 were collected. There were 219 males and 94 females, aged 38(32,44)years. Of the 313 patients, 193 patients with first-episode HTGP were allocated into the first-episode group and 120 patients with recurrent HTGP were allocated into the recurrent group. Observation indica-tors: (1) propensity score matching and comparison of general data of patients between the two groups after matching; (2) comparison of severity and prognosis in the course of disease within 14 days between the two groups; (3) the association between recurrent HTGP and the risk of persistent organ failure (POF); (4) follow-up. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the Wilcoxon rank sum test. Count data were expressed as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. Comparison of ordinal data was conducted using the Wilcoxon rank sum test. The Kaplan-Meier method was used to plot the cumulative recurrence rate curve and Log-Rank test was used for survival analysis. The Logistic regression model was used for multivariate analysis, and continuous variables were converted into categorical variables according to the mean value or common criteria. Propensity score matching was performed by 1∶1 nearest neighbor matching method, with caliper value of 0.02. Paired t test or Wilcoxon rank sum test and McNemar′s test were used for comparison between matched groups. Results:(1) Propensity score matching and comparison of general data of patients between the two groups after matching. Of the 313 patients,208 cases were successfully matched, including 104 cases in the first-episode group and 104 cases in the recurrent group. After propensity score matching, there was no significant difference in demographic characteristics, severity of illness scores and laboratory test between the two groups ( P>0.05). The elimination of gender, acute physiology and chornic health evaluation (APACHE) Ⅱ score, computed tomography severity index score, systemic inflammatory response syndrome score, sequential organ failure assessment score, apolipoprotein E, C-reactive protein, creatinine, lactic acid dehydrogenase, procal-citonin confounding bias ensured comparability between the two groups. (2) Comparison of severity and prognosis in the course of disease within 14 days between the two groups. There were signifi-cant differences in POF and local complications between the first-episode group and the recurrent group ( P<0.05). (3) The association between recurrent HTGP and the risk of POF. Results of uncor-rected univariate analysis showed that there was no association between recurrent HTGP and the risk of POF ( odds ratio=0.78, 95% confidence interval as 0.46-1.30, P>0.05). Results of multivariate analysis after adjusting for covariates such as gender, age, APACHE Ⅱ score, C-reactive protein, triglyceride and total cholesterol showed that compared with first-episode HTGP, recurrent HTGP was associated with a higher risk of POF ( odds ratio=2.22, 95% confidence interval as 1.05-4.71, P<0.05). Results of subgroup analysis showed that age<40 years was associated with an increased risk of POF ( odds ratio=3.31, 95% confidence interval as 1.09-10.08, P<0.05). (4) Follow-up. Twelve of the 313 patients died during hospitalization, including 9 cases in the first-episode group and 3 cases in the recurrent group. The rest of 301 surviving patients, including 184 cases in the first-episode group and 117 cases in the recurrent group, were followed up for 19.2(15.5, 21.9)months. Results of follow-up showed that for 184 survived patients of the first-episode group, 164 cases were followed up and 24 cases experienced recurrence, for 117 survived patients of the recurrent group,29 cases experienced recurrence, showing a significant difference between the two groups ( χ2=4.67, P<0.05). Conclusion:Compared with first-episode HTGP, patients with recurrent HTGP are more prone to POF and local complications, and are more prone to recurrence after discharge. The risk of POF in recurrent HTGP patients is 2.22 times that of those with first-episode, and the risk is higher in patients with age <40 years.