Objective To compare the effect of natural antioxidants TA9001 and EGb761 on c-jun, NOS expression and survival of spinal motoneurons following brachial roots avulsion. Methods One hundred and eighty adult Sprague-Dawley female rats were randomly divided into TA9001, ECb761 and control groups. The right C 5～T 1 nerve roots were avulsed and then the introperitoneal injection of 1ml of 0.5% TA9001, 0.5% EGb761 or normal saline was given immediately and once daily to the rats, respectively. The rats were killed after survival for 4 h, 12 h 1 d,3 d,5 d,and 1 week, 2 weeks, 4 weeks and 6 weeks. The cryostat sections of C 7 segment were prepared and carried with c-jun immunocytochemistry, NADPH-d histochemistry and neutral red counter stain. Results The c-jun and nNOS gene expression was only appeared in injured motoneurons. c-jun was first appeared at 4 h, reached its maximum at 1 d, and grandually decreased till 2 weeks. NOS was first checked at 5 d, mostly at 2 weeks and decreased until 6 weeks. Avulsed motoneuron death started at 2 weeks, reached its peak at 4～6 weeks. Both TA9001 and EGb761 can cause c-jun up-regulation, nNOS down-regulation and more motoneuron survival as compared to control. Furthermore, EGb761 had more power to enhance c-jun expression than TA9901 at each time point. Conclusion It seems that nNOS is more important in motoneuron death mechanism than c-jun. Treatment of either TA9901 or EGb761 can protect the injured motoneurons following root avulsion.

The organotin compounds in the contaminated lard samples were identified by gas chromatography-flame photometric detector and gas chromatography/mass spectrometry after propylation with Grignard reagent. Experimental results identified that all lard samples contain dimethyltin compound and most of these samples contain tri-and monomethyltin compounds.

Adult ; Aged ; Female ; Humans ; Lymphoma ; Male ; Middle Aged ; Nose Neoplasms

AIM: To investigate the influence of Ginkgo biloba extract (EGb761) on c-jun expressions and motoneurons survival following root avulsion. METHODS: One hundred and eighty adult Sprague-Dawley female rats were randomly divided into control and EGb761 groups. Immediately after avulsion of C5-T1 nerve roots, the rats were injected ip with either 1 mL of EGb761 25 mg?kg~(-1)?d~(-1) or the same volume of normal saline, and the treatment repeated everyday. At 4 h to 6 weeks following avulsion, the C7 spinal segments of all rats were collected and prepared for c-jun immunocytochemistry and neutral red stain. The numbers of (c-jun) positive and survival motoneurons were counted and compared between two groups at each time point. RESULTS: In control rats following avulsion, c-jun positive motoneurons appeared at 4 h, reached its maximum at 1 d and declined to 2 weeks. Avulsion-induced motoneurons death started at 2 weeks, climbed to its maximum at 4 weeks-6 weeks. In EGb761 treated rats, both numbers of c-jun positive and survival motoneurons were more than that in control group at each time point. CONCLUSION: EGb761 attenuates avulsion-induced motoneurons death, and this effect may be related to up-regulation of c-jun gene in avulsed motoneurons. [

AIM: To investigate the pathological changes of motoneuron's function and morphology after root avulsion in order to study the neurobiology mechanism of motoneuron death. METHODS: Twenty female adult Sprague-Dawley rats, 200-300 g were used. The C 5-C 8, T 1 roots of the right brachial plexus were avulsed. All rats were killed 3 d, 5 d or 1 week after avulsion. One group of the C 5-C 8 spinal cords freeze sections (40 ?m thick) were collected for the NADPH-d histochemistry with neural red counterstained. Another group of the C 5-C 8 spinal cords freeze sections (40 ?m thick) were collected for the c-Jun immunocytochemistry stain. The paraffin sections (5 ?m thick) were collected for HE stain. The amount of NOS-positive and survival motoneurons was counted. The percentage of NOS expression and motoneuron survive were quantitatively analyzed considering the amount of contra lateral motoneurons as one hundred percent. RESULTS: The NOS expression rate was 0.74%?0.59% (3 d), 24.84%?6.73%(5 d), or 51.16%?8.67% (1 week), respectively. The survive rate was 93.00%?4.32% (3 d), 93.67%?5.27% (5 d), or 89.83%?2.65% (1 week), respectively. The motoneuron expressed c-Jun as early as 3 days after avulsion. The expression declined afterward until one week after avulsion. There was no significant change on the size of motoneuron. The nuclear membrane was still clear but some nuclei were not located in the middle of the cell body. There were some nucleoli with the chromatin condensation. CONCLUSION: The motoneuron NOS expression and cell death were increased within one week after spinal root avulsion. meanwhile, the c-jun expression was decreased. The NO/NOS may induce the motoneuron death by inhibiting the regenerating reactions of motoneuron after root avulsion injury.

Objective To explore the clinical characteristics of critically ill children infected with pseudomonas aeruginosa(PA) and PA antibiotics resistance in pediatric intensive care unit (PICU).Methods Case records of children with PA infection admitted to PICU in children′s hospital affiliated to Shanghai Jiaotong University from Jan 2007 to Dec 2009 were reviewed for clinical characteristics,case fatality rate,prognosis and drug resistance.Results (1) Clinical features:12 cases were community-acquired infection and 46 cases were hospital-acquired infections in 58 cases.On the same period,hospital-wide surveillance obtained PA 232 strains,PICU obtained PA 112,the ratio was 48.3%.Twelve cases died and total mortality was 20.7%.The mortality was significantly difference between community-acquired infections (5 cases,41.6%)and hospital-acquired infections (7 cases,15.2%)(P<0.05).The main symptom of children with community-acquired infections were intestinal infection (5 cases) and sepsis (5 cases).The children had acute onset and developed to shock and multiple organ dysfunction syndrome rapidly.Laboratory examination revealed the white blood cell normal (7/12) and decreased in 5 cases (5/12).The value of C-reactive protein was increased significantly,and the concentration of blood endotoxin were also increased.In the hospital-acquired PA infection cases,the main symptom was respiratory abnormal (38 cases),worsen primary disease,extended staying days in PICU.(2)Drug resistance analysis:112 PA,69.8% of ceftazidime-resistant,72.8% of the imipenem-resistant.Conclusion There is significant difference of the clinical features between PA community-acquired infection and hospital-acquired infection.The former is mostly primary infections with high fatality rate.PA hospital-acquired infection has become an important pathogen of nosocomial infection in PICU.And it is important to prevent PA infection caused by a long term broad-spectrum antibiotics application and invasive medical procedures.

Objective To describe the characteristics of and emergency treatment for and outcomes of critical ill children with 2009 influenza A caused by H1N1 virus strain. Method A prospective observational study of 3 pediatric patients with severe influenza A of H1N1 virus strain complicated with acute respiratory distress syndrome (ARDS) from November to December 2009. Results The H1N1 virus strain was confirmed by using realtime reverse transcription polymerase chain reaction (Real-time RT-PCR). Two patients survived and one died. Fever and cough were the onset symptoms. The systemic responses to influenza A at first were relatively mild. The tragic deterioration occurred all of a sudden with cyanosis all over the lips and dyspnea. The roentgenography showed bilateral multiple tabular pulmonary effusion and diffuse opaque shadows. The length of time required to confirm the diagnosis of ARDS from the symptom onset was 4 to 6 days. All patients were severely hypoxic with the ratio of PaO2 to 0.7-0.9 fraction of inspired oxygen (FiO2) to be 70- 100 mmHg at admission to PICU. In order to avoid injury to the lung, the protective ventilation strategy was carried out with low tidal volume (6 mL/kg) and adequate pressure,and conservative fluid management. Conclusions The H1N1 strain influenza virus A is characterized by pyrexia, cough and other respiratory symptoms in the early stage of critically ill children. In a few days, cough increased along with a sudden burst of cyanotic lips and shortness of breath, highly suggesting ARDS. Timely oxygen therapy and respiratory support, conservative fluid management, and the prophylaxis of secondary infection may be the essential measures. More clinical data are needed to clarify the critical features and to evaluate the emergency therapy for H1N1 influenza A in critically ill children.

Objective To evaluate the validity of original plasma cortisol level and responses to lowdose ACTH stimulation test in assessing the severity of critical illness.Method Original level of cortisol and cortisol concentrations 30 min after administration of a low dose ( 1 μg/1.73m2 ) of cosyntropin were determined within 24 hours after admission to our PICU.Critical illness related cortisol insufficiency was defined by initial level of cortisol ＜ 10 μg/dL or an increment cortisol [ Δmax =Stimulated plasma cortisol level (T1) -initial cortisol level (T0)]≤ 9 μg/dL.Results Ninety-five consecutive patients were admitted to PICU from May 2010 to April 2011.The patients were assigned to severe sepsis group (35/95),major operation group (30/95),and other critical illness group (30/95).Overall mortality was 12.6％ (12/95).The initial and stimulated plasma cortisol levels in three groups were (37.17 ± 47.35 ) μg/dL,(31.52±52.78) μg/dL,(28.61 ±17.45) μg/dL,vs.(50.26±48.21) μg/dL,(58.56±73.21)μg/dL, (42.41 ± 13.56) μg/dL,respectively.There were no significantly differences between above groups ( P ＞ 0.05 ).The incidence of critical illness-related corticosteroid insufficiency (CIRCI) in this study was 55.8％.The incidences of CIRCI were 60％,53.3％,and 53.3％ in severe sepsis,other critical illness and major surgery illness,respectively ( P ＞ 0.05 ).The morbidity of CIRCI and normal response group were 7.5％ and 19％ (P ＞0.05).The levels of T0 and T1 were related to the PCIS (P ＜0.05). Conclusions CIRCI is often seen in children with critical illness. And a low-dose ACTH stimulation test can be used to evaluate the adrenal function in critical illness.However,there is no significant correlation between CIRCI and mortality of critically ill children in this study.

Purpose To investigate the value of real-time three-dimensional contrast-enhanced ultrasound (RT3D-CEUS) for the evaluation of blunt renal trauma hemorrhage. Materials and Methods Nine healthy New Zealand white rabbits were randomly divided into three groups, and after heparinization, the models of ongoing hemorrhage of blunt renal trauma were developed by self-made minitype striker in the three groups with different force levels:77.2 N (group A), 106.2 N (group B), 135.1 N (group C). All rabbits were performed ultrasonography (US), color Doppler flow imaging (CDFI) and RT3D-CEUS before and after strike (within 20 minutes). The results achieved by US, CDFI, 2D-CEUS (A-plane results in RT3D-CEUS) and RT3D-CEUS were compared with each other, and further compared with the pathological results of the executed animals after blood pressure decreased lower than 40 mmHg. Results All rabbits showed traumatic renal lesions and it proved that the bigger the force the heavier the injury (group A: 1 case of levelⅠ, 2 cases of levelⅡ;group B:3 cases of levelⅢ;group C:1 case of levelⅢ, 2 cases of level Ⅳ ). After strike, US identified the presence of increasing hematoma under the capsule but could not detect active bleeding. In CDFI, only 1 case was detected ongoing hemorrhage. 2D-CEUS clearly presented the bleeding in all cases. RT3D-CEUS presented a vivid real-time and stereoscopical image of active hemorrhage in all cases and also showed that the wider the bleeding area was shorter than the shock duration time. Conclusion RT3D-CEUS can present a real-time dynamic bleeding and locate headstream of blood in renal trauma vividly and stereoscopically, and can be used to preliminarily evaluate the degree of ongoing hemorrhage in traumatic kidney.

AIM: To investigate the influence of EGb761 on NOS expression and survival of motoneurons after spinal root avulsion.METHODS: Eighty adult SD female rats were randomly divided into control and EGb761 groups. The C5-T1 nerve roots of right brachial plexus were avulsed and injection of 1 mL of either EGb761 25 mg?kg -1 ?d -1 or normal saline (ip) was performed everyday. The treated rats were killed 1 week, 2 weeks, 4 weeks and 6 weeks following avulsion. The cryostat sections of C7 segment of every rat were collected and carried with NADPH-d histochemistry plus neutral red counterstain. The difference of the numbers of both NOS-positive and survival motoneurons were quantitatively studied. RESULTS: Following avulsion, NOS was expressed in avulsed motoneurons at 1 week, reached to its maximum at 2 weeks and then decreased gradually from 4 weeks to 6 weeks. Motoneurons died from 4 weeks to 6 weeks. With EGb761 treatment, the number of NOS-positive motoneurons were decreased at each time point and the number of survival motoneurons was increased at each time point compared to control rats.CONCLUSIONS: EGb761 protected the spinal cord motoneurons from avulsion injury. This effect may be related to inhibition of NOS expression.