Objective To investigate the relationship between sarcoplasmic reticulum Ca2+modulation proteins and postresuscitation myocardial dysfunction. Methods Thirty-eight SPF male Sprague-Dawley (SD) rats were randomly divided into control group(n=12)and cardiac arrest(CA)group(n=26). CA was induced by intravenous bolus of potassium chloride(40μg/g),and cardiopulmonary resuscitation(CPR)was conducted 8 minutes later. No CA was induced in control group except catheter placement for monitoring cardiopulmonary parameters after anesthesia. Invasive hemodynamic parameters were monitored for 1 hour after CPR. Echocardiogram was performed to evaluate cardiac function. Myocardial samples were harvested 5 minutes and 1 hour after restoration of spontaneous circulation (ROSC),and sarcoplasmic reticulum Ca2+ ATPase (SERCA2a),phosphorylated phospholamban (p-PLB) and rynodine receptor(RyR)were determined by Western Blot. Results ROSC rate of CA group was 92.3%(24/26),and mean recovery time was (68 ±39)seconds. Cardiac function was significantly impaired in CA group at 1 hour after resuscitation, and ejection fraction, fraction shortening (FS), the maximal rate of left ventricular pressure increase/decline (±dp/dt max)were significantly decreased compared with those in control group 〔ejection fraction:0.548±0.060 vs. 0.809±0.043,F=71.692,P=0.000;FS:(34.4±4.4)%vs. (46.0±3.5)%,F=55.443,P=0.000;+dp/dt max(mmHg/s):4 718±743 vs. 7 098±394,P<0.01;-dp/dt max(mmHg/s):-3 824±612 vs.-6 187±473,P<0.01〕. Compared with control group,the expression levels of p-PLB (gray value)was significantly decreased at 5 minutes and 60 minutes(5 minutes:0.64±0.15 vs. 1.29±0.13,P<0.01;60 minutes:0.95±0.08 vs. 1.30±0.09,P<0.05)after resuscitation in CA group,while the level of sarcoplasmic SERCA2a(gray value)and RyR (gray value)showed no significant differences(SERCA2a 5 minutes:1.01±0.18 vs. 1.24±0.07,60 minutes:1.03± 0.14 vs. 1.25 ±0.06;RyR 5 minutes:0.96 ±0.13 vs. 0.97 ±0.13,60 minutes:0.88 ±0.14 vs. 0.99 ±0.11,all P>0.05). Conclusions The impairment of the p-PLB is closely related to postresuscitation myocardial dysfunction.

Objective:To explore the effect of diversified nursing rehabilitation exercise in patients with SchatzkerⅡtibial plateau fracture.Methods:From January 2018 to December 2018, a total of 72 patients with Schatzker Ⅱtibial plateau fractures in Wuzhou traditional Chinese medicine hospital were selected by cluster sampling method for study. All patients were treated surgically. 36 of them were included in the control group (routine functional exercise after operation) by random number table method, and the remaining 36 patients were included in the observation group (on the basis of the control group, multiple functional rehabilitation exercise mode was given).The length of hospital stay, knee joint swelling degree and movement angle at different time after operation, preoperative and postoperative Harris Hip Score (HSS) and satisfaction were analyzed.Results:The time of fracture healing and hospitalization in the observation group were (92.58±20.65) d, (8.40±2.32) d, shorter than (108.56±25.38) d, (15.86±2.80) d in the control group ( tvalues were 2.930, 12.309, P<0.05). At 2 weeks and 6 weeks after operation, the swelling degree of knee joint in the observation group was (1.42±0.58) cm and (0.52±0.25) cm, which was less than (1.86±0.62) cm and (0.78±0.34) cm of the control group, respectively, the difference between the two groups was statistically significant ( tvalues were 3.110, 3.697, P<0.05); there was no significant difference in HSS between the two groups ( P>0.05); the score of observation group was (62.36±6.85), (70.32±5.69) points, which was significantly higher than (58.42±6.02), (63.45±6.28) points of control group ( tvalues were 2.592, 4.864, P<0.05); there was no significant difference in HSS score between the two groups 6 months after operation ( P>0.05). The satisfaction of the observation group was 97.22% (35/36), which was higher than 83.33% (30/36) of the control group, and the difference between the two groups was statistically significant ( χ 2value was 3.956, P<0.05). Conclusion:For Schatzker type Ⅱ tibial plateau fracture patients, taking diversified nursing rehabilitation exercise can quickly relieve their limb swelling, promote the recovery of joint function and fracture healing, make them recover as soon as possible, and improve their satisfaction.

Neuroendoerine carcinoma of paranasal sinuses are rare malignant tumors, neuroendocrine carcinomas cases with the lesions at different sites differ in the prognosis, The key to improving the survival rate of the disease is early accurate diagnosis and complete surgical removal of the lesions.
Adult ; Carcinoma, Neuroendocrine ; Follow-Up Studies ; Humans ; Male ; Paranasal Sinus Neoplasms ; Sphenoid Sinus

Objective:To discuss what impact prone position ventilation (PPV) plays in treatment of acute respiratory distress syndrom (ARDS)originating from pulmonary disease(ARDSp) and extra-pulmonary disease(ARDSexp).Methods: Retrospective case-control cohorts study. Sixty patients with ARDS were included, were classified two groups which were originated from pulmonary disease(n=30) and extra-pulmonary disease(n=30), they were ventilated in PPV. And oxygenation of 0,2,4, and 6 hours in PPV, static compliance(Cst), airway resistance(Raw) of were evaluated. The Ultrasonic Cardiac Output Monitor was applied to monitor the cardiac function.Results:At 2 hours after ventilation in ARDSexp group, PaO2/FiO2 have been improved significantly. The longer duration of PPV seemed to be associated with continuous improvement and peaks at 4 hours. In ARDSexp group PaO2/FiO2 after ventilation at 3 hours exceeds the other groups. At 4 hours after ventilation, PaO2/FiO2 of both ARDSp and ARDSexp groups of PPV have been improved than that of supine position. After ventilation for 4 hours, the RAW of ARDSp decreases dramatically and considerably below the other groups.Conclusion: PPV was a safe and effective maneuver for improving oxygenation in patients with ARDSp and ARDSexp. Both ARDSp and ARDSexp clearly appear to benefit from PPV, particularly in ARDSexp group. PPV aslo influenced haemodynamics in patients rarely.

Objective To investigate the relationship between endothelial damage and p120-catenin (p120-ctn) in a model of paraquat intoxication,and the modulatory effect of mangiferin on p120-ctn.Methods Human umbilical vein endothelial cells (HUVECs) were cultured in two compartment spreading apparatus in vitro.The endothelial cells were divided into three groups:control group (cultured in DMEM with 10％ fetal bovine serum),paraquat group (paraquat was added to the medium with final concentration of 0.05 μmol/L) and mangiferin group (cultured in medium with addition of paraquat for 30 minutes,then mangiferin was added in a final concentration of 20 μmol/L).The cellular permeability at 6,12,24,48,72 hours after culture in the three groups was measured.The expressions of p120-ctn 1A,p120-ctn 3A mRNA and p120-ctn protein were measured by reverse transcription-polymerase chain reaction (RT-PCR) and Western Blot analysis.The distribution of p120-ctn protein was observed by immunofluorescence.Results Compared with control group,cellular permeability in paraquat and mangiferin groups were increased with prolongation of time,and peaked at 72 hours [(29.86 ± 3.98)％,(24.39 ± 2.79)％ vs.(11.71 ± 1.67)％,both P＜0.05].The cellular permeability was significantly lower in mangiferin group than that in paraquat group at different time points (all P＜0.05).At 6 hours after intoxication,the expressions of p120-ctn 1A,p 120-ctn 3A mRNA (gray value) and p 120-ctn protein (gray value) were significantly lower in paraquat group than those in control group (p120-ctn 1A mRNA:0.150 ± 0.024 vs.0.433 ± 0.024,p120-ctn 3A mRNA:0.316 ± 0.043 vs.0.701 ±0.020,p120-ctn protein:0.485 ±0.031 vs.0.763 ±0.038,all P＜0.01).The expressions of p120-ctn 1A,p120-ctn 3A mRNA and p120-ctn protein were significantly higher in mangiferin group than those in paraquat group from 6 hours on (p120-ctn 1A mRNA:0.281 ± 0.021 vs.0.150 ± 0.024,p120-ctn 3A mRNA:0.602 ± 0.042 vs.0.316 ± 0.043,p120-ctn protein:0.675 ± 0.031 vs.0.485 ± 0.031,all P＜0.01),and they were gradually increased with prolongation of time,and peaked at 72 hours (p120-ctn 1A mRNA:1.376 ±0.128 vs.0.150 ± 0.024,p120-ctn 3A mRNA:1.251 ± 0.059 vs.0.316 ± 0.043,p120-ctn protein:0.844 ± 0.050 vs.0.485 ± 0.031,all P＜ 0.01).Under upright fluorescence microscope,p120-ctn was mainly distributed in the cell membrane in control group,with a slight expression in cytoplasm,and no expression in the nuclei.With prolongation of time,p120-ctn expression in the cell membrane was gradually decreased in paraquat group,while it was increased in the cytoplasm and nuclei,with blurring of cell membrane and widening of cellular gap.p120-ctn expression was improved on the cell membrane in mangiferin group at corresponding time points,with decreased in expression in nuclei and cytoplasm.Conclusion The p120-ctn protein plays an important role in the enhancement of endothelial permeability in paraquat intoxication,and mangiferin may attenuate endothelial injury in paraquat intoxication possibly through modulation of p 120-ctn protein.

Objective To examine the relationship between hematocrit and risk of long term mortality among patients with acute myocardial infarction. Methods A total of 274 patients with acute myocardial infarction were recruited and divided into two groups by death after long term follow-up, the relationship between hematocrit and mortality was evaluated through the methods of independent t-test,chi-square test and multivariate regression analysis. Results The mean age was 69. 79 ± 7.45 years, with 73. 0% of male. The average of followup was 44. 4± 10. 7 months, with mortality of 38.7% . Comparison of baseline data showed that NYHA classification, smoking history, hemoglobin, hematocrit, mean red cell volume, glomerular filtration rate, ejection fraction,left ventricular diastolic diameter and right ventricular diameter was significantly different between the two groups( Ps ＜ 0. 05), Multivariable logistic analysis showed that hematocrit ,glomerular filtration rate, ejection fraction and smoking history were independently predicted factors, with OR of 0. 904 (95% CI: 0. 832 - 0. 982,P =0. 016) ,0. 983 (95% CI: 0. 969 -0. 996,P =0. 014) ,0. 932 (95% CI: 0. 887 -0. 979,P =0. 005) and 3. 230 (95% CI: 1.468 - 7. 106, P = 0. 004), respectively. The power of hematocrit to predict mortality was examined by ROC curves, the area under the curve was 0. 669(P ＜ 0. 001,95% CI: 0. 603 - 0. 736) Conclusion Hematocrit is a significant independent predictor for long term death among patients with acute myocardial infarction.

Objective To investigate the effect of insulin on D_5 dopamine receptor expression and function in renal proximal tubule (RPT).Methods Immortalized RPT cells and D_5 receptor transfected HEK293 (HEK-D_5) cells were used in the study to investigate the effect of insulin on D_5 receptor expression and function,and those effects were compared in RPT cells from Wistar-Kyoto (WKY) rats and spontaneously hypertensive rats (SHR). The function of D_5 receptor was determined by measurement of the Na~+-K~+-ATPase activity in HEK-D_5 cells. Results Insulin increased D_5 receptor protein expression in a concentration and time-dependent manner in WKY RPT cells,but not in SHR.The basal level of D_5 receptor expression was higher in WKY cells than that in SHR cells. Stimulation with fenoldopam(D_1-like dopamine receptor agonist) inhibited the Na~+-K~+-ATPase activity;pretreat- ment with insulin increased the inhibitory effect of fenoldopam on Na~+-K~+-ATPase activity in HEK-D_5 cells. Conclusion The abnormal regulation of insulin on D_5 receptor expression and function might be involved in the path- ogenesis of essential hypertension.

Objective To investigate the acoustic characteristics of snoring sound in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and with simple snoring. Methods 22 patients with OSAHS and 15 with simple snoring were included in this study. Natural overnight snoring was digitally recorded and portable sleep mo-nitoring was performed simultaneously. 10 snores, which were the 1st snores after 10 cycles of obstructive apnea, from each patient in OSAHS group, and 10 snores from each patient in simple snoring group were analyzed in the time and frequency domains. Results The sound waves of snoring in the two groups exhibited different patterns both in the time and frequency domains. The snoring spectrum of patients with simple snoring showed distinct fun-damental- harmonic structures which were not clear in patients with OSAHS. The central frequency of the patients with OSAHS was higher, and 800 Hz power ratio was lower than those of the patients with simple snoring. In the OSAHS group, the central frequency of the patients with moderate-to-severe OSAHS was higher, and 800 Hz power ratio was lower than those of the patients with mild OSAHS. The differences of the two parameters were of statistical significance. Conclusion The snoring sounds in patients with OSAHS and with simple snoring have dif-ferent characteristics in time and frequency domains, indicating that it is feasible to research the OSAHS by way of snore monitoring and analyzing technique.

Objective: Our aim was to study whether the cellular bronchoalveolar lavage fluid (BALF) profile was associated with the parameters of pulmonary function tests. Methods：Lung function tests and BAL were carried out in 18 untreated, non-smoking patients suffering from sarcoidosis and 18 normal subjects. Results：（1）Lung function tests were normal at rest in patients with sarcoidosis（P＞0.05）, the single breath carbon monoxide diffusing capacity decreased (P＜0.05)，and the small airway function decreased too (P＜0.05).（2）The percentage of lymphocytes in BALF of sarcoidosis increased comparing with the normal subjects（P＜0.01），and the ratio of CD+4 to CD+8 in BALF increased significantly in sarcoidosis（P ＜0.05）, furthermore, the increase of both the percentage of lymphocytes and the ratio of CD+4 to CD+8 in BALF of sarcoidosis were well nagatively correlated with the decrease of the percentage of DLCO (r=-0.67, P＜0.01 and r=-0.55, P＜0.05, respectively), the decrease of mid-expiratory flow at 50% of vital capacity (FEF50%) was well correlated with the increase of the percentage of lymphocytes in BALF of sarcoidosis (r=-0.54, P＜0.05). Conclusion：Pulmonary diffusing capacity（DLCO) was significently correlated with BALF lymphocyte phenotype，so was small airway function，and can act as the marker of activity of sarcoidosis.

Objective To explore the relationship of content of plasma endothelin(ET)-1 with the change of pulmonary function in patients with chronic obstructive pulmonary disease(COPD).Method Thirty cases of the normal people were as group A ,34 cases of the patients with COPD with acute exacerbation before treatment were as group B and the patients with remission period after treatment were as group C,the plasma ET-1,arterial blood gas and pulmonary function parameters were determined from the patients before and after treatment.Results The plasma ET-1 in group B and group C were significantly higher than that in group A,the content of the plasma ET-1 had negatively correlated with PaO2,and that had positively correlated with PaCO2,P＜0.01.The pulmonary function parameters (VC,FEV1/FVC,MVV,V50 V25)in group B were significantly lower than those in group A and group C[(55.3±24.5)%,(54.8±19.3)%,(54.2±16.2)%,(54,8±9,9)%,(58.7±14.5)%;(114.8±24.1)%,(84.9±21.6)%,(86.4±17.2)%,(78.5±14.8)%,(90.3±15.4)% and (110.1±19.4)%,(85.8±15.5)%,(85.9±16.7)%,(74.5±13.4)%,(89.4±18.6)%,respectively],P＜0.01.Conclusion Pathophysiological effects of patients with COPD can be commonly adjusted by the plasma ET-1,oxygen and carbon dioxide retention,which affect pulmonary function.