Objective To observe influence of auxiliary treatment of bronchoscopy alveolar lavage on respira-tory mechanics index and infection control effect in patients with severe ventilator associated pneumonia(VAP). Methods 84 cases of severe VAP patients were randomly divided into the observation group (n =42 cases)and con-trol group (n =42 cases),control group was given antibiotics and conventional sputum suction lavage treatment,the observation group was given bronchoscopy alveolar lavage and antibiotics.Clinical pulmonary infection score (CPIS) and serum calcitonin level (PTC)were recorded in the two groups before and after treatment.Respiratory mechanics indexes such as the dynamic compliance (Cdyn),the airway peak pressure (PIP),work of breathing (WOB)and airway resistance (Raw)were measured in the two groups before and after bronchoscopy alveolar lavage,and the clin-ical efficacy of two groups were compared.Results CPIS of the observation group (6.37 ±1.31),(5.42 ±1.13), (3.52 ±0.53)was significantly lower than that of the control group (7.72 ±1.56),(7.14 ±1.33),(5.13 ± 0.94)(t =4.295,6.387,5.821,all P <0.05 )after 3,5,7d treatment.PTC of the observation group ((4.71 ± 0.85)μg/L,(2.65 ±0.61 )μg/L,(0.62 ±0.23)μg/L)were significantly lower than those of the control group (5.10 ±0.92)μg/L,(3.96 ±0.72)μg/L,(1.31 ±0.43)μg/L(t =4.295,6.387,5.821,all P <0.05)after 3,5, 7d treatment.Cdyn of the observation group after 1 and 4h bronchoscopy alveolar lavage (35.39 ±6.39),(35.59 ±5.83)were high those of the control group (26.82 ±4.63),(25.64 ±4.28)(t =7.038,-10.462,all P <0.05);WOB (10.08 ±0.45),(8.10 ±0.38),PIP(21.28 ±2.76),(15.29 ±1.67)and Raw (10.08 ±0.45),(8.10 ± 0.38)in the observation group after 1and 4h bronchoscopy alveolar lavage were lower those in the control group WOB (0.63 ±0.17),(0.49 ±0.12),Raw(13.49 ±0.50),(11.42 ±0.42),PIP(27.38 ±3.10),(23.44 ±2.60)(1h:t =9.681,3.937,32.853,all P <0.05;4h:t =12.231,6.064,6.313,all P <0.05).Total effective rate of the obser-vation group was obviously higher than that of the control group after treatment (93.3% vs.77.8%,chi -square =5.486,P <0.05).Conclusion Auxiliary treatment of bronchoscopy alveolar lavage has clinical curative effect in patients with severe VAP,the method can effectively decreased PTC level of VAP patients,to acquire lung infection control,and improve the respiratory mechanics parameters.

Objective To study antidepressant effects of Epimedium brevicornum extracts.Methods(Behavioral) despair models of male mice,tails suspension test(TST),and forced swimming test(FST) were used to evaluate the effects of E.brevicornum extracts on behavioral,monoamine oxidas(MAOA) and monoamine oxidase B(MAO-B) activities in brain and liver tissue,and MDA level in liver tissue of mouse.Reserpine antagonistic model was also used to investigate possible antidepressant mechanisms of E.brevicornum extracts.Results The extracts of E.brevicornum(25,50, 100,and 200 mg/kg) significantly reduced the duration of murine immobility in TST and FST,inhibited MAO-A and MAO-B activities in brain and liver of mice,and reversed the elevated liver MDA level in mice in TST.There was no significant amelioration in the decreases of body temperature in mice of Reserpine antagonistic model.Conclusion(E.brevicornum) extracts possesses the definite antidepressant properties.

Objective To investigate changes in the intraocular pressure(IOP) and anterior chamber angle in patients with chronic renal failure before and after hemodialysis. Methods Fifty?eight patients(116 eyes) with chronic renal failure were measured with Goldmann applanation tonometer and anterior segment optical coherence tomograph. The patients were divided into three groups based on gonioscopy results:the narrow angle group(22 eyes),the Iris neovascular group(3 eyes)and the open angle group(91 eyes). IOP was measured by Goldmann applanation tonometer in patients in the three groups before and after hemodialysis. Anterior chamber angle opening distance (AOD) was detected by anterior segment optical coherence tomograph before and after hemodialysis. The blood urea nitrogen,creatinine,albumin were also determined before and after hemodialysis. All changes in the parameters were analyzed with a paired t test. Results The IOP in narrow angle eyes and in neovascular eyes increased significantly after hemodialysis ,while the IOP in open angle eyes showed no significant changes. The AOD decreased significantly after hemodialysis. The blood urea nitrogen and creatinine decreased significantly in 58 patients,while albumin increased after hemodialysis. Conclusion The IOP in narrow angle eyes and in neovascular eyes increased after hemodialysis ,correlating with the resistance increase of aqueous outflow pathway and the change of plasma osmotic pressure. As a result ,it is recommended that the condition of eye of patients with chronic renal failure should be checked ,and patients should receive appropriate controlling measure or treatment before hemodialysis.

AIM: To investigate the expression of the nephrin in podocyte of the diabetic nephropathy(DN) rats and the mechanism of irbesartan-induced renal protection.METHODS: The DN model was established by a single injection of streptozotocin(STZ),and DN rats were randomly divided into 2 groups: model group and irbesartan treatment group.In addition,the normal rats served as a normal control group. All the rats were received daily gavage respectively for 8 weeks. The urinary protein quality in 24 hours,body weight(BW),kidney weight (KW),KW/BW,glucemia,urea nitrogen,creatinine,total cholesterol, triacylglycerol were detected with correlative methods and the pathological changes of kidney were also detected with optic microscope and transmission electron microscope.The expression of nephrin in podocyte were detected by immunohistochemistry. RESULTS: In DN rats, irbesartan reduced the urinary protein quality in 24 hours (P

Objective To explore the characteristics and efficacy of manual treatment for postpartum hypogalactia.Methods To retrieve the CNKI from 2007 to 2017 on the massage and manual treatment for postpartum hypogalactia,and analyze its syndrome differentiation,acupoint selection,manipulation rules,treatment frequency,treatment courses and clinical efficacy.Results Among the 83 articles included,the massage therapy for postpartum hypogalactia were based on the diseases and syndromes,and the selection of acupoints was diverse and combined with local and distance such as Danzhong (CV 17),Rugen (ST 18),Shaoze (SI 1),Zusanli (ST 36),Pishu (BL 20).The therapy were rich in techniques which often use acupoint stimulation and manipulation.Conclusions Tuina therapy for postpartum hypogalactia is widely used with safety and reliablility.But the operational procedures and efficacy standards need to be further standardized.

The use of bariatric and metabolic surgery as a central treatment for obesity has been steadily increasing. BMI, as a widely used metric for assessing obesity, has considerable relevance in the field of metabolic research. However, its limitations, such as its inability to account for variations in fat distribution, remain a subject of considerable controversy. In recent years, there has been a surge of interest in the relationship between changes in body composition and the risk of metabolic disease. Consequently, the study of the effects of bariatric and metabolic surgery on changes in body composition has become a major focus of bariatric and metabolic surgery research. As a potential replacement for BMI, body composition measurements are expected to improve and standardize the assessment of the effectiveness of bariatric and metabolic surgery. This underscores the urgent need for the development of methods and standards for body composition measurement. This paper undertakes a comprehensive review of the existing evidence on the application of body composition measurement techniques for the efficacy evaluation of bariatric and metabolic surgery. The intent is to provide new insights and pave the way for the exploration of future research directions in this area.

The use of bariatric and metabolic surgery as a central treatment for obesity has been steadily increasing. BMI, as a widely used metric for assessing obesity, has considerable relevance in the field of metabolic research. However, its limitations, such as its inability to account for variations in fat distribution, remain a subject of considerable controversy. In recent years, there has been a surge of interest in the relationship between changes in body composition and the risk of metabolic disease. Consequently, the study of the effects of bariatric and metabolic surgery on changes in body composition has become a major focus of bariatric and metabolic surgery research. As a potential replacement for BMI, body composition measurements are expected to improve and standardize the assessment of the effectiveness of bariatric and metabolic surgery. This underscores the urgent need for the development of methods and standards for body composition measurement. This paper undertakes a comprehensive review of the existing evidence on the application of body composition measurement techniques for the efficacy evaluation of bariatric and metabolic surgery. The intent is to provide new insights and pave the way for the exploration of future research directions in this area.

OBJECTIVETo evaluate and compare the value of dynamic multiple pelvic angiography and pelvic four-contrast defecography in the diagnosis of functional defecation disorder.

METHODSFrom September 2014 to July 2015, a prospective controlled trial was carried out in Chengdu Anorectal Hospital. A total of 32 patients met the inclusion criteria of functional defecation disorder simultaneously underwent pelvic four-contrast defecography and dynamic multiple pelvic angiography. The diagnostic results of these two methods were compared.

RESULTSThe absolute values of anorectal angle and level of perineum, peritoneum and bladder from rest to defecation were (29.6±13.6)°, (26.2±14.2) mm, (55.5±25.6) mm and (28.9±16.5) mm in dynamic multiple pelvic angiography, and (24.6±5.8)° (18.7±10.6) mm, (34.5±18.4) mm and (19.2±11.8) mm in pelvic four-contrast defecography respectively, whose differences were statistically significant (P = 0.026, 0.022, 0.000, 0.011 respectively). The diagnostic rate of pelvic peritoneal hernia was 93.8%(30/32) and 68.8%(22/32) in dynamic multiple pelvic angiography and pelvic four-contrast defecography respectively with significant difference(P=0.011).

CONCLUSIONDynamic multiple pelvic angiography has significant advantage in the diagnosis of pelvic peritoneal hernia, and can provide a more objective basis for the diagnosis of functional defecation disorder.

Angiography ; methods ; Constipation ; diagnosis ; Defecation ; Defecography ; methods ; Humans ; Pelvis ; Perineum ; Prospective Studies

Objective To explore the mechanisms of mesenchymal stem cell-derived extracellu-lar vesicles(MSC-EVs)in improvement of renal injury in rats with diabetic nephropathy(DN)by reg-ulating mammalian target of rapamycin(mTOR)/p70 ribosome protein S6 kinase(S6K1)/coiled-coil myosin-like Bcl-2-interacting protein(Beclin 1)pathway.Methods The model of SD rats with DN was established by a method of high-fat diet combined with intraperitoneal injection of streptozotocin,and they were randomly divided into model group,MSC-EVs group,and MSC-EVs+MHY1485(mTOR activator)group,with 12 rats in each group.Another 12 SD rats were normally fed for 6 weeks and then intraperitoneally injected with an equal dose of sodium citrate solution as controls.After grouping with MSC-EVs and MHY1485,blood glucose and levels of renal function indicators[blood urea nitrogen(BUN),serum creatinine(Scr),and urinary microalbumin(UmALB)]in rats were detected.HE staining was used to detect the pathological morphology of renal tissue in rats of each group;immunohistochemistry was used to detect the expression of mTOR/S6K1/Beclin 1 pathway related proteins in the renal tissues of rats in each group;the Western blot was used to de-tect the mTOR/S6K1/Beclin 1 pathway and autophagy-related protein expression in the renal tissues of rats in each group.Results Compared with the control group,the renal tissue morphology of rats in the model group were impaired,and the blood glucose,BUN,Scr,UmALB,relative positive ex-pressions of p-mTOR and p-S6K1,p-mTOR/mTOR,p-S6K1/S6K1 increased significantly(P＜0.05),while microtubule associated protein 1A/1B light chain 3(LC3)Ⅱ/LC3 Ⅰ,expression of Beclin 1 protein,and relative positive expression of Beclin 1 significantly reduced(P＜0.05);compared with the model group,the MSC-EVs group had less impairment in the renal tissue mor-phology,and the blood glucose,BUN,Scr,UmALB,relative positive expressions of p-mTOR and p-S6K1,p-mTOR/mTOR,and p-S6K1/S6K1 decreased significantly(P＜0.05),while expression of LC3 Ⅱ/LC3 Ⅰ,Beclin 1 protein,and relative positive expression of Beclin 1 increased signifi-cantly(P＜0.05);compared with the MSC-EVs group,the impairment of the renal tissue morphol-ogy was worse in the MSC-EVs+MHY1485 group,and the blood glucose,BUN,Scr,UmALB,rel-ative positive expressions of p-mTOR and p-S6K1,expression of p-mTOR/mTOR,and p-S6K1/S6K1 increased significantly(P＜0.05),while the expression of LC3Ⅱ/LC3Ⅰ,Beclin 1 protein,and rela-tive positive expression of Beclin 1 decreased significantly(P＜0.05).Conclusion MSC-EVs can enhance autophagy,reduce levels of blood glucose,Scr,BUN and urinary protein in rats with DN,alleviate renal tissue damage,and the mechanism may be achieved by inhibiting the activation of the mTOR/S6K1/Beclin 1 pathway.

Objective:To investigate the expression of mucin-4 (MUC4) in meningiomas.Methods:Totally 258 cases of meningiomas and 165 cases of other brain tumors were collected from the First Affiliated Hospital of China University of Science and Technology (Anhui Provincial Hospital) from 2011 to 2017. MUC4, EMA, PR, SSTR-2 protein expression was detected by immunohistochemistry, and their expression in meningiomas and other tumor tissue was compared.Results:The 258 patients with meningioma included 85 males and 173 females, with a mean age of 69 years. Among the meningiomas, 192, 54 and 12 were WHO grades Ⅰ, Ⅱ and Ⅲ respectively. The overall expression rate of MUC4 in meningiomas was 67.8% (175/258), including 46/46 (100.0%) in meningothelial meningiomas, 3/3 in secretory meningiomas, 44/45 (97.8%) in angiomatous meningiomas, 37/41 (90.2%) in atypical meningiomas, 3/4 in metaplastic meningiomas, 2/3 in microcystic meningiomas, 7/11 in psammomatous meningiomas, 7/11 in chordoid meningiomas, 14/28 (50.0%) in transitional meningiomas, 1/2 in clear cell meningiomas, 1/2 in papillary meningiomas, 4/9 in anaplastic meningiomas, 7/52 (13.5%) in fibrous meningiomas, and 0/1 in rhabdoid meningiomas. In addition, MUC4 was expressed in 44 EMA negative meningiomas and in four SSTR-2 negative meningiomas. PR, EMA, SSTR-2 were expressed in 149 cases (57.7%), 173 cases (67.1%), 235 cases (91.1%) of meningiomas, respectively. MUC4 was not expressed in other tumors in the central nervous system, including schwannomas, neurofibromas, solitary fibrous tumors/hemangiopericytoma (SFT/HPC), hemangioblastoma, gliomas and ependymomas.Conclusion:MUC4 is widely expressed in meningiomas and has great value in distinguishing meningiomas from other non-meningeal epithelial tumorsof the central nervous system.