Abstract: Objective　To explore the correlation between levels of hypersensitive C-reactive protein (hs-CRP) and procalcitonin (PCT) in serum and alveolar fluid and severity of disease in children with lobar pneumonia. Methods　A total of 112 children diagnosed with lobar pneumonia from September 2020 to September 2021 were selected as the research subjects. The levels of hs-CRP and PCT in serum and alveolar fluid were detected by double antibody sandwich enzyme-linked immunosorbent assay (ELISA). The children were divided into severe group (clinical pulmonary infection score, CPIS≥6 points) and mild group (CPIS<6 points) according to the severity of disease, and further classified into good prognosis group (cured, improved) and poor prognosis group (uncured) according to their treatment outcomes. The correlation of levels of hs-CRP and PCT in serum and alveolar fluid with disease severity in children and their predictive value on prognosis were analyzed. Results　The levels of serum hs-CRP and PCT in severe group were (17.73±3.26) μg/L and (8.59±1.84) μg/L, which were significantly higher than corresponding (12.58±3.09) μg/L, and (5.62±1.59) μg/L in mild group (P<0.05); the levels of hs-CRP and PCT in alveolar fluid in severe group were (21.25±4.18) μg/L and (8.71±1.54) μg/L, which were significantly higher than corresponding (13.79±2.76) μg/L and (5.38±1.69) μg/L in mild group (P<0.05). The levels of hs-CRP and PCT in serum and alveolar fluid were positively correlated with CPIS scores (r=0.398, 0.441; 0.475, 0.586, P<0.05). The levels of hs-CRP and PCT in serum in poor prognosis group were (20.09±4.20) μg/L and (13.35±2.91) μg/L, which were significantly higher corresponding (8.75±2.19) μg/L and (6.28±1.31) μg/L in good prognosis group (P<0.05). The levels of hs-CRP and PCT in alveolar fluid were (23.70±4.29) μg/L and (10.73±2.04) μg/L, which were higher than corresponding (15.08±3.56) μg/L and (5.79±1.10) μg/L in poor prognosis group (P<0.05). There was no significant difference in AUC between combined detection of serum indicators and combined detection of alveolar perfusion fluid indicators in predicting the prognosis of children with lobar pneumonia (P>0.05). Conclusions　The levels of hs-CRP and PCT in serum and alveolar fluid of children with lobar pneumonia are significantly increased and positively correlated with the severity of disease. However, the predictive value of the combined detection of serum indicators and combined detection of alveolar perfusion fluid indicators for the prognosis of children with lobar pneumonia is comparable.

Objective:To promote the rational drug use in the patients treated with ambulatory chemotherapy. Methods:A model of integrated pharmaceutical care was established using such service as the real-time prescription examination, configuration standardi-zation, active care and prescription review. Results:The integrated pharmaceutical care could effectively reduce the unreasonable drug use, optimize drug use structure, lower the medical expenses and provide supporting data for clinical decision-making. Conclusion:The development of integrated pharmaceutical care in the patients treated with ambulatory chemotherapy is an important field for phar-macists displaying professional skills, which can promote the rational drug use. The treatment efficacy and life quality of cancer patients can be improved with the cooperation of doctors, nurses and pharmacists.

Recent study demonstrated that insulin-like growth factor-1(IGF-1) could have benefits to improve the learning memory.Exercise can increase IGF-1 level in hippocampus.IGF-1 may mediate exercise inducing learning memory;one of the possible mechanism is that the IGF-1 and brain derived neurotrophic factor(BDNF) has a common regulatory capacity over calcium/calmodulin-dependent protein kinase Ⅱ(CAMKⅡ),mitogen-activated protein kinase Ⅱ(MAPKⅡ) and synapsin-1,and the convergence of multiple signaling pathways mediate synaptic plasticity and improve learning memory.

Objective To investigate the protective effects and underlying molecular mechanisms of hydrogen (H2) on high glucose-induced poly (ADP-ribose) polymerase-1 (PARP-1) dependent cell death (PARthanatos) in primary rat Schwann cells. Methods Cultured primary rat Schwann cells were randomly divided into five groups: blank control group (C group), H2 control group (H2 group), high osmotic control group (M group), high glucose treatment group (HG group), and H2 treatment group (HG+H2 group). The cells in H2 group and HG+H2 group were cultured with saturated hydrogen-rich medium containing 0.6 mmol/L of H2, and those in three control groups were cultured with low sugar DMEM medium containing 5.6 mmol/L of sugar, and the cells in HG and HG+H2 groups were given 44.4 mmol/L of glucose in addition (the medium containing 50 mmol/L of glucose), the cells in C group and H2 group were given the same volume of normal saline, and the cells in M group were given the same volume of mannitol. Cytotoxicity was evaluated using lactate dehydrogenase (LDH) release rate assays after treatment for 48 hours in each group. The contents of peroxynitrite (ONOO-) and 8-hydroxy-2-deoxyguanosine (8-OHdG) reflecting oxidative stress injury and DNA damage were detected by enzyme linked immunosorbent assay (ELISA). Poly (ADP-ribose) (PAR) protein expression was analyzed by Western Blot, and immunofluorescence staining was used to determine the nuclear translocation of the apoptosis-inducing factor (AIF). Results The cytotoxicity in HG and HG+H2 groups was significantly increased as compared with that of C group [LDH release rate: (61.40±2.89)%, (42.80±2.32)% vs. (9.92±0.38)%, both P < 0.01], the levels of ONOO- and 8-OHdG were markedly elevated [ONOO- (ng/L): 853.58±51.00, 553.11±38.66 vs. 113.56±14.22; 8-OHdG (ng/L): 1 177.37±60.97, 732.06±54.29 vs. 419.67±28.77, all P < 0.01], and the PAR protein expression was up-regulated (A value: 0.603±0.028, 0.441±0.010 vs. 0.324±0.021, both P < 0.01). The cytotoxicity, the levels of ONOO- and 8-OHdG, and PAR expression in HG+H2 group were significantly lower than those of the HG group (all P < 0.01). There were no significant differences in above parameters between H2 group as well as M group and C group. It was shown by immunofluorescence that AIF was expressed in the cytoplasm in C group, H2 group and M group, AIF was expressed in the whole cell in HG group, and the expression in the nucleus was particularly increased. A small amount of AIF expression was found in the nucleus of HG+H2 group, which indicated that high glucose could promote the AIF nuclear translocation, and that hydrogen-rich medium could prevent the process of translocation. Conclusions High glucose levels could enhance DNA damage that enhance PARthanatos in primary rat Schwann cells. However, H2 can not only reduce DNA damage of injured cells, but also inhibit the special death process, reduce the cell toxicity, all of which have protective effects.

Objective To evaluate the effects of hydrogen on oxidative stress injury induced by high glucose in Schwann cells and its relationship with PARP-1-dependent cell death (parthanatos).Methods Primary rat Schwann cells were cultured in 96-well plate (1×104 cells/ml,200 μl/well) or in 6-well plate (1 × 106 cells/ml,2 ml/well) with RSM culture medium and were randomly divided into 5 groups (n=30 each):control group (group C),hydrogen group (group H2),high glucose group (group HG),high glucose plus hydrogen group (group HG+H2) and high osmotic control group (group M).The cells were cultured in the common culture medium in C,HG and M groups.The cells were cultured in hydrogen-rich culture medium in H2 and HG + H2 groups.In HG and HG + H2 groups,50 mmol/L of glucose was added to the culture medium.In C and H2 groups,the equal volume of normal saline was added to the culture medium.In M group,mannitol 44.4 mmol/L was added to the culture medium.The cells were then incubated for 48 h.After 48 h of incubation,the cell viability was measured using CCK-8 assay,intracellular reactive oxygen species (ROS) level was detected by flow cytometry,the concentration of 8-hydroxy-2-deoxy Guanosine (8-OHdG) was determined by ELISA,and the expression of poly (ADP-ribose)-polymerase-1 (PARP-1),cleaved-PARP-1,poly (ADP-ribose) (PAR),and apoptosis-inducing factor (AIF) in the total protein and nucleus was measured by Western blot.PARP-1 activity (cleaved-PARP-1/PARP-1) and AIF nuclear translocation were recorded.Results Compared with C and H2 groups,the cell viability was significantly decreased,and PARP-1 activity,expression of ROS,8-OhdG and PAR,and AIF nuclear translocation were increased in HG and HG + H2 groups.Compared with HG group,the cell viability was significantly increased,and PARP-1 activity,expression of ROS,8-OhdG and PAR,and AIF nuclear translocation were decreased in HG+H2 group.There was no significant difference in each parameter between M and C groups.Conclusion Hydrogen can reduce oxidative stress injury induced by high glucose in Schwann cells,and the mechanism is related to inhibition of parthanatos.

OBJECTIVETo investigate the clinical features, surgical transcranial approaches and outcomes of giant pituitary adenomas.

METHODSA series of 112 consecutive cases of giant pituitary adenomas underwent microsurgery through transcranial approaches at People' s Liberation Army General Hospital were retrospectively analyzed. Of the 112 patients, 58 were male and 54 were female, with age ranging from 3 to 72 years(mean age 44. 3 years). There were 91 non-functioning adenomas and 21 hormone-secreting adenomas. The maximum tumor diameter varied from 4. 0 to 7. 2 cm, with mean diameter of 4. 8 cm. Unilateral subfrontal approach was chosen in 16 cases, pterional approach in 41 cases, anterior interhemispheric approach in 34 cases, transcallosal-interforniceal approach in 6 cases, transcortical- transventricular approach in 5 cases, combined approach in 6 cases and other approaches in 4 cases. Postoperative MRI and endocrine function were re-examined routinely to evaluate the therapeutic efficacy. Staged operation through transsphenoidal approach or adjuvant treatments including medical and radiation therapies were administered in patients with hormone-secreting adenomas when hormonal excess persisted after surgery and in patients with non-functioning adenomas who had postoperative MRI evidence of residual tumor.

RESULTSTotal removal of the lesion was achieved in 57 cases (50. 9%) , 26 patients (23. 2%) underwent subtotal resection, and 29 patients (25. 9%) underwent partial removal. Postoperative mortality occurred in 3 patients (2. 7%). Major surgical morbidity occurred in 38 patients (33. 9%). Vision was preserved or improved in 98 patients (87. 5%). The postsurgical follow-up period varied from 3 to 64 months (mean 19. 5 months) . Nineteen of the 21 patients with hormone-secreting adenomas were considered to be in hormonal remission, and 87. 2% of the cases were capable of normal work and life and 8 patients suffered recurrence during the followed-up period.

CONCLUSIONSSelection of appropriate transcranial approaches is the key to successful microsurgery for giant pituitary adenomas according to the morphological characteristics presented in image examinations and clinical symptoms. Staged transsphenoidal operation and/or adjuvant therapies including medical and radiation therapies offer the best chances to control the residual tumors after the maximal surgical removal of giant adenomas through transcranial approaches.

Adenoma ; surgery ; Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Combined Modality Therapy ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Microsurgery ; methods ; Middle Aged ; Neurosurgical Procedures ; methods ; Pituitary Neoplasms ; surgery ; Postoperative Period ; Retrospective Studies ; Young Adult

OBJECTIVETo compare the difference in the efficacy on low back pain of cold-damp pattern between electric-thermal Bian-stone therapy and moxibustion box therapy.

METHODSForty-one cases of low back pain of cold-damp pattern were randomized into an electric-thermal Bian-stone therapy group (group A, 26 cases) and a box moxibustion therapy group (group B, 15 cases). In the group A, the electric-thermal Bian-stone was placed over Shenshu (BL 23) and Weizhong (BL 40). The temperature of stone was adjusted in accordance with patient's comfort. In the group B, moxibustion box was used over Shenshu (BL 23) and Weizhong (BL 40). The treatment was given once every day or every two days. Ten treatments made one session. The symptom and physical signs score of low back pain and the score of cold-damp syndrome were observed before and after treatment in the patients.

RESULTSThe symptom and physical signs score of low back pain and the score of cold-damp syndrome were all improved in the two groups (all P < 0.01). The changing rate of symptom and physical signs and syndrome were (37.04 +/- 32.68)% and (22.85 +/- 29.95)% in the group A, and were (47.29 +/- 22.08)% and (23.89 +/- 22.53)% in the group B, respectively, without significant difference in comparison between the two groups (all P > 0.05).

CONCLUSIONThe efficacy on low back pain of cold-damp pattern treated with the electric-thermal Bian-stone therapy is similar to that of moxibustion box therapy. This therapy is characterized as more convenient, safer operation and less pollution.

Acupuncture Points ; Adult ; Aged ; Aged, 80 and over ; Combined Modality Therapy ; Female ; Humans ; Low Back Pain ; therapy ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Moxibustion

BACKGROUND: Recent trials and clinical studies have shown that intracoronary transplantation of bone marrow-derived mesenchymal stem cells (MSCs) improves cardiac function following acute myocardial infarction (AMI). However, whether homing of MSCs into the infarcted myocardium or not is still unknown.OBJECTIVE: To study the homing of MSCs intracoronary administration in porcine myocardial infarction model using in vivo magnetic resonance imaging tracking.METHODS: Porcine MSCs were isolated and cultured by the whole bone marrow method. Following labeling by superparamagnetic iron oxide (SPIO), MSCs were treated with trypsinization to adjust the concentration at 10~(10)/L. Myocardial infarction was induced in all 10 pigs. At one week after modeling, the labeled MSCs were delivered via intracoronary infusion with standard over-the-wire (OTW) balloon angioplasty catheters. Prussian blue staining was used to evaluate labeling efficiency, and double echo steady state was used to scan four-chamber and cor biloculare at long axis view, which was considered as locating phase to obtain image of left ventricle at short axis view. RESULTS AND CONCLUSION: MSCs could be efficiently and safely labeled with SPIO. Intracoronary transplantation of MSCs is able to home the sites of myocardial injury and the border between infarcted and normal tissue. MRI can track SPIO-labeled MSCs delivered through intracoronary and were confirmed on pathology. After 5 weeks the injected labeled cells could still be detected with MRI.

Objective To summarize the experiences in laparoscopic inguinal hernia repairing for adult patients. Methods Clinical data of 512 hernia cases admitted in our center from March 2007 to Sep 2010 were retrospectively analyzed.There were 437 cases of single-sided hernia,including 281 indirect inguinal hernia,86 direct inguinal hernia,15 femoral hernia,16 combined inguinal hernia and 39 recurrent hernia.There were also 75 cases of double-sided inguinal hernia,including 3 recurrent hernia.There were 41 acute incarcerated hernia cases.The average postoperative follow up time was(29 ± 12) months. Results 507 cases underwent successful laparoscopic repair,and 5 cases were converted to open procedure.There were 238 TAPP and 269 TEP in laparoscopic operations.The average operative time for TAPP was (69 ±19) min,and (58 ±15) min for TEP.The average length of postoperative stay was (5.0 ± 1.5) days.The percentage of resuming normal activity after 2 weeks and 4 weeks were 95.7％ (485/507) and 99.0％(502/507).The most common postoperative complications were seroma (9.7％,49/507),transient paresthesia (4.1％,21/507) and chronic pain (0.8％,4/507).The recurrence rate was 0.6％ (3/507).Conclusions Laparoscopic repair of inguinal hernia has the advantage of less trauma,faster recovery,and lower recurrence rate.

Objective To design simulated pulmonary air embolism demonstration model,so as to solve the problem of pathological anatomy of pulmonary air embolism in experiment teaching. Methods According to the principle of the disturbance of local blood circulation and air embolism, we designed a pulmonary air embolism model. We took 223 school nursing students as the object of this study,and randomly divided them into 2 groups:animal experiment teaching group and model control group,then we compared the teaching effect between the two groups. Result The test scores of students in the animal experiment teaching group were higher than control group (P<0.05) . Conclusion The use of simulated pulmonary air embolism demonstration model teaching can improve the students’experimental test scores,and can be repeatedly used,stimulate students' study interest,reduce the cost of teaching,and improve the teaching quality.