Objective To investigate the changes in the expression of Egr-1, C-jun and IL-1? mRNA and protein in the lung injured by mechanical ventilation. Methods Forty male SD rats weighing 250-320 g were randomly divided into 5 groups (n = 8 each): group A received no mechanical ventilation; group B-E received mechanical ventilaion for 30 (B), 60 (C), 90 (D) and 120 (E) minutes. The animals were anesthetized with intraperitoneal 3% pentobarbital 35 mg?kg-1 , tracheostomized and mechnically ventilated (VT =42 ml?kg-1 , RR = 40 bpm, I: E = 1:2, FiO2 = 21 % ) . Arterial blood samples were taken for blood gas analysis. The animals were killed at the end of mechanical ventilation in group B-E and after tracheostomy in group A. The lungs were removed for microscopic examination using HE staining. The expression of Egr-1, C-jun and IL-1? mRNA and protein was detected by RT-PCR and immuno-histochemical technique respectively. Results There was no significant difference in PaO2 and SaO2 among the 5 groups while PaCO2 was significantly decreased in group B and C but increased in group E as compared with group A. The expression of Egr-1, C-jun and IL-1? mRNA and protein was significantly increased by mechanical ventilation in a duration - dependent manner. Histological studies demonstrated that the damage to the lung was correlated with the duration of mechanical ventilation in terms of perivascular inflammatouy cell infiltration, exudates and hemorrhage in the alveoli and thickening of alveolar walls. Conclusion The results of our study show that mechanical ventilation activates and upregulates the expression of the early response genes in a duration - dependent manner. The upregulation of the expression of these genes might be involved in the underlying mechanism of lung damage induced by mechanical ventilation.

Objective To determine the risk factors for postoperative acute kidney injury (AKI) in the patients undergoing cardiac transplantation.Methods Forty patients with end-stage heart failure (both sexes) , aged 13-66 yr, weighing 45-84 kg, of ASA physical status Ⅳ or Ⅴ (NYHA Ⅲ or Ⅳ), undergoing heart transplantation, with normal kidney function before operation, were selected.According to whether or not AKI occurred within 7 days after operation, the patients were divided into either AKI group or non-AKI group.Factors including age, gender, body weight, complications (including hypertension and diabetes mellitus), preoperative blood glucose, hemoglobin, serum creatinine, cardiac output, ejection fraction, pulmonary arterial systolic pressure, intraoperative cardiopulmonary bypass (CPB) time, transfusion of allogeneic red blood cells, and urine volume within 24 h after operation were recorded.The risk factors of which P values were less than 0.05 would enter the multivariate logistic regression analysis to stratify postoperative AKI-related risk factors for this type of patients.Results A total of 39 patients were enrolled in this study.Of the 39 patients, 14 patients suffered from AKI after operation, and the incidence was 36％.The results of logistic regression analysis showed that preoperative pulmonary hypertension and CPB time ＞ 180 min were the independent risk factors for AKI after cardiac transplantation.Conclusion Preoperative pulmonary hypertension and CPB time＞180 min are the independent risk factors for postoperative AKI in the patients undergoing cardiac transplantation.

[Purposes] To observe the effect of urotension Ⅱ in myocardium on electro-acupuncture "Neiguan" and "Shenmen" precondition acute myocardial ischemia reperfusion rat.[Methods] To select 80 healthy male adult SD rats,divided into four groups randomly: normal group,model group,electro-acupuncture precondition group and special antagonist group.To duplicate model with ligating the left coronary artery and in the progress.After duplicating model successfully,select 10 rats to analysis.[Result] The content of UII in myocardium in model group is obviously decreased than in normal group,and in electro-acupuncture precondition group is also decreased obviously but much better than in model group(P

Objective To investigate the role of protein kinase C (PKC) in mechanical ventilation-induced lung injury in rats.Methods Thirty healthy male Wistar rats,weighing 250-300 g,were randomly divided into 5 groups (n =6 each):control group (group C),small tidal volume group (group S),small tidal volume and PKC inhibitor group (group S + P),large tidal volume group (group L),and large tidal volume and PKC inhibitor group (group L + P).VT =42 ml/kg,RR =40 bpm,I∶E =1∶ 2,PEEP =0,FiO2 =21％ in groups L and L + P,while VT=7 ml/kg,RR=40 bpm,I∶E=1∶2,PEEP=0,FiO2 =21％ in groups S and S+P.The rats were only tracheostonized in group C,while the rats were mechanically ventilated for 4 h in the other four groups.PKC inhibitor bisindolylmaleinide Ⅰ 0.12 mg/kg was injected intramuscularly 1 h before anesthesia in groups S + P and L + P.The animals were sacrificed immediacy after tracheotomy in group C,and at 4 h of ventilation in the other four groups and lungs were removed for calculation of wet/dry lung weight ratio (W/D ratio) and for microscopic examination.The expression of occludin was determined in the lung tissues by Western blot.Results Compared with group C,W/D ratio was significantly increased and the expression of occludin was down-regulated in the other four groups (P ＜ 0.05).Compared with group S,W/D ratio was significantly increased and the expression of occludin was down-regulated in group L,and W/D ratio was decreased and the expression of occludin was up-regulated in group S + P (P ＜ 0.01).W/D ratio was significantly lower and the expression of occludin was higher in group L + P than in group L (P ＜ 0.01).The pathological changes were attenuated in groups S + P and L + P as compared with groups S and L.Conclusion PKC is involved in mechanical ventilation-induced lung injury in rats.

Objective To investigate the relationship between serum CC10 protein and lung injury induced by mechanical ventilation.Methods Forty healthy Wistar rats of both sexes weighing 200-250 g were randomly divided into 5 groups(n=8 each):group Ⅰ control;group Ⅱ mild lung injury[VT=7 ml/kg,duration of mechanical ventilation(t):2 h];group Ⅲ moderate lung injury(VT=7 ml/kg,t=4 h);group Ⅳ severe lung injury(VT=40 ml/kg,t=2 h);group Ⅴ extremely severe lung injury(VT=40 ml/kg,t=4 h).The animals were anesthetized with intraperitoneal 10% chloral hyrdrate 3.5 ml/kg and tracheostomized.Group Ⅰ received no mechanical ventilation.The animals in group Ⅱ-Ⅴ were mechanically ventilated with air(FiO2=21%,RR=40 bpm,I:E=1:2).The animals were sacrificed at the end of mechanical ventilation.The lungs were immediately removed for microscopic examination and determination of W/D lung weight ratio.The left lung was lavaged.The CC10 protein level in broncho-alveolar lavage fluid(BALF)and serum were determined by Western blotting.The Clara cells in the bronchiolar epithelium were examined by immno-histochemistry.Results The level of CC10 protein in BALF was significantly lower in group Ⅳ and Ⅴ while the serum CC10 protein level was significantly higher in group Ⅱ-Ⅴ than in group Ⅰ.The serum CC10 protein level was positively correlated while the CC10 protein level in BALF was negatively correlated with the severity of lung injury and W/D ratio.Conclusion The serum CC10 protein is closely related to the severity of lung injury induced by mechanical ventilation.

Objective To compare clinical efficacy of clobetasol propionate ointment and vitamin A acid cream in the treatment of skin papule type amyloidosis.Methods 100 cases of skin papule type amyloidosis were randomly divided into the observation group and control group,each had 50 patients.The control group was treated with Vitamin A acid cream while the observation group used clobetasol propionate ointment for treatment.Skin lesion area,infiltration,skin color,skin itching score as well as the cure rate and efficiency were compared after 4 weeks of treatment.Results The two groups' symptoms was improved,symptom scores was decreased gradually after treatment than before,the observation group's symptom scores at 1,2,3,4 weeks were (9.35 ± 1.88),(6.54 ±2.16),(4.08 ±1.32),(2.04 ± 0.95) points which was significant better than (10.86 ± 2.08),(7.98 ± 2.57),(6.25 ± 1.44),(4.56 ± 1.18) points of the control group,the difference of two groups was statistically significant (t =6.22,6.71,7.30,7.41,all P ＜ 0.05) ;4 weeks after treatment,the observation group's efficience and cure rates were 94％ and 34％,significantly higher than 70％ and 22％ of the control group,the difference was statistically significant (x2 =9.040,8.391,all P ＜ 0.05).Conclusion Clobetasol propionate ointment has a exact effect in treatment of skinpapule type amyloidosis than vitamin A acid cream,which is worthy of clinical application.

Objective To investigate the effects of rosiglitazone (ROSI), a potent agonist of peroxisome proliferator- activated receptor ?( PPAR?) on acute lung injury induced by endotoxin. Methods Thirty-six male Wistar rats weighing 200-250 g were randomly divided into 6 groups (n = 6 per group): group I control; group II ROSI; group III GW; group IV LPS; group V ROSI + LPS and group VI GW + ROSI + LPS. The animals were anesthetized with intraperitoneal 3 % pentobarbital 50 mg ? kg -1 . The jugular vein was cannulated for administration of fluid and drug. In group I , II and III normal saline (NS) 2 ml was given 30 min after IV 10% DMSO 2 ml? kg-1( I ), ROSI 0.3 mg?kg-1(dissolved in DMSO) or GW9662 (PPAR? antagonist) 0.3 mg?kg-1 ( III ) . In group IV , V and VI instead of NS LPS 6 mg? kg-1 was given 30 min after 10% DMSO ( IV ) or ROSI( V , VI). In group VI GW9662 0.3 mg?kg-1 was given IV 20 min before ROSI. The rats were sacrificed and the lungs were removed for microscopic examination and determination of wet/dry lung weight ( W/D) ratio and lung myeloperoxidase (MPO) activity and malondialdehyde (MDA) and NO content. The lung was also assessed for expression of inducible nitric oxide synthase (iNOS) and nitrotyrosine ( NT) using Western blot analysis or immuno-histochemistry.Results LPS induced marked lung injury and significant increase in W/D ratio, MPO activity, MDA and NO content in the lung. All of these changes were significantly attenuated by pretreatment with ROSI. Pretreatment also significantly suppressed LPS-induced expression of iNOS protein and formation of nitrotyrosine in the lung. The specific PPAR? antagonist GW9662 counteracted the effects of ROSI. Conclusion Pretreatment with has protective effect against endotoxin-induced ALL The underlying mechanism is via the activation of PPAR?.

Objective To investigate the cost-effectiveness of cefoperazone sulbactam sodium in treating nosocomial infection (lower respiratory tract infection).Methods 80 cases of nosocomial infection in Jincheng Second People's Hospital from January 2014 to January 2017 were treated as the subjects: the observation group was treated with cefoperazone sulbactam sodium and the control group was treated with cefodizime sodium.The data of two groups of patients were recorded and the data were analyzed statistically.The cost-effectiveness of cefoperazone sulbactam sodium in hospital infection was discussed.Results There was no significant difference in the clinical curative effect between the two groups.The cost of observation group (cefoperazone sulbactam sodium) was lower than that of the control group (cefodizime sodium), the difference was statistically significant (P< 0.05).Conclusion Patients with nosocomial infection choose to use cefoperazone sulbactam sodium as the treatment method, which has exact clinical efficacy, high cost-effectiveness.It is worthy of clinical wide application.

bnormality in these parameters was improved.

Objective To evaluate the efficacy of sufentanil combined with propofol for video-assisted endoscopic transthoracic sympathectomy.Methods Twenty ASA I or II patients of both sexes aged 17-40 yr weighing 52-75 kg undergoing video-assisted endoscopic transthoracic sympathectomy were enrolled in this study.Anesthesia was induced with propofol 2.0-2.5 mg/kg and sufentanil 0.5 μg/kg.Tracheal intubation was facilitated with atracurium 0.6 mg/kg.The patients were mechanically ventilated (VT=8-10 ml/kg,RR=10-12 bpm,I:E =1:2,FiO2=80%).Anesthesia was maintained with infusion of propofol 2-4 mg·kg-1·h-1 and sufentsnil 0.2-0.3/.μg·kg-1 h-1 and intermittent iv boluses of atracurium.At the 30 rain before the end of operation propofol infusion was reduced to 1-2 mg.kg-1·h-1 and sufentanil infusion to 0.1 μg·kg-1 h-1 .BP (SP,DP) and HR were recorded and venous blood samples were taken before induction of anesthesia (baseline),at tracheal intubation at the moment of CO2 insnfflation 10 min and 30 min after CO2 insufflation,5 min after deflation and at extubation for determination of plasma corticesteroid,aldosterone and glucose levels.The duration from termination of infusion of the anesthetics to recovery of spontaneous breathing,eye opening at command and tracheal extubation were recorded.Results SP,DP and HR were within the normal range.Plasma levels of comcesteroid,aldosterone and blood glucose were significantly increased during operation as compared with the baseline values.The duration from termination of infusion of the anesthetics to recovery of spontaneous breathing,eye opening at command and tracheal extubation were4.5±1.9,6.4±2.7 and (12.6±1.5)min respectively.Conclusion Sufentanil 0.1-0.3 μ·kg-1·h-1 combined with propofol 1-4 mg·kg-1.h-1 can inhibit stress response during video-assisted endoscopic transthoracic sympathectomy with stable hemodynamics.