ObjectiveTo analyze the levels of matrix metalloproteinase 9 (MMP-9 ) in cerebrospinal fluid (CSF) of patients with central nervous system (CNS) infection caused by different pathogens.MethodsThe levels of MMP 9 in CSF were detected by enzyme linked immunosorbent assay (ELISA) in 10 patients with tuberculous meningitis in both acute phase and recovery phase,10 purulent meningitis,10 cryptococeal meningitis,10 viral encephalitis and 10 controls.The differences among the groups were compared by t test. The correlations between MMP-9 levels and the cell count,glucose, chloride, and protein in CSF were analyzed by Spearmanrank correlation.ResultsThe CSFMMP-9levelsingroupsoftuberculousmeningitis, purulentmeningitis,cryptoeoccal meningitis and viral encephalitis were (569.46±162.42),(182.79±99.06),(54.69±19.93) and (18.52±10.31) ng/mL,respectively,which were all significantly higher than that in controls (3.51± 1.53) ng/mL. There were significant differences between tuberculous meningitis group and other groups (t=2.925,3.041,3.237,3.454;P0.0340,0.0270,0.0080 and0.0001,respectively). Moreover,in tuberculous meningitis group,the MMP-9 level in acute phase was (569.46±162.42) ng/mL,which was significantly higher than that in recovry phase (294.30+89.06) ng/mL.The CSF level of MMP-9 in tuberculous meningitis group was positively correlated with CSF protein (r=0.509,P=0.044),negative correlated with CSF glucose (r=-0.451,P=0.008) and chloride (r=-0.637,P=0.007),but no correlation with CSF cell count (r=0.308,P=0.246). And there were no correlations in other groups. ConclusionsMMP-9 level in CSF increases significantly in patients with tuberculous meningitis and purulent meningitis,which can be used as a marker of CNS infection.Dynamic monitoring of thc CSF level of MMP-9 may be meaningful for the diagnosis and treatment.

Objective To explore possible role of cellular repressor of E1A-stimulated genes(CREG) in the process of phenotypic switching of adventitial fibroblasts(AFs). Methods Immunofluorescent staining was performed with tissue sections from mouse carotid arteries to evaluate the relationship between the expression of CREG and smooth muscle actin-α(α-SMA) in injured arteries, especially in the adventitia. Tissue block pasted culture method was used to isolate and culture AFs. RT-PCR and Western-blot were used to detect the change of CREG andα-SMA mRNA and protein expression in AFs in the presence of different concentrations of AngⅡfor 12 h/24 h or in the presence of 100 nmol/L Ang Ⅱ for different times. Results Normal mouse carotid arteries had little α-SMA expression throughout the tunica adventitia. Arteries at day 1 and day 3 post-injury exhibited significantly higher immunofluorescence of α-SMA compared with non-injured arteries. Alpha-SMA expression began to decrease on day 7 and progressively declined on day 14. In contrast, immunofluorescent staining revealed that CREG was expressed in the adventitia of normal arteries. Expression of CREG in the adventitia of injured arteries was decreased on the 1st day, reached its lowest value on the 3rd day, and increased gradually from the 7th day, and was higher compared with that in non-injured arteries on the 14th day after injury. Similarly, the expression of CREG in AFs was very high, and AngⅡremarkably decreased mRNA and protein expression levels of CREG in a dose-dependent and time-dependent manner. Conclusions The changes in CREG expression correlate with AF phenotypic modulation, and CREG down-regulation may facilitate AF phenotypic switching into myofibroblasts (MFs).

Objective To investigate the changes of CD11b on neutrophils during myocardial ischemia-reperfusion injury. Methods 12 patients undergoing coronary bypass grafts under CPB were studied. Blood samples were obtained from the coronary (coronary sinus) and systemic circulation (central venous and CPB machine), respectively. Samples obtained from coronary and systemic circulation were taken before the beginning of CPB, during CPB and after cardiac reperfusion. Neutrophil CD11b expression and serum cTnI concentration were measured. Results (1)Expression of CD11b increased gradually in systemic circulation during CPB and after reperfusion (P

Objective To evaluate the effect of gender and treatment strategy on remote ischemic preconditioning (RIPC)-induced reduction of myocardial damage in patients undergoing cardiac surgery.Methods We systematically searched the literature in PubMed,EMBase,and Cochrane Library (from Feb 1990 to Feb 2012) using the related keywords.Randomized control trials (RCTs) published in English with report on postoperative biomarkers of myocardial damage concerning RIPC-induced myocardial protection in adult patients undergoing cardiac surgery were included.Standardized mean difference (SMD) was calculated.Publication bias and sensitivity analysis were used to evaluate the reliability of overall enzymatic estimate.Meta-regression analysis was performed to explore the potential sources of significant heterogeneity among results of studies.Data were analyzed using Stata 12.0.Results Thirteen RCTs involving 985 patients were included in our study.Compared with controls,RIPC significantly reduced postoperative serum levels of biomarkers of myocardial damage with significant heterogeneity (SMD=-0.539; 95％CI:-0.926to-0.152; P＜0.05; I2 =88.7％,P＜0.01).No evidence of obvious publication bias was observed (P =0.083,Begg' s test; P =0.077,Egger' s test).Sensitivity analysis showed that each individual study produced no effect on the direction and magnitude of the overall effect size (P ＜ 0.05).Meta-regression analysis revealed that male (％) (coefficient =0.02 ; 95 ％ CI:-0.002-0.042 ; P =0.070 ; adjusted R2 =19.61％) and total ischemic time (min) (coefficient=-0.08; 95％CI:-0.154-0.002; P =0.055; adjusted R2 =19.47％) were the two major influential factors.Conclusion Gender affects RIPC-induced reduction of myocardial damage after cardiac surgery in patients,RIPC-induced reduction of myocardial damage infemale patients is superior to that in male patients and a better efficacy can be achieved by prolonging the single ischemic time or by increasing the ischemic cycles.

Objective To detect the gastric motility in patients with type 2 diabetes mellitus, and to explore the relationship between disorder of gastric motility in diabetes and the influential factors. Methods Sixty-five patients with type 2 diabetes mellitus and 30 health control subjects were collected. The gastric motility was tested with the signal processing device designed by Chongqing University of Posts and Telecommunications. The impedance and electrical signals were collected at the same time. Fasting blood glucose (FBG) was detected by oxidation enzyme method, while microcolumn method was adopted to test HbA1c. Results In the 65 patients with type 2 diabetes mellitus,the occurrence of abnormal gastric motility was 53.85% , they had several symptoms, such as abdominal distension, early satiety, and belching. The percentage of dominant frequency of impedance gastrogram in diabetes group was lower than that in the normal controls (P<0. 05 ). The percentage of dominant frequency of EGG in the abnormal HbA1c group( ≥6. 5% ) was significantly lower than that in the normal HbA1c group ( P<0. 01). The percentage of bradygastria in the elderly was higher than that in young and middle-aged subjects (P<0. 05), respectively. Disorder of gastric motility was not correlated with FBG and course of disease. Conclusions The incidence of disordered gastric motility is very high in patients with type 2 diabetes mellitus. Elderly patients and those with higher HbA1c are prone to suffer from disordered gastric motility. However, disorder in gastric motility is not correlated with FBG and duration of the illness.

Objective To observe the risks of hypoxemia after uvulopalatopharyngoplasty (UPPP) in patients with obstructive sleep apnea syndrome (OSAS).Methods Forty-six ASA Ⅱ or Ⅲ male patients with OSAS,aged 30-50 yr,with body mass index 27-33 kg/m2,Mallampati Ⅰ-Ⅳ,underwent UPPP under general anesthesia with propofol and remifentanil.O2 was inhaled for 24 h via a nasal catheter starting from the end of surgery.SpO2 was monitored within 24 h after surgery.Oxygen desaturation index (ODI,hourly average number of desaturation episodes in which the decrease in SpO2 ≥4% and duration ≥ 10 s) and the cumulative time percentage with SpO2 ＜ 90% (CT90) from oximetry were recorded.Results Compared with the baseline value before surgery,ODI and CT90 were significantly decreased at 2 and 2-4 h after extubation and on 1 st night after surgery (11:00 pm-6:00 am) (P ＜ 0.05).ODI and CT90 were significantly lower on 1st night after surgery than at 2 and 2-4 h after extubation (P ＜ 0.05).The rate of ODI abnormalities was 100%,48% and 50% before surgery and at 2 and 2-4 h after extubation,respectively.Compared with the baseline value before surgery,the rate of ODI abnormalities was significantly decreased at 2 and 2-4 h after extubation,while increased on 1 st night after surgery (P ＜ 0.05).There was no significant difference in the rate of ODI abnormalities between that on 1 st night after surgery and that before surgery (P ＞ 0.05).Conclusion Although UPPP can significantly improve airway obstruction in patients with OSAS,hypoxemic episodes still occur after surgery,suggesting that UPPP should not be treated as an ambulatory surgery.

Objective To measure the daily nursing workload by simplified therapeutic intervention scoring system and provide information for reasonable dynamic management of nursing manpower and improving nursing service satisfaction of patients in elderly ICU.Methods 113 patients in elderly ICU were selected from July 2012 to June 2013.The Therapeutic Intervention Scoring System 28(TISS-28) was used to measure the nursing workload,reasonably arranged the nursing staff according to the daily total nursing workload.The average daily working time and service satisfaction were compared before and after the application of dynamic management of nursing manpower.Results After the application of dynamic management of nursing manpower,the average daily working time of nurses decreased,satisfactory degree of patients with nursing service increased,and satisfactory degree of medical workers with nursing manpower management also increased.Conclusions Measurement of nursing workload by TISS-28 can provide the basis for the dynamic management of nursing manpower in elderly ICU and improve satisfaction degree of medical workers.

Objective To investigate the effect of IH764-3 on the leukocyte-mediated hypoxia-reoxygention injury of human brain microvascular endothelial cell (HBM VEC). Methods MTT assay was used to detect the survival of HBMVEC; gelatin zymography was used to check the activity of MMPs. The level of reactive oxygen species (ROS) in leukocyte was determined via commercially available kit, and the indirect enzyme-linked immunosorbent assay (ELISA) was used to quantify the contents of TNF-α, IL-1α, IL-2 and INF-γ in leukocyte culture medium. Results Survival of HBMVEC was impaired by hypoxia-reoxygenation, which was aggravated by supernatant of activated leukocytes but was attenuated by IH764-3. Leukocytes produced high level of MMP-9, ROS and cytokines (TNF-α, IL-1α, IL-2, IFN-γ) after hypoxia-reoxygenation, the process was inhibited by IH 764-3. Furthermore, IH764-3 could effectively reverse hypoxia-reoxygenation injury of HBMVEC with supernatant of activated leukocytes. Conclusion IH764-3 can protect HBMVEC from leukocyte-involved hypoxia-reoxygenation injury by attenuating the activation of leukocytes and inhibiting the pathogenic effects of leukocytes products.

Objective To investigate the effect of IH764-3 on the leukocyte-mediated hypoxia-reoxygention injury of human brain microvascular endothelial cell (HBMVEC). Methods MTT assay was used to detect the survival of HBMVEC; gelatin zymography was used to check the activity of MMPs. The level of reactive oxygen species (ROS) in leukocyte was determined via commercially available kit,and the indirect enzyme-linked immunosorbent assay (ELISA) was used to quantify the contents of TNF-?,IL-1?,IL-2 and INF-? in leukocyte culture medium.Results Survival of HBMVEC was impaired by hypoxia-reoxygenation,which was aggravated by supernatant of activated leukocytes but was attenuated by IH764-3. Leukocytes produced high level of MMP-9,ROS and cytokines (TNF-?,IL-1?,IL-2,IFN-?) after hypoxia-reoxygenation,the process was inhibited by IH 764-3. Furthermore,IH764-3 could effectively reverse hypoxia-reoxygenation injury of HBMVEC with supernatant of activated leukocytes. Conclusion IH764-3 can protect HBMVEC from leukocyte-involved hypoxia-reoxygenation injury by attenuating the activation of leukocytes and inhibiting the pathogenic effects of leukocytes products.

In drowning cases, it is difficult to judge whether the deceased died from drowning or throw-ing into the water after killed or identificate the cause of death of the decom posed corps in forensic practices. The diatom test is still considered as the im portant assistant evidence in drowning cases. This paper reviews research progress on technologies in recent years of forensic diatom test, and the applica-tion value of the newdeveloping approach in the field of forensic m edicine.