ObjectiveTo develop an experimental model of orthostatic hypotension (OH) after spinal cord injury (SCI) in rabbits and investigate the effect of tilting table exercise and Shengmaiyin on it. MethodsRabbit model of OH after SCI were induced by complete transection of spinal cord at the T5 spinal segment and raised to 60° head up tilt (HUT) on a tilting table. Tilting table exercise and Shengmaiyin were applied to different groups for 28 d from 4 days after operation. Systolic blood pressure (SBP) and pulse rate (PR) were observed with non-invasive sphygmobolometer of rabbit 3, 10, 17, 24, 31 d after the operation. Liquid chromatography with electrochemical detection(HPLC-ECD) was used to detect the concentrations of plasma norepinephrine (NE) and epinephrine(E) with horizontal position and HUT 60° on the 31st day. ResultsSBP with HUT 60° in rabbits of combined treatment group was significantly higher than that in rabbits of SCI group on the 24th day after operation,and the drop in SBP from horizontal position to HUT60° was significantly lower than that in rabbits of SCI group. SBP with HUT 60° in rabbits of exercise group and combined treatment group was significantly higher than that in rabbits of SCI group on the 31st day after operation. The drop in SBP from horizontal position to HUT 60° was significantly lower in rabbits of Shengmaiyin group, exercise group and combined treatment group than that in rabbits of SCI group on the 31st day after operation. The concentration of E and NE of SCI group, Shengmaiyin group, exercise group and combined treatment group was lower than that of sham group, but there was no significant difference among these groups. ConclusionThe treatment with tilting table exercise and Shengmaiyin can improve OH after SCI partially in rabbits without involving norepinephrine and epinephrine significantly. The period of treatment can be shorten when both therapies used together.

Objective To evaluate the effectiveness and safety of BiPAP non-invasive ventilation on COPD patients during acute exacerbation(AECOPD).Methods 20 COPD patients were ventilated using BiPAP non-inva- sive ventilation through a nose or mouth-nose mask.Their vital signs(RR,HR and BP)and arterial blood gases indi- cators(pH,PaCO_2,PaO_2 and SaO_2)before and after ventilation were monitored and the clinical effectiveness was ob- served.Results The vital signs and arterial blood gases indicators of 17 of the 20 AECOPD patients were improved. PaCO_2 was lowered,pH,PaO_2 and SaO_2 were elevated,and the difference before and after ventilation was statistically significant(P＜0.05).Conclusion BiPAP non-invasive ventilation can improve the vital signs and physiological in- dicators of AECOPD patients,relieve their respiratory muscle fatigue and prevent them from exacerbation of respira- tory failure,thereby lower the need for endotracheal inrubation.

Acquired Immunodeficiency Syndrome ; prevention & control ; Adult ; Burnout, Professional ; Chi-Square Distribution ; Female ; Humans ; Male ; Medical Staff ; Middle Aged ; Rural Population ; Surveys and Questionnaires ; Young Adult

Aim To investigate the effect of asiatic acid on apoptosis and autophagy in human glioblastoma T98G cells. Methods MTT colorimetry was employed to assay the cellular proliferating activity. The fluores-cence microscope and Hoechst 33258 staining were used to detect the morphological changes. The cell ap-optosis and autophagy were analyzed by flow cytometry with Annexin-V/7-AAD and MDC staining respective-ly. The expressions of associated proteins were detected by Western blot to analyze the mechanism of apoptosis and autophagy. Results MTT assay showed that the growth of T 9 8 G cells was inhibited by asiatic acid ( IC50 =46. 3 μmol · L-1 ) . Annexin V/7-AAD stai-ning and Western blot revealed that asiatic acid in-duced apoptosis in T98 G cells by reducing the expres-sion of Akt, decreasing the mitochondrial membrane potential, and increasing the expression of Caspase-3. MDC staining and Western blot showed that the per-centage of MDC-positive cells was decreased and the expressions of Beclin-1 , LC3-II and Atgs were inhibi-ted by asiatic acid treatment. 5 μmol·L-1 chloroquine was used to up-regulate the expressions of LC3-Ⅱand Beclin-1 . Asiatic acid-inhibited autophagy was blocked and the total apoptotic rate was reduced remarkably. Conclusion Asiatic acid suppresses T98 G cells pro-liferation by inducing apoptosis and inhibiting cell au-tophagy, and the very role of inhibiting autophagy could promote apoptosis to a certain extent.

AIM:To investigate the protective effect of puerarin on testis in diabetic rats.METHODS:The male Sprague-Dawley rats were randomly divided into normal control group,diabetic group,high dose puerarin(160 mg/kg),middle dose puerarin(120 mg/kg),low dose puerarin(80 mg/kg)treatment groups and aminoguanidine(100 mg/kg)treatment group.Corresponding drugs were intraperitoneal injected once a day.The animals in normal control group and diabetic group were given equal propylene glycol.12 weeks later,the rats were sacrificed and their testes were collected.Testicular structure was observed under transmission electronic microscope(TEM).The contents of nitric oxide(NO),malondialdehyde(MDA)and the activity of nitric oxide synthase(NOS),inducible nitric oxide synthase(iNOS),superoxide dismutase(SOD),Ca2+-ATPase and Na+-K+-ATPase in testis homogenate were detected biochemically.The levels of endothelin-1(ET-1)and calcitonin gene-related peptide(CGRP)were also measured by radioimmunoassay.In addition,the mRNA expressions of eNOS,iNOS,CGRP,ET-1 and AR in testis tissues were determined by reverse transcription polymerase chain reaction(RT-PCR).RESULTS:The pathologic changes such as cytoplasmic inclusion of sertoli cell and obvious vacuoles between sertoli cells and basal membrane of the contorted seminiferous tubules were observed under TEM in diabetic group.The contents of NO and CGRP,the activities of SOD,Ca2+-ATPase,Na+-K+-ATPase as well as the mRNA expressions of eNOS and CGRP decreased significantly(P

Objective To investigate the application of antimicrobial agents in a tertiary first-class hospital before and after implementing special rectification activity on clinical antimicrobial use.Methods Data about antimicrobial use in a hospital in Sichuan Province between January 2011 and December 2013 were collected and analyzed retro-spectively,data included antimicrobial varieties,the ratio of antimicrobial prescription in outpatient department to emergency department,percentage of antimicrobial application expense in the total hospitalization expense,antimi-crobial use rate and use density,antimicrobial use rate and use density of special use antimicrobial agents,microbial detection for patients receiving restricted and special antimicrobials.Results Before implementing rectification of an-timicrobial use,there were 88 kinds of antimicrobial agents in hospital,after implementing rectification,there were 50 kinds of antimicrobial agents.The ratio of antimicrobial prescription in outpatient department to emergency de-partment,and the percentage of antimicrobial expense in the total hospitalization expense were both lower than be-fore rectification (both P <0.05 ).Antimicrobial use rate and antimicrobial use rate of special use antimicrobial agents before and after rectification were all statistically different(all P <0.05).Compared with before rectification, microbial detection rate of specimens from patients receiving restricted and special use antimicrobial agents improved significantly (both P <0.05 ).Perioperative antimicrobial prophylactic use rate in patients with class Ⅰincisional operation after rectification was lower than before rectification,while percentage of antimicrobials used 30 min-2 h before operation was higher than before rectification (both P <0.05).Conclusion After three year special rectifica-
tion,antimicrobial use become more rational,but management still needs further and continuous improvement.

Objective: To analyze the trends in incidence and mortality of Alzheimer's disease (AD) in Zhejiang Province from 2003 to 2017, so as to provide the evidence for the development of AD prevention and control strategies. Methods: The data pertaining to the incidence and mortality of AD in China from 2003 to 2017 were collected from the Global Burden Disease Study, and standardized to the data of the Sixth National Population Census in China in 2010. The trends in incidence and mortality of AD were analyzed using annual percent change (APC) and average annual percent change ( AAPC ) in Zhejiang Province from 2003 to 2017. Results: The incidence of AD increased from 96.05/105 in 2003 to 140.96/105 in 2017 in Zhejiang Province, with AAPC of 2.776% ( P<0.05 ), and the greatest APC ( 3.419% ) was found during the period between 2003 and 2005 ( P<0.05 ). The standardized incidence of AD increased 102.06/105 in 2003 to 106.09/105 in 2017 in Zhejiang Province, with AAPC of 0.274% ( P<0.05 ), and the greatest APC ( 1.177% ) was measured during the period between 2003 and 2005 ( P<0.05). The mortality of AD increased from 24.60/105 in 2003 to 41.44/105 in 2017 in Zhejiang Province, with AAPC of 3.862% ( P<0.05 ), and the greatest APC (4.667%) was found during the period between 2005 and 2011 ( P<0.05 ). The standardized mortality of AD increased 26.83/105 in 2003 to 27.16/105 in 2017 in Zhejiang Province, with AAPC of 0.142% ( P>0.05 ), and the greatest APC ( 1.048% ) was measured during the period between 2005 and 2012 ( P<0.05 ). Conclusion Both the incidence and mortality of AD appeared a tendency towards a rise in Zhejiang Province from 2003 to 2017.

Objective:To investigate the feasibility of real-time screening and diagnosing fundus diseases with Wild Field Imaging System (WFIS SW-8000) in the eyes with dense cataract patients.Methods:A series of case-observational study was carried out.Ninety-six dense cataractous eyes of 90 patients with suspected fundus diseases were included in Affiliated Hospital of Nantong University from April to July 2019.Lens phacoemulsification combined with intraocular lens implantation was performed after the opacity lens was removed, and fundus examination was performed with WFIS SW-8000.Super field lens, optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) was used to verify the fundus findings after surgery, which were compared with WFIS SW-8000.This study protocol was approved by Ethics Committee of Affiliated Hospital of Nantong University and followed the Declaration of Helsinki.Written informed consent was obtained from each patient prior to any medical examination.Results:Among 96 eyes, fundus diseases were detected in 40 eyes with the detection rate of 41.67% by WFIS SW-8000 examination, including dry age-related macular degeneration (AMD) in 2 eyes, wet AMD in 3 eyes, polypoidal choroidal vasculopathy (PCV) in 1 eye, high myopia retinopathy (HMR) in 7 eyes, central retinal vein occlusion (CRVO) with macular edema (ME) in 1 eye, mild non-proliferative diabetic retinopathy (NPDR) in 12 eyes, moderate NPDR in 7 eyes, severe NPDR in 4 eyes and proliferative diabetic retinopathy (PDR) in 3 eyes.Fundus diseases were detected in 45 eyes with detection rate of 46.88% after surgery by a super field lens, OCT and FFA.The detectable rate of digital retinal camera examination and super field lens, OCT and FFA showed no significant difference between intraoperation and postoperation (χ 2=0.528, P=0.468). Twenty-two eyes with fundus neovascular disease or macular edema requiring drug intervention were identified intraoperatively, and intravitreal anti-inflammatory and/or anti-vascular endothelial growth factor (VEGF) drugs were injected in 11 eyes during the operation. Conclusions:WFIS SW-8000 is a useful tool for the accurate and convenient method in real-time fundus examination during phacoemulsification, which is feasible and helpful for timely intervention in and treatment of fundus diseases.

Objective:To summarize the experiences of the surgical treatment of tumors in the posterior part of the third ventricle and pineal region. Methods: Twenty-seven patients with tumors in this region treated microsurgically from 1990 to 2000 were analyzed. The surgical indications, approaches, and operative key points were discussed. The prognostic factors were also analyzed. Results:Tumors were removed totally in 11 patients, removed subtotally in 7 and removed partially in 5. Biopsy and ventriculo-peritoneal shunt was performed in 4 patients. Of 17 patients in follow-up, 13 patients survived longer than 5 years. Conclusions: Most tumors in the posterior part of the third ventricle and pineal region can be surgically removed.Sufficient specimen obtained in the operation can confirm pathologic property of the tumor,guiding next chemotherapy and radiotherapy.

BACKGROUND: Previous research has demonstrated that dermal tissue has mesenchymal stem cells, which have a possibility of autologous transplantation. If the mesenchymal stem cells derived from the skin differentiate into lymphocytes under a certain condition, the immune system disease can be solved generally.OBJECTIVE: To investigate the possibility of differentiation of human skin-derived mesenchymal stem cells into lymphocytes. METHODS: Surface marker expression was detected in the 14th passage human skin-derived mesenchymal stem cells using flow cytometry. Transdifferentiation medium of human skin-derived mesenchymal stem cells consisted of human lymphocyte supernatant and fresh human skin-derived mesenchymal stem cells based on the ratio of 7:3. Inverted microscope was employed to observe morphological changes, and flow cytometry was used to detect surface marker expression in the lymphocytes at 1-8 days after induction. Self-marker expression of human skin-derived mesenchymal stem cells was then detected at 3,6, and 9 days after induction.RESULTS AND CONCLUSION: Human skin-derived mesenchymal stem cells stably expressed self-specific marker CD73, Vimentin and so on, but did not express specific markers of hematopoietic system, I.e., CD34, CD45 and so on, lowly expressed HLA-I, but did not express HLA-DR at all. At 3 days after induction, the cell volume significantly increased, cell proliferation rate was significantly lower than before induction, and a lot of cystic-like particles with strong refraction were observed in or between cells. The CD45 lymphocyte expression was not significantly changed, but CD3, CD19, CD16, CD4, and CD8 expression rates of human skin-derived mesenchymal stem cells were linearly increased at 1-4 days after induction and stabilized at 5-8 days after induction. In addition, CD37, CD34, Vimentin, and HLA-DR expressions were not changed at 3, 6, and 9 days after induction, but HLA-I expression rate was gradually increased with the prolongation time of induction. This suggested that human skin-derived mesenchymal stem cells can differentiate into lymphocyte and potentially participate in repairing immune system injury.