Objective To observe the morphologic change in rats with pulmonary fibrosis induced by bleomycin through antisense-human tissue inhibitor of metalloproteinase-1(hTIMP-1)transfection.Methods Thirty rats were divided into five groups randomly(six rats in each group),namely,hTIMP-1 transfection group,anti-sense hTIMP-1 transfection group,empty retroviral vectors transfection group,pulmonary fibrosis group,and the normal group.On the 1st,3rd,7th,14th,28th,60th,90th day of BLM administration to the hTIMP-1,anti-sense hTIMP-1 and retroviral vectors transfection group,the hTIMP-1 cDNA retroviral vectors containing sense and anti-sense ones and the empty vectors were conducted into the lungs of rats with pulmonary fibrosis,which were sacrificed on the 28th days.The pulmonary fibrosis group was given just BLM for the same period of time.The rats in the normal control groups were sacrificed on the same day.Observe the role of anti-sense hTIMP-1 transfection and the change of hydroxyproline.Results The degree of fibrosis and content of HYP were extenuated by antisense hTIMP-1 transfection on 1st and 3rd day after BLM exposure compared with the same time of fibrosis and transfection by empty retroviral vectors group,morphologically.Conclusion Transfection with antisense-TIMP-1 on the first and third day can suppress the process of pulmonary fibrosis induced by BLM to some extent.

Objective To summarize the experience of harvesting and using the lungs from donation after citizens death.Method From November 2007 to December 2013,19 cases of potential donation after brain death (DBD) and donation after cardiac death (DCD) were evaluated,including 9 cases of DCD and 10 cases of DBD.All the patients received the tests of sputum culture,bedside bronchoscopes,chest X rays,and blood gas analysis.After clear evaluation,3 cases of DCD and 3 cases of DBD were discharged from the group for bilateral inflammatory infiltration and poor oxygenation index,and the rest one case of DCD was precluded due to long warm ischemic time (＞60 min).The donor lungs from remaining 12 cases were harvested successfully after the declaration of brain death or cardiac death.The donors suitable for the transplant procedure were transported to our transplant center.Result Twelve lung transplants were performed successfully,including 10 cases of bilateral lung transplantation and 2 cases of right single lung transplantation.Two patients was complicated with severe infection and died of sepsis postoperatively,and the remaining 10 patients all recovered uneventfully with dramatic improvement of pulmonary function.During the follow-up period,all the patients lived an active life style with high quality of life.The mean survival time was 34.7 months (4-60 months).Conclusion Lung transplantation using DCD and DBD can be successfully performed after adequate preoperative evaluation of donor lung and abundant preparation for donor harvesting.

Objective To investigate effect of hypothermia on coagulation function in major trauma patients and assess value of thromboelastography (TEG) monitoring.Methods Twenty-two patients with major trauma admitted to the emergency intensive care unit between January 2010 and June 2011 were enrolled in the study.The venous blood of the patients was sampled for TEG determination at different temperatures (37,35 and 33 ℃) to analyze variation of the indices including coagulation reaction time (R),clot formation time (K),rate of clot formation (Angle),maximum amplitude (MA)and coagulation index (CI).The patients were divided into normal coagulation group and abnormal coagulation group based on the CI value at 37 ℃ to analyze effects of temperature on TEG indices in both groups and their differences between groups.Results (1) Among 22 patients,TEG indices including R and K trended upward (P ＜ 0.01),but Angle,MA and CI trended downward (P ＜ 0.01) with decline of the temperatures.(2) K and Angle values,indicators of fibrinogen function,were obviously inhibited (P ＜ 0.05) with the temperature decreasing from 37 ℃ to 35 ℃,but other TEG indices had no significant changes.Whereas,all TEG indices were significantly inhibited when the temperature was decreased from 35 ℃ to 33 ℃.(3) There were significant differences in variation of each TEG index inhibited by hypothermia (P ＜ 0.01).All TEG indices showed significant differerces in the pairwise comparison,except for the differences between R and K as well as between Angle and MA (P ＜0.01).(4) R and K were increased,but Angle,MA and CI were decreased in both groups,with decline of the temperatures.Moreover,all TEG indices in the abnormal group were worse than those in the normal group.Conclusions Hypothermia has significant effect on coagulation function of patients with major trauma.TEG,which may be measured at any temperature,is more accurate in reflection of patients' actual coagulation function and is helpful for choice of an appropriate temperature in the mild hypothermia therapy.

10.3969/j.issn.2095-4344.2013.25.025

Telomere maintenance plays a critical role in cancer progression.Approximately 85% human cancer cells maintain their telomere length through activation of telomerase.Other 15%of cancers maintain telomere length independently of telom-erase by alternative lengthening of telomeres (ALT)pathway. Both events are equally important for telomere length mainte-nance of cancer cells.Human telomere consists of a series of G rich DNA sequences,which could form G-quadruplex.The for-mation of this structure can block the extension of telomeres by telomerase or ALT,resulting in cancer cell death.Thereby,G-quadruplex has been one of the focuses of anticancer therapy in recent years.This review focuses on the latest progress of G-quadruplex stabilizers.

Objective · To detect the vitamin D2 and D3 levels in the patients with moderate and severe depression. Methods · Eighty-five patientswho met the criteria for major depressive disorder were recruited (53 patients with moderate depression, 32 patients with severe depression). Fifty agematchedhealthy volunteers were recruited as controls. Serum 25 (OH) D2, 25 (OH) D3 and total 25 (OH) D2/D3 levels were detected by using liquidchromatography-tandem mass spectrometry (LC-MS/MS). The risk factors which might influence the severity of depression were screened by Logisticregression analysis. Results · The serum 25 (OH) D2, 25 (OH) D3 and total 25 (OH) D2/D3 levels in the case group was lower than those in the controlgroup (P=0.012, P=0.000, P=0.000). The patients with moderate depression presented significantly lower serum 25 (OH) D3 and total 25 (OH) D2/D3 levelsthan the controls did (P=0.000), although no significant difference in serum 25 (OH) D2 levels was found between these two groups. As well, the serum 25 (OH) D2, 25 (OH) D3 and total 25 (OH) D2/D3 levels in patients with severe depression were significantly lower than those in patients with moderate depression and controls (P<0.05). The body mass index of severe depression group was much higher than that of moderate depression group and control group (P=0.002). Both overweight/obesity and the concentration of vitamin D may be the major influencing factors of depression severity (P=0.034, P=0.011). Conclusion · Vitamin D2 and D3 deficiency in depressive patients, particularly in those patients with severe depression, was shown in the present study. In addition, overweight/obesity as well as the concentration of vitamin D may exert the significant influence on the severity of depression. Vitamin D supplementation and weight control may be needed to be considered in making therapeutic strategies of major depressive disorder.

ObjectiveTo systematically evaluate the efficacy and safety of glycyrrhizin in patients with chronic severe hepatitis B. MethodsLiterature published from January 1990 to July 2014 were searched in databases including PubMed, Cochrane Library, CBMdisc, CNKI, VIP, and Wanfang Data. The randomized controlled trials comparing the efficacy of glycyrrhizin combined with internal comprehensive therapy versus internal comprehensive therapy alone in patients with chronic severe hepatitis B were included in the analysis. The methodological quality of included trials was independently assessed and the data were extracted. Meta-analysis was carried out with Review Manager Software 5.1, and the heterogeneity, sensitivity, and bias of the analysis were evaluated. ResultsSeven randomized controlled trials involving 298 patients in the test group and 294 in the control group were included in the analysis. The results of meta-analysis showed that glycyrrhizin combined with internal comprehensive therapy was remarkably more effective than internal comprehensive therapy alone, indicated by significantly reduced mortality rate ［relative risk(RR)=0.56, 95% confidenceinterval(CI):0.42~0.76, P＜0.01］, significantly decreased level of total bilirubin (TBil) ［mean difference(MD)=-92.56, 95%CI:-122.92~-62.20, P＜0.01］, and significantly higher prothrombin activity (PTA) ［mean difference(MD)=11.14, 95% CI:5.40~16.87, P＜0.01］. No severe adverse reactions were found in all patients. ConclusionGlycyrrhizin can significantly reduce the mortality and improve TBil and PTA in patients with chronic severe hepatitis B.

Obstructive sleep apnea (OSA) may induce chronic intermittent hypoxia, which may lead to the disorders of multiple systems and organs and even sudden cardiac death in severe cases. Besides respiratory, cardiovascular, endocrine, and metabolic diseases, OSA is also closely associated with nonalcoholic fatty liver disease (NAFLD). This article briefly describes the current status of OSA and NAFLD, introduces the impact of OSA on NAFLD, and reviews the mechanisms of OSA in NAFLD. It is pointed out that clarifying the mechanisms of OSA in affecting NAFLD and discovering potential prevention and treatment targets for NAFLD from the aspect of OSA are of great significance in delaying and even blocking the progression of NAFLD.

Objective:To investigate the clinical efficacy of low-energy laser in the treatment of erosive oral lichen planus (OLP) and its effect on patients' pain.Methods:Eighty-six patients with erosive OLP who were treated in Shanxian Central Hospital from February 2018 to January 2020 were included in this study. They were randomly divided into control and observation groups ( n = 43/group). The control group was treated by local injection of dexamethasone, and the observation group was treated with semiconductor low-energy laser irradiation. All patients were treated for 8 weeks. Pain scores and physical sign score before and after treatment were evaluated in each group. Therapeutic effects were compared between the two groups. Area of lesion was measured in each group. Recurrence of erosive OLP was calculated at 3 and 6 months after surgery. Results:Before treatment, there were no significant differences in visual analogue scale (VAS) score and physical sign score between the two groups (both P > 0.05). At 7, 14, 28 and 56 days after treatment, VAS score and physical sign score were significantly decreased in each group compared with those before treatment, and VAS score and physical sign score in the observation group were significantly lower than those in the control group (all P < 0.05). Total response rate in the observation group was significantly higher than that in the control group [93.02% (40/43) vs. 83.72% (36/43), χ2 = 1.81, P > 0.05). Before and 1 month after treatment, there was no significant difference in area of lesion between control and observation groups (both P > 0.05). At 3 and 6 months after surgery, area of lesion in the observation group was (0.31 ± 0.14) cm 2 and (0.32 ± 0.12) cm 2, respectively, which were significantly smaller than those in the control group [(0.42 ± 0.18) cm 2, (0.48 ± 0.19) cm 2, t = 3.16, 4.67, both P < 0.05). At 3 and 6 months after treatment, recurrence of erosive OLP in the observation group was 2.33% (1/43) and 13.95% (6/43), respectively, which were significantly lower than those in the control group [13.95% (6/43), 37.21% (16/43), χ2 = 3.89, 6.11, both P < 0.05]. Conclusion:There is no significant difference in the short-term efficacy of low-energy laser versus conventional corticosteroids in the treatment of erosive OLP. However, low-energy laser has a more obvious short-term pain relief effect than conventional corticosteroids. It can accelerate the healing of injured tissue and decrease the recurrence rate of erosive OLP.

Objective:To investigate the value of transperineal ultrasound assessment of levator hiatal antero-posterior (LHap) diameter changes in the diagnosis of pelvic floor dysfunction.Methods:The clinical data of 246 patients with suspected pelvic floor dysfunction who received treatment in Yuyao People's Hospital of Zhejiang Province from October 2020 to June 2021 were retrospectively analyzed. All these patients underwent clinical examination and modified Oxford score (MOS) evaluation. They were divided into observation group (low pelvic floor muscle contractility) and control group (normal pelvic floor muscle contractility) according to MOS. All patients were subjected to ultrasound examination and LHap diameter measurement under three conditions (at rest, pelvic floor muscle contraction, and maximal Valsalva maneuver). The percentage of shortening of LHap diameter (PDC%) and the percentage of elongation of LHap diameter (PIV%) were calculated. The differences of PDC% and PIV% were compared between the observation and control groups. The receiver operating curve was used to evaluate the values of PDC% and PIV% in the diagnosis of pelvic floor dysfunction.Results:Age, body mass index, the proportion of parturient women among included patients, and the proportion of patients who underwent vaginal delivery were significantly higher in the observation group than those in the control group (all P < 0.001). LHap diameters measured when patients were at rest, pelvic floor muscle contraction, and maximal Valsalva maneuver as well as PIV% in the observation group were (45.23 ± 5.74) mm], (37.71 ± 8.44) mm, (51.03 ± 7.41) mm and (11.42 ± 4.79)%, respectively, which were significantly higher than those in the control group [(41.78 ± 4.56) mm, (29.15 ± 4.64) mm, (44.28 ± 4.87) mm, (6.05 ± 2.13)%, t = -4.62, -8.29, -7.26, -9.36, all P < 0.001]. PDC% in the observation group was significantly lower than that in the control group [(17.52 ± 5.58)% vs. (32.19 ± 4.27)%, t = 20.39, P < 0.001]. MOS was positively correlated with PDC% ( r = 0.56, P < 0.001) and it was negatively correlated with PIV% ( r = -0.49, P < 0.001). Taking PDC% < 35.36% as the cut-off value, the area under the receiver operating curve was 0.85, the sensitivity, specificity and accuracy values were 66.40%, 97.38%, and 73.90%, respectively. Taking PIV% > 5.18% as the cut-off value, the area under the curve was 0.70, and the sensitivity, specificity and accuracy values were 71.45%, 57.90% and 68.15%, respectively. When PDC% and PIV% were used together, the area under the curve was 0.73 and the sensitivity, specificity and accuracy values were 84.57%, 55.05% and 77.32%, respectively. Conclusion:Transperineal ultrasound assessment of LHap diameter changes are of certain value in the prediction of pelvic floor dysfunction and can provide objective and quantitative data support for clinicians to diagnose pelvic floor dysfunction. This study is highly innovative and scientific.