ObjectiveTo observe the effects of mechanical ventilation with different tidal volumes (VT) on coagulability and fibrinolytic characteristics in rabbits with acute respiratory distress syndrome (ARDS) induced by two-hits with oleic acid (OA) and lipopolysaccharide (LPS).Methods Forty healthy adult male rabbits were randomly divided into five groups (8 rabbits in each group): sham operation group, model group, low VT group (6 mL/kg), rontine VT group (10 mL/kg), high VT group (15 mL/kg). ARDS model was reproduced by sequential injection of 0.1 mL/kg OA and 500μg/kg LPS via auricular vein, and the rabbits in sham operation group received normal saline in same volume. Mechanical ventilation was performed in different VT groups after model reproduction, and the end of the experiment was determined as 6 hours after LPS injection. Blood was collected from the carotid artery at 30 minutes and 360 minutes after LPS injection, with which arterial partial pressure of oxygen (PaO2) was determined, and oxygenation index was calculated. Internal jugular vein blood was collected at 5, 120, 240, and 360 minutes after LPS injection, and activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen (Fib) and antithrombinⅢ(AT-Ⅲ) were determined. The blood was collected at the end of the experiment, and then the rabbits were sacrificed, and serum levels of procollagen typeⅢ (PⅢP), plasminogen activator inhibitor-1 (PAI-1) as well as PⅢP level in lung tissue were determined. The wet/dry weight ratio (W/D) of lung tissues was calculated.Results Compared with sham operation group, oxygenation index at both 30 minutes and 360 minutes were significantly decreased in model group, while W/D ratio was significantly increased. PT and APTT at 5 minutes were significantly shortened followed by a gradual increase. Fib and AT-Ⅲ showed no change at 5 minutes followed by a gradual decrease, while serum PAI-1 and PⅢP as well as PⅢP in lung tissue were significantly increased. There was no significant difference in oxygenation index between all VT groups and model group, with a tendency to increase in low VT group. W/D ratio in low VT group was the lowest (5.09±0.19), and it was significantly lower than that of the model group (6.02±0.27, P< 0.01), while it was the highest in high VT group (6.27±0.32). PT and APTT in all VT groups were gradually prolonged, and Fib and AT-Ⅲ were gradually decreased. PT and APTT in low VT group were significantly shorter than those in model group from 120 minutes on [PT (s): 120 minutes: 8.90±0.28 vs. 11.43±0.28, 240 minutes: 9.18±0.21 vs. 11.99±0.50, 360 minutes: 9.25±0.15 vs. 12.49±0.29; APTT (s): 120 minutes: 69.09±3.91 vs. 76.08±4.21, 240 minutes: 67.53±2.14 vs. 79.71±2.25, 360 minutes: 66.95±1.13 vs. 83.21±4.01, allP< 0.05], Fib (g/L) was significantly elevated (120 minutes: 3.80±0.09 vs. 3.38±0.15, 240 minutes: 3.91±0.05 vs. 2.47±0.16, 360 minutes:4.06±0.13 vs. 2.39±0.16, allP< 0.05), and no significant difference was found in AT-Ⅲ. Serum contents of PAI-1 and PⅢP as well as PⅢP in lung tissue were significantly lowered [serum PAI-1 (ng/L): 1.14±0.26 vs. 1.63±0.91, serum PⅢP (ng/L): 1.62±0.52 vs. 2.91±0.64, lung PⅢP (ng/L): 4.40±0.58 vs. 5.75±0.47, allP< 0.01]. The change tendency of all parameters in routine VT group was lower than that in low VT group, PT at 120 minutes and 360 minutes, APTT at 240 minutes and 360 minutes was significantly shorter than that in model group, and Fib at 120 minutes and 240 minutes were significantly higher than those in model group (allP< 0.05). No significant difference was found in AT-Ⅲ, serum PAI-1 and PⅢP as well as lung PⅢP as compared with model group. PT and APTT at 360 minutes in high VT group were significantly longer than those in model group, Fib at 360 minutes was significantly lower than that in model group, and lung PⅢP was significantly higher than that in model group. Conclusions There are some important changes in coagulability which changes from a hyper state into a hypo coagulate state, while fibrinolysis is inhibited during the pathological process of ARDS produced by two-hit of OA and LPS. Mechanical ventilation with low VT can obviously improve coagulability and fibrinolytic status, while ventilation with routine VT has little effect on coagulability and fibrinolytic status. Mechanical ventilation with high VT, however, will greatly deteriorate the coagulability and fibrinolytic function in ARDS.

Objective To explore the best way to deal with infection of expanded skin flap during auricle reconstruction. Methods 12 cases (12 ears) of expanded skin flap infection was analyzed and treated with the method of stretching the expanded skin flap during auricle reconstruction during Jan. 2003 to Dec. 2005. Results In 12 cases (12 ears) the infection was controlled well, auricles were reconstructed smoothly and no obvious difference was detected between the infected and normal skin flaps after the reconstruction of auricles. Conclusion Stretching the expanded skin flap is a good method to deal with its infection during auricle reconstruction.

Objective To investigate the best way for the operation of congenital microtia with deformities of external auditory meatus (EAM) and middle ear. Method To analyze retrospectively 305 cases (332 ears) of auricle reconstruction operated in the Plastic Department of Auricle, Plastic Surgery Hospital, PUMC, CAMS during June to October 2005, and 49 cases (58 ears) of reconstructions of EAM and middle ear operated in the Otolaryngology Department, General hospital of PLA from December 1988 to July 2002. Results The patients/families rested content with the reconstructed auricles operated with the 3-stage way. The hearing was improved obviously after reconstruction of the EAM and ossicle for the patients with normal stapes footplate. In those patients, for whom EAM was reconstructed first, the scar developed around the orifice which affected the skin flap for auricle reconstruction later, while in those patients, for whom the auricle was reconstructed first, wrong location of the EAM orifice happened easily. Conclusions For the patients with congenital deformities of EAM and middle ear and with the requirement of recovering the appearance and hearing function, the EAM orifice should be located first according to the results of temporal CT, then the auricle reconstruction was conducted with 3-stage method. A simultaneous reconstruction of EAM and ossicle at the third stage may ensure the improvement of both outward appearance and hearing function.

Objective To detect TCRγ gene rearrangements in skin lesions and peripheral blood of patients with parapsoriasis, and to study their clinical significance. Methods Totally, 20 patients with parapsoriasis were included in this study. BIOMED?2 multiplex PCR was performed to detect TCRγgene rearrangements in lesional skin (n=20)and peripheral blood(n=11)samples from the patients with parapsoriasis. Statistical analysis was performed to assess the relationship of TCRγ gene rearrangements with clinical types of parapsoriasis as well as general information and histopathological manifestations(including non?specific manifestations and atypical manifestations)of patients. Results TCRγ gene rearrangements were positive in lesional skin from 7 of the 20 patients, in peripheral blood from 3 of 11 patients, and in both lesional skin and peripheral blood from 2 patients. Positive TCRγ gene rearrangements in skin lesions were significantly correlated with mycosis fungoides(MF)?related atypical histopatho?logical manifestations(P<0.05), but those in neither skin lesions nor peripheral blood were correlated with gender and age of patients or clinical course and types of parapsoriasis(all P>0.05). During an average follow?up time of 44.85 ± 18.48 months, 1 case progressed into MF, and 2 were cured. Conclusions Positive TCRγgene rearrangements in skin lesions of patients with parapsoriasis may be correlated with MF?related atypical manifestations. The presence of TCRγgene rearrangements and atypical histopathological manifestations may suggest the possibility of progression from parapsoriasis into MF.

Sick sinus syndrome (SSS) is a disease of multiple arrhythmias and symptoms.It has great impact on patients in the quality of life for the symptoms of high incidence.The asynchrony of myocardial electromechanical movement caused by the SSS electrophysiological changes are focused.The ultrasound can not only observe the electrical physiological activity,but also measure the mechanical movement caused by electrophysiological delay.The research progresses of ultrasound in quantitative evaluation of myocardial function in SSS patients was reviewed in this article.

Objective To evaluate the possibility of AG490 as a potential immunosuppressor and to explore its basic mechanism. Methods Human peripheral blood lymphocytes (both T and B) isolated from healthy donors were cultured with PHA or IL 2 separately for MLC to induce the proliferation of human lymphocytes. The inhibitory rate of human lymphocyte proliferation, the release of cytokines (IL 2, IL 6 and IFN ?) and the changes in differentiation of lymphocyte subsets were observed under different immunosuppressors of AG490, CsA and FK506. Results In vitro experiment, AG490 could suppress the proliferation of lymphocytes induced by various mechanisms (especially the CD3 + and CD4 + cells), obviously inhibit the IL 2 and IFN ? production, but could not inhibit the IL 6 production. Conclusion AG490 is a potential immunosuppressor.

Acrylonitrile ; poisoning ; Adult ; Female ; Humans ; Male ; Middle Aged ; Young Adult

Objective To detect the expressions of Wnt2 and dishevelled (Dvl) protein in esophageal squamous carci-noma, and analyze their relationship with the occurrence and development of esophageal squamous cell carcinoma. Meth-ods The expression levels of Wnt2 and Dvl protein were detected by Western blot assay in 60 samples of esophageal carci-noma and adjacent non-carcinomatous esophageal tissues, and their relationship with clinical pathological features were ana-lyzed. Results The relative expression levels of Wnt2 and Dvl protein were higher in esophageal squamous carcinoma tis-sue (0.512 ± 0.406, 1.218±1.082) than those of esophageal tissue adjacent to carcinoma (0.153 ± 0.189, 0.505±0.358). There were significant differences in the expression levels of Wnt2 and Dvl protein between different infiltration depth, different TNM stages, and lymph node metastasis (P<0.01). There was a positive correlation between Wnt2 and Dvl protein in esopha-geal squamous carcinoma (r=0.718, P<0.01). Conclusion The high expression levels of Wnt2 and Dvl protein promote the development and metastasis of esophageal squamous cell carcinomas collaboratively via Wnt2 signal transduction path-ways.

OBJECTIVE: To investigate the protection mechanism of volatile oil of Magnolia biondii Pamp. (VOMBP) against diabetic nephropathy in rats by observing its effects on level of soluble P-selectin (sP-selectin) in serum and expression of P-selectin in renal tissue. METHODS: Fifty SD rats were randomly divided into normal control group, untreated group, and low-, medium- and high-dose VOMBP-treated group. Diabetic nephropathy was induced in rats by intraperitoneal injection of 1% streptozotocin. Before and the 1st day, 4th, 8th and 12th week after the induction, random blood glucose (RBG) and 24-hour urinary micro-albumin were detected in different groups. At the 12th week, the rats were sacrificed to collect the blood samples and renal tissues. The contents of blood urea nitrogen (BUN) and serum creatinine (SCr) were detected and the pathological change in renal tissues was observed by light microscope; the level of sP-selectin was detected by enzyme-linked immunosorbent assay and the expression of P-selectin protein in renal tissues was measured by immunohistochemical method. RESULTS: Compared with the normal control group, RBG, 24-hour urinary micro-albumin, the contents of BUN, sP-selectin in serum and expression of P-selectin protein in renal tissue in the untreated group were significantly increased (P<0.01), the content of SCr was significantly decreased (P<0.01), and pathological change of renal tissues was also obvious. Compared with the untreated group, 24-hour urinary micro-albumin, the level of sP-selectin in serum and expression P-selectin protein in renal tissue of the three VOMBP-treated groups were all significantly decreased (P<0.01), and pathological change was lessened too. However, there were no significant differences among the three VOMBP-treated groups (P>0.05). CONCLUSION: VOMBP can protect the kidney in rats with diabetic nephropathy by inhibiting the expressions of P-selectin protein in serum and in renal tissue.

Objective To evaluate the effect of polysaccharide nucleic acid fraction of bacillus Calmette-Guerin (BCG-PSN) on peripheral blood CD4+CD25+Foxp3+ regulatory T (Treg) cells in patients with condyloma acuminatum (CA).Methods Forty-two patients with first onset of CA were randomly assigned to receive either injection of BCG-PSN (0.35 mg every other day for 3 months) after fulguration (combination group,26 patients),or fulguration only (fulguration group,16 patients).Venous blood samples were obtained from all the patients at the initial visit and three months after the beginning of treatment,as well as from 30 healthy checkup examinees.The percentage of peripheral Treg cells in CD4+ T lymphocytes was determined by flow cytometry.The recurrence of CA was evaluated during the three months after the beginning of treatment.Results The percentage of peripheral Treg cells in CD4+ T lymphocytes was significantly higher in patients with CA than in the controls (8.31％ ± 1.24％ vs.5.15％ ± 0.72％,P ＜ 0.01),and in patients with clinical recurrence of CA than in those without (9.34％ ± 0.72％ vs.7.45％ ± 0.85％,P ＜ 0.01).The recurrence rate was significantly lower in the combination group than in the fulguration group (30.77％ vs.68.75％,P ＜ 0.05).After three months of treatment,the combination group showed lower percentage of Treg cells in CD4+ T cells compared with the fulguration group (5.87％ ± 1.05％ vs.6.60％ ± 0.75％,P ＜ 0.05).Conclusions The percentage of Treg cells has a close relationship with the progression of CA,i.e.,the higher the percentage,the more frequent the relapse.BCG-PSN may enhance the antiviral immune response in patients with CA and improve their prognosis by reducing the number of Treg cells.