Objective To investigate the characteristics of lung involvement in microscopic polyangiitis(MPA)patients and its influence on treatment and prognosis.Methods From Jan 2006 to Dec 2007,29 patients were diagnosed with MPA in Peking Union Medical College Hospital.Their clinical data,including clinical manifestations,radiologic and laboratory test results,were retrospectively analyzed.Results The patients included 14 males and 15 females.The mean age was(63.7?10.1)years;28 patients(96.6%)were involved in the lung;20 patients(69.0%)had respiratory symptoms and 15 patients(51.7%)had respiratory signs.Two kinds of patterns were found in radiology:hemorrhage and fibrosis.Seventeen patients(17/27)were hypoxemia in room air blood gas analysis.Five patients(5/18)were diagnosed with pulmonary hypertension by echocardiograghy.Seven patients(7/10)were abnormal in lung function test.Four patients(4/6)were abnormal in BALF.Ten patients(34.5%)were diagnosed with alveolar hemorrhage and 18 patients(62.1%)were complicated with pulmonary infection.Totally 10 patients(34.5%)died,2 patients of diffuse alveolar hemorrhage and 8 of pulmonary infection.Conclusion Most MPA patients have pulmonary involvement and the clinical manifestations vary.There is a high mortality in MPA patients and the main causes are pulmonary infection and diffuse alveolar hemorrhage.

Objective To observe the effect of Cyclosporine A on the brain immunoligical reject reaction of transgenic cellular transplant in rats with experimental brain hemorrhage.Methods We established the brain hemorrhagic models of rats and the models were divided into group A (treated with Cyclosporin A) and group B (without treatment) randomly after transplanting brain cells modified by NGF gene. The levels of CD~+_4, CD~+_8T cells subsets in peripheral blood were examined by using flow cytometry at 15 d after transplantation. The expressions of MHC-classⅡantigens and infiltration of CD~+_4, CD~+_8T lymphocyte subsets were examined by SP immunocytochemical stain.Results The count of CD~+_4, CD~+_8T lymphocyte and CD~+_4/CD~+_8 in peripheral blood were 29.20?3.97, 20.65?2.02 and 1.41?0.86 in group A, and were 47.39?3.01, 28.30? 2.36 and 1.68?0.69 in group B, respectively.There were significant differences between the two groups (all P

Objective To evaluate the application of the LMA CTrach for airway management during cervical spine surgery.Methods A total of 80 patients received cervical spine surgery under general anesthesia. During the operation, the LMA CTrach was used for ventilation and insertion of endotracheal tube. The authors recorded the time of laryngeal mask insertion, the success rate of ventilation, the success rate of the first attempt of endotracheal intubation, the number of attempts of endotracheal intubation, the time from insertion of the LMA CTrach to the completion of tracheal intubation. Results The LMA CTrach insertion was successfully completed in all but 2 patients. In 78 patients with good ventilation, the first attempt of endotracheal intubation failed in 5 patients. Except for unsuccessful ventilation in 2 patients and intubation failure for 3 times in 3 patients, the endotracheal intubation by using the LMA CTrach was accomplished in 75 patients. The mean time from insertion of the LMA CTrach to the completion of tracheal intubation was 192 s (range, 156～273 s). Conclusions The LMA CTrach system has the ability to align the LMA outlet with the larynx under direct view, and can increase the success rate of intubation and avoid some unnecessary injuries, giving certain advantages for airway management during cervical spine surgery.

Objective To discuss the feasibility and safety of propofol used in senile patients undergoing minor surgery including gastroscopy and colonoscopy.Methods 40 patients aged 80-88 years old were randomly divided into two groups with 20 cases for each group.Group P received only propofol by intravenous injection in a speed of 1ml/s till eyelash response disappeared.In patients of group F fentanyl was first given at 0.5?g/kg,and 1 minute later,the patients were given propofol by intravenous injection in a same speed as in group P if there was no discomfort until eyelash response disappeared.MAP,HR,SpO2 and RR were determined before induction of anesthesia,beginning of operation,and 1st,3rd and 5th minute after operation.The onset time of anesthesia,total dosage of propofol used,time of palinesthesia and follow-up results were recorded.Results MAP was significantly decreased in both groups at the beginning of operation,and more stable in group F at the 3rd and 5th minute after operation.There were significant differences between two groups in amount of propofol used,and the dosage in group F was less than that used in group P(P

0.05).Various degrees of pharyngalgia and hoarseness occurred in 2 patients in the Group Ⅰ,3 patients in the Group Ⅱ,and 2 in the Group Ⅲ,the incidence of complications being not statistically different(?2=0.323,P=0.851).Conclusions Compared with local anesthesia or endotracheal intubation,percutaneous dilational tracheostomy under laryngeal mask airway ventilation offers more stable circulation,higher reliability,and less influence to tracheostomy.This technique may give certain protection against cervical spinal cord injury during anesthetic induction.

OBJECTIVEThis study aims to investigate the regulatory effects of calcitonin gene-related peptide (CGRP) on Nod-like receptor protein 3 (NLRP3) and interleukin-1β (IL-1β) to promote osteoblast differentiation.

METHODSDifferent concentrations of CGRP (0, 10, 30, 100 ng · mL⁻¹) were added to mouse osteoblasts in vitro. The mRNA and protein expression levels of both NLRP3 and IL-1β were examined using Real-time polymerase chain reaction and Western blot, respectively. Moreover, the concentrations of IL-1β protein and intracellular reactive oxygen species (ROS) were detected using enzyme-linked immunosorbent assay and flow cytometry, respectively. The osteogenic differentiation of mouse osteoblasts was identified through alizarin red staining.

RESULTSThe protein and mRNA expression levels of both NLRP3 and IL-1β significantly decreased (P < 0.05) with increasing CGRP concentration. Moreover, the contents of intracellular ROS gradually decreased (P<0.05). The osteogenic differentiation of the osteoblasts was more enhanced in the group treated with 100 ng · mL⁻¹ CGRP than in the empty group (0 ng · mL⁻¹ CGRP).

CONCLUSIONCGRP promotes osteoblast differentiation by inhibiting the expression of inflammatory factors.

Animals ; Blotting, Western ; Calcitonin ; Calcitonin Gene-Related Peptide ; Cell Differentiation ; Enzyme-Linked Immunosorbent Assay ; Interleukin-1beta ; Mice ; NLR Family, Pyrin Domain-Containing 3 Protein ; NLR Proteins ; Osteoblasts ; Osteogenesis ; RNA, Messenger ; Reactive Oxygen Species ; Real-Time Polymerase Chain Reaction

AIM:To investigate the effect of oleuropein on interleukin-1β( IL-1β)-induced SD rat articular chondrocytes .METHODS:The SD rat articular chondrocytes were isolated by 2 step enzyme digestions .The chondrocytes were cultured in vitro.Inverted microscopic observation was performed during the culture .Alcian blue staining and type II collagen immunohistochemical staining were used to identify the chondrocytes .The effects of oleuropein on the viability of chondrocytes were determined by CCK-8 assay.The cells in 3rd passage were pretreated with oleuropein at 10, 50 or 100 μmol/L and subsequently stimulated with IL-1βat 10 μg/L for 24 h.Production of prostaglandin E 2 ( PGE2 ) and ni-tric oxide (NO) were evaluated by the Griess reaction and an enzyme linked immunosorbent assay (ELISA).The mRNA expression of matrix metalloproteinase ( MMP)-1 and MMP-13 was measured by real-time PCR.The protein levels of in-ducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2) and nuclear factor-kappa B (NF-κB) were detected by Western blotting .RESULTS:The cell viability of chondrocytes was not significantly impaired by treating with oleuropein at concentration of 10, 50 or 100μmol/L for 24 h compared with control group .Pretreatment with oleuropein significantly in-hibited the production of PGE 2 and NO induced by IL-1β.Oleuropein also significantly decreased the IL-1β-stimulated MMP-1 and MMP-13 mRNA expression in articular chondrocytes .Pretreatment with oleuropein inhibited the IL-1β-media-ted activation of NF-κB by suppressing the degradation of its inhibitory protein IκBαin the cytoplasm .CONCLUSION:Oleuropein inhibits IL-1β-induced inflammatory gene expression by suppressing NF-κB activation at the transcriptional le-vel, suggesting a new mechanism for the anti-inflammatory effects of oleuropein as a novel agent on treating with osteoarthri-tis.

Actins ; metabolism ; Adult ; Desmin ; metabolism ; Diagnosis, Differential ; Histiocytoma, Malignant Fibrous ; pathology ; Humans ; Immunohistochemistry ; Leiomyoma ; pathology ; Leiomyosarcoma ; metabolism ; pathology ; surgery ; Male ; Mediastinal Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Objective To investigate the effect of dexmedetomidine on postoperative renal function of patients with rheumatic heart disease following valvular heart surgery. Methods Fifty patients following valvular heart surgery were randomized into experimental group and control group,with 25 cases in each group. The patients in experimental group receiveddexmedetomidine 0.5 μg/kg infusion 15min before induction, and then 0.5 μg/(kg·h) infused to the end of surgery, while those in control group received the same amount of saline in the same way. Blood from central venous was collected before surgery, at the end of surgery, 24 h and 48 h after surgery in order to detect Src, BUN and Cys C and the length of ICU duration was also recorded. Results Src and Cys C of the patients in both groups obviously elevated 24h after surgery when compared with pre-operation , while BUN elevated at both 24 h and 48 h after surgery(P < 0.05). Compared with those in control group, Src, BUN and Cys C were lower in experimental group ( P < 0 . 05 ) , and the length of ICU duration was shorter (P < 0.05). Conclusion Dexmedetomidine could improve the postoperative renal function after valvular heart surgery and lead to a better prognosis.

To analyze the epidemiological characteristics of human infection with avian influenza A(H7N9) virus from 2013 to 2016 in Xiaoshan,China,we collected the epidemiological data of human A(H7N9) cases as well as the results of environmental monitoring and analyzed it by case study,descriptive epidemiological method,and statistical analysis.Results showed that a total of 22 cases were confirmed,including 12 deaths.All the cases occurred in winter and spring,and most of them had been exposed to live poultry,and with the underlying condition of chronic diseases.Chi-square test showed that the ratio of cases with chronic diseases in death group was higher (P=0.01).The environmental monitoring result showed there were distinctive seasonal differences of positive rate with peaks in winter and spring and nadirs in autumn and summer.Positive rates for the samples from external environmental monitoring were consistent with the distribution of the case onset.Due to rise of environmental monitoring positive rate,we should be alert to the occurrence of new cases,especially in rural areas where live poultry fairs still exist and among people with occupational exposure.We should further improve ability to prevent and control this disease.