Objective To investigate the effects of a-melanocyte stimulating hormone (?MSH) on serum cytokine levels in rats with acute respiratory distress syndrome (ARDS) induced by acute hemorrhagic shock and intratracheal lipopolysaccharide (LPS) administration (two-hit model) .Methods Thirty male SD rats weighing (337? 25) g were randomly assigned to six groups of five animals in each group: group A normal control; group B ARDS control; group C-F treatment groups in which ?MSH 1.7 mg/kg was given at different time points - Ih before LPS(C), at the time as LPS was administratered (D), 1h after LPS (E) or together with and 3 h and 6 h after LPS (F) . The animals were anesthetized with intravenous thiopental 30 mg?kg-1 and tracheotomized and mechanically ventilated (FiO2 : 0.5, RR 100 bpm, VT12ml, I: E = 1:1.5) . Right common carotid artery was cannulated for BP monitoring, removal of blood and blood sampling. Acute hemorrhagic shock was induced by removal of blood and MAP was maintained at 45 mm Hg for 1 h, then the animals were resuscitated with reinfusion of removed blood and lactated Ringer's solution, then endotoxin (LPS 200 ?g/kg in 500 ?l normal saline). The criterion for ARDS was PaO2/FiO2

OBJECTIVE:To evaluate the effects of clinical pharmacist participating in clinical consultation,and to provider ref-erence for clinical pharmacists participating in clinical practice. METHODS:436 cases/times of clinical consultation in which clini-cal pharmacists participated in Zhengzhou Seventh People’s Hospital from 2012 to 2015 were analyzed statistically. RESULTS:2012-2015,the number of clinical consultation in the hospital showed rising tendency;23 departments applied the consultation, among which top 5 were endocrinology department,gynaecology department,neurosurgery department,neurology department and orthopedics department. The reasons for consultation mainly were the formulation of therapy plan (430 cases/times,accounting for 97.95%). The consultation suggestions were adjusting drug types(303 cases/times,69.17%). Consultation suggestions were adopt-ed completely in 405 cases/times(92.89%). There were 307 cases/times of effective outcome,with effective rate of 75.80%(307/405). CONCLUSIONS:Clinical pharmacists participated in clinical consultation is helpful to optimize therapy plan,play a positive play on the safety of drug use. Clinical pharmacists should further learn clinical medical and pharmaceutical knowledge and summa-rize the experience of clinical practice to improve the quality of consultation.

AIM: To establish a method for determination of astragloside Ⅳ in Danqi Injection (Radix Salviae Miltiorrhizae,Radix Astragali). METHODS:HPLC-ELSD with Hypersil C_(18) column was used.The mobile phase was composed of acetonitrile-water(38∶62).The flow rate was 0.85 mL?min~(-1).An evaporative light-scattering detector(ELSD) model 2000 was used as detector. RESULTS:For astragloside Ⅳ,the linear range was 1.074-(3.408 ?g),and the average recovery was 100.71%,RSD was 1.79%. CONCLUSION:The method is simple,accurate,reproducible and can be applied to the quality control of the preparation. anqi

Objective:To construct and express the fusion protein between ZZ affinity peptide and alkaline phosphatase and examine its biological activities.Methods:The alkaline phosphatase gene was cloned into pEZZ 18 vector containing ZZ peptide gene resulted in the pEZZ-AP recombinant vector.Then the vector was transformed and expressed in E.coli DH5α.And HisTrap affinity chromatography was employed to separate and purify the target protein.After analyzed by Western blot , ZZ-AP fusion protein was applied to immunocytochemistry as an alterative second antibody.Results:The result of SDS-PAGE showed that the fusion protein with a relative molecular weight was consistent with the theoretical values (62 kD).The fusion protein has rabbit IgG-binding ability and en-zymatic activity of alkaline phosphatase ,those were validated in Western blot;and it produced a good signal that was comparable in its staining pattern to that generated with goat anti-rabbit IgG-AP in immunocytochemistry.Conclusion: The ZZ-AP fusion protein was constructed successfully ,it has rabbit IgG-binding ability and enzymatic activity of alkaline phosphatase.We anticipate that the ZZ-AP fusion protein has a potential application in immunoassay field.

Objective To study the initial application of 3.0T high field intensity intraoperative magnetic resonance(iMR)for cranial tumors.Methods Forty-three patients with cranial tumors including 23 glioma cases,12 pituitary tumor cases,3 brain stem cavernous hemangioma cases,2 meningioma cases,2metastatic tumor cases,1 neurilemmoma case,received operation examined with GE Signa HDX 3.0T iMR system.The operation process and influence of iMR were reviewed.Results In 43 patients,average iMR examination was 1.3(1-3)times.In 16 patients the first iMR examination revealed tumor remnants,and in 13 of them continued surgical interventions and complete resection.The rate of complete resection was increased from 63％(27/43)to 93％(40/43).No complications related to iMR occurred.Conclusion 3.0T high field intensity iMR can provide accurate positioning and real-time navigation for the surgery,increase the rate of complete resection,improve the accuracy and safety of cranial tumor resection,and decrease complications.

Objective To measure the normal sagittal and coronal diameters of thumb and great toe distal phalanx bottom by ultrasonography. Methods One hundred and twenty volunteers' sagittal and coronal diameters of thumb and great toe distal phalanx bottom were measured by ultrasonography. The measurements was analysed by the statistical method. Results The thumb and great toe distal phalanx bottom showed hyperechoic zone,clear boundary with the adjacent fascia and tendon tissue showed low echo area at cross section by high frequency ultrasound. The sagittal diameters of thumb distal phalanx bottom was (8. 07 ± 0. 67)mm in men, while that of great toe distal phalanx bottom was (8. 34 ± 1. 02) mm( t = 1.73, P =0.86).The coronal diameters of thumb distal phalanx bottom was (11.61 ±0.89)mm in men, while that of great toe distal phalanx bottom was (14. 25 ± 0. 84)mm( t = 16. 77, P = 0. 00). The sagittal diameters of thumb distal phalanx bottom was (7. 52 ± 0. 62) mm in women, while that of great toe distal phalanx bottom was (7. 72 ± 0. 67) mm( t = 1. 72, P =0. 14). The coronal diameters of thumb distal phalanx bottom was (10.94 ± 0.97) mm in women, while that of great toe distal phalanx bottom was (13. 51 ±0. 75) mm( t =16.21, P = 0.00). Conclusions The normal sagittal and coronal diameters of thumb and great toe distal phalanx bottom measured by the ultrasonography can guide the operation of wrap-around flap of a great toe with phalanx ungual for thumb II degree defect reconstruction.

Objective:To prepare the site-specific biotinylation of enhanced green fluorescence protein with double biotin molecules using Avi-tag technology.Methods:The EGFP gene was prepared by PCR and cloned into pdi-Avitag resulting the vector pEGFP-( Avitag) 2.The fusion protein EGFP-( Avitag ) 2 was expressed in E.coli DH5αand purified by employing IMAC.The site-specific biotinylation was implemented by BirA enzyme in vitro, and then was identified by competitive ELISA and Western blot.Results:The recombinant prokaryotic expression vector pEGFP-(Avitag)2 was correctly constructed,and EGFP-(Avitag)2 fusion was successfully expressed in E.coli DH5α.The results of competitive ELISA and Western blot showed that the EGFP-( Avitag) 2 could be site-specific biotinylation with double biotin molecules based on Avi-tag technology.Conclusion: The site-specific biotinylation of EGFP with double biotin molecules is successfully prepared,and we anticipate that can be used for BAS to improve the sensitivity and specificity of immunosensors.

Objective:With the development of modern skull base minimally invasive technology mature and neural radio surgery techniques,it is necessary to re-examine the therapeutic strategy for the treat-ment of petroclival meningiomas.To sum up the operative experience and methods in microsurgical resec-tion of petroclival meningiomas by the combining trans-subtemporal and suboccipital retrosigmoid keyhole approach.To explore the minimally invasive operation approach of petroclival meningiomas,to raise the removal degree and to improve the postoperative result using this approach.Methods:The clinical data of the consecutive 21 patients with the petroclival meningiomas were reviewed retrospectively.The meth-od,degree of tumor resection,techniques of the combining keyhole approach,Karnofsky performance score (KPS)before and after operation were also analyzed.The neuronavigation guided operation was performed in 9 cases,and 12 cases were operated in the neuroelectrophysiological monitoring.Results:Total excision of the tumor resection (Simpson,Ⅰ -Ⅱlevels)was conducted in 18 cases (85.7%,18 /21),and 3 patients underwent close resection (Simpson Ⅲ level,14.3%,3 /21).Postoperative three-dimensional CT showed good lock bone flap restoration;Postoperative pathology confirmed meningioma. Postoperative cranial nerve dysfunction or new original nerve dysfunction were aggravated in 5 cases (23.8%),including transient trochlear nerve (3 cases),abducent nerve (1 case),and the motor branch of trigeminal nerve paralysis (1 case).Abducent nerve paralysis (1 case)appeared,with hearing impairment.After the 3-month follow-up,11 cases had the same KPS aspreoperation,7 cases improved,and 3 cases not improved.The KPS score was 77.14 ±23.12 on average,and there was no statistically significant difference compared with that before operation (P >0.05 ).The postoperative follow-up for half a year showed fluent speaking and writing in 19 cases (KPS 70 or higher),and general recovery in 2 cases (KPS <70).The postoperative follow-up for 3 -29 months showed no tumor recur-rence or progress.Conclusion:The combining trans-subtemporal and suboccipital retrosigmoid keyhole approach is simple,safe,and minimally invasive,and an ideal operation approach of petroclival menin-gioma.To master the operation skills and the intraoperative matters needing attention in the operation,is favorable to improve the resection rate and curative effect.

Brachytherapy plays an important role in radical radiotherapy of cervical cancer. At present, most hospitals in China use high-dose-ate brachytherapy, which irradiatevolume by simulating line source with a single approximate point source. Therefore, the dwell positions and dwell times can be optimized appropriately. However, due to various reasons, the initial state of the optimization plan must start from the standard loading pattern, and ensure that the optimized plan basically maintains the pear-shaped dose distribution. This paper introduces the standard loading pattern of intracavitary brachytherapy and intracavitary combined interstitial brachytherapy for cervical cancer through literature review, and expounds the planning optimization model and the constraints in the optimization process, to provide important reference for the planning of brachytherapy for cervical cancer.

Objective To explore the changes of serum angiopoietin-like protein 4(ANGPTL4)and NOD-like receptor protein 3(NLRP3)levels after traumatic brain injury(TBI)and their diagnostic value for sec-ondary massive cerebral infarction.Methods A total of 100 TBI patients admitted to the hospital from Au-gust 2019 to August 2021 were enrolled as the TBI group,meantime,100 healthy people in the hospital were enrolled as the control group.The serum levels of ANGPTL4 and NLRP3 were detected by enzyme-linked im-munosorbent assay(ELISA).The clinical characteristics of TBI patients with and without secondary massive cerebral infarction were compared.Receiver operating characteristic(ROC)curve was applied to analyze the serum levels of ANGPTL4 and NLRP3 on their diagnostic value for TBI patients with secondary massive cere-bral infarction.Multivariate Logistic regression analysis was applied to analyze the factors affecting the occur-rence of secondary massive cerebral infarction in TBI patients.Results The serum ANGPTL4 level in TBI group was lower than that in the control group,and the serum NLRP3 level was higher than that in the con-trol group(P<0.05).There were obvious differences in proportion of brain hernia,proportion of subarach-noid hemorrhage,serum levels of ANGPTL4 and NLRP3 between patients with secondary massive cerebral infarction and patients without secondary massive cerebral infarction(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of serum ANGPTL4 and NLRP3 in diagnosing secondary massive cere-bral infarction in TBI patients was 0.792 and 0.812 respectively,with sensitivity of 77.80%and 83.30%re-spectively,and specificity of 86.60%and 64.60%respectively.The sensitivity,the specificity and AUC of the combined detection were 83.30%,82.90%and 0.867 respectively.Multivariate Logistic regression analysis showed that serum NLRP3 level was a risk factor for TBI patients with secondary massive cerebral infarction(P<0.05).After treatment,it was found that serum ANGPTL4 level increased and NLRP3 level decreased in TBI patients(P<0.05).Conclusion The serum level of ANGPTL4 in TBI patients decreases,while the level of NLRP3 increases,and the level of ANGPTL4 in the serum of patients with secondary massive cerebral in-farction decreases and the level of NLRP3 increases,both of them are of great significance in the diagnosis of secondary massive cerebral infarction in TBI patients.