Objective To develop a smoke inhalation unit simulating airtight cabin.Methods We designed a completed smoke inhalation unit composed of smoke generation cabinet,circulation pipe line and inhalation cabinet.The unit was verified with 42 SD rats inhaled with smoke generated from combustion of 9 nonmetal materials used in a airtight cabin.The rats were randomly divided into experimental group and 5 inhalation groups,with 7 rats in each group.The concentrations of CO,O2 and acid gases in the inhalation cabinet were analyzed.The activities and mortality of the rats within 7 d were recorded.COHb% of 21 rats in ten-minute inhalation groups was detected quickly after exposure.Results The concentration of smoke increased with the time of combustion and kept constant on each time point.The degree of intoxication in rats increased with the time of inhalation,and COHb% of ten-minute inhalation groups showed good reproducibility.Conclusion Our developed unit can simulate the smoke generation and intoxication in airtight cabin and keep good reproducibility of animal injury.

Mesenchymal chondrosarcoma originated in the primitive mesenchymal tissue .It usually devel-ops in the short bones such as hand ,foot and body bone ,while extremeIy rare in the orbit .We report a case of mesenchymal chondrosarcoma of the orbit which is confirmed by pathology .

event and treat circular,respiratory and renal insufficiency.

Object To study the effect of puerarin on the expression of inflammatory factors and miR-155-3p in human umbilical vein endothelial cells ( HUVEC) induced by visfatin.Methods The HUVEC cell injury model was es-tablished with visfatin.Cell proliferation was measured by MTT assay.Cell apoptosis was detected by flow cytometry.The level of CRP and NF-κB was detected by ELISA, and the expression of miR-155-3p was detected by RT-PCR.The expres-sion of myeloid differentiation factor 88 ( MyD88) was identified by western blotting.Results Visfatin induced cell prolif-eration and inhibited apoptosis in HUVEC, meanwhile the expressions of both CRP and NF-κB were significantly increased, compared with that of the control group (P<0.01).Puerarin at moderate and high concentrations obviously reduced the HUVEC injury induced by visfatin, mainly through down-regulating the expression of CRP and NF-κB, as well as up-regu-lating the level of miR-155-3p in the HUVEC.MiR-155-3p mimic markedly decreased the level of MyD88, CRP and NF-κB in the HUVEC induced by visfatin (P<0.05).Conclusions Pueprarin obviously alleviates HUVEC injury induced by visfatin, probably related to down-regulating the level of MyD88, CRP, NF-κB, and up-regulating the expression of miR-155-3p in HUVEC.

Background:Intestinal metaplasia(IM)and dysplasia in Barrett’s esophagus(BE)can be detected by endoscopic biopsy combined with pathological examination. Aims:To evaluate the efficacy of acetic acid stain-guided biopsies in detection of IM and dysplasia in BE under standard endoscopy. Methods:One hundred patients found to have columnar-lined esophagus by endoscopy from January 2012 to November 2014 at Shanghai Jing’an District Central Hospital were enrolled. Under standard endoscopy,acetic acid was sprayed and multi-point biopsies were performed in visible abnormal regions. This was followed by four-quadrant biopsies at every 1 to 2 cm of the remaining BE segments. Detection rates of columnar epithelium,IM and dysplasia were compared between acetic acid stain-guided biopsies and four-quadrant biopsies. Results:A total of 96 patients were diagnosed as BE. Detection rates of columnar epithelium by acetic acid stain-guided biopsies and four-quadrant biopsies were 96. 9%(93 / 96)and 90. 6% (87 / 96),respectively,no significant difference was found between the two methods(McNemar test,P = 0. 146),however,consistency of the two methods was poor(κ = 0. 340). A total of 32 patients were diagnosed as BE with IM. Detection rates of IM by acetic acid stain-guided biopsies and four-quadrant biopsies were 84. 4%(27 / 32)and 40. 6%(13 / 32),respectively,difference in detection rate between the two methods was significant(McNemar test,P = 0. 007),and consistency of the two methods was poor(κ =0. 266). Five cases of low-grade dysplasia were detected by acetic acid stain-guided biopsies only. Conclusions:Acetic acid stain-guided biopsies can detect BE with IM and dysplasia better than four-quadrant biopsies.

Objective To investigate the clinical characteristics,pathogenic causes and treatment outcomes of acute kidney injury (AKI) in very old patients in order to improving the diagnosis and treatment.Methods 39 AKI patients aged ≥80 years in the department of geriatric medicine of our hospital were enrolled and followed up for 3 months.Clinical and laboratory data were analyzed and the pathogenic causes as well as the treatment outcomes were summarized.Results Among the 39 very old patients,31(79.5％) were male,8(20.5％) were female,and the mean age was (93.5±4.6) years.33 (84.6％)patients had chronic kidney diseases.The pathogenic causes of AKI were mainly as follows:urological infections (71.8％),blood volume deficiency (48.7％),cardiac dysfunction (23.1％) and hypotension (15.4％).2 to 4 pathogenic causes were co present in 64.1％ patients.Renal function was improved and recovered in 69.2 ％ patients and the death rate was 25.6％ after treatment.The main causes of death were septic shock (30.0％),multiple organ failure (20.0％),massive gastrointestinal hemorrhage (20.0％) et al.Conclusions Most of the very old patients may suffer from AKI on the basis of chronic kidney disease.AKI is often induced by multiple pathogenic causes.The main factors leading to AKI are urological infections,followed by blood volume deficiency and cardiac dysfunction.Most patients with AKI can recover after the precipitating factors are removed and supportive treatments are administered in time.Septic shock is the main cause of death.

Objective To study the MRI features of pituitary lesions in children with short stature caused by growth hormone de-ficiency.Methods The MRI findings of clinical and pathological confirmed pituitary lesions in 40 children were retrospectively re-viewed.All cases had 3.0T MRI examination.Results The pituitary lesions included hypoplasia of antehypophysis (25 cases),pitu-itary stalk interruption syndrome (3 cases),pituitary atrophy after craniopharyngioma excision (2 cases)and pituitary hyperplasia (10 cases).MRI of antehypophysis hypoplasia showed that the height of antehypophysis was less than normal.Pituitary stalk inter-ruption syndrome showed not only hypoplasia of antehypophysis,but also absence or marked thinning of pituitary stalk and ectopic bright signal of posterior pituitary lobe on T1 WI.Atrophy of the pituitary was seen after resection of craniopharyngioma,and the stalk was unclear.All of the pituitary hyperplasia were caused by hypothyroidism.MRI of pituitary hyperplasia displayed antehy-pophysis enlargement and upward apophysis symmetrically.There were no pituitary stalk interruption,translocation and abnormal signal.The pituitary hyperplasia had obvious homogeneous enhancement.Pituitary gland reduced in size after replacement therapy. Conclusion MRI can show the features of pituitary lesions in children with short stature caused by growth hormone deficiency clear-ly.Correct diagnosis can be made and the therapeutic effect can be monitored combining with clinical manifestation.

Objective To study the changes of mRNA and protein expressions of Kras gene in thymic lymphomas induced by ionizing radiation,and to detect the methylation of CpG islands in promoter region of Kras gene,then to investigate the mechanisms for the occurrence of radiation carcinogenesis.Methods The thymic lymphoma models of BALB/c mice were made by X-ray irradiation,then the total RNA was extracted,cDNA was synthesized and the total protein was extracted from both thymic lymphoma tissue and normal thymus tissue;the mRNA and protein expressions of Kras gene in thymic lymphoma tissue and normal thymus tissue were detected by RT-PCR and Western blotting method, and the methylation of CpG islands in promoter region of Kras gene was detected by bisulfite sequencing PCR. Results The mRNA expression level of Kras gene in thymic lymphoma tissue was significantly higher than that in normal thymus tissue(P<0.01).The protein expression level in thymic lymphoma tissue was about 1.41 times higher than that in normal thymus tissue;4 CpG sites were methylated detected by bisulfite sequencing PCR in normal thymus tissue, however, 1 CpG site was methylated in thymic lymphoma tissue,the CpG islands in promoter region of Kras gene were demethylation state in thymic lymphoma. Conclusion Ionizing radiation can cause the changes of mRNA and protein expression levels of Kras gene in thymic lymphoma tissue by demethylation state of Kras gene,eventually lead to the occurrence of tumor;it might be one of the mechanisms for the occurrence of radiation carcinogenesis.

25 mmHg) had no response to conservative management, and,therefore,had to be decompressed by invasive procedure,including 6 patients performed by decompression laparotomy,2 patients by laparoscopic decompression and 5 patients by ultrasound/computed tomography location and needle paracentesis drainage.These 13 ACS patients had obvious amelioration in physiological variables (hemodynamic,respiratory and tissue perfusion) after 24 hour post-decompression (P

Objective: To explore the prognostic capacity of RALE scoring system in children with hematologic malignancies complicated with acute respiratory distress syndrome (ARDS). Methods: The clinical data were retrospectively analyzed of 57 ARDS child patients complicated with hematologic malignancies in pediatric intensive care unit (PICU) from Jan. 2014 to Jun. 2018. According to the therapeutic outcome within 28 days, they were divided into survival group (n=23) and non-survival group (n=34). The clinical features of the two groups were compared, and the relativity between RALE score and oxygenation index (P/F value) and the prognostic capacity of RALE score for ARDS were analyzed. Results: For the 57 child patients, the D1 P/F value was lower in non-survival group [116.0(70.0, 192.0)] than in the survival group [189.5(136.5, 251.3)], while the D1 pedicatic risk of mortality score (PRISM) HI, D1 RALE score and D3-D1 RALE score were higher in non-survival group [10.0(8.0, 16.0), 27.0(25.0, 37.0) and 5(0, 8), respectively] than in the survival group [7.6(4.0, 13.4), 24.0(13.8, 35.3) and -3.5(-7, 1), respectively]. The D1 RALE score was negatively correlated with the D1 P/F value (r=-0.831, P<0.001). A larger value of D3-D1 RALE score was an independent risk factor for 28 day mortality. The survival rate was higher in children when D1 RALE score ≤23 and the D3-D1 RALE score ≤-3 at D28. Conclusion: The RALE score can reflect the oxygenation status of ARDS, which is helpful for risk stratification and screening the high-risk patients.