OBJECTIVE: To investigate the possible effects of recruitment maneuver (RM) imposing on extravascular lung water (EVLW) in patients with acute respiratory distress syndrome (ARDS). METHODS: Twenty patients with ARDS who were eligible for the study were randomized to two groups, one group of which received regular therapy+RM (RM group), and to the other group only regular therapy was given (control group). Mechanical ventilation of all the patients was performed on the principles of lung protective ventilation. RM was carried out in bi-level positive airway passage (BIPAP) mode, and repeated every 8 hours per day until on the 7th day or before weaning of mechanical ventilation. The treatment was same between the two groups except RM. Baseline data and the influencing factors of EVLW were all recorded, which included everyday EVLW, extravascular lung water index (EVLWI) after RM, respiratory mechanics, oxygenation parameters, central venous pressure (CVP), plasma colloid osmotic pressure (COP), dosage of corticosteroid and adrenergic drugs, 24-hour net fluid balance. RESULTS: EVLW and EVLWI in RM and control group showed a tendency of decrease with passage of time, but the difference between both groups had no statistical significance (all P>0.05). The comparisons between the influencing factors of the groups, consisting of CVP, COP, noradrenalin and hydrocortisone, had no significant difference either (all P>0.05). Dopamine dosage in RM group on the 4th day was smaller than that of control group (P<0.05). Net fluid balance in RM group on the 7th day was negative, whereas it was positive in control group (P<0.05). Mean airway pressure [Pmean, RM group (18.8+/-3.2) cm H(2)O (1 cm H(2)O=0.098 kPa) vs. control group (16.6+/-3.9) cm H(2)O] and lung quasi-static compliance [Cstat, RM group (36.5+/-14.5) ml/cm H(2)O vs. control group (29.3+/-12.0) ml/cm H(2)O] in RM group were higher than those in control group (both P<0.05). Cstat on the 5th day was higher than that on the 2nd and 3rd day in RM group (both P<0.05). But oxygenation index (PaO(2)/FiO(2)) showed no distinct difference between the groups (all P>0.05). CONCLUSION: RM for the patients with ARDS can merely improve lung mechanics without obvious effect on EVLW. Neither of the influencing factors involved in the study has impact on emergence and clearance of EVLW.

OBJECTIVETo investigate the effects of glycyrrihizic acid (GA) and prednisone on renal injury in chronic aristolochic acid nephropathy (AAN) rat model.

METHODSNinety-eight male Wistar rats of SPF grade were randomly divided into 4 groups, the normal control group (n = 20), the GA group, the model group, and the prednisone group, 26 rats in each group. Rats in the latter 3 groups were made into AAN model by administration of aristolochic acid (AA, contained in extract of Caulis Aristolochiae Manshuriensis) 20 mg/(kg x d) by gastric gavage, and equal volume of drinking water was given to rats in the control group. Medication was started 2 h later, the GA group was treated with GA 25 mg/(kg x d), the prednisone group with prednisone 3.15 mg/(kg x d), and to the other two groups equal volume of drinking water was given. Body weight was measured weekly, renal function related indices and morphology of the renal tissue were examined at the 4th, 8th and 12th weekend.

RESULTSAlong with the feeding time, body weight in the control group increased steadily, while that in the treated groups increased slowly. The ratio of serum creatinine/body weight increased markedly in the model group, while it significantly lowered in the treated groups. Morphological examination showed that the structural injury in the treated groups was milder than that in the model group, and its degree of fibrosis was milder also (15% - 20% vs 30%). Electronmicroscopy showed that AA induced, injury degeneration and necrosis of renal tubular epithelial cells, and markedly injured the cell organs, such as mitochondria, and induced nuclear variation, while in the treated groups, it was mainly limited in renal tubule, with normal cell organs, few nucleolus variation and less interstitial collagen fibers.

CONCLUSIONGA and prednisone could reduce the serum creatinine level, improve renal function, relieve the renal morphological changes, and decrease the inter stitial fibrosis, showing a definite preventing effect on chronic AAN in rats.

Animals ; Anti-Inflammatory Agents ; therapeutic use ; Aristolochic Acids ; Chronic Disease ; Drug Therapy, Combination ; Glycyrrhetinic Acid ; therapeutic use ; Kidney ; drug effects ; pathology ; ultrastructure ; Kidney Diseases ; chemically induced ; drug therapy ; Male ; Microscopy, Electron ; Prednisone ; therapeutic use ; Random Allocation ; Rats ; Rats, Wistar ; Treatment Outcome

Objective To investigate the clinical features of myelin oligodendrocyte glycoprotein-IgG-associated disorders （MOGAD）. Methods A retrospective analysis was performed for the clinical data of nine patients with MOGAD who were admitted to our department. Results Among the nine patients with MOGAD， there were five male patients and four female patients， with a median age of onset of 29.0 years. The main clinical symptoms included optic neuritis in five patients， cerebral symptoms （including mental symptoms）in five patients，seizures in four patients， brainstem symptoms in three patients， pyramidal signs in three patients， cerebellar symptoms in three patients， rectal and bladder dysfunction in three patients， myelitis in two patients， paresthesia in two patients， and comorbidity with autoimmune encephalitis in one patient. All patients tested positive for serum MOG-IgG， and two patients tested positive for MOG-IgG in cerebrospinal fluid. MRI showed that cerebral lesions mainly involved the midline structure and deep gray matter，and there were four patients（44.4%） with lesions in the midbrain， the pons， and the medulla oblongata and four patients （44.4%）with lesions in the fourth ventricle； spinal lesions often involved long segments （≥3 segments）， and there were two patients with lesions in cervical spinal cord and one patient with lesions in the thoracic spinal cord. All nine patients received immunotherapy in the acute stage， with a mean Expanded Disability Status Scale score of （3.94±2.28） for neurological function assessment. Three patients experienced recurrence during the median follow-up time of 36.0 months，among whom two patients had myelitis. Conclusion There was no significant sex difference in the prevalence rate of MOGAD，and the age of onset of MOGAD is earlier than that of multiple sclerosis and neuromyelitis optica spectrum disorder.Optic neuritis is the most important clinical phenotype of MOGAD， and MOGAD patients with myelitis phenotype all have longitudinal long-segment lesions of the spinal cord. The different clinical phenotypes of MOGAD may be associated with recurrence rate.

Objective: To investigate the curative effect of rib cartilage framework supporting combined with local flap grafting for correction of cryptotia. Methods: Fourteen cases (nineteen ears) were corrected by rib cartilage framework supporting combined with local flap grafting method from January 2017 to March 2019. Part of the 7th rib cartilage was carved into a scalloped cartilage piece, which was implanted on the retroauricular cartilage to release and expand the deformed cartilage. A "M" incision was designed on the retroauricular skin to make the local flap grafting. Results: All corrected auricles were followed up for four months to three year and abtained satisfactory and stable appearance. In one case, the edge of the helix was broken two weeks after the operation, and well healed after repairing. Conclusions: The rib cartilage framework supporting combined with local flap grafting method can fully correct the deformity of cryptotia, and the long-term effect is satisfied. It can be an important complement to the classic methods.
Cartilage ; Ear, External/surgery* ; Humans ; Reconstructive Surgical Procedures ; Ribs ; Surgical Flaps

Low oxygen partial pressure is the main cause of acute mountain sickness.Hemoglobin plays a crucial physiological role in the binding, utilization, transportation and release of oxygen in the body. To increase the capacity of oxygen binding of hemoglobin or the capacity of oxygen supply in tissues can help alleviate altitude sickness. However, increasing hemoglobin content has certain limitations. Using techniques from molecular biology, researchers are looking for endogenous or exogenous substances that can regulate the conformation of hemoglobin to increase oxygen uptake in the alveoli, or the availability of alveolar oxygen in the tissues. At present, the research on allosteric modulators to improve the affinity of hemoglobin has made some progress, and research on applying this mechanism to plateau hypoxia is also underway. This article reviews the relationship between hemoglobin and hypoxia, the structure of hemoglobin and the role of various allosteric modulators in hypoxia, which would provide information for finding new substances regulating the conformation of hemoglobin.

Objective: Rheumatoid arthritis (RA) is one of the most common inflammatory arthropathy diseases, characterized by synovium hyperplasia and progressive destruction of articular cartilage, which is significantly associated with dysfunction and shortening of life span. Drug therapy is the main intervention for RA, but the glucocorticoid and immunosuppressant have many shortcomings in treatment, such as great side effect, slow onset and poor efficacy, while biological agents are too expensive. RA belongs to the category of "arthralgia syndrome" in traditional Chinese medicine (TCM). TCM treatment for RA has a well-established history and multiple advantages such as good curative effect and less side effects, but its mechanism needs to be further studied. Signaling pathway is involved in the pathogenesis and progression of RA, so it is one of the main targets in research on the pathogenesis of RA and related pharmacological research of therapeutic drugs. In recent years, a large number of studies have been carried out on the regulation effect of active components of TCM on RA signaling pathways. These signaling pathways include Wnt signaling pathway, Janus tyrosine kinase (JAK)-signal transducers and transcription activator (STAT) signaling pathway, mitogen-activated protein kinase (MAPKs) signaling pathway, phosphoinositide-3-kinase (PI3K)/serine/protein kinase B (Akt) signaling pathway, nuclear factor-kappa B (NF-κB) signaling pathway, Toll like receptor (TLRs) signaling pathway, receptor activator of the nuclear factor kappa B ligand (RANKL)/receptor activator of the nuclear factor kappa B (RANK)/Osteoprotegerin (OPG) signaling pathway and so on. By reviewing the research results in recent years, we hope to provide ideas and reference for the basic research, development of new drugs and clinical treatment of RA.

OBJECTIVE: To investigate the effects of high-altitude hypoxic environment on the expression of pregnane X receptor (PXR) in rat liver and related mechanism. METHODS: Wistar rats were randomly divided into five groups with 8 rats in each group, the rats were exposed to high-plateau hypoxia for 0 (control group), 12, 24, 36 and 48 h, respectively. Abdominal aortic blood samples were collected for blood gas analysis. HE staining was used to observe the pathological changes of liver tissue. The expression levels of PXR mRNA in liver tissues were determined by RT-PCR. Western blot analysis was performed to determine the protein expression of PXR and protease SUG1 in liver tissues of rats. RESULTS Compared with the control group, the blood pH of the rats decreased after 12 h of acute hypoxia. After 24 h exposed to hypoxia, SaO₂ was lower than 80%, PaO₂ was lower than 60 mmHg (1 mmHg=0.133 kPa); and PaCO₂ increased after 48 h exposed to hypoxia (P<0.05). There was obvious edema in the central vein of the liver tissue at 12 h and 24 h after exposure to hypoxia. The liver tissue of the rats exposed to hypoxia for 36 h and 48 h showed inflammatory infiltration. The expression of PXR mRNA was significantly decreased by 63%, 96%, 86%, and 85%at 12, 24, 36 h, and 48 h after exposure to hypoxia (all P<0.05), respectively. The protein expression of PXR was significantly up-regulated by 93%and 99%after 36 h and 48 h exposure to hypoxia (all P<0.05), respectively. The protein expression of proteinase SUG1 decreased by 14%, 34%and 46%after 24, 36 and 48 h after hypoxia (all P<0.01). CONCLUSIONS Acute hypoxia at high altitude can affect the expression of nuclear receptor PXR in rat liver, and protease SUG1 may be a regulatory factor for PXR expression in hypoxia.

Drugs for the treatment of central nervous system diseases need to enter the brain tissue through the blood-brain barrier to function. In high altitude hypoxic environment, there are changes in tight junction proteins of blood-brain barrier tissue structure, transporters in astrocytes and endothelial cells and ATP in endothelial cells; at the same time the permeability of the blood-brain barrier is increased. These changes are an important reference for rational drug use in patients with central nervous system disease in the plateau region. This article reviews the research progress on the effects of plateau hypoxia on the structure of the blood-brain barrier and related drug permeability.

OBJECTIVE: To investigate the structural abnormalities of brain in patients with antisocial personality disorder (ASPD) but without alcoholism and drug abuse. METHODS: Volunteers from Hunan Reformatory (n=36) and the matched healthy subjects (n=26) were examined by high-spatial resolution magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI). Voxel-based morphometry and fractional anisotropy (FA) maps were generated for each subject to reveal structural abnormalities in patients with ASPD. RESULTS: Compared with the healthy controls, ASPD patients showed significantly higher gray matter volumes in the inferior parietal lobule (P≤0.001, uncorrected), white matter volumes in the precuneus (P≤0.001, uncorrected), FA in the left lingual gyrus, bilateral precuneus, right superior frontal gyrus and right middle temporal gyrus (P≤0.01, uncorrected). CONCLUSION Our results revealed the abnormal neuroanatomical features in ASPD patients, which might be related to the external behavioral traits in ASPD patients.
Anisotropy ; Antisocial Personality Disorder ; diagnosis ; Brain ; anatomy & histology ; Case-Control Studies ; Diffusion Tensor Imaging ; Humans ; Magnetic Resonance Imaging

OBJECTIVE To summarize the strategies and potential drugs that can improve the oxygen affinity of red blood cells in the hypobaric and hypoxic environment in the current research. METHODS The retrieved literatures were screened, extracted and summarized by referring to the literature on the relationship between hypobaric hypoxic environment and erythrocyte oxygen affinity in CNKI database, Web of Science database and Pubmed database. RESULTS Under the hypobaric and hypoxic environment, the body’s oxygen uptake capacity and oxygen utilization efficiency decreased, resulting in the body being in a state of hypoxia. Improving the oxygen affinity of red blood cells could help the body adapt to and get used to the hypobaric and hypoxic environment, and many improvement methods had been applied in other diseases. CONCLUSION Improving the oxygen utilization rate of red blood cells by increasing the oxygen affinity of erythrocytes under hypobaric and hypoxia environment is the starting point and focus of the current research on preventing the damage of high altitude hypobaric and hypoxic environment to the human body.