Objective To validate and compare the two spinal microdialysis techniques: a linear tissue probe (LM-3) in the spinal dorsal horn and a loop probe in the cerebral spinal fluid (CSF) in determining peripheral nociceptive stimulation-evoked glutamate (Glu) release in the spinal cord of freely moving rats. Methods Twenty-eight adult male Wistar rats weighing 300-350 g were randomly divided into two groups: in group A a LM-3 probe was implanted into the spinal dorsal horn and in group B a loop probe was placed in the CSF. Twenty-four hours after the implantation of the probe, microdialysis was initiated with perfusion of modified Ringer' s solution at a low flow rate of 5 ?l?min-1 . Following an 1 h equilibration phase the baseline Glu concentrations were measured every 10 min for 1 h. Thereafter 50 ?lof 5% formalin was injected into one hindpaw of the rats and samples were collected every 10 min for 90 min. Furthermore 8 rats in group A were further divided into 2 subgroups to investigate the effects of the flow rate of microdialysis and composition of perfusate on the baseline Glu release.Results The baseline levels of Glu were (0.82?0.09) ?mol?L-1 with LM-3 probe and (5.96?0.22) ?mol?L-1 with the loop probe. In group A (LM-3 probe) when the flow rate of the modified Ringer's solution was decreased from 5 to 2 ?l?min-1 the extracellular Glu concentrations were increased to 223%?7% of the baseline (n = 4) , whereas perfusion with artificial CSF reduced Glu concentrations to 62% ?10% of the baseline (n = 4) . Injection of formalin into the hindpaw induced a short-lasting but significant increase in Glu concentration with a similar profile and time course using either of the two microdialysis approaches. Conclusion Microdialysis in the dorsal horn or in the CSF are both effective techniques to assess Glu release in the spinal cord of rats. Peripheral nociceptive input induces a short-lasting increase in Glu release with a similar profile and time course using either of the two microdialysis approaches. The microdialysis of the dorsal horn provides a useful tool to precisely locatewhere the release of the neurotransmitter occurs, whereas the loop probe in CSF is more reproducible for simultaneous investigation of drug effects.

Objective To investigate the specific pathogenesis of O-antigen polysaccharide(OPS) which is a subunit component of lipopolysaccharide(LPS) from enteroinvasive Escherichia coli. Methods The OPS was extracted and purified from Escherichia coli O29(enteroinvasive E.coli) strain. Effects of OPS, contrasted with the whole LPS molecule, were observed by in vitro experiments (HeLa cell culture) and in vivo experiments (rabbit ileal loop assay). Results It was revealed that the purified EIEC OPS alone cause cytopathic effect to HeLa cell, and that the OPS caused mucosal hemorrhage, but no fluid accumulation in ileal loop of rabbits. The scanning electron microscope and transmission electron microscope demonstrated the fine structures of cytopathic HeLa cell were damaged. Conclusion Escherichia coli O29 OPS might be one of the factors causing diarrhea and its mechanism was different from endotoxin reaction of LPS. Escherichia coli O29(pathogen) OPS showed a marked serious toxicity as compared with Escherichia coli HB101(nonpathogen) OPS.

In resent years, the accounts about adults' sudden death without specific reason have been increased. The definition of cause of death was a hot potato to legal medical experts. With the deep - going of etiology to molecular level, clinical cardiac diseases' researches have confirmed that the arrhythmia has been resulted from a kind of " idiopathic disorder of cardiac action potential" that is related to cardiac sodium channel diseases by SCN5A mutation confirmed by using the techniques of molecular genetics. The paper reviewed the characteristic of SMDS ( Sudden Manhood Death Syndrome) in forensic science and some kinds of diseases' genotype and phenotype in clinical medicine, and hoped to acquire some revelation for further related research.

Objective To analyze the correlation between serum lipoprotein associated phospholipase A 2(Lp‐PLA2) with five traditional inflammatory factors of TC ,TG ,LDL‐C ,hs‐CRP and Hcy in the patients with coronary heart disease(CHD) ,and to in‐vestigate the relationship between its concentration with the lesions and severity of CHD .Methods Two hundreds cases of CHD were selected as the lesion group(which was subdivide into single vessel lesion ,double vessel lesion and three vessel lesion) ,at the same time ,100 persons undergoing physical examination were selected as the control group .The correlation between Lp‐PLA2 with five traditional inflammatory factors of TC ,TG ,LDL‐C ,hs‐CRP and Hcy was analyzed .The differences of Lp‐PLA2 in the lesion group and the control group were compared and the relation between Lp‐PLA2 level with lesion vessels number was analyzed .Re‐sults Lp‐PLA2 was significantly correlated with LDL‐C ,Hcy ,TC and hs‐CRP(P<0 .05) and had no relation with TG(P>0 .05) , the level of Lp‐PLA2 in the lesion group was significantly higher than that in the control group (P<0 .01) ,the Lp‐PLA2 level was elevated with the number of coronary lesion vessels ,but the correlation is unobvious(P>0 .05) .Conclusion High concentration of Lp‐PLA2 is a risk factor for coronary atherosclerosis ,but the correlation between the Lp‐PLA2 level and the severity of coronary arterial lesion needs further study .

Objective To assess the sensitivity of indices of hip development in children with spastic diple-gia resulting from cerebral palsy. Methods X-ray images of the hips of 57 children with cerebral palsy ( the cere-bral palsy group) were checked, and the acetabular index ( AI), femur head migration percentage ( MP), center-edge angle and neck-shaft angle (NSA) were compared with those of normal children ( the control group, n = 30).Results The differences in MP and NSA between the two groups were significant. The prevalence of hip subluxation was 20.45% among the children with spastic diplegia who could not walk independently, and the prevalence was sig-nificantly greater in children 3 to 5 years old than among those under 3. Conclusion The MP can be used as a sen-sitive index to evaluate hip development. Age is a relevant factor affecting the hip development of children with cere-bral palsy.

Objective To explore the changes of corticotropin releasing factor (CRF) levels secreted by hypothalamus neuron in children with acute brain injury. Methods Fifty-one intracranial-infection children with brain injury and 11 intracranial-noninfection children with brain injury were chosen from pediatric intensive care unit of our hospital. Severities of their brain damage were evaluated by Glasgow score,and CRF level in cerebrospinal fluid (CSF) and serum TNF-α and IL-6 levels were measured by radioimmunoassay. Results There was no significant difference of Glasgow scores between the intracranial infection group and intracranial-noninfection group ( P = 0. 302 6 ), CSF CRF level of intracranial infection group was significantly lower than that of intracranial-noninfection group ( P ＜ 0. 01 ), serum TNF-α and IL-6 levels of intracranial infection group were significantly higher than those of intracranial-noninfection group ( P ＜ 0. 01,P ＜0. 001 ). As comparing to the children with Glasgow score of 6 ～ 7, the levels of CSF CRF and serum TNF-α and IL-6 in children with Glasgow score of 4 ～ 5 were significantly increased ( P ＜ 0. 05, P ＜ 0. 001 ).Conclusion CSF CRF level of the children with acute brain injury is changing, which may be concerned with the secretion of hypothalamus CRF neuron stimulated by TNF-α, IL-6 and hypoxia stress in children with brain injury.

OBJECTIVETo analyze the diagnosis and treatment of autoimmune hemolytic anemia (AIHA) in liver transplant recipients.

METHODSA retrospective analysis was conducted of 3 patients who developed AIHA following orthotopic liver transplantation. The results of hemolysis tests and examinations of hemoglobin, white blood cells, platelets, total bilirubin, and alanine aminotransferase before and after treatments were reviewed.

RESULTSThese 3 patients developed AIHA following the transplantation possibly in association with the use of immunosuppressive agents, and the condition was effectively controlled after corresponding treatments.

CONCLUSIONAIHA is a uncommon complication after liver transplantation and can be cured after a definitive diagnosis with corresponding treatments.

Aged ; Anemia, Hemolytic, Autoimmune ; diagnosis ; etiology ; therapy ; Humans ; Liver Transplantation ; adverse effects ; Male ; Middle Aged ; Retrospective Studies

Objective: To evaluate the diagnostic value of BRAF V600E mutation combined with shear wave elastography(SWE) for thyroid nodules of Bethesda Ⅲ diagnosed by fine-neddle aspiration(FNAC). Methods: One hundred and seventeen thyroid nodules diagnosed as Bethesda Ⅲ in the department of ultrasound and confirmed by BRAF V600E gene detection, SWE examination and surgery were collected. BRAF V600E detection, SWE examination and both combined with pathological results were using to retrospective analysis. Results: There were 75 benign nodules and 42 malignant nodules according to pathology. Sensitivity and negative predictive value of BRAF V600E combined with SWE were higher than single BRAF V600E mutation detection and SWE with statistically significant(P=0.01, 0.001; P=0.029, 0.01, respectively). There were no statistically differences between single BRAF V600E mutation detection and SWE for Bethesda Ⅲ nodules(P=0.483, 0.645). Conclusions BRAF V600E mutation detection combined with SWE can improve the sensitivity and negative predictive value in the diagnosis of Bethesda Ⅲ thyroid nodules.

BACKGROUNDSuccessful aging (SA) and mild cognitive impairment (MCI) are heterogeneous groups of aging. To explore the heterogeneity, the functional connectivity was studied in these populations.

METHODSThe present study utilized functional connectivity magnetic resonance imaging (fcMRI) to investigate default mode network (DMN) in 8 healthy subjects of SA, 8 subjects of usual aging (UA), and 8 MCI patients during verbal fluency tests (VFTs). Functional connectivity (based seeds) of different groups was analyzed by using statistical test.

RESULTSCompared with SA and UA groups, MCI subjects exhibited decreased functional connectivity in the DMN regions, including the inferior parietal lobule and left angular gyrus (t = 3.53, P < 0.001). Compared with UA and MCI groups, the SA elderly exhibited increased functional connectivity in the precuneus (t = 3.53, P < 0.001).

CONCLUSIONSThese findings suggested that abnormalities of functional connectivity in DMN might be related with semantic memory impairment in aging. Left angular gyrus and precuneus might be the potential imaging-based biomarker for distinguishing heterogeneous process of elderly.

Aged ; Aged, 80 and over ; Aging ; physiology ; Brain ; physiopathology ; Cognitive Dysfunction ; physiopathology ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Neuropsychological Tests

Objectives To determine the risk factors of ventilator-associated pneumonia (VAP) in the pediatric intensive care unit and to explore effective strategies to reduce the morbidity of VAP. Methods A retrospective analysis was conducted on 455 children admitted into the PICU of Hunan Children's Hospital from June 2014 to June 2017. The 455 children were divided into VAP group (n=43) and non-VAP group (n=412). The incidence of VAP was identified and risk factors were compared using the logistic regression analysis via SPSS 19.0 software.Results There were 311 males and 144 females with a median age of 11 months old (29 days to 9 years and 4 months). The incidence of VAP was 9.45% (43/455). Congenital laryngeal and trachea malformation with pulmonary infection was the first reason for the occurrence of VAP (23.3%), followed by congenital heart diseases with pulmonary infection (18.6%). Via univariate analysis, types of endotracheal intubation (χ2=45.33, P<0.001), duration of mechanical ventilation (Z=1.21, P=0.034), re-intubation (χ2=20.22, P=0.004), early usage of antibiotics (χ2=4.98, P=0.026),and methods of nutritional support(χ2=10.15,P=0.006)were identified as risk factors of VAP in the pediatric intensive care unit patients (P<0.05). Based on the multivariate logistic regression analysis, the followings were all independent predictor for VAP:types of endotracheal intubation(OR=1.87,95%CI:1.48~9.75),duration of mechanical ventilation(OR=1.14, 95%CI:1.08~2.35), re-intubation (OR=3.42, 95%CI:1.26~5.57), early usage of antibiotics (OR=4.55, 95%CI:2.21~8.77). Conclusions Many risk factors were found related with the occurrence of VAP. A comprehensive analysis of the host factors and iatrogenic factors should be conducted. Rational use of antibiotics and daily assessment of extubation might help reduce the incidence of VAP.