OBJECTIVETo investigate the effect of astragali injection on the expression of epithelial sodium channel in mice with acute lung injury (ALI) and explore the possible mechanism.

METHODSThirty C57BL/6 mice were randomized into 3 equal groups, namely the control group, ALI model group, and astragali injection treatment group. Twelve hours after the treatments, The wet-dry ratio (W/D) of the lungs, inflammation cell percentages in the bronchoalveolar lavage fluid (BALF) and histopathological changes of the lung tissues were examined, and the expressions of α-ENaC, TNF-α, and IL-8 mRNA in the lung tissues were determined with quantitative RT-PCR.

RESULTSThe neutrophil percentage in the BALF increased significantly in ALI group as compared with that in the other two groups. Pathological examination revealed milder lung tissue inflammation, congestion and edema in astragalus injection treatment group than in the ALI model group. Compared with those in the control group, α-ENaC mRNA expression decreased significantly while TNF-α and IL-8 mRNAs increased markedly in ALI group. In astragalus injection treatment group, the expression level of α-ENaC mRNA was higher than that in ALI group, and TNF-α and IL-8 mRNA expression lower than those in ALI group but higher than those in the control group.

CONCLUSIONAstragalus injection can ameliorate ALI in mice by inhibiting the release of inflammatory factors and up-regulating ENaC mRNA expression to promote the clearance of pulmonary edema fluid.

Acute Lung Injury ; metabolism ; Animals ; Astragalus Plant ; chemistry ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacology ; Epithelial Sodium Channels ; drug effects ; metabolism ; Interleukin-8 ; metabolism ; Male ; Mice ; Mice, Inbred C57BL ; Tumor Necrosis Factor-alpha ; metabolism

OBJECTIVETo analyze the opportunity and condition of aeromedical transportation in critically burn patients.

METHODSEighteen severely burn patients were operated by aeromedical transportation. Among them, four patients were transported in the shock stage and fourteen patients were transported after shock stage. Some aspects of treatment were introduced including escharectomy,clinical index, equipment of medicine, and so on. The transportation card and abstract of case file were recorded carefully before aeromedical transportation. When there were over 2 patients, those with more severe burns received the treatment in the priority.

RESULTSEach aeromedical transportation airplane carried 1 to 6 cases, and flies 420 to 2 500 km for 1.5 to 3. 5 hours. The patients were safely arrived at destination. Except one died for multiple organ failure, others were cured during further treatment.

CONCLUSIONProvide that the conditions were permissive and preparation were adequate, it is safe to carry out aeromedical transportation during shock stage.

Adolescent ; Adult ; Air Ambulances ; Burns ; therapy ; Critical Illness ; Humans ; Male ; Shock ; therapy ; Young Adult

OBJECTIVEStem cells transplantation is a promising strategy in cardiology. This meta-analysis summarizes the efficacy and safety of stem cells transplantation on top of standard medication on chronic heart failure patients.

METHODSThe following databases were searched, including Cochrane Library (Issue 4, 2011), PubMed (1980 to 2011), Embase (1990 to 2011), CBM (1978 to 2011), CNKI (1994 to 2011), VIP (1989 to 2011), and WanFang Data (1998 to 2011). Search criteria:studies were screened and the quality was evaluated according to predefined inclusion and exclusion criteria. Intervention measures: the treatment group using stem cell transplantation therapy on top of standard drug treatment, while the control group using standard drug treatments.

RESULTSA total of 31 studies involving 2375 patients were included. The results show that the improvement of LVEDV in the stem cell treatment group is greater than in the control group [SMD = -11.8% (95%CI: -0.223 - 0.013), P = 0.027] and the relative-risk of cardiac events is lower in stem cell treatment group [RR = 0.77 (95%CI: 0.66 - 0.90), P < 0.01] than in control group.

CONCLUSIONStem cells therapy is effective in improving cardiac remodeling and reducing the relative-risk of cardiac events in patients with chronic heart failure.

Chronic Disease ; Heart Failure ; physiopathology ; surgery ; Humans ; Stem Cell Transplantation ; Ventricular Remodeling

Objective To investigate the characteristics of sleep patterns and their effects on the risk of diabetes mellitus (DM) among adults in Guangzhou. Methods A retrospective study was conducted using data collected by the lifestyle survey and health outcomes of 5 666 employees from Guangzhou who underwent physical examination between November 2012 and October 2013 at Guangdong Provincial People's Hospital. Sleep patterns and their distribution profiles were analysed using latent class analysis (LCA). Multiple logistic regression models were performed to investigate the association between sleep patterns and DM. Results LCA identified five sleep patterns: “very short sleep duration with insomnia” (class 1, 5.6%), “sleep insufficiency with mild daytime dysfunction” (class 2, 20.4%), “normal sleep” (class 3, 47.7%), “sleep insufficiency with daytime functioning complaints” (class 4, 4.7%) and “sleep insufficiency with poor nocturnal sleep” (class 5, 21.6%). After adjustment for the confounding factors, subjects of class 1 (OR=2.28, 95% CI: 1.51-3.43, <0.001), class 4 (OR=2.48, 95% CI: 1.54-4.00, P<0.001) and class 5 (OR=1.31, 95% CI: 1.01-1.71, P=0.045) had a higher risk of DM when compared with those of class 3. Conclusions There were significant associations between various sleep-related factors, leading to distinct sleep behavioral patterns among adults. Poor sleep patterns could increase the risk of DM.

Objective: To investigate the influence of single-port laparoscopic percutaneous extraperitoneal closure (LPEC) on the orientation of the vas deferens and the volume and perfusion of the testis in pediatric patients undergoing inguinal hernia repair. METHODS: A total of 92 consecutively enrolled boys diagnosed with unilateral inguinal hernia underwent single-port LPEC between June 2013 and June 2014. The orientation of the vas deferens and the testicular volume and perfusion of the patients were ultrasonographically assessed preoperatively and at 1 and 6 months after surgery. RESULTS: All the surgical procedures were performed successfully without conversion or serious perioperative complications. Ultrasonography showed no angulation or distortion of the vas deferens on the surgical side during a six-month follow-up period. Similarly, no obvious changes were observed in the testicular volume or perfusion. CONCLUSIONS Single-port LPEC is safe and effective in the treatment of pediatric inguinal hernia and does not affect the orientation of the vas deferens or testicular volume and perfusion.
Child ; Hernia, Inguinal ; surgery ; Herniorrhaphy ; methods ; Humans ; Laparoscopy ; methods ; Male ; Organ Size ; Testis ; anatomy & histology ; diagnostic imaging ; Treatment Outcome ; Ultrasonography ; Vas Deferens ; anatomy & histology ; diagnostic imaging

Objective To investigate the surgery-related factors of strangulated small bowel obstruction in the elderly patients. Methods The clinical data of 261 elderly patients with acute small bowel obstruction treated between July 2010 and September 2016 were analyzed retrospectively. Differences of clinical data,laboratory Results ,and CT findings were compared between the elderly strangulation group(ESt group,n=139)and the elderly simple group (ESi group,n=122). The surgery-related factors of strangulated small bowel obstruction in the elderly were analyzed by univariate and multivariate Logistic regression analysis. Results The ESt group and the ESi group showed significant differences in factors including muscle guarding (χ=102.331,P=0.000),American Society of Anesthesiologists(ASA) score≥3 (χ=69.748,P=0.000),leukocyte count (t=7.453,P=0.000),C-reactive protein (t=2.128,P=0.034),segmental mesenteric fluid (χ=78.655,P=0.000),thick-walled small bowel (χ=100.806,P=0.000),intestinal wall of hyperattenuation (χ=69.068,P=0.000),ascites (χ=89.299,P=0.000),mesenteric fat stranding (χ=80.255,P=0.000),bird's beak sign (χ=84.451,P=0.000),and stranding sign (χ=98.635,P=0.000). Univariate regression analysis indicated the above 11 factors were the surgery-related factors in elderly patients with strangulated small bowel obstruction. Multivariate Logistic regression analysis showed that the surgery-related factors included segmental mesenteric fluid (OR=3.576,95%CI:1.043-12.261,P=0.043),ASA score≥3 (OR=3.463,95%CI:1.149-10.441,P=0.027),muscle guarding (OR=3.288,95%CI:1.010-10.707,P=0.048),thick-walled small bowel (OR=3.046,95%CI:1.074-8.638,P=0.036),and increased leukocyte count (OR=1.307,95%CI:1.170-1.458,P=0.000). Conclusion Muscle guarding,ASA score≥3,segmental mesenteric fluid,thick-walled small bowel,and increased leukocyte count are the surgery-related factors of strangulated small bowel obstruction in the elderly patients.

Objective: To explore the clinical characteristics and prognosis of the new coronavirus 2019-nCoV patients combined with cardiovascular disease （CVD). Methods: A retrospective analysis was performed on 112 COVID-19 patients with CVD admitted to the western district of Union Hospital in Wuhan, from January 20, 2020 to February 15, 2020. They were divided into critical group (ICU, n=16) and general group (n=96) according to the severity of the disease and patients were followed up to the clinical endpoint. The observation indicators included total blood count, C-reactive protein (CRP), arterial blood gas analysis, myocardial injury markers, coagulation function, liver and kidney function, electrolyte, procalcitonin (PCT), B-type natriuretic peptide (BNP), blood lipid, pulmonary CT and pathogen detection. Results: Compared with the general group, the lymphocyte count (0.74 (0.34, 0.94)×10⁹/L vs. 0.99 (0.71, 1.29)×10⁹/L, P=0.03) was extremely lower in the critical group, CRP (106.98 (81.57, 135.76) mg/L vs. 34.34 (9.55,76.54) mg/L, P<0.001) and PCT (0.20 (0.15,0.48) μg/L vs. 0.11 (0.06,0.20) μg/L, P<0.001) were significantly higher in the critical group. The BMI of the critical group was significantly higher than that of the general group (25.5 (23.0, 27.5) kg/m² vs. 22.0 (20.0, 24.0) kg/m²，P=0.003). Patients were further divided into non-survivor group (17, 15.18%) group and survivor group (95, 84.82%). Among the non-survivors, there were 88.24% (15/17) patients with BMI> 25.0 kg/m², which was significantly higher than that of survivors (18.95% (18/95), P<0.001). Compared with the survived patients, oxygenation index (130 (102, 415) vs. 434 (410, 444), P<0.001) was significantly lower and lactic acid (1.70 (1.30, 3.00) mmol/L vs. 1.20 (1.10, 1.60) mmol/L, P<0.001) was significantly higher in the non-survivors. There was no significant difference in the proportion of ACEI/ARB medication between the critical group and the general group or between non-survivors and survivors （all P>0.05). Conclusion: COVID-19 patients combined with CVD are associated with a higher risk of mortality. Critical patients are characterized with lower lymphocyte counts. Higher BMI are more often seen in critical patients and non-survivor. ACEI/ARB use does not affect the morbidity and mortality of COVID-19 combined with CVD. Aggravating causes of death include fulminant inflammation, lactic acid accumulation and thrombotic events.
Betacoronavirus ; COVID-19 ; Cardiovascular Diseases/therapy* ; Coronavirus Infections/complications* ; Humans ; Pandemics ; Pneumonia, Viral/complications* ; Prognosis ; Retrospective Studies ; SARS-CoV-2 ; Treatment Outcome