Objective To explore the methodology of reconstruction of a three-dimensional model of lid/cheek junction through continuous paraffin sections and stained lid/cheek junction three-dimensional visualization,and to further explore the feasibility and reliability to provide anatomical basis for clinical teaching of plastic and reconstructive surgery.Methods The full size of lid/cheek junction was cut from the specimens,the size of 25 mm× 15 mm× 10 mm,and then embedded in paraffin,and sectioned in thickness of 15 μm for 200 slices;the experimental HE staining and Masson staining were conducted,Sony camera photos using Adobe Photoshop CS 5.1 image processing software for image registration and 3D-Docter software image segmentation were used to give different colors for establishment of complete three-dimensional model.Results Histologically the LOT of the fascia area,the existence of reconstruction and the LOT model were confirmed.It showed the histological characteristics:the Masson stain displayed red,blue and white tissues in color;fascia tissue staining infered intertexture of elastic fibers and collagen fibers in LOT.LOT was the bottom edge of the triangle toward the orbital base with length of 26 mm,31 mm in high,0.8 mm in thick,and area of approximately 4.03 cm2 in size.Layers of skin,orbicularis oculi muscle,orbicularis retaining ligament,middle temporal fascia,periosteum and LOT were visible in the 3D model.By the three-dimensional model of lid/cheek junction,adjacent relationship could be rotated to any angle.Conclusions This initial establishment of a three-dimensional model of the lid/cheek junction confirms that the histological characteristics of lid/cheek junction and the feasibility of the fine structure of soft tissue within the three-dimensional model can be used as a new method for further research.

Objective To study the inhibitory effects ofisorhamnetin on six kinds of CYPs of liver in vitro,and the toxic effect on rat hepatocytes Methods This report uses warm incubation of human liver microsomes in vitro to investigate the inhibition of isorhamnetin on 6 kinds of CYPs (CYP2C19,CYP2D6,CYP3A4,CYP2E1,CYP1A2 and CYP2C9),and using HPLC-MS/MS to detect product of metabolism as well as analysing of the pathways of metabolic.At the same time,using rat primary hepatocytes which has low CYPs activity in vitro to explore whether the use of isorhamnetin will cause effects on the ALT,AST and LDH of hepatocytes.Results Isorhamnetin has inhibition effects on CYP2E1 and CYP1A2,the inhibition rate were 59.48％ and 39.91％,respectively.Methylated metabolite is produced after incubating of isorhamnetin and HLMs.The isorhmnetin becomes high polarity and water solubility metabolite 3,3',4',5,7-hydroxyflavone.Isorhamnetin of 30,100 and 300 μmol/L cause a significant rise of ALT and LDH in primary cultured rat hepatocytes cultured (P ＜ 0.01).isorharnnetin of 100 μmol/L cause a rise of AST in primary cultured rat hepatocytes cultured (P ＜ 0.05) and 300 μmol/L cause a significant rise (P ＜ 0.01).It was a dose-dependent manner.Conclusion Isorhamnetin in vitro mainly metabolized by HLMs,and at the same time have a certain inhibitory effect on CYP2E1 and CYP1A2,which may cause the drugs which are metabolized by CYP2E1 and CYP1A2 in vivo accumulation that lead to a series of drug interactions.The results also indicate that heavy use of isorhamnetin cause some adverse effects on hepatocytes,and it was a dose-dependent manner.Individuals need to pay attention to the dose ofisorhamnetin and the potential drug interactions.

Objective To discuss the effects and the possible mechanismof curcumin on pulmonary functions and expression of TGF-β1 and NF-κB in paraquat-induced pulmonary fibrosis of rats.Methods SPF Wistar rats were randomly (random number) divided into three groups:paraquat-poisoned group (PQ group,with PQ 50 mg/kg by gavage),Curcumin-treatment group (PC group after 30,with curcumin (200 mg/kg) by intraperitoneal injection),and Blank group (B group,with same volume of sterile saline at the same time).After 14 d,the lung function of rats was observed,and the expression of TGF-β1 and NF-κB protein were detected by immunohistochemistry.Results The survival rates of mice significant difference in the PC and PQ groups with (70.83％ vs.41.67％,P ＜0.05).Compared with the B group,lung function index (Te,PIF,PEF,EF50,TV,F) of PQ group significantly decreased (P ＜ 0.05,P ＜ 0.01).Compared with the PQ group,lung function index (Te,PEF,TV,F) of PC group significantly increased (P ＜ 0.05 or P ＜ 0.01).There are some expression of lung tissues of rats with TGF-β1,NF-κB in B group.Compared with B group,PQ group significantly enhanced (P ＜0.01or P ＜0.05).Compared with the PQ,PC group significantly decreased (P ＜ 0.01 or P ＜ 0.05).Conclusions Curcumin can relieve paraquat-induced pulmonary fibrosis by inhibiting the over expression of TGF-β1,NF-κB in lung tissue of rats.

Objective To observe the effects of curcumin on the lung collagen area and the expression of TNF-α,IL-6 and NE in paraquat-poisoning rats at different intervals,and discuss the possible mechanism of curcumin antagonizing paraquat poisoning.Methods A total of 108 SPF Wistar rats were divided into three groups (random number):blank group (B group) for control,paraquat poisonin group (PQ group) and curcumin-treatment group (PC group).The rats of PQ group and PC group were given paraquat (50 mg/kg) by gavage,and the rats of B group were given equal volume of sterile saline solution at the same time.Thirty minutes later,the rats of PC group were given curcumin (200 mg/kg) by intraperitoneal injection,and rats of B group and PC group were given equal volume of sterile saline solution instead.At 3 d,7 d and 14 d after modeling,the distribution and pathological changes of lung tissue and collagen fiber were observed by HE and Masson staining.The concentration of tumor necrosis factor (TNF-α) and interleukin-6 (IL-6) were detected by enzyme-immunoassay.The lung neutrophil elastase (NE)expression was observed by immuno-histochemical method.Result Compared with B group,PQ group had pulmonary alveolitis in different degrees at different intervals,and the most serious pulmonary alveolitis was observed at 7 d after modeling.Diffused pulmonary fibrosis of the lung tissue and a large area of collagen fiber deposition were observed especially at 14 d after modeling,as well as the expression of NE was observed obviously,especially at 14 d after modeling.The concentration of TNF-α,IL-6 in serum were significantly increased (P ＜ 0.05,P ＜ 0.01).Compared with PQ group,the pulmonary alveolitis and fibrosis obviously in PC group with obvious reduction in the expression of NE and significant descrease in the concentrations of TNF-o and IL-6 (P ＜ 0.05).Conclusion Inhabiting inflammatory factors to alleviate the seriousness of alveolar inflammation and pulmonary fibrosis might be one of the mechanism of treatment with curcumin for paraquat poisoning rats.

Objective To observe the effects of curcumin on pulmonary fibrosis and functions on paraquat (PQ)-challenged rats, and investigate the possible mechanism. Methods 108 SPF Wistar rats were divided into three groups according to random number sheet: normal saline (NS) control group, PQ model group and curcumin-treatment group. The rats in each group were subdivided into three subgroups according to different time points (3, 7, 14 days), with 12 rats in each subgroup. PQ-challenged models were reproduced by intragastrical administration of PQ solution 50 mg/kg, and those in NS control group were given the equal volume of NS. After 30 minutes, the rats in curcumin-treatment group were given 200 mg/kg of curcumin by intraperitoneal injection, and those in NS control group and PQ model group were given the equal volume of NS. At 3, 7, 14 days, the tidal volume (VT) was examined, and the blood was drawn from femoral artery for blood gas analysis. Then the rats were sacrificed and the lung tissues were harvested, the hydroxyproline (Hyp) content was measured by alkaline hydrolysis; the expression of transforming growth factor-β1 (TGF-β1) was determined by immuno-histochemistry; the distribution and the change of the pulmonary collagen fiber were observed after Masson staining. Results After exposure to PQ, the VT and arterial partial pressure of oxygen (PaO2) were decreased gradually, and the levels of Hyp and TGF-β1 were increased gradually, reaching the trough or the peak at 14 days, which were significantly lower or higher than those in NS control group [14-day VT (mL):1.52±0.33 vs. 2.81±0.47, 14-day PaO2(kPa): 5.87±0.95 vs. 14.15±1.02, 14-day Hyp (μg/mg): 3.12±0.06 vs. 1.14±0.05, 14-day TGF-β1 (integral A value): 29.72±4.27 vs. 4.15±0.52, all P < 0.01]. After intervene of curcumin, the parameters were significantly improved as compared with those of PQ model group [14-day VT (mL): 2.34±0.19 vs. 1.52±0.33, 14-day PaO2(kPa): 10.23±1.01 vs. 5.87±0.95, 14-day Hyp (μg/mg): 2.31±0.04 vs. 3.12±0.06, 14-day TGF-β1 (integral A value): 15.46±2.89 vs. 29.72±4.27, all P < 0.01]. It was shown by Masson staining that in PQ model group, with the PQ-poisoned time prolonging, diffused pulmonary fibrosis and a large number of collagen deposition were observed gradually, and the most serious collagen deposition was observed at 14 days; after intervene of curcumin, pulmonary fibrosis was alleviated significantly at different time points as compared with the PQ model group. Conclusion Curcumin can enhance the pulmonary function by reducing the deposition of collagen fiber and inhabiting pulmonary fibrosis of PQ-poisoned rats.

Background: Cardiopulmonary resuscitation (CPR) strategies in COVID-19 patients differ from those in patients suffering from cardiogenic cardiac arrest. During CPR, both healthcare and non-healthcare workers who provide resuscitation are at risk of infection. The Working Group for Expert Consensus on Prevention and Cardiopulmonary Resuscitation for Cardiac Arrest in COVID-19 has developed this Chinese Expert Consensus to guide clinical practice of CPR in COVID-19 patients. Main recommendations: 1) A medical team should be assigned to evaluate severe and critical COVID-19 for early monitoring of cardiac-arrest warning signs. 2) Psychological counseling and treatment are highly recommended, since sympathetic and vagal abnormalities induced by psychological stress from the COVID-19 pandemic can induce cardiac arrest. 3) Healthcare workers should wear personal protective equipment (PPE). 4) Mouth-to-mouth ventilation should be avoided on patients suspected of having or diagnosed with COVID-19. 5) Hands-only chest compression and mechanical chest compression are recommended. 6) Tracheal-intubation procedures should be optimized and tracheal-intubation strategies should be implemented early. 7) CPR should be provided for 20-30 min. 8) Various factors should be taken into consideration such as the interests of patients and family members, ethics, transmission risks, and laws and regulations governing infectious disease control. Changes in management: The following changes or modifications to CPR strategy in COVID-19 patients are proposed: 1) Healthcare workers should wear PPE. 2) Hands-only chest compression and mechanical chest compression can be implemented to reduce or avoid the spread of viruses by aerosols. 3) Both the benefits to patients and the risk of infection should be considered. 4) Hhealthcare workers should be fully aware of and trained in CPR strategies and procedures specifically for patients with COVID-19.