Objective To prepare medical chitosan microspheres used in blood lipid adsorption. Methods Medical chitosan microspheres were prepared by suspending chitosan in liquid paraffin, adding proportional glutaraldehyde as crosslinking agent and a small amount of polyvinyl alcohol(PVA) to improve its flexibility. The blood lipid adsorption v/ere studied in a dynamic way. Results The medical chitosan microspheres containing a small amount of PVA were more effective in decreasing the contents of cholesterol(CH) , triglyceride(TG) , LDL in human serum. Conclusion The chitosan microspheres obtained by adding a small amount of PVA could be used as a desirable medical microsphere in the adsorption of blood lipids.

AIM and METHODS: To observe the dynamic changes in relative power of rats brain electrocorticogram(ECoG) and electrohippocampogram(EHG) after ischemia, we studied the changes of rat's ECoG and EHG after ischemia using the method of chronic implanting electrodes in cortex and hippocampus and the effects of Chinese herbs 9602 on them. RESULTS: The frontal ECoG relative power of all bands and total power decreased in 8 hours after ischemia, restored in 24 hours and decreased again after 72 hours. It decreased significantly as compared with that of sham-control 7 day postischemia. The occipital ? band at 72 hour, all bands and total power decreased 7 day after ischemia. As compared with sham-operated control, the ??? and total power of EHG decreased notably at 8, 24 and 72 h after ischemia. The changes were more markedly in 7 day after ischemia. Treated with 9602 and hydergine, the ischemic animals showed significant elevation of ECoG and EHG relative power in comparison with ischemic rats. CONCLUSION: The power of ECoG and EHG decreased after ischemia, it may be correlated with delayed neuronal death induced by ischemia. 9602 prevented the decreases in ECoG and EHG power obviously after ischemia,which probably related to the neuroprotective effects.

AIM: To explore the relationship between dynamic changes of population spike (PS) and morphologic alterations in hippocampal CA1 region and morphology after transient ischemia/reperfusion and the improving effects of Chinese herbs 9602. METHODS: Changes of evoking population spike ware investigated by electrical stimulating Schaffer collateral in CA1 region of hippocampal slice after ischemia/reperfusion in vivo . Apoptosis and morphologic alterations at different time points after cerebral ischemia/reperfusion were detected by using TUNEL and Nissl staining. RESULTS: The threshold voltage of CA1 region in evoking population spike increased markedly as compared with sham control. The enhancement of wave amplitude was reduced significantly after tetanic stimulation. The duration of enhancement in amplitude decreased with the passage of reperfusion. Above all were observed from 8 h after ischemia/reperfusion. They became remarkable and got to its top at 7 day after ischemia/reperfusion treatment. TUNEL positive cells were observed in hippocampal CA1 region at 8 h, got to the top at 24 h and then gradually reduced after ischemia/reperfusion. A lot of abnormal cells in CA1 region was found, and the number of pyramidal cell reduced progressively by Nissl staining after ischemia/reperfusion. Chinese herbs 9602 reduced the threshold voltage of CA1 region in evoking population spike remarkably, enhanced the wave amplitude and prolonged the duration of PS enhancement; decreased the number of TUNEL positive cell, prevented the reduction of pyramidal cell in CA1 region. CONCLUSIONS: The excitability and reactivity were decreased and there was a gradual functional disturbance of synaptic transmission in CA1 pyramidal cell and most notable changes happened at 7 d ischemia/reperfusion, suggesting that was partly due to delayed neuronal death induced by ischemia/reperfusion. Apoptosis plays an important role in the functional deficiency of CA1 region of hippocampus induced by cerebral ischemia/reperfusion. The effects of 9602 on ameliorating the excitability and reactivity of CA1 pyramidal cells relate to inhibiting apoptosis, attanuating delayed neuron death induced by ischemia/reperfusion.

AIM: To explore the role of plasma ?-endorphin(?-EP) in the suppression of cellular immunity following trauma-hemorrhagic shock(T-HS). METHODS: ① Wistar rats with T-HS were sacrificed at 0 h, 1 h, 3 h, 6 h, 12 h, 24 h after T-HS. Plasma sample was collected and ?-EP levels in plasma was measured. Rats with sham-operated were served as the controls. ②In in vitro experiment, splenic cells were isolated and mixed from four normal rats and cocultured with shock plasma (SP) or SP +?-EP antiserum. ConA-induced splenic cell proliferation, IL-2 production, IL-2R expression were examined. RESULTS: ① Levels of plasma ?-EP elevated remarkably after T-HS immediately, peaked at 1h , showed decreasing tendency and restored normal 24 h after T-HS. ② Shock plasma significantly suppressed ConA-induced splenic cell function. Levels of plasma ?-EP were negatively correlated with spenic cell proliferation and IL-2 production and IL-2R expression. Compared with SP group, splenic cell function elevated markedly in SP + ?-EP antiserum group, but still lower than that in controls. CONCLUSION: The elevated plasma ?-EP following T-HS was involved in the suppression of cellular immunity.

0.05).CONCLUSIONS The rising rates of the drug-resistant Uu strains may be resulted of no-standard treatments.The treatment time will be shortened and the curative effects will be better if the treatments are based on the results of the susceptibility test.

Objective:To explore the efficacy of etanercept combined leflunomide to treat ankylosing spondylitis (AS) and its safety.Methods:90 cases with AS patients admitted in our hospital from June 2016 to January 2015 were selected.The patients were divided into observation group and control group by random number table method,45 cases in each group.Observation group was treated with etanercept combined with leflunomide,the control group were treated by leflunomide only.Morning stiffness time,AS activity index (BASDAI),AS measurement index (BASMI) were recorded before and after treatment in two groups,the total effective rate and adverse reaction were compared between the two groups.Results:After treatment,the BASDAI and morning stiffness time,BASMI of two groups of patients compared with before treatment were decreased,and the indexes above of the observation group were significantly lower than the control group,the difference was statistically significant (P＜0.05);The effective rate of the observation group was significantly higher than that of the control group,the difference was statistically significant (P＜0.05);During the course of treatment,the main adverse reactions occurred in patients with liver function damage,diarrhea and allergic skin rash,but there was no significant difference in the incidence of adverse reactions between the two groups (P＞0.05).Conclusion:Etanercept combined with leflunomide can obtain ideal effect,and low incidence rate of adverse reaction,it is worth popularizing in clinical use.

Background: The rate of death among people living with HIV/AIDS has decreased significantly as a result of treatment with highly active antiretroviral therapy (HAART). However, the issues of drug induced toxicities and complexity of current HAART regimens has remained of great concern. The aim of this study was to determine factors influencing antiretroviral regimen changes among people living with HIV/AIDS in China. Methods: This retrospective study collected data through face-to-face interviews with people living with HIV/AIDS who were receiving HAART, and gathered relevant information from infectious disease hospitals. The following information were collected: social-demographic characteristics, antiretroviral therapies, CD4 cell counts, virus loads, reasons for changing medication and other related data. Mean and percentages were used to describe the frequency of regimen change among patients, and binary logistic regression was employed to test the factors influencing regimen change. Results: 1,123 people who had experienced regimen change were included in the analysis. On average, patients remained on HAART for 10.2 months before changing regimen, and the average CD4 cell count and viral load (VL) were 383.1 cells/μl and 28,132.4 copies/mL respectively when changing regimen. The reasons for modification were determined as treatment failure (52.5％), adverse reactions (32.3％), and other reasons including pregnancy (15.2％). There are significant differences in regimen change among people with different genders (P<0.001), modes of transmission (P<0.001), duration of HAART (P<0.001) and initial CD4 cell counts (P=0.0024). Males, drug users, people taking long-term medication, and those with lower initial CD4 counts when starting HAART tend to change regimen. Conclusion: Treatment failure was the main reason for the change of HAART regimen. Males, drug users, people on long-term medication and those with lower initial CD4 cell counts when starting HAART were most likely to change regimen.

Background:This study aimed to investigate the changes in the clinical indicators and influencing factors of treatment duration among human immunodeficiency virus (HIV) patients in whom antiretroviral therapy (ART) was unsuccessful.Methods:In this retrospective study,a total of 9,418 HIV patients who failed in ART during 2004-2016 were included and divided into two treatment groups-Group 1 (treatment time ≤ 3 years,n1 =5,218) and Group 2 (treatment time ＞ 3 years,n2 =4,200).Patient follow-up data,including age,cluster of differentiation 4 (CD4) count,and viral load,glucose,creatinine,and triglyceride levels,were extracted from electronic health record databases.Covariance analysis for repeated measures was used to analyze the biochemical indicators,and multiple logistic regression modeling was used to compare relevant data extracted from the Group 1 and Group 2 HIV patient cohorts with different treatment time.Results:The median initial CD4 count was 175.0 cells/μl (interquartile range,77.0-282.0),while the initial CD4 counts for Group 1 were lower than those for Group 2 (P ＜ 0.05).A significant interaction between group and time effects was observed (P ＜ 0.05) in total cholesterol (TC).Changes in hemoglobin level among HIV patients were also significantly associated with treatment time (P =0.001).The initial CD4 count (odds ratio [OR] =0.756),female sex (OR =0.713),Zerit (d4T) (OR =1.443),TC (OR =1.285),and aspartate aminotransferase level (OR =1.002) were significantly associated with the survival time of dead patients with HIV (P ＜ 0.05).Additionally,the initial CD4 count (OR =1.456),age (OR =1.022),time interval (OR =0.903),patient's living status (OR =0.597),d4T (OR =2.256),and triglyceride (OR =0.930) and hemoglobin levels (OR =0.997) were significantly associated with the treatment time of HIV patients with drug withdrawal (P ＜ 0.05).Conclusion:The initial biochemical parameters can affect the survival and treatment time of HIV patients.With a comprehensive understanding of the physiological and biochemical indicators of patients,we can reduce the probability of drug withdrawal and prolong the survival time of HIV patients.

Objective To explore the related factors of diarrhea onset in critically ill patients during early enteral nutrition (EEN). Methods Thirty Zhejiang Provincial Emergency Intensive Care Units (EICU) and ICU to implement EEN support for critically ill patients from July 2016 to August were enrolled, and the incidence of diarrhea within 1 week after EEN administration was observed. The patients were divided into a diarrhea group and a non-diarrhea group according to whether diarrhea occurred or not during EEN. The basic status data [sex, age, body mass index (BMI), albumin, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), nutritional risk screening (NRS2002), major disease diagnosis], and EN status (feeding route, infusion method, EN type, amount of EN on days 4 and 7), and clinical treatment (applying following treatments or not: mechanical ventilation and its duration, vasoactive drugs, gastrointestinal motility drugs, probiotics) and clinical outcomes (survival after discharge or not) were collected in two groups. Multivariate Logistic regression analysis was performed on the indexes with statistically significant differences obtained from the univariate analysis to screen out the relevant risk factors of occurrence of diarrhea in critically ill patients during EEN administration. The receiver operating characteristic curve (ROC) was drawn to analyze the predictive value of each risk factor for occurrence of diarrhea in critically ill patients with EN therapy. Results Of the 510 critically ill patients who underwent EEN, 156 had diarrhea, 70.5% (110/156) had diarrhea within 4 days of EEN, most diarrhea lasts for 3 days and most frequency of diarrhea was 3-4 times a day. The univariate analysis showed that the age of patients in the diarrhea group was significantly higher than that in the non-diarrhea group (years:69.42±17.94 vs. 65.76±17.69), the mechanical ventilation time and ICU hospitalization time were significantly longer than those of non-diarrhea group [mechanical ventilation time (days): 8 (5, 14) vs. 8 (4, 9), ICU hospitalization time (days): 11.5 (8.0, 19.0) vs. 9.0 (6.0, 14.0)], the proportion of probiotics used and the proportion of feeding by nasal tube were significantly higher than those of non-diarrhea group [proportion of probiotics: 26.9% (42/156) vs. 14.4% (51/354), proportion of nasal tube feeding: [26.9% (42/156) vs. 14.4% (51/354)]. Multivariate Logistic regression analysis showed that the use of probiotics was a protective factor for diarrhea during EEN in critically ill patients [odds ratio (OR) = 0.447, 95% confidence interval (95%CI) = 0.273-0.730, P = 0.001]. ROC analysis showed that the area under the curve (AUC) of probiotics predicting diarrhea was 0.598 (95%CI = 0.554-0.640), P < 0.001, sensitivity was 35.9%, and because AUC was less than 0.7, the accuracy and sensitivity of predicting diarrhea with probiotics was considered to be relatively poor. Conclusion The incidence of diarrhea is high in EEN in critical illness patients and its occurrence is related to various factors. The addition of probiotics can reduce the incidence of diarrhea.

Objective To study the association between mean platelet volume(MPV),platelet distribution width(PDW)and procalcitonin(PCT)and cardiac function in patients with pulmonary hypertension(PH)and their diagnostic value on heart failure.Methods 103 patients with PH(PH group)in the 3rd People's Hospital of Chengdu from October 2021 to October 2022 and 103 healthy subjects with physical examination(control group)were selected as study subjects.Fasting peripheral venous blood was collected on the 1st day of admission and MPV,PDW and PCT were detected.The left ventricular ejection fraction(LVEF)was measured and the cardiac function was evaluated by New York Heart Association(NYHA)grading criteria.The patients with PH were divided into failure group and non-failure group according to the diagnosis results of heart failure.The relations of MPV,PDW and PCT with cardiac function in patients with PH and the diagnostic value on heart failure were analyzed.Results The levels of MPV,PDW,and PCT were all higher in the experimental group compared to the control group,while the LVEF was lower,and these differences were statistically significant(P<0.05);as the NYHA classification increased,the levels of MPV,PDW,and PCT showed an increasing trend,while LVEF showed a decreasing trend,and the differences between the groups were statistically significant(P<0.05);in the heart failure group n = 65,the levels of MPV,PDW,and PCT were higher compared to the non-heart failure group n = 38,while LVEF was lower,and these differences were statistically significant(P<0.05).The levels of MPV,PDW,and PCT werr signifi-cantly positively correlated with NYHA functional classification and LVEF(P<0.05).The levels of MPV,PDW,and PCT had good reference value for the diagnosis of heart failure in PH patients,with AUC values of 0.816,0.897,and 0.825 respectively,and the combined diagnostic AUC is 0.952,which wass statistically different from the application of the three indicators alone(P<0.05).Conclusion RDW,PDW and PCT are closely related to cardiac function in patients with PH,and can provide reference information for diagnosis and treatment of heart failure in patients with PH.