Spesis/severe sepsis remains a serious problem in pediatric intensive care unit.The mortality of sepsis/severe sepsis is still very high.The waterfall cascade reaction of cell factors is the main reason leading to the continued deterioration of the condition.Continuous blood purification technology can not only remove inflammatory mediators by adsorption and filtration function,but also improve the immune function,even reduce the mortality rate.But there is a controversial topic on the selection of the appropriate dose.This review not only introduces the effects of high-volume hemofiltration and low-volume hemofiltration from different aspects,but also analyses the influencing factors of different effects.

Objective To compare the rat model of slow transit constipation (STC) established with gavage or feeding compound di-phenoxylate. Methods Forty Sprague-Dawley rats were randomly divided into gavage control group (A), gavage group (B), feeding control group (C) and feeding group (D) equally. Group B was given compound diphenoxylate suspension by gavage for 14 days while group A ac-cepted isodose normal saline. Group D were given feed containing compound diphenoxylate for 120 days while group C accepted normal feed. Carbon ink was poured into stomachs to observe the propelling rate after modeling, and the content of aquaporin 3 and aquaporin 4 were detected with immunohistochemistry. Results There were two rats died in group A and group B, respectively. The carbon ink propel-ling rate was lower in group D than in group B (P<0.05). Both aquaporin 3 and aquaporin 4 were more in group D than in group B (P<0.05). Conclusion STC rat model can be established by eating diphenoxylate feed for 120 days, which is safer and more stable than that of gavage for 14 days. Aquaporins in colons may play a role in onset and development of STC.

The scar tissue, resulting from aberrant process of wound healing , can bring about cosmetic deformeties and func-tional limitation, even the displacement of tissues and organs .The widely use of autologous fat graft in regenerative medicine offers a relatively new option for scar treatment .Lipofilling has improved symptoms and appearance of scars in several studies .The application , therapeutic effect and mechanism research of autologous fat graft for scar treatment are summarized in this paper .

Objective To establish a multidrug-resistant cell subline NCI-H446/CDDP of human small cell lung cancer and characterize its biological properties. Methods The cell subline NCI-H446/CDDP was derived from human small cell lung cancer cell line NCI-H446 by exposing it to high concentration first followed by being cultured with gradually increasing dose of cisplatin, which used to be the first-line chemotherapeutic drug for lung cancer. The cell growth curve and the doubling time were determined by cell counting. The chemosensitivities of NCI-H446/CDDP and NCI-H446 to cisplatin, hydroxycamptothecine, vincristin, 5-fluorouracil and topotecan were tested and IC 50 measured by MTT. Changes in cellular morphology and ultrastructure were observed under inverted-microscope, scanning electron microscope and transmission electron microscope, respectively. Results Multidrug-resistant cell subline (NCI-H446/CDDP) of human small cell lung cancer was established successfully after culturing NCI-H446 in a high concentration of cisplatin first, followed by subjecting it to increasing concentrations of CDDP until they could stably grow in the culture medium containing 0.5?g/mL CDDP. The rate of cell proliferation of NCI-H446/CDDP was similar to that of NCI-H446, but the number of the former cells exhibiting S phase increased (20.24% vs 18.42% P

Humans ; Quality of Life ; Rhinitis ; Sinusitis

Objective To study the MR imaging appearances in a series of patients with stages T1N0M0 and T2N0M0 peripheral cholangiocarcinoma of the liver and to differentiate these tumors from hepatic metastases and from other solitary necrotic nodules.Methods A retrospective analysis was carried out on MR examinations of 26 patients with histologically confirmed choangiocarcinoma.The imaging findings were compared with those of 2 non-choangiocarcinoma groups including 23 patients with metastasis and 29 patients with solitary necrotic nodules confirmed with surgery,biopsy or follow-up imagings.Statistical analysis included Chi-square test or Fisher's exact test and the use of receiver operating characteristic (ROC) curves.Results Peripheral choangiocarcinomas in stages T1N0M0 and T2N0M0 were less than or equal to 3 cm in diameter (10 patients,≤2 cm and 16 patients,2 cm).Common findings for cholangiocarcinoma were defined margins (n =22,85％),slightly high signal on T2W1 (n =23,88％),patchy enhancement (n =20,77％),“fill-in” enhancement from periphery toward the center (n =21,81％) and diffuse hypointensity at the periphery and center of tumor (n =9,35％).There were significant differences (P ＜ 0.05) between the choangiocarcinoma group and the non-cholangiocarcinoma group in the above imaging findings.The area under the curve (Az) for differentiating peripheral cholangiocarcinoma was 0.896 ± 0.037,sensitivity was 84.6％,and specificity was 86.5％.Conclusions Our data indicated that MRI features of peripheral cholangiocarcinoma in stages T1N0M0 and T2N0M0 could be determined.MR imaging,when combined with clinical and biochemical data,provided reliable information to diagnose peripheral cholangiocarcinoma.

Background:CDK14 is a novel cyclin-dependent kinase,which is overexpressed in a variety of cancer and related to their malignant behavior. Aims:To investigate the effect of CDK14 on proliferation of human esophageal carcinoma cells and its possible mechanism. Methods:Expressions of CDK14 and two cell proliferation markers,PCNA and Ki-67 were estimated in 8 fresh-frozen specimens of esophageal squamous cell carcinoma(ESCC),96 paraffin-embedded specimens of ESCC,and human ESCC cell line Eca-109 by Western blotting and immunohistochemistry. Correlations of CDK14 expression with the clinicopathological characteristics and prognosis of ESCC were analyzed. Serum starvation and release assay was performed to evaluate the relationship between CDK14 expression and cell cycle progression in Eca-109 cells. Furthermore,Eca-109 cells were transiently transfected with shRNA-CDK14 to reduce CDK14 protein level,and then the phosphorylation of tumor suppressor protein Rb,cell cycle progression and proliferation capability of Eca-109 cells were determined. Results:CDK14 was highly expressed in both ESCC tissue and cell line,which was paralleled with the expressions of PCNA and Ki-67 and correlated significantly with the tumor size,histological grade,invasiveness and metastasis of ESCC(P < 0. 05). The overall survival was poor in patients with high CDK14 expression than those with low CDK14 expression(P < 0. 05). Serum starvation and release assay showed that the expression of CDK14 was cell cycle-dependent. Knockdown of CDK14 reduced the expression level of phosphorylated Rb,induced significant G1 phase arrest and resulted in less colony formation in Eca-109 cells(P all < 0. 05). Conclusions:CDK14 is highly expressed in ESCC. It may promote cell cycle progression by phosphorylating downstream Rb protein,thus enhancing the proliferation of tumor cells,and ultimately participating in the occurrence and development of ESCC.

Objective To investigate the effects of different concentrations of ketamine on the differentiation of human T helper (Th) cells.Methods Twenty ASA Ⅰ patients (aged 20-60 years) undergoing elective operation under general anesthesia were enrolled in this study.Peripheral venous blood samples were taken before anesthesia.Peripheral blood mononuclear cells were isolated and divided randomly into three groups (n =20 each):being incubated in the presence of 0.9％ NaCl (group C),2.5 μg/ml ketamine (group K1) and 25.0 μg/ml ketamine (group K2),respectively,for 24 hours,and were then stimulated with phytohaemagglutinin for 48 hours,respectively.The percentages of Th1 and Th2 cells were detected by four-color fluorescence flow cytometry.The Th1/Th2 ratio was calculated.The levels of interleukin-2 (IL-2),IL-4,IL-6,IL-10,immunoreactive fibronectin-γ (IFN-γ) and tumor necrosis factor-alpha (TNF-α) in the supernatant were determined by cytometric bead array.Results There was no significant difference in the levels of IL-2,IL-4,IL-6,IL-10,IFN-γ and TNF-α in the supernatant,the percentages of Th1 and Th2 cells and the ratio of Th1/Th2 among groups C,K1 and K2(P＞ 0.05).Conclusion The sedative and anesthetic concentrations of ketamine exert no effect on the differentiation of human Th cells in vitro.

Objective To investigate the utilization of liver enhancement in hepatobiliary phase of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI for liver function evaluation.Methods Fifty-five patients who received enhanced MRI with Gd-EOB-DTPA were retrospectively analyzed.Images were obtained before injection and in hepatobiliary phase (5,10,and 20 minutes after Gd-EOB-DTPA injection).The patients were assigned into two subgroups according to individual liver function (n =35 in Group 1:normal liver and Child-Pugh class A; n =20 in Group 2:Child-Pugh class B and C).The relative liver enhancement (RE) was calculated at different time point.The general data (age,sex) and relevant laboratory results were recorded.Independent sample t-test was conducted to compare the RE between two groups at different time point.ROC curve was used to determine the best time point and RE threshold that can reflect the differences between two groups.Univariate analyses was performed to analyze the relationship between RE at the best time point and laboratory results.Multivariate analyses was performed to screen the independent influencing factor for RE at the best time point.Results The differences of RE between two groups were statistically significant at all time points (P ＜ 0.0001).10 minutes was the best time point for detecting the differences of liver function between two groups.When an RE cutoff value (＞ 1.52) was applied,normal or Child-Pugh class A could be predicted with sensitivity of 74.3％ and specificity of 90％.RE at the best time point was significantly related with total serum bilirubin level (TBil),serum albumin level (Alb) and prothrombin time (PT).And TBil was an independent influencing factor.Conclusion RE can be used to evaluate the liver function,and 10 minutes is the best time point that can be used to differentiate patients with normal or mild liver damage from those with moderate or severe liver damage.

Resting energy expenditure is the main indicator to assess energy consu mpit on of ap tine ts. The ne eryg expenditure of critically ill children can be influenced by many factors.Different ts atse of diseases are followed by different values of resting energy expenditure.Right now,indirect calorimetry is the “golden standard” of measurement of energy metabolism.Indirect calorimetry can be used to accurately grasp energy expenditure of patients.And it is beneficial to optimization of nutrition support,also for individualized nutri-tion therapy.