Objective To investigate the relationship between edema and aquaporin 4 (AQP4) within traumatic penumbra (TP) of rats with brain trauma.Methods Eighty-eight healthy adult Wistar rats were randomly divided into control group (n =11) and trauma group (n =77),according to the random number table.Trauma group were further subdivided into seven time points (1 h,6 h,12 h,24 h,48 h,72 h and 7 d) of 11 animals each.Brain tissue samples from the moderate brain models were collected to evaluate brain edema with histological observation,blood brain barrier (BBB) permeability with semiquantitative immunohistohemical staining of IgG,and AQP4 expression with immunofluorescence and Western blotting.Results In control group pathology and IgG staining revealed no abnormalities and expression of AQP4 was few.In trauma group light edema zone was visualized at 1 h,began widening,reached the peak at 12 h [(1.589 ±0.020)mm],and then began narrowing.There were significances in width of the edematous band at each time point except for the comparison at 24 h vs.48 h and 72 h vs.7 d (P ＜ 0.05).After trauma,vasogenic edema was found in edema zone at 1 h,intracellular edema was found at 6 h,both aggravated at 12 h and alleviated slightly at 24 h,and intracellular edema predominated at 48 h.IgG showed intensively positive staining at 1,12 and 48 h,and weak staining at 6 h,24 h,72 h and 7 d.After trauma,expression of AQP4 decreased at 1 h (0.659 ± 0.021),returned slightly at 6 h (1.257 ±0.058),peaked at 12 h (2.499 ±0.136),declined again at 24 h (2.267 ± 0.068),re-raised at 72 h (2.078 ± 0.065),and returned to the baseline at 7 d (1.280 ± 0.065).There were significant differences in level of AQP4 at each time point except for the comparison at6h vs.7 d,24 h vs.72 h and 24 h vs.72 h (P＜0.05).Conclusions In the early phase vasogenic edema characterized by BBB damage is significant within TP,which leads to decreased expression of AQP4.However,the subsequent up-regulation of AQP4 results in intracellular edema,which accelerate the spreading of TP.AQP4 may involve in body's defense reaction.

Objective To discussion of secondary intussusception in children based on ultrasound image,and the diagnosis and the therapeutic value.Methods 23 cases of secondary intussusception in children by the ultrasound image were reviewed and pathogeny analyzed.Results Within this 23 cases of secondary intussusception in children:8 cases in 23 cases were caused by Meckel di-verticulum,4 cases were caused by juvenile polyps,4 cases were caused by intestinal duplication,3 cases were caused by intestinal lymphoma,2 were caused by appendicitis,and 2 cases were caused by intestinal adhesion.And 23 cases of them were all detected by ultrasound at the very first time.22 cases of 23 cases was operated by hydrostatic enema of ultrasonic monitoring treating intussusception successfully,and 1 failed.13 cases were confirmed as secondary intussusception after first enema (Meckel di-verticulum 6 cases,juvenile polyps 3 cases,intestinal duplication 2 cases,intestinal lymphoma 1,and appendicitis 1 cases).9 cases were operated by hydrostatic enema of ultrasonic monitoring treating intussusception again when palindromia happened,which were confirmed as secondary intussusception (Meckel di-verticulum 2 cases,juvenile polyps 1 cases,intestinal duplication 2 cases,intestinal lymphoma 2 cases,appendicitis 1 cases,and intestinal adhesion 1 cases).Conclusion Meckel di-verticulum,juvenile polyps and intestinal duplication are the most common pathologic lead points caused the secondary intussusception in children.The diagnosis of ultrasound is sensitive to children secondary intussusception,and hydrostatic enema of ultrasonic monitoring treating intussusception can be operated under ultrasonic monitoring,which has an even better result than air enema under X-ray.The situation of bowel,which is full of 0.9％ sodium chloride solution,gives operators a good effect of visual to find pathologic lead points.And that really helps to provide valuable image in accordance with clinical surgery therapy of secondary intussusception.

OBJECTIVETo observe serum contents of granulocyte-macrophage colony-stimulating factor (GM-CSF) and granulocyte colony-stimulating factor (G-CSF) in mice with marrow inhibition before and after acupuncture and moxibustion treatment, so as to discuss the molecular biological mechanisms of acupuncture and moxibustion on improving marrow inhibition and increasing white cells after chemotherapy.

METHODSEighty clean-grade male Kunming mice were selected and randomly divided into a normal group, a model group, an acupuncture group and a moxibustion group according to the weight, 20 cases in each one. Mice in the model group, acupuncture group and moxibustion group were injected with cyclophosphamide (CTX) to establish mice models of marrow inhibition, while mice in the normal group received intraperitoneal injection of 0.9% NaCl. Four hours after model establishment, mice in the acupuncture group and moxibustion group were treated with acupuncture or moxibustion at "Dazhui" (GV 14), "Geshu" (BL 17), "Shenshu" (BL 23) and "Zusanli" (ST 36), respectively. Mice in the normal group and model group were immobilized without any treatment. All the treatment was given once a day for consecutive 5 days. Mice blood samples were collected from caudal vein. With manual examination, the white blood cells in peripheral blood were measured on each day from model establishment to end of treatment. Enzyme linked immunosorbent assay (ELISA) method was used to measure the serum contents of GM-CSF and G-CSF 3 days and 5 days after treatment.

RESULTSCompared with the normal group, the white cells in the model group were all reduced at each time point (all P<0.05), and the serum contents of GM-CSF and G-CSF were significantly reduced (all P<0.05). Three days after treatment, compared with the model group, the white cells in the acupuncture group and moxibustion group were increased, and the difference in acupuncture group was significant (P<0.05); the serum contents of GM-CSF and G-CSF were significantly lifted (P<0.05). Four days after treatment, compared with the model group, the white cells in the acupuncture group and moxibustion group were increased (both P<0.05). Five days after treatment, compared with the model group, the white cells in the acupuncture group and moxibustion group were increased and close to the normal level; the serum contents of GM-CSF and G-CSF were significantly lifted (all P<0.05).

CONCLUSIONThrough increasing serum contents of GM-CSF and G-CSF in CTX mice, acupuncture and moxibustion could prompt maturation and proliferation of myeloid hematopoietic cells, which is benefit to the reconstruction of hematopoietic function and relieve the marrow inhibition caused by CTX, and thus lift peripheral white blood cells.

Acupuncture Therapy ; Animals ; Bone Marrow ; drug effects ; Cyclophosphamide ; adverse effects ; Granulocyte Colony-Stimulating Factor ; blood ; Granulocyte-Macrophage Colony-Stimulating Factor ; blood ; Male ; Mice ; Moxibustion

A derivatization method for the determination of oligosaccharides with high sensitivity by matrix-assisted laser desorption/ionization-time of flight-mass spectrometry(MALDI-TOF-MS) based on a labeling regent 1-(4-Cyanophenyl)-4-piperidinecarbohydrazide(CPH) was proposed. The hydrazones were generated by the reaction of the reducing ends of oligosaccharides and the hydrazide of CPH. The derivatives were directly analyzed by MALDI-TOF-MS. Reaction conditions such as reaction temperature, concentration of acetic acid and excess ratio of CPH regent were optimized. When the oligosaccharides reacted with 100 time excess of CPH at 100 ℃ and in 0.125% acetic acid (V/V), the yield was highest. The results showed the derivatization with CPH increased the sensitivity of MS detection and this method was suitable for the analysis of oligosaccharides′ compositions.

Liver fibrosis is a major cause of morbidity and mor-tality worldwide which poses a great threat to public health. Con-siderable evidence suggests that the immune system is closely re-lated to the development of hepatic fibrosis especially the dendrit-ic cells ( DCs) . In recent years, many studies have showed that DCs play a key role in regulating the immune function of liver, which not only mediate the activation of the immune system and inflammation reaction in liver, but influence the occurrence and development of liver fibrosis. Further study has found that DCs exert different effects on liver fibrosis at different stages of the disease, and it exerts anti-fibrosis in early stages and recession period, while plays opposite effect in the middle of the disease. This article reviews the research progress of the role of DCs in liver fibrosis and discusses the underlying mechanisms of DCs in regulation of liver fibrosis, which may provide references for bas-ic and clinical studies of liver fibrosis.

Objective To evaluate image quality of 640-slice coronary CT angiography by combined anesthesia in Tibet minipigs. Methods Tibet minipigs underwent 640-slice coronary CT angiography after anesthesia with xylazine hydrochloride and pentobarbital sodium. The effect of anesthesia was observed and the image quality was evaluated.Results The anesthesia maintained in 40 minutes.The heart rate was (66.66±6.62)beat per minutes.The respiratory frequency was (15.62±1.53)beat per minutes.The revived time was 30 -60 minutes. All of images were good enough to be diagnosed.Conclusion Combined anesthesia with xylazine hydrochloride and pentobarbital sodium has excellent anesthetic effect.It is also simple,convenient and safe.Therefore,it is one of ideal anesthetic methods on such study for 640-slice coronary CT angiography in Tibet minipigs.

Objective To investigate the relationship between prothrombin fragment 1+2 (F1+2) and peripherally inserted central catheter (PICC) associated thrombosis in cervical cancer patients, and provide certain clinical basis of early prevention in peripherally inserted central catheter associated thrombosis in cervical cancer patients. Methods One hundred and forty cervical patients with PICC were enrolled in this study, and they were divided into thrombosis group (35 patients) and non-thrombosis group (105 patients). The level of F1+2 was examined using enzyme-linked immunoassay, and was analyzed according to the clinic features. Results The level of F1+2 was correlated with clinical stage (r = 0.640, P = 0.004);but was not correlated with age, type of tumor and concurrent radiochemotherapy (P>0.05). The level of F1+2 in thrombosis group was (520.343 ± 121.759) pmol/L, in non- thrombosis group was (388.361 ± 104.873) pmol/L, and there was significant difference (P =0.001). The multi-factors Logistic analysis showed that the level of F1+2 (OR=1.011, P=0.001) and age (OR = 21.025, P = 0.031) were independent risk factors for the PICC associated with thrombosis in cervical cancer. Conclusions The level of F1+2 is closely related with clinical stage and PICC associated thrombosis, and it is an independent risk factor for the PICC associated with thrombosis in cervical cancer.

Objective To determine the median effective dose (EDs0) of etomidate inducing electroencephalogram (EEG) burst suppression (BS) in the patients with non-intracranial diseases.Methods American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes,aged 18-64 yr,with body mass index of 19-27 kg/m2,scheduled for elective non-intracranial surgery,were enrolled in this study.ED50 of etomidate was determined by Dixon's up-and-down sequential method.Etomidate was intravenously injected for 30 s at an initial dose of 0.30 mg/kg.The BS ratio was recorded within 6 min following the end of injection.Each time ED50 increased/decreased in the next patient depending on whether or not BS occurred.The difference between the two successive doses was 0.05 mg/kg.Successful induction of BS was defined as BS ratio＞ 10％,lasting more than 1 min.Probit analysis was used to calculate the ED50 and 95％ confidence interval of etomidate inducing EEG BS in the patients with non-intracranial diseases.Results The ED50 of etomidate inducing EEG BS was 0.70 mg/kg,and the 95％ confidence interval was 0.65-0.81 mg/kg in the patients with non-intracranial diseases.Conclusion The ED50 of etomidate inducing EEG BS is 0.70 mg/kg in the patients with non-intracranial diseases.

Objective:To explore the application of perioperative nutrition management strategy in patients with hepatic cystic echinococcosis.Methods:From October 2017 to February 2019, 53 patients with hepatic cystic echinococcosis who met the inclusion criteria were selected as the control group. Another 53 patients from June 2018 to January 2019 were collected as the experimental group, the nutritional index, liver function, complication rate and postoperative recovery were compared between the two groups.Results:The levels of retinol-binding protein, prealbumin and transferrin were (24.32 ± 3.76) μg/L, (167.00 ± 24.12) mg/L, (2.08 ± 0.43) μg/L on the day of admission in the experimental group, and one day before the operation were (27.78± 4.98) μg/L, (245.00 ± 22.02) mg/L,(2.47 ± 0.54)μ g/L, there was no significant difference ( t=0.576-3.552, P < 0.05). The incidence of infection, biliary leakage and hemorrhage in the experimental group were 0, 1.89% (1/53) and 0 respectively, which were lower than 9.43% (5/53), 13.21% (7/53), 11.32% (6/53) in the control group ( χ2 value was 4.867, P < 0.05). The aspartate aminotransferase and alanine aminotransferase of the experimental group on the 7th day after operation were (51.50 ± 6.30), (29.54 ± 2.03) U/L, which were significantly different from (69.53 ± 7.07), (43.72±3.67) U/L of the control group ( t value was 2.032, 2.015, P<0.05). Anal exhaust, defecation time, hospitalization time and expenses in the experimental group were (15.89±8.34) h, (49.12±10.56) h, (8.69 ± 1.69) d, (2.84±1.37) thousand yuan, which were significantly different from (34.13±7.13) h, (63.45±11.03) h, (11.51±4.18) d, (3.76±1.53) thousand yuan in the control group. There was statistical significance ( t values were 3.372-12.592, P<0.05). Conclusions:The application of perioperative nutrition management strategy in patients with hepatic cystic echinococcosis can improve the nutritional status of patients during perioperative period, promote the recovery of liver function and reduce the occurrence of postoperative complications.

Objective:To evaluate the lung protection of pressure-controlled ventilation volume guaranteed (PCV-VG) in elderly patients undergoing laparoscopic surgery in Trendelenburg position.Methods:Sixty patients of American Society of Anesthesiologists physical status Ⅰ-Ⅲ, aged 65-80 yr, with body mass index of 19-27 kg/m 2, scheduled for elective laparoscopic radical prostatectomy or laparoscopic radical cystectomy, were allocated into 2 groups ( n=30 each) by a random number table method: VCV group (group V) and PCV-VG group (group P). Tracheal intubation was performed after induction of anesthesia.The anesthesia machine was connected to perform mechanical ventilation with tidal volume of 7 ml/kg (corrected body weight), positive end-expiratory pressure at 5 cmH 2O, inspiratory/expiratory ratio 1∶2, fraction of inspired oxygen 50%, fresh gas flow at 2 L/min and respiratory rate 12-15 breaths/min in two groups.Recruitment maneuver was performed with a pressure of 30 cmH 2O, lasting for 30 s, starting from 5 min before the end of administration.The airway peak pressure (P peak), airway plateau pressure (P plat), driving pressure (DP), and dynamic lung compliance (Cdyn) were measured at 5 min after intubation (T 1), 5 min after changing position (T 2), 5, 30, 60, 90 and 120 min of pneumoperitoneum (T 3-7) and 5 min after restoring the supine position and after the end of pneumoperitoneum (T 8). Blood samples were collected from the radial artery for blood gas analysis at T 1, T 4 and T 6 and when modified Aldrete score reached 10 in postanesthesia care unit, and pH value, partial pressure of arterial oxygen (PaO 2), partial pressure of arterial carbon dioxide (PaCO 2), arterial oxygen saturation (SaO 2) and alveolar-arterial oxygen gradient (P A-aO 2) were recorded.Blood samples were collected from the radial artery before induction of anesthesia and at the end of surgery for determination of concentrations of Clara cell protein (CC-16), interleukin-6 (IL-6) and neutrophil elastase (NE) in serum by enzyme-linked immunosorbent assay.The development of pulmonary complications was recorded within 7 days after surgery. Results:Compared with group V, P peak was significantly decreased at T 1-8, P plat and DP were decreased at T 5-7, Cdyn was increased at T 2-7, P A-aO 2 was decreased at T 1, 4, 6, serum CC-16, IL-6 and NE concentrations were decreased at the end of surgery ( P<0.05), and no significant change was found in the incidence of pulmonary complications within 7 days after surgery in group P ( P>0.05). Conclusion:PCV-VG can produce lung protection to some extent in elderly patients undergoing laparoscopic surgery in Trendelenburg position.