Objective To explore the stress response and immune balance in patients with severe trauma hemorrhage after fluid resuscitation and to clarify the clinical effect of Propofol administered with continuous intravenous infusion pump on it.Methods With prospective,randomized and control analysis,54 patients treated with fluid resuscitation following severe trauma hemorrhage admitted from October 1st,2008 to December 1st,2009 were studied.Another 20 healthy volunteers were enrolled as control group (C group). Patients were randomly divided into:conventional treatment group (R group,n =27 ) and conventional therapy combined with propofol treatment ( P group,n =27) as per gender,age,ISS score,estimated blood loss four factors and the principle ofminimum distribution imbalance index.HR,MAP,the levels of stress hormones [ norepinephrine (NE),cortisol (Cor) ],immune function ( T lymphocyte subsets Th1/Th2) and other biomarkers were observed.Mortality within 28 d between R group and P group was compared.ANOVA was used for the comparison of biomarkers,and independent samples t test was employed to compare variables between the two groups. Results Plasma cortisol (Cor),norepinephrine (NE),alanine aminotransferase (ALT),creatinine ( Cr),blood glucose,and Th1 and Th2 lymphocytes in patients were significantly higher than those in healthy volunteers of group C (P ＜0.01 ),and Th1/Th2 was significantly lower than those in healthy volunteers of C group (P =0.001 ).The ALT (48 h),Glu (6 h),NE (24 h and 48 h) and Cor (6 h and 24 h) of patients in P group were lower than those in R group ( P ＜0.05 ),and Th1 and Th2 were lower than those in R group at different intervals ( Th1:24h P =0.028,48 hP=0.002 ; Th2:6 h P=0.033,24 h P=0.007,48 h P=0.009),and Th1/Th2 ratio (48 h) was significantly higher in P group than that in R group (P =0.028),but there was no significant difference in mortality within 28d between the two groups. Conclusions Strong stress response,immune suppression and organ dysfunction can occur in the early stages of severe trauma hemorrhage after fluid resuscitation.Propofol can inhibit excessive stress response,modulate the immune balance and protect the important organs in those exsanguination patients from severe trauma.

Adult ; Atrioventricular Block ; complications ; Cardiomyopathies ; complications ; diagnosis ; Humans ; Male ; Sarcoidosis ; complications ; diagnosis

Tetraspanins belongs to the transmembrane 4 superfamily(TM4SF). They can be as a bridge to connect the proteins outside or inside the cell membrane. A tetraspanins web is formed by the tetraspnins-proteins complex, and the web is believed to involve in fundamental functions of immunity system, and consequnently, signaling between cells and inside cells, regulating cell activation and adhesion, participating in the identification and infection of some virus. As a family of conservative transmembrane proteins, tetraspanins play multiplex roles in invertebrate. It was described how tetraspanin microdomains might have functions in the immune system, and how they contact with virus. In addition, the important role of tetraspanins in the innate immune system of invertebrate were discussed.

Objective To study and evaluate the therapeutic safety and effect of frequency-doubled-double-pulse laser(FREDDY)lithotripsy for treating upper urinary calculi combined with acute renal failure.Methods The clinical data of 32 cases treated by frequency-doubled-double-pulse laser(FREDDY)lithotripsy were retrospectively analyzed.Results After the operation the serum BUN and Cr levels in the patients got close or returned to normal and the free rate of the stones was up to 90.6%(29/32).Conclusions The ureteroscopic frequency-doubled-double-pulse laser(FREDDY)lithotripsy has the advantage of safety,high efficiency and less trauma for treating the upper urinary tract obstruction combined with acute renal failure.It can also deal with the bilateral ureteral stones at one time.It can be the first choice when the condition is proper.

Objective To observe the intimal changes of inferior caval vein(ICV) wall after combined thrombolysis and anticoagulation therapy for acute thrombosis in rats.Methods The inferior caval venous thrombosis model was established in 105 rats and they were randomly diride into 3 treated groups:heparin(A) treatment group(n=35),urokinase(B) treatment group(n=35),and combination of urokinase and heparin(C) treatment group(n=35),and also eslablished a sham(D) group(n=30).The thrombosed caval veins were taken 1,4,7,14,and 28 d after thrombosis.Changes of thrombus structure and orgainization and intimal hyperplasia were observed by light microscope.The expression areas of collagen fiber were measured by histochemistry.Scanning electron microscopy was used to observe the damage of endothelial cells.Results The intimal hyperplasia in A group was the most severe.The expression area of collagen fiber in group C was less than that of A and B groups(P

ObjectiveTo observe whether lipopolysaccharide (LPS) derived fromEscherichia coli (E.coli) can induce apoptosis of murine platelets in vitro.Methods Washed platelet suspension was prepared and adjusted to the final concentration of 3×108/mL. According to the difference in stimulants, samples were divided into control group (non-calcium Tyrode buffer), thrombin-treated group (1 U/mL final concentration and non-calcium TB) and LPS in different concentrations treated groups (1, 10 and 100μg/mL final concentration respectively and non-calcium TB). To each specimental group corresponding stimulus was added and incubated 30 minutes at room temperature. Chemiluminescence was adopted to determine the concentration of adenosine triphosphate (ATP) and the activity of cysteinyl aspartate specific proteinase-3 (caspase-3). The percentage of Annexin V positive platelets was determined by flow cytometry to reflect the level of phosphatidylserine (PS) exposure. Mean channel fluorescence (MCF) of platelets was determined by flow cytometry for reflecting the level of mitochondrial inner transmembrane potential (ΔΨm) depolarization.Results Compared with control group, the ATP concentration in thrombin-treated group was decreased obviously [relative light unit (RLU): (5.46±0.14)×105 vs. (6.25±0.26)×105,P< 0.05], Annexin V positive ratio [(50.43±2.45)% vs. (1.58±0.25)%,P< 0.05] and caspase-3 activity [RLU: (26.92±1.60)×103 vs. (1.30±0.10) ×103,P< 0.05] were increased obviously, and platelets MCF was lowered significantly [(8.32±0.58)×104 vs. (13.05±1.10)×104,P< 0.05], suggesting an increase inΔΨm depolarization. After being treated with different concentrations of LPS, ATP concentration, Annexin V positive ratio and caspase-3 activity were increased obviously, platelet MCF was decreased obviously, suggestingΔΨm depolarization was increased in a concentration-dependent manner. Compared with control group, 1μg/mL LPS could increase Annexin V positive ratio [(10.45±1.08)% vs. (1.58±0.25)%,P< 0.05], elevate caspase-3 activity [RLU: (14.06±0.61)×103 vs. (1.30±0.10)×103,P< 0.05], and decrease MCF significantly [(9.48±0.50)×104 vs. (13.05±1.10)×104,P< 0.05]. The ATP concentration, Annexin V positive ratio and caspase-3 activity reached maximum levels after the treatment with 100μg/mL LPS, and they were higher obviously than those of the control group [ATP (RLU): (7.00±0.03)×105 vs. (6.25±0.26)×105, Annexin V positive ratio: (55.35±2.42)% vs. (1.58±0.25)%, casepase-3 (RLU): (32.00±3.75)×103 vs. (1.30± 0.10)×103, allP< 0.05], and platelets MCF reached trough levels, and they were obviously lower than those of the control group [(4.69±0.55)×104 vs. (13.05±1.10)×104,P< 0.05].ConclusionE.coli LPS can induce an increase in ATP, PS exposure,ΔΨm depolarization and activity increase of caspase-3 on mouse platelet in vitro, which indicate that LPS can induce apoptosis of platelets in a concentration-dependent manner.

ObjectiveTo explore the relationship between thrombocytopenia (TCP) induced by lipopolysaccharide (LPS) and coagulation or inflammatory response in mouse.Methods Forty-eight C57BL/6 mice were divided into control group, low-dose, and high-dose LPS treatment groups by random number table method, and each group was subdivided into 4-hour and 24-hour subgroups randomly, with 8 mice in each subgroup. 0.5 mg/kg or 50 mg/kg LPS was injected intraperitoneally in low-dose or high-does group respectively, and equal amount of normal saline was injected in control group. Blood was collected from endocanthal vein at the specified time point, platelet count (PLT) was counted, and the levels of thrombin antithrombin complex (TAT), D-dimer, fibrinogen degradation product (FDP), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were determined by enzyme linked immunosorbent assay (ELISA).Results Compared with control group, PLT (×109/L) at 4 hours and 24 hours in low-dose and high-dose LPS groups was significantly decreased (4 hours: 660.65±180.48, 568.55±117.99 vs. 1 199.13±110.54; 24 hours:505.63±218.92, 256.33±72.86 vs. 1 229.13±1 189.37, allP< 0.05), and the changes were more obvious in high-dose LPS group compared with those of the low-dose LPS group (allP< 0.05). Factorial analysis showed that the changes in PLT were related with LPS dosage and time (F1 = 135.660,P1 = 0.000;F2 = 12.120,P2 = 0.001). It was also found that there was an interactive effect of the dose of LPS and time on PLT (F = 5.580,P = 0.007). Compared with control group, TAT, TNF-α, and IL-6 at 4 hours and 24 hours in low-dose and high-dose LPS groups were significantly decreased [TAT (ng/L) at 4 hours: 1.10±0.59, 0.22±0.13 vs. 3.47±1.73; 24 hours: 1.18±0.68, 0.39±0.29 vs. 3.19±1.27;TNF-α (nmol/L) at 4 hours: 87.35±12.29, 93.70±5.25 vs. 101.59±10.96, 24 hours: 81.94±8.26, 93.23±4.71 vs. 102.84±10.56; IL-6 (ng/L) at 4 hours: 81.78±7.82, 78.59±9.06 vs. 110.88±9.66, 24 hours: 76.03±9.85, 71.34±3.69 vs. 110.88±10.35, allP< 0.05]. TAT at 4 hours and 24 hours in high-dose LPS group was further decreased, and TNF-αat 24 hours was increased as compared with those of low-dose LPS group (allP< 0.05). TAT, TNF-α and IL-6 were influenced only by different dosage of LPS (TAT:F = 42.350,P = 0.000; TNF-α:F = 14.810,P = 0.000; IL-6:F =81.910,P = 0.000), not time (TAT:F = 0.002,P = 0.967; TNF-α:F = 0.342,P = 0.562; IL-6:F = 2.973,P = 0.092). Changes in TAT was not found to be related with the dose of LPS and its time of action, or levels of TNF-α and IL-6 (TAT:F = 0.236,P = 0.791; TNF-α:F = 0.572,P = 0.569; IL-6:F = 0.774,P = 0.468). The dosage of LPS and time of admission showed no influence on D-dimer (F1 = 2.448,P1 = 0.099;F2 = 0.024,P2 = 0.877). The effect of different doses of LPS and time of administration showed no influence on FDP (F1 = 0.106,P1 = 0.900;F2 = 0.013,P2 = 0.908), and no interactive effects were found (D- dimer:F = 0.002,P = 0.998; FDP:F = 0.582,P = 0.563).Conclusion LPS can induce TCP in mouse, but this effect may not related to the activation of coagulation system and excessive inflammatory response.

Objective To investigate the clinical effect of porcelain fused for metal crown restoration after root canal therapy.Methods Totally 90 patients with pulpitis or periapical periodontitis from December 2013 to December 2015 had their clinical data analyzed,who underwent root canal therapy and were divided equally into an observation group and a control group.The observation group took porcelain endocrowns repair and the control group applied ceramic crown.The two groups were compared on the restoration integrity,edge sealing,residual rate,gum,food impaction and color 3 months,6 months and 1 a after treatment.Results The observation group behaved significantly better than the control group in the edge sealing and restoration integrity (P＜0.05).There were significant differences between the residual rates,gum and food impaction in the two groups (P＜0.05).Conclusion Porcelain endocrowns repair gains advantages over ceramic crown repair in edge sealing,integrity,gum,food impaction and color after root canal therapy,though its long-term effect needs further investigation.

Objective To summarize the experience of the integrated treatment on mid-face ageing for better cosmetic results.Methods A total of 56 cases were treated.With using subciliary approaches,the orbicularis oculi was resected to expose the orbital septum,the orbital fat relieved and orbital septum reseted.Hyaluronic acid was injected to some patients with obvious nasolabial fold after operation.Results 56 cases were all followed up from 6 to 26 months (11.8 months on average) postoperatively.The flabby tissue had been tightened and all got better effects.Conclusions Various combination of technologies can be applied to reach the purpose of rejuvenation by correcting the volume abnormality,resetting the tissue,elevating reasonably,and filling the facial depression.

Objective To evaluate the significance of human interleukin-31(IL-31)in the pathogenesis of atopic dermatitis and its correlation with pruritus in patients with atopic dermatitis(AD).Methods Twenty-two children with mild to severe atopic dermatitis and 22 age-matched healthy controls were included in this study.Patients and controls were randomly and equally assigned into stimulation and non-stimulation groups.Venous blood samples were obtained from all participants,peripheral blood mononuclear cells were isolated from these samples and cultured with(stimulation groups)or without(non-stimulation groups)staphylococcal enterotoxin B(SEB)for 24 hours.Then,the mRNA expression of IL-31 on PBMCs was assessed via real-time reverse transcription-PCR.ELISA was used to detect the total serum IgE level in these objects.The severity of AD in patients was rated according to scoring atopic dermatitis(SCORAD).The relationship between the mRNA expression of IL-31 and the level of serum total IgE.severity of atopic dermatitis,and degree of pruritus.was evaluated.Results The expression of IL-31 mRNA on non-stimulated PBMCs from patients was 23.2 folds as high as that from the healthy controls(P＜0.01).The stimulation with SEB upregulated the mRNA expression of IL-31 on PBMCs.and the increase on PBMCs from patients was 20.44 times of that from the controls.The total serum IgE level was 260.05 IU/mL(5.9-1131.01 IU/mL)and 17.7 IU/mL(5-140.7 IU/mL)in the Patients and controls respectively(P＜0.01).There was no significant correlation between the mRNA expression of IL-31 and disease severity or total serum IgE level(r=0.07.0.22respectively.both P＞0.05)in patients witll AD.Condusions IL.3 1 is involved in t11e pathogenesis of AD,which is unlikely to be IgE-dependent.SEB can induce the rapid expression of IL-31 on PBMCs of healthy human,and is an important modulator for the production of IL-31.