Objective:To evaluate the changes of maxillary sinus density after mid-facial fractures.Methods: A retrospective review was performed on patients with mid-facial fractures from 1995 to 2006.The changes of maxillary sinus density were evaluated by Water's view.Results: There were 219 cases,including 165 male and 54 female patients,who showed changes of maxillary sinus density on Water's view.Their ages ranged from 3 to 78 years.78 cases had follow-up plain radiograph.Among them,51 cases had normal maxillary sinus density,the density of sinuses of 19 cases became lower and the density of sinuses of 8 cases did not change or became higher.Conclusion: The maxillary sinusitis is a late complication and develops in some maxillary sinus after treatment of mid-facial fractures.Attention to the maxillary sinus density should be paied when following-up.

ObjectiveTo investigate the effect of focal ischemic preconditioning (IPC) on the expression of protein kinase-like endoplasmic reticulum kinase ( PERK ) and glucose-regulated protein 78 (GRP78) mRNA and protein after focal cerebral ischemia/reperfusion (I/R) in rats.MethodsAll 120 male SD rats were randomly divided into three groups: sham-operation group,middle cerebral artery occlusion (MCAO) group and brain ischemia preconditioning (BIP) group.Each group was further divided into 4 subgroups according to 12 h,1,2 and 3 d after I/R.The IPC models were made in order to measure the expression of PERK,GRP78 mRNA and protein by in situ hybridization and Western blot,and the apoptosis rate of neuron by flow cytometry. Results ①The expression of PERK mRNA increased and reached the peak at 12 h,then decreased continuously after 1 d.BIP could decrease its expression.The expression of PERK protein increased at 12 h and reached the peak at 24 h,then decreased continuously after 2 d.BIP could decrease its expression.②The expression both of GRP78 mRNA and its protein all increased and reached the peak at 12 h,then decreased continuously.BIP could increase their expression (mRNA:12 h: 136.70±9.53,F=32.265; 24 h:147.54 ±9.97,F=54.920; 2 d:158.16 ±9.44,F=45.374; 3d: 165.85±10.26,F=16.493,P＜0.05; protein:12 h: 1.319±0.116,F=5.619,P＜0.05; 24 h: 1.226±0.108,F=33.742,P＜0.01; 2 d:1.183 ±0.112,F =46.556,P ＜0.01; 3 d:1.115± 0.098,F =11.730,P＜0.05).③The rate of apoptosis neuron of rats in MCAO increased markedly at 12 h after reperfusion,and reached the peak at 1 d,then decreased continuously.BIP could decrease the rate of apoptosis neuron. Conclusion BIP can protect neurons through inhibiting the expression of PERK and inducing the expression of GRP78 after endoplasmic reticulum stress in rats.

Objectives:To analyze the effect of cytokine-like protein 1 (CYTL1) on the pro-inflammatory functions of neutrophils in septic mice.Methods:C57BL/6 mice were randomly (random number)divided into the sepsis group and control group, with 6-12 mice in each group. A septic mouse model was established by the procedure of cecal ligation and puncture (CLP). Neutrophils were isolated from peripheral venous blood 8 h after the procedures according to the density gradient centrifugation method, and the neutrophils were treated with CYTL1 recombinant protein. The Boyden chemotaxis assays were used to detect the activity of CYTL1. fMLF and interleukin-8 were used as positive controls. Phagocytosis was determined by confocal microscopy or on a FACSVerse. Reactive oxygen species generation in neutrophils were monitored with the commercial CellROX Green fluorescent probe.Results:Compared with the control group, CYTL1 showed strong chemotactic activity on neutrophils of septic mice [(10.0 ± 2) vs (66.3 ± 4), t=-21.6, P <0.0001]. CYTL1 has stronger chemotactic activity than IL-8 [(66.3 ± 4.0) vs (21.7 ± 6.5), t = 10.1, P = 0.001]. But the chemotactic activity of fMLF and CYTL1 changed little on neutrophils of septic mice [(66.3 ± 4.0) vs (86.0 ± 13.5), t=-2.4, P = 0.073]. CYTL1 could augment the uptake of E.coli by neutrophils compared with the sepsis group [(7.35 ± 1.66) vs (2.84 ± 0.62), t = 4.4, P = 0.012]. The number of E.coli particles swallowed intracellular by a single cell significantly increased upon the stimulation of CYTL1. CYTL1 could also enhance the intracellular reactive oxygen species production of neutrophils of septic mice [(84340.1 ± 5353.5) vs (351018.7 ± 72291.7), t = 6.4, P = 0.003]. Conclusions:CYTL1 can prompt the pro-inflammatory functions of neutrophils in septic mice. In the early phase of bacterial infection, this protein may play an important role in regulating the inflammation.

Objective:To analyze the influence of factors before initiation of extracorporeal cardiopulmonary resuscitation (ECPR) on the prognosis of patients, so as to explore the intervention timing and improvement strategy of ECPR.Methods:A retrospective analysis was performed on 29 patients who underwent ECPR in the First Affiliated Hospital of Hunan Normal University (Hunan people's Hospital)from July 2018 to April 2021. Patients were divided into the survival group ( n = 13) and death group ( n = 16) according to whether they survived at discharge. The duration of conventional cardiopulmonary resuscitation (CCPR), initial heart rate before ECPR, the ratio of out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA), and the ratio of transported cases outside the hospital were compared between the two groups. According to different CCPR time, the patients were divided into the ≤45 min group, 45-60 min group and >60 min group to compare the hospital survival and sustained return of spontaneous circulation (ROSC) rate . According to the location of cardiac arrest, the patients from emergency department and other department were divided to compare the survival of IHCA. Results:The total survival rate was 44.83%, the average duration of extracorporeal membrane oxygenation (ECMO) was 114 (33.5, 142.5) h, and the average duration of CCPR time was 60 (44.5, 80) min. The duration of ECMO was longer in the survival group than in the death group ( P = 0.001). The duration of CCPR (the time from CPR to ECMO) in the survival group was significantly shorter than that in the death group ( P = 0.010). Patients with defibrillatory rhythm had higher hospital survival rate ( P = 0.010). OHCA patients had higher mortality than IHCA patients ( P = 0.020). Mortality of patients transferred from other hospitals was higher ( P = 0.025). Hospital survival and ROSC decreased in turn by CCPR duration ≤ 45 min, 45-60 min, and > 60 min ( P = 0.001). The location of CA occurrence had no impact on the hospital survival rate of IHCA patients ( P=0.54). Conclusions:Hospital survival of ECPR is higher than that of CCPR. ECPR is effective for refractory cardiac arrest. The prognosis of ECPR is significantly related to the duration of CCPR, initial heart rate, and location of CA. Education and team training should be strengthened to improve the survival rate of ECPR.

Objective: To analyze the risk factors related to the myocardial injury after non-cardiac surgery (MINS) in patients who underwent major abdominal surgery. Methods: The clinical data of all patients admitted in the surgical ICU of Peking University People′s Hospital from Jan 2016 to Dec 2018 were analyzed. Logistic multivariate analysis was performed to analyze the association of clinical characteristics with the incidence of MINS. Results: A total of 322 patients were included, 48.4% (156/322) were diagnosed as with MINS. 97.4% (152/156) of MINS occurred during the first 72 h of admission. Multivariate analysis showed that independent predictive factors of MINS were age >65y (OR=1.747, P=0.021), body mass index (OR=1.085, P=0.008), acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ, OR=1.066; P=0.047), hypertension (OR=1.747, P=0.027), blood lactate (OR=1.393, P=0.001) and acute kidney injury (OR=2.065, P=0.047). Conclusions The incidence of MINS in patients who underwent major abdominal surgery was high. Age, body mass index, APACHE Ⅱ score, hypertension, blood lactate level and acute kidney injury after surgery were independent risk factors of MINS.