The pathophysiofogy and treatment of flail chest was studied on a modified Maloney ' s model in 10 dogs. Pendulum airflow was not found in this experiment. It is concluded that the pathophysiological changes of the flail chest is mainly caused by paradoxical respiration, and the traction of the flail segment is a sim le and effective method of treatment. This study provides some experimental and clinical data for the treatment of flail chest

Objective:To observe the clinical effect of acupuncture on chronic obstructive pulmonary disease (COPD), and the improvements of patients’ pulmonary ventilation function and 6-minute walk test (6-MWT) distance. Methods:A total of 80 COPD patients [grade 3-4 in Global Initiative for Chronic Obstructive Lung Disease (GOLD), qi deficiency of the lung and kidney in traditional Chinese medicine (TCM) pattern] were randomly allocated into a treatment group (n=40) and a control group (n=40). Salmeterol Xinafoate and Fluticasone Propionate powder (Seretide,50μg/250μg) for inhalation was used for basic treatment in both groups (once in the morning and once in the evening). Patients in the treatment group received acupuncture at Feishu (BL 13), Shenshu (BL 23), Qihai (CV 6), Guanyuan (CV 4), Dingchuan (EX-B 1), Danzhong (CV 17) and Zusanli (ST 36) twice a week for 3 months. After 3 months of treatment, clinical effects, lung ventilation functions and 6-MWT distance were observed and compared in the two groups. Results:After 3 months of treatment, the total effective rate was 95.0% in the treatment group, versus 80.0% in the control group, showing a statistical difference (P<0.05); the phlegm expectoration, dyspnea and shortness of breath were more significantly improved in the treatment group than those in the control group (P<0.01,P<0.05); and the 6-MWT distance and forced expiratory volume in 1 second percentage of predicted value (FEV1%) were more significantly improved in the treatment group than those in the control group (P<0.05,P<0.01). Conclusion:Seretide inhaler combined with acupuncture can improve signs and symptoms in COPD patients, increase the 6-MWT distance, improve FEV1% and obtain better results than Seretide alone.

AIM: To investigate the feasibility and infection efficiency of MSCs with replication-deficient adenovirus containing delivered gene, and whether enhanced green fluorescence protein (EGFP) gene track the change during rMSCs differentiating neuron-like cells. METHODS: Rat marrow mesenchymal stem cells (rMSCs) were expanded in low density in vitro . Under the control of CMV promoter, pAd-EGFP-Vector was constructed by homologous recombination in E.coil BJ 5183, and the recombinant virus was produced in HEK 293 packaging cell line. rMSCs infected with Ad-EGFP were observed and analyzed with fluorescence microscope. Infection efficiency was assessed by microscopical scoring and flow cytometrics. After withdrawing serum and exposure to ?-mercaptoethanol medium, rMSCs infected with Ad-EGFP was induced to differentiate into neuron-like cells. As a control, the plasmid of pTrack-EGFP also was transfected into rMSCs to evaluate transfection efficiency.RESULTS: The results showed that Adenovirus vector (AdVec) delivered EGFP gene with high efficiency to marrow mesenchymal stem cells. Gene expression analysis showed that 36%?2 % of rMSCs infected with recombinant adenovirus expressed the transgene of EGFP at high levels. However, the transfection of plasmid pTrack-EGFP using routine method of lipofectamin mixed with plasmid DNA (pTrack-EGFP) was not easily successful and the transfection efficiency was much lower. rMSCs infected with Ad-EGFP in different passage could differentiate into typical morphology alike neural cells after withdrawing serum and exposure to ?-mercaptoethanol medium. Immuno-staining with neuron-specific enolase (NSE), a neuronal marker, was strong positive, which suggested that rMSCs infected with Ad-EGFP had the potential to differentiate into neurons or neuron-like cells. CONCLUSION: The AdVec system can deliver target gene into MSCs and EGFP gene carried by AdVec can track the change during rMSCs differentiating into neuron-like cells.

Objective:To analyze Traditional Chinese Medicine(TCM) prescriptions in COVID-19 patients in Shanghai area.Methods:Two hundred and forty patients were enrolled in the study, including 19 mild cases, 199 moderate cases, 16 severe case and 6 critical cases. The COVID-19 formula in Shanghai area was extracted and input in TCM Inheritance platform. Data association method such as software association rules,improved mutual information method,complex system entropy clustering,unsupervised entropy hierarchical clustering were used to analyze the frequency,herb flavor and meridian, combination rule and core combination of different types of Chinese herbs in the treatment of COVID-19 in Shanghai area.Results:According to the frequency analysis of 240 prescriptions of Chinese medicine,194 herbs were found. The COVID-19 formula herbs were all "cold", the frequency of use in mild, moderate, severe and critical cases was [46.02%(104/226), 46.31%(1 230/2 656), 37.06%(146/394), 39.24%(31/79)]. The flavor was mainly "bitter" and the frequency of use in 4 types of disease were [36.53%(122/332), 37.33%(1 445/3 857), 35.96%(205/564), 33.62%(39/113)]. Scutellaria was the most frequently used TCM of "bitter and cold". The drugs used were mainly lung,stomach and spleen meridians. By comparing the formulas between mild and moderate cases,herb combinations with the highest frequency were all "scutellaria glycyrrhiza" and "tangerine glycyrrhiza". The formulas for 19 mild cases were collected,and 197 drug combinations were counted, and 125 Chinese medicine association rules,including 13 Chinese herbs. The formulas were extracted in 199 moderate cases of COVID-19, a total of 92 drug combinations and 38 Chinese medicine association rules were collected,including 19 Chinese herbs. In 16 severe cases, a total of 62 drug combination models and 46 Chinese medicine association rules were collected,including 17 Chinese herbs. For the 6 critical cases,80 Chinese medicine prescriptions were combined,and 10 Chinese medicine association rules, including 12 Chinese herbs.Conclusions:The herbal prescriptions of COVID-19 in Shanghai are characterized by clearing away heat and resolving dampness. By analyzing prescription rules with complex system entropy clustering, association compatibility ideas of different types of traditional Chinese medicine are found to be different among four types of COVID-19 cases. Analyzing the connection rules in formulas, by using the theory of TCM and pharmacology of traditional Chinese medical formula in different COVID-19 patients may be helpful for general practitioners.

OBJECTIVETo explore the changes of soluble interleukin-2 receptor(sIL-2R) in serum and cerebrospinal fluid (CSF) of patients with delayed encephalopathy after acute carbon monoxide poisoning (DEACMP).

METHODSThere were 31 patients with DEACMP, 32 patients with other encephalopathy and 31 controls in this study. The levels of sIL-2R in serum and CSF were detected by ELISA.

RESULTSSerum sIL-2R in patients with DEACMP[(329.21 +/- 160.99)U/ml] was significantly higher than that in control[(115.67 +/- 89.58) U/ml, P < 0.05)], but not significantly different from that in the other encephalopathy group[(367.50 +/- 123.14) U/ml, P > 0.05)]. CSF sIL-2R in patients with DEACMP[(54.48 +/- 43.04) U/ml] measured a little before discharge was significantly lower than that in patients with the other encephalopathy[(110.24 +/- 76.56) U/ml, P < 0.05)], but not significantly different from that in the control group[(34.96 +/- 22.70)U/ml, P > 0.05)]. At the pre-discharged period, CSF sIL-2R in patients with DEACMP[(100.26 +/- 93.65) U/ml] was significantly higher than that at the early stage of hospitalization[(52.28 +/- 43.31) U/ml, P < 0.05)]. No significant difference in serum sIL-2R was found between early stage of hospitalization[(338.34 +/- 161.53) U/ml] and pre-discharge [(351.31 +/- 175.93) U/ml, P > 0.05)].

CONCLUSIONThe occurrence of DEACMP may be related with immunopathological damage. The sIL-2R levels in serum and CSF may give information about the state of immunological function of the patients with DEACMP and may contribute to determining the patient's condition and prognosis.

Brain Diseases ; cerebrospinal fluid ; immunology ; Carbon Monoxide Poisoning ; cerebrospinal fluid ; immunology ; Enzyme-Linked Immunosorbent Assay ; Hospitalization ; Humans ; Receptors, Interleukin-2 ; analysis ; blood