Objective To improve the digestion method of sewage samples for determing mercury with cold atomic absorption spectrometry.Methods 1+1 aqua fortis was used in microwave digestion of sewage samples instead of KMnO4-K2S2O8,then mercury was determined by cold atomic absorption spectrometry.Results The linear range was 0-10.0 ?g/L,the detection limit was 0.25 ?g/L,the relative standard deviation was less than 2.7% and the recovery rate was 95.0%-102.0%.It proved that the results by 1∶1 aqua fortis by microwave had high.Conclusion Compared with the KMnO4-K2S2O8 digestion method,microwave digestion method is simple,sensitive and suitable for determination of heavy metals in the environmental samples.

Objective:To investigate the effects of lipopolysaccharide (LPS)on the acute lung injury (ALI)and expressions of aquaporin 1 (AQP1)and aquaporin 5 (AQP5)in lung tissue of the rats. Methods:Forty-eight SPF grade male Wistar rats were randomly divided into control group and LPS group (n=24).The rats in LPS group were intravenously injected with LPS to induce ALI models,and the rats in control group were injected with saline. The rats were sacrificed at 2,6,12 and 24 h,and the samples were collected after the successful modeling.The pathological changes of lung tissue were observed with HE staining;the lung wet/dry weight (W/D)ratio and lung permeability index were detected;ELISA was used to detect the levels of TNF-αand MIP-1α.The expression levels of AQP1 and AQP5 protein and mRNA were measured by Western blotting,immunohistochemistry and Real-Time PCR methods. Results:Compared with control group, the TNF-α and MIP-1α levels in LPS group were significantly elevated at 2,6 and 12 h (P<0.05),and at 24 h they were gradually reduced to the normal level. The HE staining results showed the alveolar and interstitial edema at 2 h after LPS injection,obviously in 12 h. The lung W/D ratios and pulmonary permeability indexes at different time points in LPS group were significantly higher than those in control group (P<0.05),and they reached the peak at 12 h.The expression levels of AQP1 and AQP5 mRNA and protein in lung tissue of the rats at different time points in LPS group were significantly lower than those in control group (P<0.01 ). Conclusion:LPS can induce ALI in the rats and down-regulate the expressions of AQP1 and AQP5;LPS is involved in the formation of pulmonary edema.

ObjectiveTo investigate the correlation between disease severity,prognosis and blood serum thyroxine level in patients with severe pneumonia. MethodsBlood was obtained from 69 severe pneumonia patients to detect serum thyroxine level( T3 、FT3 、T4 、FT4 、rT3 and TSH),and patients were grouped according to APACHE Ⅱ score.Results APACHE Ⅱ score exhibits positive correlation with serum T3 ( r =0.46,P ＜ 0.01 ),FT3 ( r =0.44,P ＜ 0.01 ) and T4 ( r =0.29,P ＜ 0.05 ) levels,but have no correlation with FT4 and rT3 levels.Conclusion The changes of T3,FT3,T4 levels have correlation with disease severity in patients with severe pneumonia,the lower serum T3,T4,the more severe disease and more mortality.

Objective To assess the efficacy of oral erythromycin on the functional gastrointestinal dysmotility in neonates.Methods In this double-blind,randomized,placebo controlled trial,90 neonates consecutively admitted to the neonatal intensive care unit of Shenzhen Children's Hospital from Jan 2009 to Dec 2011 were enrolled and randomly divided into low-dosage erythromycin group ( LE group,n =30 ),highdosage erythromycin group ( HE group,n =30 ) and control group ( n =30).Patients received either erythromycin ( 3 mg/kg or 10 mg/kg) or equivalent normal saline with oral or nasal feeding every 8 hours one time for 14 d.The time to achieve half,three-quarters,and full enteral nutrition,the time of parenteral nutrition,and hospital length of stay were compared among each group.Results The time to achieve half,three-quarters,and full enteral nutrition in HE group [ ( 3.0 ± 0.5 ) d,( 6.2 ± 0.7 ) d,( 8.2 ± 1.0 ) d ] and in LE group [(6.2±0.5) d,(8.3 ±0.6) d,(10.6 ±1.1) d] were shorter than that in control group [(8.1 ±0.4) d,( 13.5 ± 1.0) d,( 15.7 ± 1.2) d] ( P ＜ 0.05 ).The duration of parenteral nutrition [ ( 14.2 ± 1.4) d vs (9.3 ± 1.2) d vs (7.8 ± 1.1 ) d ] and hospital length of stay [ ( 13.0 ± 1.4 ) d vs ( 8.1 ± 0.8 ) d vs ( 6.8 ±0.7) d] were significantly prolonged in control group compared with LE and HE groups,and there were significant differences among the three groups ( P ＜ 0.05).The incidence of liver injury and septicemia during the treatment of erythromycin were similar between HE group and LE group,but it was significantly lower than control group.No serious adverse effect such as prolongation of QT intervals,dysrhythmia associated with erythromycin treatment was found.Conclusion Oral erythromycin can be considered as a treatment for neonates with functional gastrointestinal dysmotility who fail to establish adequate enteral nutrition,and highdosage oral erythromycin is more effective than low-dosage.

Purpose:To investigate the possible causes, diagnosis, and treatment of functional delayed gastric emptying (FDGE) after colonic operation.Methods:The clinical data of 6 patients with coon cancer from 1995 to 2000 were retrospectively analysed.Results:FDGE occurred in all of the 6 patients 4 to 6 days after surgery and the clinical symptoms disppeared gradually with medical therapy.Conclusions:The causes of FDGE are due to many factors such as mental stress, asleep, inutration, low albumine, ertent of lymphadectomy and the combined organ resection. An upper gastrointestional radiography is the main method of diagnosis of FDGE and gastrointestinal motility can return spontaneously after a long period of medical therapy with some prokinetic drugs. [

Objective To investigate the clinical therapeutic effect of Xuebijing injection for treatment of patients with diabetic nephropathy(DN)and its mechanism. Methods 60 DN patients were randomly divided into Xuebijing group and control group(each,30 cases). The patients in both groups received western conventional treatment,and the patients in Xuebijing group received additionally Xuebijing injection intra-venous injection once a day for 14 days. The fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),urinary albumin excretion rate(AER),blood urea nitrogen(BUN),serum creatinine(SCr),hematocrit(HCT),fibrinogen(Fg),whole blood viscosity,total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)and interleukin -6(IL-6),tumor necrosis factor-α(TNF-α)and urine β2-microglobulin(β2-MG)levels before and after treatment were detected,and the curative effect was also observed in both groups. Results In the control group blood FBG,BUN,SCr,TC,IL-6 and TNF-αafter treatment were significantly decreased and HDL-C significantly increased compared with those before treatment(all P<0.05). Compared with those before treatment,in Xuebijing group after Xuebijing therapy,blood FBG,β2-MG,AER,BUN, SCr,TC,TG,HCT,blood viscosity,IL-6 and TNF-αwere significantly decreased,and HDL-C was obviously increased,but there were no significant differences in HbA1c,LDL-C and Fg before and after treatment. The above indexes were changed significantly in Xuebijing group compared with those in control group〔FBG(μg/L):6.98±1.14 vs. 9.73±1.62,β2-MG(μg/L):32.1±10.9 vs. 57.2±15.1,AER(μg/min):86.0±28.1 vs. 152.0±51.6,BUN (mmol/L):12.4±8.1 vs. 19.5±8.9,SCr(μmol/L):301.2±151.9 vs. 371.3±168.6,HCT:0.283±0.075 vs. 0.351±0.059,TC(mmol/L):3.4±1.8 vs. 4.1±1.5,TG(mmol/L):3.4±1.5 vs. 3.6±1.7,HDL-C(mmol/L):1.90±0.75 vs. 1.50±0.25, IL-6 (ng/L):8.96±2.07 vs. 12.75±2.47, TNF-α(pmol/L):17.85±4.75 vs. 20.87±4.90,P<0.05 or P<0.01〕. The total efficiency in Xuebijing group was significantly higher than that in control group(83.3%vs. 36.7%,P<0.01). Conclusion Xuebijing injection has significant protective effects on patients with DN,and the mechanism might be associated with increasing tissue perfusion and inhibiting excessive inflammatory cytokines release.

Objective:To explore the feasibility and safety of long-term home mechanical ventilation(HMV) in children with chronic respiratory failure.Methods:Clinical data of 11 children with chronic respiratory failure, who underwent HMV with the care of the First Affiliated Hospital of Xiamen University from January 2013 to December 2019, were retrospectively reviewed. The clinical manifestation, growth and development, quality of life, adverse events and prognosis of HMV children were analyzed.Results:There were 8 boys and 3 girls with the onset age of 26 days to 13 years old; and the age at starting HMV was 3 months to 13 years old. Eight children were diagnosed as neuromuscular diseases, and 3 children were diagnosed as respiratory diseases. The duration of institutional mechanical ventilation was 2 weeks to 8 months. Six patients underwent invasive HMV via a tracheostomy, and 5 received non-invasive ventilation via nasal and face masks. Bi-level positive airway pressure ventilation mode was applied in all the patients. The duration of HMV was 3 months to 27 months. During follow-up, no HMV related adverse events were observed. Both the quality of life and nutritional status were improved in all cases. One patient lost follow-up 9 months later and 1 patient died of severe adenovirus pneumonia during hospitalization for examination, the remaining 9 cases survived. Liberation from HMV was obtained in 4 patients. The frequency of readmission was 1 to 2 times.Conclusion:It is suggested that long-term HMV is safe and feasible for children with chronic respiratory failure.

Objective To investigate the effects of ketogenic diet ( KD) treatment on helper T cell subsets in children with intractable epilepsy( IP) . Methods Thirty-five children with IP and eighteen age-matched healthy subjects were enrolled in this study.The percentages of CD3+CD8-IFN-γ+( Th1 ) cells, CD3+CD8-IL-17A+(Th17) cells and CD4+CD25+Foxp3+(Treg) cells were analyzed by flow cytometry.Re-al-time PCR assay was performed to evaluate the expression of T-bet, ROR-γ, IFN-γ, IL-17A and peroxi-some proliferator activated receptorγ( PPAR-γ) at mRNA level in CD4+CD25-T cells and the transcription-al levels of Foxp3, GITR, CTLA-4 and PPAR-γin CD4+CD25+T cells.The concentrations of cyclooxygen-ases-2 (COX-2) and prostaglandin F2a (PGF2α) in plasma samples were measured by enzyme-linked im-munosorbent assay.The expression of IL-17A and IFN-γin plasma samples were detected by using cytomet-ricbeadarray(CBA).Results (1)ThepercentagesofTregcellsinperipheralbloodsamplesfrompa-tients with IP were lower than those in healthy subjects (P<0.05), which were significantly increased with the treatment of KD (P<0.05).The percentages of Th17 and Th1 cells in patients with IP were significantly higher than those in healthy children (P<0.05), but were remarkably decreased with the treatment of KD (P<0.05).Patients with IP showed decreased transcriptional levels of Foxp3, GITR and CTLA-4 in CD4+CD25+T cells as compared with healthy controls, but were up-regulated with the treatment of KD.The ex-pression of transcription factors including T-bet, ROR-γ, IFN-γand IL-17A in CD4+CD25-T cells in pa-tients with IP were higher than those in healthy subjects and were down-regulated after the treatment of KD (P<0.05).(2) The expression of PPAR-γat mRNA level in CD4+CD25-T and CD4+CD25+T cells were decreased in patients with IP as compared with those in heathy controls, but were increased after the treat-ment of KD (P<0.05).Correlation analysis showed that Treg cells had a positive correlation with PPAR-γ(r=0.61, P<0.05).However, the Th1 and Th17 cells were negatively correlated with PPAR-γ[Th1 (r=-0.54, P<0.05), Th17 (r=-0.64, P<0.05) ].(3) The levels of IL-17A and IFN-γin patients with IP were higher than those in healthy controls, but were decreased with KD treatment (P<0.05).The levels of COX-2 and PGF2αin plasma samples from patients with IP were higher than those in healthy controls ( P<0.05).A negative correlation was observed between COX-2 and PPAR-γ(r=-0.571, P<0.05). Moreover, PGF2αand PPAR-γhad a negative correlation as well (r=-0.586, P<0.05).Conclusion The treatment of KD might enhance the expression of PPAR-γthrough inhibiting the products of oxidative stress such as COX-2 and PGF2α, resulting in the rebalance of Th cell subsets and reduced expression of in-flammatory cytokines.

Objective To explore the impact of ketogenic diet (KD) on follicular helper T cells(TFH) in children with intractable epilepsy.Methods Thirty-three cases with intractable epilepsy were selected between Jul.2013 and Jan.2014 in Shenzhen Children's Hospital,19 boys and 14 girls; average age was 39.6 months,and seventeen age-matched healthy children who took a physical examination in the same hospital were assigned as the healthy control group.Blood samples were collected from the children with refractory epilepsy before and after 1 week of KD treatment.The proportions of the various stages of B cells and TFH cells were detected by flow cytometry.The plasma concentration of interleukin-21 (IL-21) was determined by enzyme-linked immunosorbent assay(ELISA),and realtime quantitative PCR(RT-PCR) was performed to detect the levels of peroxisome proliferator-activated receptor gamma (PPAR-γ),B-lymphocyte-induced maturation protein-1 (Blimp-1),B-cell lymphoma 6 (Bcl6) and IL-21 mRNA expression in CD4 + T cells.Results (1) The number of TFH cells in children with intractable epilepsy [(3.57 ± 0.58) ％] was remarkably decreased after KD treatment(P ＜ 0.01),while there were no difference between after KD treatment and healthy control group[(4.93 ±0.70)％ vs (5.03 ±0.63)％,P ＞0.05].(2) The levels of transcription factor Bcl6 expression after treatment were significantly decreased,while inhibitory factor Blimp-1 expression increased (P ＜ 0.05).(3)The plasma concentration of IL-21 had a trend to decrease (P ＞ 0.05),while there were no difference before and after KD treatment,and levels of IL-21 mRNA expressions in CD4 +T cells were significantly decreased after the treatment (8.28 × 10-3 ± 1.19 × 10-3 vs 1.72 × 10-2 ± 0.81 × 10-2,t =3.08,P ＜ 0.05).(4) There was no significant difference in CD27-IgD + B cells before and after KD treatment (P ＞ 0.05),CD27 + IgD + B cell and CD27-IgD-B cells had a trend to decrease after KD treatment(P ＞0.05),and CD27 + IgD-B cells and CD27 + IgD-CD38 high plasma cells were significantly decreased after KD treatment (P ＜ 0.05).(5) The number of TFH cells were correlated positively with the number of CD27 + IgD-B cells and CD27 + IgD-CD3g high plasma cells (r =0.785,0.745,P ＜ 0.05).(6) The levels of PPAR-γmRNA in CD4 + T cells expression were significantly up-regulated after KD treatment (3.49 × 10-3 ± 1.10 × 10-3 vs 2.28 ± 10-3 ± 1.30 × 10-3,t =3.41,P ＜0.05),and the number of TFH cells and PPAR-γgene expression was correlated negatively (r =-0.619,P ＜ 0.05).Conclusions KD might down regulate TFH cell number and function through inducing PPAR-γexpression and could inhibit B cell differentiation,which might be one of the factors for hypogammaglobuinemia by KD treatment.

BACKGROUND: Intrapulmonary vascular abnormalities result in the right-to-left shunting and severe hypoxemia in liver transplantation candidates. Currently, a convenient, sensitive and effective method is absent to screen the intrapulmonary vascular dilatations.OBJECTIVE: To evaluate the role of contrast-enhanced echocardiography on clinical diagnosis of intrapulmonary shunting in liver transplantation candidates.DESIGN, TIME AND SETTING: The experiment, prospective controlled observation based on cases, was performed at the Hepatology Unit of the 458 Hospital of PLA (Guangzhou, Guangdong, China) from February 2004 to February 2006.PARTICIPANTS: Twenty-four consecutive liver transplantation candidates were recruited from the Hepatology Unit of the 458Hospital of PLA.METHODS: Routine examination was conducted under the condition without any regimen of vascular dilatation drugs.Contrast-enhanced echocardiography was applied to detect the prevalence of right-to-left shunting in the patients with end-stage liver disease. The microvesicle of the left ventricle in patients was qualitatively assessed by a score from 1+ to 3+. Accordingly, all patients were divided into two groups: intrapulmonary shunting and non-intrapulmonary shunting.MAIN OUTCOME MEASURES: The prevalence of right-to-left shunting and clinical characteristics of liver transplantation candidates were determined.RESULTS: Ten (41.7%) of 24 patients with positive contrast-enhanced echocardiography were proved to develop the intrapulmonary right-to-left shunting, including 6 for l+ and 4 for 2+ by left ventricle abnormality, which emerged after 6-10 cardiac cycles of right ventricle abnormality. There were no significant differences in age, gender, arterial blood gas analysis and liver function tests between the two groups (P > 0.05). Echocardiography results demonstrated that, the upper digestive tract hemorrhage,spleen thickness that indicated portal hypertension, pulmonary artery systolic pressure and Tei index were significandy higher in the patients of intrapulmonary shunting than in those of non-intrapulmonary shunting (P<0.05-0.01 ).CONCLUSION: Intrapulmonary vascular dilatation occurs frequently in liver transplantation candidates associated with intrapulmonary shunting but without hypoxemia. Contrast-enhanced echocardiography is a sensitive and non-invasive method for the early diagnosis of intrapulmonary vascular dilatation. The pathogenic cause is portal hypertension. Tel index can be used as an important parameter for evaluating right ventricular function in patients of intrapulmonary vascular dilatation.