Objective To evaluate the effects and side effects of three different recruitment maneuvers (RM) in acute respiratory distress syndrome (ARDS) caused by extrapulmonary disease.Methods Forty-four patients of extrapulmonary ARDS, according to crossover design methods, were undergone three RM in different periods, including sustained inflation (SI), increase progressively positive end expiratory pressure (IP), pressure control ventilation (PCV). Heart rate (HR), mean arterial blood pressure (MAP), central venous pressure (CVP), oxygenation index, lung compliance were recorded before and after RM, and were analyzed for statistical analysis. Results Oxygenation index and lung compliance were increased obviously in a short time after RM, improvement of IP method were better more obviously than the other two methods [1 h oxygenation index after RM:227 ± 42 vs 190 ± 19,186 ± 21; lung compliance:(59.4±12.5 ) ml/cm H2O(1 cm H2O = 0.098 kPa) vs (50.1 ± 9.3 ), (49.7 ± 10.6) ml/cm H2O;P＜ 0.05], 2h after RM,there were no statistical difference among the three methods (P＞0.05). After RM,HR and CVPwere increased, MAP was decreased in a short time, changes of SI method were smaller than the other two inethods [10 min HR after RM: (94.0±10.3 ) beats/min vs (116.0 ± 14.8 ), ( 107.0 ± 5.7 ) beats/min; CVP:(13.7±3.1 )cm H2O vs ( 18.4 ± 6.7 ), ( 15.4 ± 2.7 )cm H2O; MAP: ( 87.0 ± 12.1 ) mm Hg( 1 mm Hg = 0.133 kPa) vs (73.0 ± 4.8), (81.0 ± 6.6) mm Hg;P＜ 0.05), 20 min after RM, there were no statistical difference among the three methods (P＞ 0.05). Conclusion When extrapulmonary ARDS undergo RM ,IP method is the most effective on increasing oxygenation index and lung compliance, SI method has the smallest side effect on hemodynamics.

This device is composed of dissolving bucket,magnetic pump,four-passage valve,heater, stirrer,filter,speed-changing equipment,dividedfilling controller and etc.It can be used for preparing and filling various liquid medicament,such as oral or external-use solution,colloid,emulsion and suspension. The proposed device is highly automatic and efficient.Time and labour saving,simple and safe.Moreover, its performance is reliable and stable,and the working capacity is large.

OBJECTIVETo investigate the impact of adding folic acid, vitamin B(12) and probucol to standard antihypertensive medication on plasma homocysteine (Hcy) and asymmetric dimethylarginine (ADMA), serum NO and eNOS of essential hypertensive patients.

METHODA total of 120 patients with hypertension were randomly divided to three groups (n = 40 each): group 1 (standard medication), group 2 (adding folic acid 5 mg/day and vitamin B(12) 500 µg twice daily) and group 3 (adding folic acid 5 mg/day and vitamin B(12) 500 µg twice daily and probucol 500 mg twice daily). Plasma Hcy and ADMA, serum NO and eNOS levels were observed at baseline, 2 and 12 weeks after various therapy.

RESULTSIn group 1, concentrations of plasma Hcy [(23.06 ± 14.15) µmol/L, (23.67 ± 12.31) µmol/L, (23.25 ± 11.64) µmol/L], ADMA [(0.21 ± 0.12) µmol/L, (0.23 ± 0.13) µmol/L, (0.21 ± 0.09) µmol/L] and serum NO [(64.14 ± 15.07) µmol/L, (65.29 ± 15.04) µmol/L, (65.32 ± 13.58) µmol/L], eNOS [(20.02 ± 4.50) µg/L, (20.79 ± 4.03) µg/L, (19.82 ± 5.70) µg/L] remained unchanged during the 12 weeks therapy (all P > 0.05). In group 2, concentrations of plasma Hcy [(12.54 ± 6.49) µmol/L] and ADMA[(0.18 ± 0.07) µmol/L] were significantly decreased after the treatment of 12 weeks than the treatment baseline value [(21.51 ± 7.82) µmol/L, (0.20 ± 0.12) µmol/L] and 2 weeks value[(19.38 ± 8.14) µmol/L, (0.21 ± 0.12) µmol/L], however the concentrations of serum NO and eNOS showed contrary results of the Hcy and ADMA's. (all P < 0.05). In group 3, similar changes occurred at 2 weeks after therapy (P < 0.05 2 weeks vs. baseline and 12 weeks vs. 2 weeks). Plasma ADMA level was positively correlated with Hcy at baseline (r = 0.546, P < 0.05).

CONCLUSIONSSupplementation of folic acid, VitB(12) and/or probucol helps to improve endothelial function and reduce plasma Hcy and ADMA levels in patients with hypertension.

Aged ; Antihypertensive Agents ; therapeutic use ; Arginine ; analogs & derivatives ; blood ; Female ; Folic Acid ; therapeutic use ; Homocysteine ; blood ; Humans ; Hypertension ; blood ; drug therapy ; Male ; Middle Aged ; Nitric Oxide ; blood ; Nitric Oxide Synthase Type III ; blood ; Plasma ; metabolism ; Probucol ; therapeutic use ; Vitamin B 12 ; therapeutic use ; Vitamin B Complex ; therapeutic use ; Vitamins ; therapeutic use

Objective To explore expression of hypoxia inducible factor-1?(HIF-1?)in kidney cells during hypoxia/reoxygenation injury,and to study the effect of Danshen on prevention of the hypoxia/reoxygenation injury to cells.Methods Human renal proximal tubular cells(HK-2)were used as the target cell.There were 3 groups:control group,model group,Danshen group.hypoxia/reoxygenation models after neonatal asphyxia were established with liquid paraffin covering method.Expression of HIF-1? were detected with strcp avidin biotin complex(SABC)immunohistochemistry at following different time points:hypoxia 1,4,8,12,24 h,which means 1,4,8,12,24 h respectively after hypoxia;and hypoxia/reoxygenation 1,4,8,12,24 h,which means 1,4,8,12,24 h respectively after hypoxia/reoxygenation.Results HIF-1? was expressed mainly in HK-2's nucleus.There had low expression of HIF-1? in HK-2 cells under the normal culture,and its expression level kept rising quickly during hypoxic/reoxygenatic culture,until 4 h after the beginning of reoxygenation.Compared with the study group,the expression level of HIF-1? in HK-2 cells of the Danshen group were significantly lower at different time points(Pa

Objective To analysis and determine the possibility of the Citellus undulatus infected with Yersinia pestis surviving the winter in an experimental study, and to provide scientific experimental basis for the study on the mechanism of Yersinia pestis preservation. Method In 2006,09 to 2007,04 and 2007,09 to 2008,04 in Xinjiang Wusu-Gurtu natural foci of plague, under natural conditions, the over the winter process of Citellus undulatus carrying the plague bacteria was simulated, and 178 Citellus undulatus were infected with Yersinia pestis (1×107 Bacteria/mouse) using artificial injection method. One hundred seventy-eight Citellus undulatus infected with Yersinia pestis were kept into a construction of the black (1-5 ℃) basement (2 meters under the ground) in the plague focus. In doing so, these Citellus undulatuses almost simultaneously stepped into hibernation. After waking up from hibernation in following year in April, the survived mice carrying the plague bacteria were observed. Results Sixty-eight mice survived among the 178 infected with Yersinia pestis after 6 months of hibernation (through October to the following year in April), and the remaining 110 were all dead without pulling through the hibernation period. The survival rate was 38.2% (68/178). The organ culture of Yersinia pestis of the 110 dead mice(Citellus undnlatus) were tested, 67 were negative(-), 43 positive(+), with a positive rate of 39.1%(43/110). Among the rats with positive plague bacteria, the congestive pulmonary edema and the pathological changes of the hemorrhagic inflammation of the heart, liver, spleen, kidney and injection site could be seen clearly; the plague-free mice were not found to have any pathological changes. The survived 68 mice over the winter were autopsied and observed after being fed up for 20 days. No any pathological changes were found among these mice, and culturing of Yersinia pestis of the heart, liver, spleen, lungs and the tissue of injection site of these mice were all negative (-). Conclusions Citellus undulatus can carry Yersinia pestis during hibernation, but some fail to carry the bacteria through the entire process of hibernation persistently. Yersinia pestis was negative in the survived mice at the end of hibernation. The results showed that Citellus undulatus can not carry Yersinia pestis over the winter.

Nine compounds were isolated from the leaves of Ilex latifolia. Their structures were respectively identified as 5-hydroxy-6, 7, 8, 4'-tetramethoxyflavone (1), tangeretin (2), nobiletin (3), 5-hydroxy-6, 7, 8, 3', 4'-pentamethoxyflavone (4), 5, 6, 7, 8, 4'-pentamethoxyflavonol (5), 5, 6, 7, 8, 3', 4'-hexamethoxy-flavonol (6), 5-hydroxy-3', 4', 7-trimethoxyflavanone (7), soyacerebroside I (8), and soyacerebroside II (9) by their physicochemical properties and spectroscopic data Compounds 1-9 were isolated from this plant for the first time.
Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Ilex ; chemistry ; Plant Leaves ; chemistry

Currently, the randomized controlled trial (RCT) becomes the generally accepted golden standard for clinical trials. It can be classified into two types based on different design, that is, the explanatory randomized controlled trial (ERCT) and the pragmatic randomized controlled trial (PRCT). In designing a clinical trial, researcher may select either of them according to the goal of research. The design feature of PRCT and its application in designing clinical trials of acupuncture were introduced in this paper. Further attention should be paid on resolvent of how to apply PRCT in combining with other design methods organically to work out clinical trial scheme with high quality and consistent with the characteristics of acupuncture as possible, for evaluating the effect of acupuncture more accurately and objectively, so as to promote the international application and development of acupuncture therapy.
Acupuncture Therapy ; methods ; Biomedical Research ; Humans ; Randomized Controlled Trials as Topic ; methods

Objective To investigate the characteristics and diagnostic value of 18F-fluorodeoxyglucose (FDG) PET/CT in patients with secondary malignant peripheral nerve lesions. Methods 18F-FDG PET/CT studies of 8 cases of secondary malignant peripheral nerve lesions confirmed by histopathology or follow-up were analyzed retrospectively. The maximum standardized uptake value ( SUVmax ) of infiltrating peripheral nerves and contralateral normal peripheral nerves was measured and compared with their morphological appearances on CT. Paired student t-test was performed by SPSS 10.0. Results Twelve secondary malignant peripheral nerve lesions with high 18F-FDG metabolism were found in 8 cases. On PET imaging,the lesions distributed along the neurovascular tissues or intervertebral foramina with appearances resembling those of fibre bundles,radices or nodes on PET but no density differences with the surrounding soft tissue or fat planes on CT. The SUVmax was 6.86 ± 3.87. The contralateral normal peripheral nerves showed no abnormal 18F-FDG uptake with a SUVmax of 1.10 ±0.46,which was significantly different from that of the secondary malignant peripheral nerve lesions (t = 9.231,P ＜ 0.001 ). Conclusion 18 F-FDG PET/CT may be useful in locating the secondary malignant peripheral nerve lesions and in assessing its regional infiltration.

OBJECTIVETo investigate the intracellular trafficking pathway of fusion protein epidermal growth factor-adenovirus early region 4 open reading frame 4 protein (EGF-E4orf4) internalized via epidermal growth factor (EGF) receptor and its affectivity on extracellular signal-regulated kinase (ERK) phosphorylation.

METHODSMDA-MB-231 and BGC823 cells were incubated with fluorescein isothiocyanate-EGF-E4orf4 or EGF at different time points. The specific molecular mark of early endosome or late lysosome was labeled by indirect immunofluorescence, and then colocalization staining was observed using confocal laser microscopy. The levels of ERK phosphorylation were detected by Western blot.

RESULTSThe fluorescent signal of fusion protein EGF-E4orf4 accumulated within the cells and congregated to the perinuclear region. A nucleus localization of the fusion protein was only at MDA-MB-231 cell. Colocalization of EGF-E4orf4 with early endosome/late lysosome was observed. EGF-E4orf4 stimulated ERK phosphorylation, which was most obvious 10 minutes after stimulation, and then gradually attenuated, which was similar to EGF stimulation but with a less decrease.

CONCLUSIONSInternalized EGF-E4orf4 can be slowly degraded via endosome-lysosome pathway. The action features of EGF-E4orf4 are remarkably different between MDA-MB-231 and BGC823 cells, which may help explain the differences in its anti-tumor potency and in the special selectivity toward different tumor cells.

Adenovirus E4 Proteins ; pharmacokinetics ; Cell Line, Tumor ; Epidermal Growth Factor ; pharmacokinetics ; Extracellular Signal-Regulated MAP Kinases ; metabolism ; Humans ; Phosphorylation ; drug effects ; Protein Transport ; Recombinant Fusion Proteins ; pharmacokinetics ; Viral Proteins ; pharmacokinetics

OBJECTIVETo investigate the clinical effect of the nervus cutaneus femoris posterior pedicle flap on repairing large soft tissue defects at the heel or inferior segment of the shank.

METHODSTotally 14 cases were followed up for 8-22 months (mean 15.5 months) to observe the clinical effects of nervus cutaneus femoris posterior pedicle flap on repairing large soft tissue defects of the heel or inferior segment of the shank. Among them, there were 3 patients afflicted with infection and cutaneous defects in the middle and inferior segment of the shank after internal fixation of open fracture, 4 patients with soft tissue defects of the ankle and uncovered tendo calcaneus, and 7 patients with soft tissue defects of the heel and exposed calcaneus.

RESULTSThe flaps survived well in 13 cases and partial necrosis occurred in 1 case that was thereafter cured with changing dressing. Various extents of pain and stiffness of the knee joints were present in all cases and disappeared through 1-8 weeks' (mean 3.2 weeks) functional exercises. The last follow-up showed that all the flaps kept good texture and satisfactory appearance.

CONCLUSIONSThe nervus cutaneus femoris posterior pedicle flap, having the advantages of simple surgical procedures, anastomosing the nerves and restoring the sensation of recipient site, can be used for recovering large soft tissue defects of the shank and ankle.

Adolescent ; Adult ; Aged ; Female ; Heel ; surgery ; Humans ; Leg ; surgery ; Male ; Middle Aged ; Soft Tissue Injuries ; surgery ; Surgical Flaps