Objective To evaluate the effects of electroacupuncture (EA) at Zusanli and Chize on sepsisinduced acute lung injury (ALI) in patients.Methods Sixty patients with sepsis-induced ALI/respiratory distress syndrome,aged 43-78 yr,weighing 49-89 kg,with their APACHE-Ⅱ scores of 16-23 and oxygenation index of 125-256 mm Hg,were randomly divided into 3 groups (n =20 each):conventional therapy group (group S),conventional therapy + acupuncture at non-acupoint group (group SNE) and conventional therapy + acupuncture at acupoint group (group SE).Bilateral Huantiao and Chize points were stimulated with electric stimulator (frequency 2/50 Hz,wave length 300μs,starting at a voltage of 0 and increasing by 0.1 mA every time until the maximal tolerance level was reached) for 30 min once a day for 5 days based on the conventional therapy in group SE.In group SNE,EA was performed at the non-acupoint based on the conventional therapy and the parameters of EA were same as those previously mentioned in group SE.Before EA stimulation (T1) and at 3 and 5 days after the end of EA stimulation (T2-3),arterial blood samples were taken for blood gas analysis,oxygenation index (OI) was calculated,and APACHE-Ⅱ] scores were assessed.Venous blood samples were collected at T1 and T3 for detection of TNF-α and IL-10 concentrations in the broncho-alveolar lavage fluid (BALF) and serum (by ELISA).Results Compared with the baseline value at T1,OI was significantly increased and APACHE-Ⅱ scores were decreased at T2 and T3,and TNF-α concentrations in the BALF and serum were decreased and IL-10 concentrations in the BALF and serum were increased at T3 in the three groups (P ＜ 0.05 or 0.01).The OI was significantly higher and APACHE-Ⅱ scores were lower at T3 than at T2 in the three groups (P ＜ 0.05).Compared with group S,the OI was significantly increased at T2 and T3,APACHE-Ⅱ scores and TNF-α concentrations in the BALF and serum were decreased at T3,and IL-10 concentrations in the BALF and serum were increased at T3 in group SE (P ＜0.05 or 0.01),and no significant changes were found in the parameters mentioned above in group SNE (P ＞0.05).There were no significant differences in the incidence and survival rate of multiple organ dysfunction syndrome among the three groups (P ＞ 0.05).Conclusion EA at Zusanli and Chize is helpful in mitigating sepsisinduced ALI in patients,and regulation of the balance between proinflammatory factors and anti-inflammatory factors and inhibition of inflammatory responses may be involved in the mechanism.

OBJECTIVETo develop an intelligent adjustable leg raising system which could realize the quantification and visualization of lower limbs' elevation angle and frequency.

METHODSWe determined the pole adjustable length of thighs and cruses and the flexion angle range of hips and knees according to the requirements of clinical lower limb function rehabilitation, and made force analysis of hip's and knee's flexion motivation mechanism and clinical observation on its security and effectiveness.

RESULTSThis device was small and compact in overall appearance, which could adjust the angle of the hips and knees bending and ankles turning alone. The force analysis of the hips and knees flexion power element was consistent with the design requirements. The preliminary studies showed the device could relieve pain, improve the range of motion and promote the rehabilitation, which was superior to that of the Brown Ska (P < 0.05).

CONCLUSIONThe intelligent adjustable leg raising system meets the requirements of clinical usage, which is suitable for different heights, and the flexion angle ranges of hips and knees are wide and in high accuracy, which is worth of being improved and generalized.

Humans ; Leg ; Manipulation, Orthopedic ; instrumentation ; Range of Motion, Articular ; Rehabilitation ; instrumentation

Objective To understand the management status quo of migrant workers with chronic hepatitis B (CHB) to ex‐plore the management countermeasures and improve the survival quality for tamping the foundation of the healthy project .Methods Totally 300 migrant workers with CHB were performed the living quality evaluation and investigation on the service needs ,com‐pliance ,economic condition ,categories and proportion of reimbursement by adopting the supplementary revision of SF‐36 living quality scale and general information questionnaire ;the influencing factors of their living quality were performed the univariate anal‐ysis and multivariate stepwise regression analysis .Results The statistical analysis found that whether convenient for outside visit‐ing hospital ,categories and proportion of reimbursement ,whether normalized antiviral therapy ,whether conducting examination and follow up at regular intervals and liver disease specific symptoms were the influencing factors of living quality in the migrant work‐ers with CHB(P<0 .05);the living quality in the patients with outside convenient visiting hospital ,high reimbursement proportion , normalized antiviral therapy and examination and follow up at regular intervals was significantly higher than that in the patients with inconvenient outside visiting hospital ,low reimbursement proportion ,non‐normalized anti‐viral therapy and examination and follow up without regular intervals(P<0 .05);the liver disease specific symptom score showed the positive correlation trend with the living quality score (B=7 .657 ,SD=2 .650 ,t=2 .889 ,P=0 .004) .Conclusion It is necessary to improve the patient′s medical needs ,reimbursement type and proportion ,increase the compliance of patient′s normalized examination and follow‐up at regular in‐tervals and standard antiviral treatment ,thus to realize the standardized examination and treatment in CHB patients ,prevent or de‐lay the disease progression ,avoid liver cirrhosis and decompensated hepatopathy ,reduce the occurrence of HCC ,improve the quality of life and prolong the survival period .

OBJECTIVETo explore the effects of different concentrations of putrescine on the proliferation, migration and apoptosis of human skin fibroblasts (HSF).

METHODSHSF cultured in the presence of 0.5, 1.0, 5.0, 10, 50, 100, 500, and 1000 µg/ putrescine for 24 h were examined for the changes in the cell proliferation, migration, and apoptosis using MTS assay, Transwell migration assay, and flow cytometry, respectively.

RESULTSCompared with the control cells, HSF cultured with 0.5, 1.0, 5.0, and 10 µg/ putrescine showed significantly increased cell proliferation (P<0.01), and the effect was the most obvious with 1 µg/ putrescine, whereas 500 and 1000 µg/ putrescine significantly reduced the cell proliferation (P<0.01); 50 and 100 µg/ did not obviously affect the cell proliferation (P>0.05). Putrescine at 1 µg/ most significantly enhanced the cell migration (P<0.01), while at higher doses (50, 100, 500, and 1000 µg/) putrescine significantly suppressed the cell migration (P<0.05); 0.5, 5.0, and 10 µg/ putrescine produced no obvious effects on the cell migration (P>0.05). HSF treated with 0.5, 1.0, 5.0, and 10 µg/ putrescine obvious lowered the cell apoptosis rate compared with the control group (P<0.01), and the cell apoptosis rate was the lowest in cells treated with 1 µg/ putrescine; but at the concentrations of 100, 500, and 1000 µg/, putrescine significantly increased the cell apoptosis rate (P<0.01), while 50 µg/ml putrescine produced no obvious effect on cell apoptosis (P>0.05).

CONCLUSIONLow concentrations of putrescine can obviously enhance the proliferation ability and maintain normal migration ability of HSF in vitro, but at high concentrations, putrescine can obviously inhibit the cell migration and proliferation and induce cells apoptosis, suggesting the different roles of different concentrations of putrescine in wound healing.

Apoptosis ; drug effects ; Cell Movement ; drug effects ; Cell Proliferation ; drug effects ; Cells, Cultured ; Fibroblasts ; cytology ; drug effects ; Flow Cytometry ; Humans ; Putrescine ; administration & dosage ; pharmacology ; Skin ; cytology ; Wound Healing

OBJECTIVETo observe the clinical efficacy of shensong yangxin capsule (SYC) on ventricular premature beat (VPB) differentiated in TCM as palpitation of Qi-yin deficiency syndrome or Xin collateral stagnation syndrome, and cardiovascular autonomic nervous function in patients with coronary heart disease (CHD).

METHODSThe randomized, double-blind, parallel contrast method was adopted, patients were randomly assigned by 3:1 ratio into two groups. One hundred and sixty-five patients in SYC treated group and 56 in the control group (treated with Xinlvning tablet), and the therapeutic course for both groups was 4 weeks.

RESULTSThe clinical efficacy on VPB and in improving TCM syndromes was better in SYC group than that in the control group (P < 0.01). After treatment, the heart rate variability (HRV) and QT dispersion in the two groups were improved in a certain degree. The changes of SDNN, SDANN, SDNN Index and PNN50 in the two groups were significantly different (P < 0.05, P < 0.01), the efficacy in the treated group was superior to that in the control group.

CONCLUSIONSYC has definite effect on VPB and TCM Syndromes, it can obviously meliorate the activity of cardiovascular autonomic nervous system in the patients with CHD.

Adult ; Aged ; Autonomic Nervous System ; drug effects ; physiopathology ; Capsules ; Coronary Disease ; complications ; drug therapy ; Double-Blind Method ; Drug Administration Schedule ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Heart ; innervation ; Humans ; Male ; Middle Aged ; Phytotherapy ; Ventricular Premature Complexes ; drug therapy ; etiology

Objective:To investigate the efficacy of plasma exchange (PE) in treatment of patients with acute respiratory distress syndrome (ARDS).Methods:Forty-two patients who met the inclusion criteria in the intensive care unit of Chenzhou First People′s Hospital were randomly divided into control group and plasma exchange (PE) group with 21 cases in each group. The control group received conventional treatment; while the PE group received conventional treatment plus PE. The mechanical ventilation time (MVT), length of ICU stay (ICU LOS), 28-day mortality and 90-day mortality of patients were analyzed. The oxygenation index, SOFA score, norepinephrine (NE) dose, C-reactive protein (CRP), procalcitonin (PCT) and IL-6 levels were evaluated before and after treatment.Results:In the control group the oxygenation index, IL-6, PCT and CRP were significantly improved after treatment ( t=-4.50, 2.46, Z=-3.53, t=5.55, all P<0.05), but the SOFA score and NE dose were not significantly changed ( t=1.98, Z=-0.47,all P>0.05). In the PE group, the oxygenation index, SOFA score, IL-6, PCT, CRP were significantly improved and the NE dose was reduced after treatment ( t=2.18, 9.23, 5.26, Z=-3.77, t=7.27 and Z=-2.54,all P<0.05). The oxygenation index, SOFA score, IL-6, CRP were significantly better after treatment and NE dose was lower in PE group than those in the control group ( t=2.18, -2.21, -2.12, -2.61 and Z=-2.11, all P<0.05). Compared with the control group, the MVT(14.0±5.2d vs. 18.4±6.3d), ICU LOS(19.3±4.9d vs. 23.2±7.3d) and 28-day mortality (14.3%(3/21) vs. 42.8%(10/21)) in the PE group were significantly decreased ( t=-2.48, -2.04 and χ2=4.20,all P<0.05). There was no significant difference in the 90-d mortality between the two groups (28.6%(6/21) vs. 52.4%(11/21), χ2=2.47, P=0.208). Conclusion:Therapeutic plasma exchange can significantly reduce the inflammatory response, improve the organ function and reduce the short-term mortality of ARDS patients.

Objective: Computed tomography (CT)-guided percutaneous lung biopsy is difficult for small nodules and lesions that are adjacent to large blood vessels. This study investigated the validity of CT-guided percutaneous lung biopsy in the diagnosis of pulmo-nary nodules with a digital angle instrument. Methods: This study was a retrospective analysis of 35 patients with lung mass≤60 mm, who underwent CT-guided percutaneous lung biopsy from January 2018 to September 2018. Patients were assigned in to three groups. Group A and B were patients with pulmonary nodules≤30 mm. Biopsy of group A was performed with the help of a digital an-gle instrument, and group B didn’t use digital angle instrument. Group C had lung mass of>30 mm, and the biopsy was performed without using the instrument. The size of the mass, frequency of punctures, distance of the puncture, and complication of pneumotho-rax after puncture were compared among the three groups. Results: The maximum diameter of pulmonary nodules in group A (18.4 ± 2.1) mm was significantly lower than that in groups B (28.3 ± 2.0) mm and C (43.2 ± 3.6) mm, and their P value were 0.0034 and 0.0028, respectively. Some patients in group A were at risk because of severe chronic obstructive pulmonary disease and proximity of lesions to large blood vessels. The puncture distance in group A was also significantly more than groups B (P<0.039). However, the probability of puncture success in group A was 100%, which was significantly higher than groups B and C. The postoperative complica-tions in group A were also significantly fewer than in other two groups. Conclusions: CT-guided percutaneous lung biopsy with a digital angle instrument is a safe, simple, and accurate diagnostic method, especially in patients with pulmonary nodular lesions.

OBJECTIVETo observe the effect of the decomposition products of necrotic tissues from wounds on the serum levels of inflammation factors in comparison with endotoxin.

METHODSThirty adult New Zealand rabbits were randomly divided into 3 groups and received injections of saline, necrotic tissue homogenate or endotoxin. From each rabbit, blood samples (2 ml) were collected from the central artery of the ears at 0, 2, 6, 12, 24, 30, 36, 48, and 60 h after the injection for measurement of serum levels of tumor necrosis factor-alpha (TNF-α), interleukin-1 (IL-1) and IL-6.

RESULTSThe serum level of TNF-α, IL-1 and IL-6 in the rabbits increased 2-4 h after injection of the necrotic tissue homogenate and reached the peak level at 12 h, followed by a gradual reduction since 36 h. No obvious changes in the levels of the inflammatory factors were found in saline group (P<0.01). Compared with endotoxin, necrotic tissue homogenate resulted in an early increment (2-4 h vs 5-6 h) and significantly higher peak levels (at 30 h) of the inflammation factors (P<0.05). Curve fitting showed a distinct difference between necrotic tissue homogenate and endotoxin in their effect on the inflammatory factors.

CONCLUSIONThe necrotic tissue decomposition products contain toxic substances that possess a different toxicity profile from endotoxin, and their toxicity can be even stronger.

Animals ; Endotoxins ; adverse effects ; Inflammation ; Interleukin-1 ; blood ; Interleukin-6 ; blood ; Necrosis ; Rabbits ; Tumor Necrosis Factor-alpha ; blood ; Wounds and Injuries ; blood ; pathology

Objective:To evaluate the effect of esketamine on postoperative acute lung injury (ALI) in pediatric patients undergoing living donor liver transplantation.Methods:Sixty pediatric patients of either sex with biliary atresia, aged 0-36 months, of American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ, with cardiac function grade I or Ⅱ, with Child-Pugh grade B or C, undergoing living donor liver transplantation, were divided into 2 groups ( n=30 each) using a computer-generated table of random numbers: control group (group C) and esketamine group (group S). Combined intravenous-inhalational anesthesia was performed with propofol and sevoflurane in both groups, and in addition esketamine was intravenously infused continuously after induction in group S. After anesthesia induction (T 0), at 60 min after start of surgery (T 1), at 10 min after anhepatic phase (T 2), at 60 min after portal vein opening (T 3), and immediately after abdominal closure (T 4), central venous blood samples were collected for determination of the serum concentrations of Clara cell secretory protein 16, surface active protein D, soluble receptor for advanced glycation end-products, high mobility group protein B1, interleukin-1beta and tumor necrosis factor-alpha (using enzyme-linked immunosorbent assay), concentrations of malondialdehyde (using TBA method), and activity of superoxide dismutase (using hydroxylamine method). The dynamic lung compliance was recorded from T 0 to T 4. Blood samples were taken from the radial artery at T 0 and 24 h after surgery (T 5) for blood gas analysis, and oxygenation index and respiratory index were calculated. Lung ultrasound scores were recorded at 24 h before surgery and T 5. The postoperative mechanical ventilation time and duration of intensive care unit stay were recorded. The occurrence of ALI within 7 days after liver transplantation was observed. Results:Compared with group C, the serum concentrations of Clara cell secretory protein 16, surface active protein D, soluble receptor for advanced glycation end products, high mobility group protein B1, interleukin-1beta, tumor necrosis factor-alpha and malondialdehyde were significantly decreased, and the activity of superoxide dismutase was increased at T 3, 4, the oxygenation index was increased and respiratory index was decreased at T 3-T 5, lung ultrasound C score and B score were decreased at T 5, the postoperative mechanical ventilation time and duration of intensive care unit stay were shortened, and the incidence of ALI was decreased in group S ( P<0.05). Conclusions:Esketamine can alleviate postoperative ALI in pediatric patients undergoing living donor liver transplantation.

OBJECTIVETo explore the effects of different concentrations of putrescine on proliferation, migration, and apoptosis of human umbilical vein endothelial cells (HUVECs).

METHODSHUVECs were routinely cultured in vitro. The 3rd to the 5th passage of HUVECs were used in the following experiments. (1) Cells were divided into 500, 1 000, and 5 000 µg/mL putrescine groups according to the random number table (the same grouping method was used for following grouping), with 3 wells in each group, which were respectively cultured with complete culture solution containing putrescine in the corresponding concentration for 24 h. Morphology of cells was observed by inverted optical microscope. (2) Cells were divided into 0.5, 1.0, 5.0, 10.0, 50.0, 100.0, 500.0, 1 000.0 µg/mL putrescine groups, and control group, with 4 wells in each group. Cells in the putrescine groups were respectively cultured with complete culture solution containing putrescine in the corresponding concentration for 24 h, and cells in control group were cultured with complete culture solution with no additional putrescine for 24 h. Cell proliferation activity (denoted as absorption value) was measured by colorimetry. (3) Cells were divided (with one well in each group) and cultured as in experiment (2), and the migration ability was detected by transwell migration assay. (4) Cells were divided (with one flask in each group) and cultured as in experiment (2), and the cell apoptosis rate was determined by flow cytometer. Data were processed with one-way analysis of variance, Kruskal-Wallis test, and Dunnett test.

RESULTS(1) After 24-h culture, cell attachment was good in 500 µg/mL putrescine group, and no obvious change in the shape was observed; cell attachment was less in 1 000 µg/mL putrescine group and the cells were small and rounded; cells in 5 000 µg/mL putrescine group were in fragmentation without attachment. (2) The absorption values of cells in 0.5, 1.0, 5.0, 10.0, 50.0, 100.0, 500.0, 1 000.0 µg/mL putrescine groups, and control group were respectively 0.588 ± 0.055, 0.857 ± 0.031, 0.707 ± 0.031, 0.662 ± 0.023, 0.450 ± 0.019, 0.415 ± 0.014, 0.359 ± 0.020, 0.204 ± 0.030, and 0.447 ± 0.021, with statistically significant differences among them (χ(2) = 6.86, P = 0.009). The cell proliferation activity in 0.5, 1.0, 5.0, and 10.0 µg/mL putrescine groups was higher than that in control group (P < 0.05 or P < 0.01). The cell proliferation activity in 500.0 and 1 000.0 µg/mL putrescine groups was lower than that in control group (with P values below 0.01). The cell proliferation activity in 50.0 and 100.0 µg/mL putrescine groups was close to that in control group (with P values above 0.05). (3) There were statistically significant differences in the numbers of migrated cells between the putrescine groups and control group (F = 138.662, P < 0.001). The number of migrated cells was more in 1.0, 5.0, and 10.0 µg/mL putrescine groups than in control group (with P value below 0.01). The number of migrated cells was less in 500.0 and 1 000.0 µg/mL putrescine groups than in control group (with P value below 0.01). The number of migrated cells in 0.5, 50.0, and 100.0 µg/mL putrescine groups was close to that in control group (with P values above 0.05). (4) There were statistically significant differences in the apoptosis rate between the putrescine groups and control group (χ(2)=3.971, P=0.046). The cell apoptosis rate was lower in 0.5, 1.0, 5.0, and 10.0 µg/mL putrescine groups than in control group (with P values below 0.05). The cell apoptosis rate was higher in 500.0 and 1 000.0 µg/mL putrescine groups than in control group (with P values below 0.01). The cell apoptosis rates in 50.0 and 100.0 µg/mL putrescine groups were close to the cell apoptosis rate in control group (with P values above 0.05).

CONCLUSIONSLow concentration of putrescine can remarkably enhance the ability of proliferation and migration of HUVECs, while a high concentration of putrescine can obviously inhibit HUVECs proliferation and migration, and it induces apoptosis.

Apoptosis ; drug effects ; Biological Products ; Cell Line ; Cell Movement ; drug effects ; Cell Proliferation ; drug effects ; Cells, Cultured ; Flow Cytometry ; Human Umbilical Vein Endothelial Cells ; cytology ; drug effects ; Humans ; Putrescine ; administration & dosage ; adverse effects ; pharmacology ; physiology ; Skin ; cytology ; Wound Healing