Objective To investigate the effects of dexmedetomidine on acute lung injury induced by hind limb ischemia-reperfusion in rats. Methods Sixty healthy male Wistar rats were randomly allocated into 4 groups: group C(control), group I-R(ischemia-reperfusion), group Pre-Dex(dexmedetomidine)and group Post-Dex. The morphological changes of the lung tissues were observed under light microscope , and polymorphonuclear neutrophils (PMN) in alveolar septum were counted. Meanwhile, lung coefficient, arterial partial PaO2, lung levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6, interleukin (IL)-10, and malondialdehyde (MDA) were measured. Results Rats in the I-R group were resulted in the damage of the lung tissues. The rats in group Pre-Dex and group Post-Dex were featured with obvious mild lung injury. TNF-α、IL-6、IL-10 and MDA in lung levels were significantly increased in group I-R , Pre-Dex and Post-Dex. TNF-α, IL-6 and MDA in the lung were significantly decreased in group Pre-Pex and group Post-Dex. IL-10 was increased in group Pre-Dex and group Post-Dex. Conclusions Inflammatory response and oxidative stress are involved in the pathogenesis of acute lung injury induced by hind limb ischemia-reperfusion in rats. Dexmedetomidine attenuated the lung injury through anti-inflammation and anti-oxidation.

In order to meet the requirements of ultrasound bone density measurement, we designed a sofware based on Visual Studio C+ + 2008. The software includes interface design, acquisition and control, data processing and parameter extraction, data storage and printing. Excellent human-computer interface (HCI) will give users a convenient experience. Auto gain control (AGC) and digital filter can improve the precision effectively. In addition, we can observe waveform clearly in real time. By using USB communication, we can send control commands to the acquisition and get data effectively, which can shorten the measuring time. Then we calculated the speed of sound (SOS) and broadband ultrasound attenuation (BUA). Patients' information can be accessed by using XML document. Finally, the software offers printing function.
Absorptiometry, Photon ; instrumentation ; Bone Density ; Humans ; Information Storage and Retrieval ; Software ; Sound ; Ultrasonics ; methods ; User-Computer Interface

Objective To determine the risk factors for imipenem-resistant Pseudomonas aeruginosa (IRPA) infections in neonatal intensive care unit (NICU).Methods One hundred and eighty-eight Pseudomonas aeruginosa infected children (confirmed by pathogenic examination) in the NICU of Maternal and Child Health Hospital of Guangdong from January 1,2008 to December 31,2011,were chosen as the objects of study,and were divided into two groups.The first group included 73 children that had been isolated with IRPA strains(IRPA group),and the second group included 115 children that only had imipenem-sensitive Pseudo monas aeruginosa (ISPA) strains (ISPA group).Chi-square test or t-test was applied.The risk factors were investigated by univariate or multivariate Logistic regression analysis.Results Data from univariate analysis showed that the gestational age and birth weight of neonates were lower than those in ISPA group [(34.0±3.5) weeks vs (35.6±2.8)weeks,t=3.413,P＜0.01; (1848.1±276.4) g vs (2110.7±345.6) g,t=5.472,P＜0.01].There were more neonates with gestational age ≤ 32 weeks [67.1％ (49/73) vs 45.2 ％ (52/115)],birth weight ＜1500 g [73.9％ (54/73) vs 33.0％(38/115)],small for gestational age [68.5％ (50/73) vs 29.6％ (34/115)],receiving imipenem [72.6％ (53/73) vs 27.0％ (31/115)] or the third generation cephalosporins [65.8％ (48/73) vs 33.0％ (38/115)] two weeks before the isolation of Pseudomonas aeruginosa,and mechanical ventilation [78.1％ (57/73) vs 61.7 ％ (71/115)],deep vein catheterization [83.6％(61/73) vs 65.2％(75/115)] in the IRPA group than in the ISPA group (all P＜0.05 or 0.01).The multivariate Logistic regression analysis revealed that imipenem treatment within two weeks before the isolation of Pseudomonas aeruginosa (OR=6.409; 95％ CI:1.926-21.333,P =0.002) was an independent risk factor.Conclusions IRPA infection in NICU hospitalized infants is strongly related to their gestational age and birth weight.History of imipenem administration could be an independent risk factor.

Objective To explore the effect and its possible mechanism of human umbilical cord mesenchymal stem cells (hUCMSCs) on bacterial growth in bronchoalveolar lavage fluid (BALF) of newborns with ventilator associated pneumonia (VAP).Methods Newborns admitted to neonatal intensive care unit (NICU) in Guangdong Women and Children Hospital Affiliated to Guangzhou Medical University from June 1,2012 to December 31,2012 were reviewed.The inclusion criteria were:(1)Positive BALF culture results.(2) Requirement of mechanical ventilation with tracheal intubation.(3) Diagnosed as ventilator-associated pneumonia.Two pieces of BALF samples of newborn were collected and randornaly divided into experimental and control group.hUCMSCs were added into the experimental group,while the same volume of conditioned medium was added into the control group.Both groups were incubated for six hours in humidified CO2 incubator at 37 ℃,then,bacterial growth was assessed by colony forming unit (CFU) counts.Levels of the antimicrobial peptides (Cathelicidin/LL-37 and human HBD-2) were determined by enzyme-linked immunosorbent assay and Western blot.Paired t-test was used for statistical analysis.Results Among the culture results of 31 newborns,there were Klebsiella pneumoniae (6 cases,19.3％),Stenotrophomonas narrow food aeromonas (6 cases,19.3％),Hemolytic staphylococci (5 cases,16.1％),Escherichia coli (3 cases,9.7％),Bacterial meningitis septicemia Elizabeth Platinum (3 cases,9.7％),Acinetobacter baumannii (3 cases,9.7％),Pseudomonas putida (2 cases,6.4％),Pseudomonas aeruginosa (1 case,3.2％),Staphylococcus aureus (1 case,3.2％) and Enterobacter cloacae (1 ease,3.2％).The CFU counts in experimental group were much less than those in control group [(2.60±0.67) ×104] CFU/ml vs [(1.18±0.32) ×105] CFU/ml,(t=-20.19,P＜0.01).Levels of Cathelicidin/LL-37 and HBD-2 in experimental group were higher than those in control group [Cathelicidin/LL-37:(8.98 ± 3.22) ng/ml vs (3.18 ± 1.57) ng/ml,t =17.79,P ＜ 0.01 ;HBD-2:(379.87±11.74) pg/ml vs (39.89±2.86) pg/ml,t=37.62,P＜0.01].Conclusions hUCMSCs had antimicrobial effect on bacterial growth in BALFs from ventilator associated pneumonia possibly by the secretion of antimicrobial peptides (Cathelicidin/LL-37 and HBD-2).

Objective To investigate errors and the mechanism of acalculia in patients with left or right hemisphere cerebral infarction.Methods Fifty-six patients with single hemisphere cerebral infarction and 56 normal adults who were matched in age,sex and years of education were tested with EC301-CR.The patients were divided into a left hemisphere cerebral infarction group(n =34)and a right hemisphere cerebral infarction group(n =22).Results The scores on 30 out of 32 EC301-CR items were significantly lower among the patients than in the normal control group.Scores on 14 EC301-CR items were significantly lower in the left hemisphere group than in the right hemisphere group.In the left hemisphere group the item scores of aphasia patients were significantly lower than those of no-aphasia patients except on digit identity.Conclusion Mathematical processing and calculation were impaired in patients with single hemisphere cerebral infarction.Calculation was significantly worse among left hemisphere patients compared with right hemisphere cerebral infarction.There was a highly significant correlation between acalculia and aphasia.

BACKGROUND: The injury of blood-brain barrier following cerebral ischemia reperfusion is a considerate pathological basis for injury caused by cerebral ischemia and reperfusion.OBJECTIVE: To investigate the effects of four most basic Chinese medicinal herbs, or safflower, peach seed, ligusticum and red peony with actions of activating blood and resolving the stasis on the contents of nitric oxide, immunoglobulins, C-reactive protein (CRP) and complements (immunological indices) of serum and cerebral homogenate, as well as the morphological and structural changes of cerebral tissue cells in rats with ischemia and reperfusion to vertify relationship between time effectiveness and quantitative effectiveness.DESIGN: A randomized controlled study, and evaluation by single blind.MATERIALS: The experiment was completed in the Laboratory of Traumatology Institute of Guangzhou Red Cross Hospital from January 2001 to De cember 2002. Safflower, peach seed, szechwan lovge rhizome and red peony are concentrated granules of single decocting pieces, the blood activating and stasis resolving decoction was prepared at 2.5 g/L according to 1:1:1:2 ratio.Totally 138 adult female SD rats were selected for the experiment,weighing 280-300 g, provided by Animal Center of Guangzhou University of TCM.INTERVENTIONS:The models rats with middle cerebral artery occlusion were set up by thread ligation(24 hours reperfusion after 2 hours middle cerebral artery occlusion).All 138 rats were randomly divided into 6 groups with 23 in each group.Sham operation group:The vessels were ligated but the middle cerebral artery was not occluded.No.1 medicated group: The BASR was by gavage given in a dose of 2 g/kg 30 minutes before operation. No. 2 medicated group: The BASR was by garage given in a dose of 2.5 g/kg 30 minutes before operation. No. 3 medicated group: The BASR was by garage given in a dose of 2 g/kg for consecutive 7 days be fore operation. No. 4 medicated group: The BASR was by gavage given in a dose of 2.5 g/kg for consecutive 7 days before operation.Control group:the same volume of saline was by gavage given for consecutive 7 days before operation. ① Scoring of dysneuria (5-score system: 0-1 score meant mild dysneuria, 2-4 scores meant severe dysneuria) for all rats were performed after consciousness following 2 hours ischemia and 24 hours reperfusion.② After 24 hours reperfusion,10 rats in each group were at random selected for assay of levels of CRP, complement 3 (C3) and complement 4 (C4) (rate nephelometry), and concentration of nitric oxide (nitrate reductase method)in both cerebral homogenate and serum.③ After 24hours reperfusion, 10 rats in each group were at random selected, and after anesthesia was completed, the brain was quickly collected through decapitation, put into a 110 ℃ drying oven till its constant weight, then the water content in brain was calculated.④ The cerebral cytomorphology in every group was observed under light microscope. ⑤ After reperfusion, 3 rats in each group were randomly selected for preparation of coronal section of cerebral tissue,the cerebral ultrastructure in each group was observed under transmission electronic microscope.MAIN OUTCOME MEASURES: ① The results of dysneuria scoring in each group. ② The levels of CRP, C3 and C4, and concentration of nitric oxide in both cerebral homogenate and serum.③ The water content in brain. ④ The cerebral cytomorphology and the cerebral ultrastructure. RESULTS: All 138 rats entered into the result analysis. ① Comparison of the extents of dysneuria of rats in each group: The ratio of severe dysneuria after 24 hours ischemic reperfusion in all medicated groups was obviously lower than that in control group(P ＜ 0.01),and the ratio in No.4 medicated group was lower than that in No.2 medicated group(P ＜ 0.05).② Comparison of water contents in brain of rats in each group:The water contents in sham operation group and all medicated groups were obviously lower than that in control group (P ＜ 0.05). ③ Comparison of the nitric oxide concentration in cerebral homogenate of rats in each group: The concentration in sham operation group and all medicated groups were obviously lower than that in control group (P ＜ 0.01). The concentration in No. 3medicated group was obviously lower than that in No. 1 medicated group (P ＜ 0.05).The concentration in No.4 medicated group was obviously lower than that in No. 2 medicated group (P ＜ 0.01). ④ Comparison of the nitric oxide concentration in serum of rats in each group:The concentrations in sham operation group and all medicated groups were obviously lower than that in control group(P ＜ 0.01).The concentration in No.3 medicated group was higher than that in No. 1 medicated group (P ＜ 0.05). The concentration in No. 4 medicated group was higher than those in No. 2 and in No. 3 medicated groups (P ＜ 0.05). ⑤ Comparison of the levels of CRP in cerebral homogenate and serum of rats in each group: The levels in sham operation group and all medicated groups were lower than that in control group(P ＜ 0.05-0.01).The level in No.3 medicated group was lower than that in No. 1 medicated group (P ＜ 0.01). The level in No. 4 medicated group was lower than those in No. 2 and in No. 3 medicated groups (P ＜0.05-0.01).⑥ Comparison of the levels of C3 in cerebral homogenate and serum of rats in each group:The levels in sham operation group and all medicated groups were lower than that in control group (P ＜ 0.05-0.01). The level in No.3 medicated group was lower than that in No.1 medicated group (P ＜ 0.05). The level in No. 4 medicated group was lower than those in No. 2 and in No. 3 medicated groups (P ＜ 0.01). ⑦ Comparison of the levels of C 4 in cerebral homogenate and serum of rats in each group:The levels in sham operation group and all medicated groups were lower than that in control group (P ＜ 0.05-0.01). The level in No. 3 medicated group was lower than that in No. 1 medicated group (P ＜ 0.05). The level in No.4 medicated group was lower than those in No. 2 and in No. 3 medicated groups (P ＜ 0.01). ⑧ Comparison of the condition of cerebral edema of rats in each group:In control group there was obvious cerebral congestive edema,indicating an obvious infection;while in medicated groups the extent of cerebral edema was milder than that in control group.⑨ Changes of cerebral ultrastructure of rats in each group:The ultrastructure in sham group was normal. In control group, there obvious edema of cells, capillaries and sheaths in the marginal zone of cortex necrosis,and reduction of organelles of neuron. As well. In No. 3 and No. 4 medicated groups, the limits of cell membranes were clear, the structure was integral, the chondriosomes were rich and even in size,the medullated fibers were morphologically normal.And in No.1 and No.2 medicated groups the changes were between the twoCONCLUSION:① The scoring of dysneuria in rats was decreased after the blood-activating and stasis-resolving medicine was given,and it was lower in rats that were given a longer period of medication,indicating that the improved extent for dysneuria is related to prolonged medication.②The nitric oxide concentration of cerebral tissue in rats that recevied the blood-activating and stasis-resolving medicine was decreased, and the nitric oxide concentration of serum in the rats was increased,indicating that the blood-activating and stasis-resolving medicine can reverse the anomalies of nitric concentration in different tissues after ischemic reperfusion so as to reduce cerebralinjury.③ The levels of C3 and C4 of cerebral tissue and serum in rats that received the blood-activating andstasis-resolving medicine were obviously decreased,indicating that the medicine may reduce the cerebral injury through triggering complement system;and the CRP was also get decreased,further suggesting that the medicine can inhibiting infective reaction.④ The longer the period of medication,the milder the cerebral injury, and the dose of 2.5 g/L was better in effect.

BACKGROUND: It has been known that re-recovery of blood flow after cerebral ischema may aggravate brain injury. It has been verified in some researches that the components for activating blood circulation and removing stasis in Chinese herbs can resist cerebral ischemic reperfusion injury.OBJECTIVE: To observe 4 most basic Chinese herbs for activating blood circulation and resolving stasis [honghua (Flos Carthami), taoren (Semen Persicase), chuanxiong (Rhizoma ligustici Chuanxiong) and chishao (Radix Paeoniae Rubra)] as the exertive factors on their influences on immune index changes in IgG, C-reactive protein (CRP) and complements of serum and homogenate in brain tissue so as to verify their graded and time effects.DESIGN: Randomized control experiment and single blind method.SETTING: Guangzhou Red Cross Hospital and Department of Neurology of the Fourth Hospital Affiliated to Jina University.MATERIALS: The experiment was performed from January 2001 to Decemb er 2002 in Experimental Room of Traumatic Institute of Guangzhou Red Cross Hospital. Totally 138 SD female adult rats were employed, mass weighted varied from 280 to 300 g, provided from Experimental Animal Center of Guangzhou University of Chinese Medicine. Honghua (Flos Carthami), taoren (Semen Persicase), chuanxiong (Rhizoma ligustici Chuanxiong)and chishao (Radix Paeoniae Rubra)] were the concentrated granules individually. At the ratio of 1:1:1:2, they were prepared into 2.5 g/mL raw herbal decoction (huoxue huayu tang).INTERVENTIONS: Thread embolic method was used to prepare cerebral medium sized artery obstruction model in rats (reperfusion for 24 hours after cerebral medium sized artery obstruction for 2 hours). Totally 138 rats were randomized into 6 groups, 23 rats in each. Sham operation group: ligature was done in each vessel without blocking medium sized artery of cerebrum.First perfusion group: 30 minutes before operation, gastric peffusion was done with 2 g/kg huoxue huayu tang. Second peffusion group: 30 minutes before operation, gastric perfusion was done with 2.5 g/kg huoxue huayu tang. Third perfusion group: before operation, gastric perfusion was done with 2 g/kg huoxue huayu tang continuously for 7 days. Fourth perfusion group: before operation, gastric perfusion was done with 2.5 g/kg huoxue huayu tang continuously for 7 days. In the control, physiological saline of all of the groups, when rats woke up, after 24 hours reperfusion and 2 hours ischemia, neural functional deficits were evaluated (5-score system, 0-1:After 24 hours reperfusion, 10 rats were randomized from each group for determination of the contents of CRP in homogenate and serum, complehours reperfusion, 10 rats were randomized from each group. After anesthetized, they were sacrificed rapidly to collect brains. Dried over heat in oven at 110℃ till constant weight, the water content of brain tissue was domized from each group to observe ultrastructure of brain tissue under transmission electron microscope (TEM) of rats in each group.and homogenate, complement C3 and C4 as well as serum IgG in rats of of severe neural functional deficits after 24 hours ischemic reperfusion in rats of each peffusion group was lower remarkably than the control (P ＜ 0.01),in which, that in fourth peffusion group was lower than second group (13%,group and each perfusion group was lower than the control (P ＜ 0.05), in which, that in third peffusion group was lower than first group (P ＜ 0.01).ment C3: That in sham operation group and each perfusion group was lower sham operation group and each perfusion group was lower than the control ( P ＜ 0.01), in which, that in third perfusion group was lower than first group (P ＜ 0.01); That in fourth perfusion group was lower than second and group and each perfusion group was lower than the control (P ＜ 0.01), in which, that in fourth perfusion group was lower than second group(P ＜ 0.05).each perfusion group was lower than the control (t=5.626-17.929, P ＜ 0.01),in which, that in third perfusion group was lower than first group (P ＜ 0.01),complement C3 in brain homogenate: That in sham operation group and each perfusion group was lower than the control (P ＜ 0.05-0.01), in which, third perfusion group was lower than first group (P ＜ 0.01), that in fourth group brain homogenate: That in sham operation group and each perfusion group was lower than the control ( P＜ 0.05-0.01), in which, that in third perfusion group was lower than first group (P ＜ 0.01), that in fourth group was lower tissue: The inflammatory reaction in the control was obvious. Brain edema and pathological damage in perfusion groups were milder than the control.Ulztrastructure was normal in sham operation group. The edema was obvious in cells, capillaries and myelin sheath in cortical necrosis margin area and neuronal cell organs were decreased in the control. In third and fourth peffusion groups, cellular membrane was clear in boundary line,integrative in structure, rich in mitochondria and even in size and the morphology of medullated fibers was normal. The situation of first and second perfusion was between two of them.deficits in the evaluation of rats and the score with long medication was lower, suggesting that long medication can even better improve neural funcplement C3 and C4 in brain bomogenate and serum and decreases serum IgG content, explaining that the medicine alleviates brain tissue injury by startup complement system. The remarkable decrease of C-reactive protein further suggests the inhibition of such medicine on inflammatory reaction.jury is, and the better result is achieved at dosage of 2.5 g/L.

Objective:To compare the effects of citrate and heparin anticoagulation on coagulation function and efficacy in children with septic shock undergoing continuous blood purification (CBP), and to provide guidance for CBP anticoagulation in children with septic shock.Methods:A case control study was conducted. Thirty-seven children with septic shock admitted to the pediatric intensive care unit (PICU) of the First Affiliated Hospital of Gannan Medical University from July 2019 to September 2022 were enrolled as the research subjects. The patients were divided into citrate local anticoagulation group and heparin systemic anticoagulation group according to different anticoagulation methods. The baseline data, the level of coagulation indicators [prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (Fib), D-dimer] before treatment and 1 day after weaning from CBP, serum inflammatory mediators [interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), hypersensitivity C-reactive protein (hs-CRP), procalcitonin (PCT)], bleeding complications during CBP and 7-day mortality were collected.Results:A total of 37 cases were enrolled finally, including 17 cases with citric acid local anticoagulation and 20 cases with heparin systemic anticoagulation. There was no statistically significant difference in general data such as gender, age, and body weight of children between the two groups. There were no statistically significant differences in baseline levels of coagulation indicators and inflammatory mediators before treatment of children between the two groups. One day after weaning from CBP, both groups showed varying degrees of improvement in coagulation indicators compared with those before treatment. Compared with before treatment, the PT of the heparin systemic anticoagulation group was significantly shortened after 1 day of weaning (s: 11.82±2.05 vs. 13.64±2.54), APTT and TT were significantly prolonged [APTT (s): 51.54±12.69 vs. 35.53±10.79, TT (s): 21.95±4.74 vs. 19.30±3.33], D-dimer level was significantly reduced (mg/L: 1.92±1.58 vs. 4.94±3.94), with statistically significant differences (all P < 0.05). While in the citrate local anticoagulation group, only APTT was significantly prolonged after treatment compared with that before treatment (s: 49.28±10.32 vs. 34.34±10.32, P < 0.05). There were no statistically significant differences in other coagulation indicators compared with before treatment. Compared with the citric acid local anticoagulation group, the PT of the heparin systemic anticoagulation group was significantly shortened after treatment (s: 11.82±2.05 vs. 13.61±3.05, P < 0.05), and the D-dimer level was significantly reduced (mg/L: 1.92±1.58 vs. 3.77±2.38, P < 0.01). The levels of inflammatory mediators in both groups were significantly reduced 1 day after CBP weaning compared with those before treatment [citric acid local anticoagulation group: hs-CRP (mg/L) was 12.53±5.44 vs. 22.65±7.27, PCT (μg/L) was 1.86±1.20 vs. 3.30±2.34, IL-6 (ng/L) was 148.48±34.83 vs. 202.32±48.62, TNF-α (ng/L) was 21.38±7.71 vs. 55.14±15.07; heparin systemic anticoagulation group: hs-CRP (mg/L) was 11.82±4.93 vs. 21.62±8.35, PCT (μg/L) was 1.90±1.08 vs. 3.18±1.97, IL-6 (ng/L) was 143.81±33.41 vs. 194.02±46.89, TNF-α (ng/L) was 22.44±8.17 vs. 56.17±16.92, all P < 0.05]. However, there was no statistically significant difference between the two groups (all P > 0.05). There was no statistically significant difference in bleeding complication during CBP and 7-day mortality in children between the citrate local anticoagulation group and the heparin systemic anticoagulation group (5.9% vs. 30.0%, 17.6% vs. 20.0%, both P > 0.05). Conclusions:Heparin for systemic anticoagulation and regional citrate anticoagulation can significantly reduce the levels of IL-6, TNF-α, hs-CRP and PCT in children with septic shock, and relieve inflammatory storm. Compared with citric acid local anticoagulation, heparin systemic anticoagulation can shorten the PT and reduce the level of D-dimer in children with septic shock, which may benefit in the prevention and treatment of disseminated intravascular coagulation (DIC).

Objective To understand the distribution of novel coronaviruses in the external environment of confirmed COVID-19 cases. Methods Environmental surface swab specimens such as bed rails, doorknob, closestool, hand washing sink, table, locker,ward pager, mobile phone, cup, clothes, were collected from the sentinel hospital of COVID-19, and samples were collected for the nucleic acid detection by RT-PCR. Results A total of 150 environmental samples were collected from 30 confirmed COVID-19 cases, 6 samples were determined to be novel coronaviruses postive (positive rate 4.00%). The total 14 mobile phone showed 3 novel coronaviruses positive.Among the 30 confirmed COVID-19 cases, 6 cases (positive rate 20.00%)were found novel coronaviruses in the external environment. Conclusions Novel coronaviruses exists in external environment of confirmed COVID-19 cases, which indicates the potential risk of COVID-19 infection.