Objective To evaluate the efficacy and safety of helmet delivered continuous positive airway pressure (Helmet-CPAP)for hypoxemia in airway extubated patients after cardiac surgery.Methods 120 adult patients in ICU from March 2014 to July 2015,who were after cardiac surgery,were enrolled.These patients who suffered hypoxemia within 48 hours after extubation,defined as that PaO2/FiO2 with oxygen mask could not reach 200,were divided into two groups.In the control group high concentration oxygen therapy with mask was delivered,while helmet-CPAP was delivered in the experimental group.Treatment duration was 6 hours.Results Helmet-CPAP significantly improved PaO2/FiO2 (144.35 ± 24.43 vs.201.35 ± 52.97,P ＜ 0.05) and left ventricular ejection fractions(0.5383 ± 0.0844 vs.0.5540 ± 0.0844,P ＜ 0.05).Breathing rate (22.60±5.08 vs.18.53 ±4.13,P＜0.05),heart rate(102.72±17.9 vs.95.15 ±13.79,P＜0.05)and shock index (0.85 ± 0.35 vs.0.75 ± 0.15,P ＜ 0.05) were significantly lower.The rate of using mechanical ventilation (6.67％ vs.28.33％,P ＜ 0.05) and length of ICU stay[41.0(25.0,67.5) hours vs.49.5 (32.5,90.8) hours,P ＜ 0.05] was significantly less than control group.Conclusion Helmet delivered continuous positive airway pressure is an effective and safe treatment for hypoxemia in airway extubated patients after cardiac surgery.

Objective More early esophageal cancers are treated by endoscopy.However,whether submucosal patients are suitahle for endoscopic treatment is still controversial,and few domestic researches were conducted in this area.The present study investigated the impact of submucosal invasion depth on lymph node metastasis.Methods A total of 258 patients who underwent esophagectomy from November 2009 to March 2014 were studied.Submucosal invasion was equally categorized into inner one-third(sml),middle one-third(sm2),and deep one-third(sm3) invasion by pathologists.Demographics of patients,tumor characteristics,and surgical information were retrospectively collected through medical records.They were compared according to different submucosal invasions.Cancer characteristics and its association with LNM were analyzed by univariate and multivariate analysis.Results The study included 75 sml (29.1％),73 sm2(28.3％),and 110 sm3(42.6％) patients,and the rates of LNM were 12.0％ (9/75),11.0％ (8/73),20.9％ (23/110),respectively.sm3 might be associated with regional LN M (univariate analysis,P =0.041).Tumor volume ＞ 1.856 cm3 (P =0.022) and lymphovascular invasion (P =0.004) predicted LNM using multivariate analysis.Conclusion Submucosal ESCC showed a substantial rate of LNM and it seems that they are not suitable for endoscopic treatment.Depth of invasion was not an independent risk factor for LNM.

Objective To detect the effect of a new bioactive bone screws composed of nanohydroxyapatite/polyamid 66/glass fiber (n-HA/PA66/GF) biomaterial on biological behavior of osteoblasts with a view to a later clinical application of the screws.Methods Mice osteoblasts were co-cultured with n-HA/PA66/GF biomaterial or its extract.Cell growth was detected under a microscope,cell proliferation using MTT assay,apoptosis by flow cytometry,osteocalcin by ELISA method,cell migration using Transwell invasion assay,cell adhesion and growth by scanning electron microscope,and cytoskeleton and actin filament distribution using immunofluorescene.Results Direct contact test demonstrated n-HA/PA66/GF material had no obvious cytotoxicity to osteoblasts.Extract of n-HA/PA66/GF material stimulated osteoblast proliferative activity over time with absorbance value of 0.96 ± 0.14,1.54 ± 0.15,and 2.39 ±0.27 respectively after 2,4,and 6 hours of coculture (P ＜ 0.05).The n-HA/PA66/GF material induced more osteoblasts to entering S period without obvious influence on apoptosis rate and promoted osteocalcin secretion.Migrated cells in medium supplied with n-HA/PA66/GF material or FBS was 8.73 ± 3.26 and 9.47 ± 3.29 in each visual field,but there was no significant difference (P ＞ 0.05).Osteoblasts had a regular form on the surface of n-HA/PA66/GF material,closely adhered to the surface,and reproduced and aggregated with each other to form stratified cell layers.However,nHA/PA66/GF material exhibited no obvious influence on distribution of cytoskeleton and actin filament.Conclusion The new n-HA/PA66/GF screws has excellent cytocompatibility with positive regulatory effect on cell growth,proliferation,secretion,adhesion,cycle,and osteocalcin secretion.

Objective To study the bystander effect of tumor necrosis factor related apoptosis inducing ligand(TRAIL) gene and it's mechanism. Methods Full length cDNA of human TRAIL was transfected into SMMC7721 with binary adenoviral vectors system. RT PCR was used to determine the expression of TRAIL gene. By MTT assay the effects of the TRAIL gene on the proliferation of SMMC7721 was studied; The apoptosis inducing ability of TRAIL gene on SMMC7721 was tested by fluorescence activated cell sorting (FACS). Bystander effect by testing the proliferation of the mixed cells of SMMC7721/TRAIL and SMMC7721 with different ratios, and the mechanism of bystander effect by testing the proliferation of SMMC7721 cultured with media of SMMC7721/TRAIL without cell components were also studied. Results TRAIL gene expressed by binary adenoviral vector system was able to inhibit proliferation(91.2%) and induce apoptosis(29.07%) of SMMC7721, significant difference between TRAIL gene and the other three controls were observed(PBS, LacZ, Bax)( P

OBJECTlVE To estabIish a simpIe,sensitive and quick method for determination of B7011 in rat pIasma. METHODS The method of protein precipitation with methanoI was used for pre-treatment of pIasma sampIes determined by Iiquid chromatography mass spectrometer. The Iinear reIa-tionship,intra-batch and inter-batch precision,specificity,matrix effect,recovery rate,the accuracy and stabiIity of the pIasma sampIes were vaIidated. The concentration of B7011 in pIasma was determined by LC-mS/ mS foIIowing a singIe intravenous injection of B7011 0.5 mg·kg-1 to rats. RESULTS The Iinear range of B7011 was 30-20 000 μg·L-1 ,the Iower Iimit of quantification was 30 μg·L-1 in pIasma,the in-tra-batch precision of 60,1000,16 000 and 10 000 ng·mL-1 was 5.61% -13.31%,2.31% -8.35%, 2.02%-9.47% and 4.0%-15.0% respectiveIy,and inter-batch precision was 10.05%,2.55%,3.75% and 8.58% respectiveIy. The recovery of 60,1000,and 16 000 μg·L-1 was 114.12%,109.2% and 101.06%respectiveIy. The average peak concentrations were 8373.28 and 8564.59 μg·L-1 ,the mean AUC was 98 400 and 104 000 μg·L-1·h and the t1/ 2z for B7011 was 41.7 and 63.6 h in bIood of maIe and femaIe rats, respectiveIy. CONCLUSlON The estabIished method is sensitive, fast and simpIe and concentration of B7011 in pIasma is determined by LC-mS/ mS foIIowing a singIe intravenous injection of B7011 0.5 mg·kg-1 to rats. It can satisfy the requirements of pharmacokinetic and toxicokinetic studies.

AIM:To screen and verify the effective ingredient of traditional Chines medicine (TCM) Q0409 in improving learning and memory ability of mice.METHODS:The mouse learning and memory impairment model was induced by intraperitoneal injection of scopolamine.The mice in each group were given the corresponding drug by gavage at the same time for 14 d in succession.Morris water maze test was used to measure the learning and memory ability of the mice, and then the hippocampal tissue homogenate was taken to determine the activity of acetylcholinesterase (AChE).The animals were divided into 8 groups according to L8(27) orthogonal table.The variance analysis and factorial analysis were used to analyze the pharmacological effects of seven kinds of single herbal in TCM Q0409 and determine the screening ingredients.The animals were divided into 6 groups according to the results of the preliminary screening results, and further testing and validation of TCM Q0409 screening ingredients were performed to get the final simplified ingredients.RESULTS:Three medicinal herbs of Polygalae, Panax ginseng and Acori graminei rhizome were screened by the orthogonal results of Morris water maze test and the activity of AChE in mouse hippocampal tissues.The simplified ingredients of TCM Q0409 were obtained through the variance results of Morris water maze test and the activity of AChE in mouse hippocampal tissues.CONCLUSION:Polygala and ginseng were eventually determined as simplified ingredients of TCM Q0409 and it was verified that they improve the learning and memory ability of the mice with learning and memory impairment.

Objective:To analyze the effect of ultrasound-guided stellate ganglion block combined with dexmedetomidine on Narcotrend index and pain degree after hip replacement.Methods:Seventy patients who underwent hip replacement in the Third People′s Hospital of Dalian City from January 2018 to June 2019 were selected. The patients were divided into control group and experimental group by random digits table with 35 cases in each group. Before induction of anesthesia, the patients in control group were given dexmedetomidine 0.25 μg/(kg·h) venous pump injection; the patients in experimental group were anesthetized by ultrasound-guided stellate ganglion block combined with dexmedetomidine 0.25 μg/(kg·h). The anesthesia recovery, Narcotrend index pain degree and adverse reaction were compared between 2 groups.Results:The postoperative finger-pointing-nose time, spontaneous breath recovery time, head up time and eye opening time in experimental group were significantly shorter than those in control group: (17.78 ± 2.33) min vs. (22.07 ± 2.59) min, (2.50 ± 0.51) min vs. (3.61 ± 0.58) min, (12.01 ± 1.33) min vs. (18.01 ± 2.05) min and (7.35 ± 1.18) min vs. (9.53 ± 1.46) min, and there were statistical differences ( P<0.01). There was no statistical difference in the Narcotrend index at the time of going into the operating room between 2 groups ( P>0.05); the Narcotrend index at the time of intubation, 5 min after intubation and 10 minutes before conclusion of the surgical procedure in experimental group was significantly higher than that in control group (95.15 ± 3.66 vs. 89.77 ± 4.39, 90.36 ± 3.71 vs. 86.44 ± 4.28 and 88.50 ± 4.06 vs. 82.22 ± 4.17), and there was statistical difference ( P<0.01). The static and dynamic visual analogue score 4, 8, 12, 24 and 48 h after operation in experimental group was significantly lower than that in control group, and there was statistical difference ( P<0.01). No adverse reaction associated with ultrasound-guided stellate ganglion block was observed in the experimental group. Conclusions:Ultrasound-guided stellate ganglion block combined with dexmedetomidine has a significant anesthetic effect in hip replacement patients, which can promote postoperative recovery, as well as improve Narcotrend index and pain level.

Hepatic encephalopathy (HE) has various clinical symptoms, and its etiology and pathogenesis have not been fully understood. Recent studies have shown that the composition of intestinal flora is associated with the changes in the central nervous system in patients with HE. With reference to recent studies in China and foreign countries, this article analyzes and summarizes the regulatory mechanism of intestinal flora on HE through the liver-brain axis from the perspectives of microbiology, nervous system, and immunology, and it is pointed out that in-depth studies on the mechanism of action of intestinal flora are needed for the treatment of HE and can provide a clear basis for clinical diagnosis and treatment.

Objective To establish the CTRP4 transgenic mouse model and investigate the function of the novel adipocytokine CTRP4.Methods CTRP4 overexpressing vector in pCAGGS was firstly constructed and then microinjected into zygote to establish the founder transgenic mice .F1 heterozygotes were generated by founder mice mating with wildtype mice, and the CTRP4 transgenic homozygotes were generated by F 1 littermates.The genotype was confirmed by PCR and test cross method .The expression level of CTRP 4 in transgenic mice was detected by western blot .Result The human CTRP4 transgenic homozygote mice line was established , and the expression level of CTRP 4 was confirmed raletively high in detected tissues including heart , liver, brain and kidney . Conclusion The human CTRP4 transgenic mice was successfully established .

Objective:To construct a quality evaluation index system of pulmonary rehabilitation for lung cancer patients in order to supply reference for evaluation of rehabilitation quality for lung cancer patients.Methods:This research adopted Delphi technique of non-experimental study. A total of 25 experts were invited to participate 2 rounds of letter enquiry from January to April in 2022. Literature retrieval, group discussion and Delphi method were used to establish the evaluation system of pulmonary rehabilitation for patients with lung cancer based on the social ecology theory.Results:The recovery rates of the two rounds of expert correspondence were 84%(21/25) and 100%(21/21), respectively, the expert authority coefficient was 0.824, and the Kendall′s W value was 0.279 and 0.186, respectively, which were statistically significant ( χ2=409.57, 218.23, both P<0.05). The finally formed quality evaluation index system of pulmonary rehabilitation for lung cancer patients based on social ecology theory included 4 first-level indicators, 11 second-level indicators, and 42 third-level indicators. Conclusions:The evaluation system of pulmonary rehabilitation for lung cancer surgery patients constructed in this study has certain scientificity and practicability, and provides a reference for the continuous improvement of the quality of care for lung cancer patients in our country.