Adult ; Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Biopsy ; Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; Lung ; diagnostic imaging ; metabolism ; pathology ; Lung Diseases, Interstitial ; metabolism ; pathology ; Silicosis ; diagnostic imaging ; metabolism ; pathology ; Tomography, X-Ray Computed ; Vimentin ; metabolism

Objective Total 21 pulmonary artery sling( PA sling)combined with tracheal stenosis children who received treatment in our hospital were reviewed. The feasibility of treatment strategy including left pulmonary artery( LPA)re-implantation without tracheoplasty was discussed in this study. Methods From April 2009 to November 2015,a total of 21 pediatric patients received surgical treatment due to PA sling with tracheal stenosis. Six patients received LPA re-implantation and trachea intervention simultaneously. The other 15 patients received LPA re-implantation alone to relieve the trachea compression without tracheoplasty. The postoperative strategy including early extubation and CPAP ventilation was employed in PICU. Results A total of 21 PA sling with tracheal stenosis children who underwent surgical treatment in our hospital were recruited. There were 9 females and 12 males. Ages of these children were from 1 months to 10 years old,and body weights were from 2. 9 kg to 25. 0 kg. Five patients needed mechanical ventilation for severe respiratory symptoms preoperatively. Six patients received LPA re-implantation and tracheal interven-tion simultaneously. Among them,3 patients received slide tracheoplasty,and one was discharged after recov-ery. The remaining 3 patients received tracheal stent implantation,but finally died. The survival rate was 16. 7% in these patients. Fifteen patients received LPA re-implantation alone,and slide tracheoplasty was per-formed in 2 patients for extubation failure who finally died of air leakage. The survival rate of 15 patients who received LPA re-implantation alone was 86. 7%. Conclusion The strategy in LPA re-implantation alone to relieve the trachea compression without tracheoplasty and early extubation and CPAP ventilation postoperative may be an ideal treatment for the pediatric patients with PLA sling combined with tracheal stenosis.

Objective To preliminarily develop a scale to measure the proactive socialization behavior of new nurses and test validity and reliability of the scale, to explore the impact of proactive socialization behavior on turnover intention. Methods Using a questionnaire survey method to investigate 696 new nurses who had worked within three years in nursing organization, structural equation model and hierarchical line regression methods were performed to analyze the data. Results Proactive socialization behavior scale included eight items under one dimension;the consistency coefficient of scale was 0.858;new scale had a good convergent and predictive validity;the proactive socialization behavior of new nurses was significantly negative related to turnover intention (β=-0.236,P<0.01). Conclusions The proactive socialization behavior scale has a good reliability, convergent and predictive validity. Meanwhile, new nurses with higher level of proactive socialization behavior have lower turnover intention. Because they can quickly fit the new environment, role definition and organizational culture, which in turn organization embeddedness is promoted.

Disinfection ; Escherichia coli ; isolation & purification ; Hospitals ; Medical Waste ; Sewage ; Waste Products ; Water Microbiology

OBJECTIVETo evaluate the effect of ulinastatin on hypoxia-induced phenotype modulation of pulmonary artery smooth muscle cells (PASMCs) and explore the underlying mechanism.

METHODSCultured PASMCs from SD rats were exposed to normoxic condition, normoxia with ulinastatin treatment, hypoxia, or hypoxia with ulinastatin treatment. After 24 h of exposures, the cells were examined for SM-α-actin and caplonin expressions with immunofluorescence assay and for cell migration with CCK-8 andH-TdR assays. Western blotting was used for detecting the expressions of PPAR-γ in the cells, and PPAR-γ-responsive firefly luciferase reporter was employed for measuring the transcriptional activity of PPAR-γ. The PPAR-γ inhibitor GW9662 was used to explore the mechanism of the inhibitory effect of ulinastatin on hypoxia induced-phenotype modulation of PASMCs by measuring the changes in cell proliferation and migration.

RESULTSUlinastatin obviously enhanced the expressions of SM-α-actin and calponin (P<0.05), inhibited the proliferation and migration (P<0.05), and up-regulated the expression of PPAR-γ in PASMCs exposed to hypoxia (P<0.05). Pretreatment of the cells with GW9662 abolished the effect of ulinastatin on hypoxia-induced phenotype modulation of PASMCs and enhanced the cell proliferation and migration (P<0.05).

CONCLUSIONUlinastatin inhibits hypoxia-induced phenotype modulation of PASMCs from rats possibly by up-regulating the expression of PPAR-γ.

Actins ; metabolism ; Animals ; Calcium-Binding Proteins ; metabolism ; Cell Hypoxia ; Cell Proliferation ; Cells, Cultured ; Glycoproteins ; pharmacology ; Microfilament Proteins ; metabolism ; Myocytes, Smooth Muscle ; cytology ; drug effects ; PPAR gamma ; metabolism ; Phenotype ; Pulmonary Artery ; cytology ; Rats ; Rats, Sprague-Dawley ; Up-Regulation

OBJECTIVETo observe the effect of Tripterygium glycosides (TG) on the expression of hypoxia-inducible factor-1α and endothelin-1 in the kidney of diabetic rats and explore the possible mechanism underlying the protective effect of TG against diabetic nephropathy.

METHODSSixty 8-week-old male SD rats were randomly divided into normal control group (n=10) and streptozotocin-induced diabetes mellitus (DM) model group (n=50). The diabetic model rats were then randomly divided into DM group, low-dose (8 mg/kg) and high-dose (16 mg/kg) TG treatment groups, and Irbesartan (50 mg/kg) treatment group. After 8 weeks, the levels of blood glucose (BG), 24-h urine protein (24 h Upro), serum creatinine (Scr) and blood urea nitrogen (BUN) were measured. The pathological changes in the renal tissues were examined by optical microscopy, and the mean glomerular area (MGA) and mean glomerular volume (MGV) were measured with pathological image analysis. Immunohistochemical and Western blotting were used to detect the expression of HIF-1α and ET-1 protein in the renal tissue, and their mRNA expressions were detected using real-time fluorescence quantitative PCR.

RESULTSHIF-1α and ET-1 expression increased in the kidney of diabetic rats. Compared with the diabetic model rats, the rats receiving TG and Irbesartan treatment showed decreased levels of Scr, BUN, 24h Upro, MGA and MGV, improved renal histopathology, and reduced expression of HIF-1α and ET-1 mRNA and protein in the renal tissue. These changes were more obvious in high-dose TG treatment group. Correlation analysis showed that the expression of HIF-1α was positively correlated with that of ET-1, and they were both positively correlated with kidney weight index (KW/BW), 24 h Upro, MGA, and MGV.

CONCLUSIONHIF-1α and ET-1 are overexpressed in the kidney of diabetic rats. TG can improve kidney damage in diabetic rats and delay the development of diabetic nephropathy by inhibiting the HIF-1α and ET-1 expression.

Animals ; Biphenyl Compounds ; pharmacology ; Blood Glucose ; Blood Urea Nitrogen ; Creatinine ; blood ; Diabetes Mellitus, Experimental ; metabolism ; Endothelin-1 ; metabolism ; Glycosides ; pharmacology ; Hypoxia-Inducible Factor 1, alpha Subunit ; metabolism ; Kidney ; drug effects ; metabolism ; Male ; Rats ; Rats, Sprague-Dawley ; Tetrazoles ; pharmacology ; Tripterygium ; chemistry

A male patient undergoing extracorporeal ultrasound lithotripsy developed the symptoms of dyspnea, low blood pressure, palpitations, chest tightness, and sweating, and a clinical diagnosis of pulmonary capillary leak and hypovolemic shock was made. Pulse indicator continuous cardiac output (PiCCO) technique was used for resuscitation according to the measurements of extravascular lung water index (EVLWI) and global end-diastolic volume index (GEDI). The patient showed low levels of cardiac output (CO) and GEDI with a peak EVLWI of 32 ml/kg and profuse pink and thin sputum overflow from the trachea. The high ventilator support parameters failed to correct low oxygen saturation. Restricted fluid infusion was used to reduce pulmonary edema. Colloidal solution was given when GEDI was below 500 ml/m(2), and the volume and fluid infusion rate were reduced for a GEDI higher than 500 ml/m(2). Pulmonary edema was gradually reduced after the treatments with improvement of lactic acid level and liver and kidney functions. Vasopressors were withdrawn 6 days later, mechanical ventilation was discontinued 10 days later, and tracheal intubation was removed 25 days later, after which the patient was discharged. In the treatment of the patient, PiCCO monitoring played an important role.
Adult ; Capillary Leak Syndrome ; complications ; therapy ; Fluid Therapy ; Humans ; Lithotripsy ; adverse effects ; Male ; Pulmonary Edema ; complications ; therapy ; Shock ; complications ; therapy

OBJECTIVETo study the clinical characteristics, the principles of diagnosis and surgical treatment for primary pulmonary lymphoma.

METHODTen patients with primary pulmonary lymphoma were treated surgically and their clinical characteristics, the experiences of clinical diagnosis and surgical treatment were analyzed. The tumors located in left upper lobe in 2, left lower lobe in 1, right upper lobe in 3, right middle lobe in 3 and right lower lobe in 1. The main symptoms were cough and (or) hemoptysis. Imageological representations (X-ray and CT scanning of thorax) were similar to primary pulmonary carcinoma. Broncho-fibroscopic examination was performed on all cases with negative findings. Eight cases were mistakenly diagnosed as primary pulmonary carcinoma by imageological representations. Only 2 cases were diagnosed as primary pulmonary lymphoma by percutaneous needle biopsy and pathologic examination. All cases received pneumonectomy, ipsilateral hilar and mediastinal lymphadenectomy. All cases with non-Hodgkin's lymphoma received regular chemotherapy (MOPP and ABVD scheme for 1 case with Hodgkin's disease respectively, CHOP for 8 cases with non-Hodgkin's lymphoma), and 3 cases received radiotherapy postoperatively.

RESULTSEight cases were non-Hodgkin's lymphoma (B-type) and 2 cases were Hodgkin's disease (mixed type) confirmed by pathological examination. Six cases with non-Hodgkin's lymphoma (3 cases for stage IE, 2 cases for stage II 1E, and 1 case for stage II 2E W) had been surviving for 18-42 months until the follow-up. Two cases with non-Hodgkin's lymphoma (stage II 2E, B-cell, low-grade) and 2 cases with Hodgkin's disease (stage IE and II 2E, mixed type) died in 24, 32, 8 and 17 months postoperatively respectively.

CONCLUSIONSPrimary pulmonary lymphoma is a rare type of malignant lung neoplasm without special clinical features. The preoperative diagnosis is difficult. Treatment modalities include surgical treatment, radiotherapy and regular chemotherapy postoperatively.

Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; diagnosis ; drug therapy ; mortality ; surgery ; Lymph Node Excision ; Lymphoma ; diagnosis ; drug therapy ; mortality ; surgery ; Male ; Middle Aged ; Pneumonectomy ; methods ; Retrospective Studies

Objective:To observe the anatomical characteristics of the semispinalis capitis plane (SCP) to provide a reference for clinically effective implementation of ultrasound-guided SCP block.Methods:Ultrasound scanning was performed in six certain districts of SCP in 30 healthy volunteers (60 sides). The key point was to examine and describe the anatomical characteristics of semispinalis capitis (SCA), deep space of SCA and structures within the space.Results:(1) Transverse scanning at the posterior arch of atlas revealed that the SCA was separated into medial and lateral head by an oblique thick septum; in the space between SCA and obliquus capitis inferior (SCA-OCI), the third occipital nerve (TON) and the greater occipital nerve (GON) were separated by a fascia.There was often a branch of occipital vein between them.The distance from TON to GON was (12.9±0.6) mm.(2) Transverse scanning at the lamina of axis revealed that the axial image of SCA and the structures in SCA-OCI space were similar to the results previously described in (1). The distance from TON to GON was (12.1±0.5) mm.(3) Sagittal scanning beside the spinous process of axis revealed that SCA was separated into superior and inferior belly by a septum which connected to the end of axis spinous process.(4) Sagittal scanning at the C 2, 3 facet joint revealed that in the space between OCI and C 2, 3 facet joint (OCI-C 2, 3) beneath SCA, there was no septum between TON and GON.The distance from TON to GON was (8.0±0.5) mm.(5) Transverse scanning at the lamina of C 4 revealed that in the space between SCA and semispinalis cervicis, the deep cervical artery and vein were observable except medial branch of C 4, and the characteristics of the short axis of the SCA belly were similar to the results previously described in (1). (6) Transverse scanning at the lamina of C 5 revealed that the view was similar to the results previously described in (5). The posterior branch of C 5 nerve was not found. Conclusions:SCP is rich in fascia, and blood vessels often pass through the deep surface space of SCA under ultrasound.The anatomical structure is complex, and there is individual variation.Grasping its ultrasonic anatomical characteristics is helpful in safely and effectively implementing ultrasound-guided SCP block.

Pediatric acute respiratory distress syndrome (PARDS) is the most leading cause of death in Pediatric Intensive Care Unit.PARDS can be classified as mild, moderate, and severe according to the oxygenation index.In recent years, because of the application of lung protection ventilation strategy, the outcome of PARDS has been greatly improved, but the mortality of severe PARDS still remains high.Therefore, it is of great clinical significance to understand the definition, diagnosis, and the application of lung protective ventilation strategy and the application of extracorporeal membrane oxygenation in severe PARDS.