As a result of the early amplification of the inflammatory response in the acute pancreatitis, systemic inflammatory response syndrome (SIRS) is a main cause of acute pancreatitis-associated lung injury (APALI) , while early combined acute lung injury or acute respiratory distress syndrome causes a high mortality of acute pancreatitis.A series of inflammatory mediators and cytokines play important roles in the process of SIRS and APALI, therefore, inflammatory reaction restoring a balance becomes a key point of the treatment of pancreatitis lung injury.

With the enhancing treatment concept and the improvement of diagnosis and treatment technology in recent years,multidisciplinary cooperation and minimally invasive treatment has been the dominant treatment methods for acute pancreatitis,and they reduces the mortality effectively.At the same time,a series of new treatment methods such as step-up approach,which has obvious advantages over traditional surgery,improves the prognosis of severe acute pancreatitis significantly,and it has been recognized by scholars both at home and abroad.

Background Immediately ocular rinsing is a key step for the prevention of eye tissue damage after acute chemical bums.A good ophthalmic rinsing solution can neutralize chemical substance and improve the prognosis of patients.Objective This study attempted to evaluate the therapeutic effect of self-made citric aciddisodium hydrogen phosphate buffer and citric acid-disodium hydrogen phosphate-potassium chloride buffer on corneal chemical burns in mice.Methods Citric acid-disodium hydrogen phosphate buffer solution (solution 1) and citric acid-disodium hydrogen phosphate-potassium chloride buffer solution (solution2) with the pH 7.4 were prepared.One hundred and twenty clean male C57 mice aged 6-8 weeks were randomized to two groups,and filter papers containing 1 mol/L H2SO4 or 0.15 mol/L NaOH were attached to the central corneas of the right eyes to create the acid or alkali burning models.Then the eyes were immediately rinsed by 40 ml solution 1,tap water or solution 2 according to the grouping and the model eyes without rinsing served as the control group.The corneal opacity was examined by slit lamp microscope and scored in 3,7 and 14 days after modeling.The percentages of corneal fluorescein staining,corneal neovascularization and corneal ulcer were analyzed.The study protocol was approved by Experimental Animal Ethic Commission of Second Military Medical University.Results In the corneal acid burning models,the number of eye with corneal opacity scored 1 in the solution 1 group,tap water group and solution 2 group was significantly more than that in the non-rinsing group in 3,7 and 14 days after modeling (all at P＜0.01);In 3 days after modeling,the numbers of eye scored 1 were more in the solution 1 group than those in the tap water group and solution 2 group (x2 =11.000,P =0.001;x2 =4.000,P =0.046).There were no differences in the eye number of different corneal opacity scores in 14 days after acid burning (all at P＞0.05).In 3,7 and 14 days after corneal alkali burning,the number of eyes with corneal opacity scored 1-2 was significantly increased in the solution 1 group,tap water group and solution 2 group compared with non-rinsing group (all at P＜0.01).The percentage of corneal ulcer in the solution 1 group,tap water group and solution 2 group was 7％,27％ and 13％,respectively,which was significantly lower than 73％ in the non-rinsing group (P =0.000,0.027,0.003),and no significant differences were seen in various time points after corneal alkali burning (all at P＞O.05).Corneal neovascularization occurred in 50％ mice in non-rinsing group in 14 days after acid burning.However,no neovascularization was seen in the mice of the solution 1 group,tap water group and solution 2 group in both acid and alkali burning mice.Conclusions Citric aciddisodium hydrogen phosphate buffer (pH 7.4) appears to be an effective emergency rinsing solution for corneal chemical burns and the rinsing solution with or without potassium chloride is not obviously affected to the prognosis of corneal chemical burns in the mice.

Objective To investigate the balance of Th1/Th2 cytokines and its relationship with prognosis of severe chronic hepatitis B ( CHB ). Methods Peripheral blood samples were collected from 112 severe CHB patients, 30 CHB patients and 30 healthy controls. IL-4, IFN-γ levels and HBV DNA loads were measured by ELISA and fluorescent PCR, respectively. The levels of cytokines in different stages, and their correlations with HBV DNA loads and short-term prognosis were analyzed. Results Higher levels of IL-4, IFN-γ and Th1/Th2 ratios in peripheral blood were detected in patients with severe CHB than those with CHB and the healthy controls (Z = 8.968, 10. 004 and 26. 067, P =0. 009, 0. 007 and 0. 000). IL4 levels in patients with end-stage server CHB were markedly higher than those in other stages ( Z = 3. 672 and 3. 158, P= 0.000 and 0.002), while their Thl/Th2 ratios were lower (Z=3. 161 and 2. 166, P=0.002 and 0. 030). No significant differences on levels of IL-4, IFN-γ and Th1/Th2 ratios were observed in severe CHB patients with different HBV DNA levels (Z =4.431, 2.626 and 0. 140, P =0.219, 0.403 and 0. 987). Elevated IL-4 was closely correlated with the high case-fatality rate within 12 weeks. Conclusions The balance between Th1 and Th2 cytokines is- disturbed in patients with severe CHB. Thl/Th2 ratio decreases with the aggravation of diseases, which may indicate unfavorable short-term prognosis.

Objective To observe the clinical efficacy of diltiazem in patients with coronary disease following percutaneous coronary intervention(PCI).Methods From Jan 2014 to Jan 2016,116 cases of coronary disease were selected as the research subjects,they were randomly divided into the observation group(62cases)and the control group(54 cases).The control group was given conventional therapy,while the observation group was given diltiazem therapy on the basis of control group.The levels of BP,HR,NT -proBNP,CRP and angina frequency in the two groups were compared before and 24h,48h after PCI.The incidence of major adverse cardiovascular events(MACEs) was assessed at the sixth month after PCI.Results After surgery,the CRP levels of the observation group and control group were (40.1 ±7.4)mg/L and (41.7 ±8.8)mg/L,the NT -proBNP levels of the two groups were (501.8 ± 56.5)ng/L and (445.7 ±50.6)ng/L,which were significantly higher than preoperation(t =5.684,P <0.05).The blood pressure,heart rate,CRP,NT -proBNP of the observation group since 24 hours after PCI were (73.1 ± 6.2)mmHg,(121.7 ±15.8)mmHg,(68.1 ±7.9)times/min,(24.8 ±3.7)mg/L,(201.7 ±20.6)ng/L,which were significantly lower than those of control group [(85.6 ±9.3 )mmHg,(134.3 ±17.4)mmHg,(77.5 ± 9.2)times/min,(36.5 ±7.9)mg/L,(481.5 ±48.2)ng/L].The effect was kept over 48 hours(F =7.281,8.097, 6.945,7.682,6.517,all P <0.05).Angina pectoris after treatment in the observation group and control group were (1.5 ±0.9)times/month,(2.9 ±0.7)times/month,which were significantly lower than before treatment(t =7.584,P <0.05).The incidence rate of total MACE in the observation group was 4.84%,which was significantly lower than that in the control group(χ2 =6.942,P <0.05).Conclusion Diltiazem after PCI can decrease the adverse reaction, and help to improve the prognosis of patients.

Objective:To investigate the clinical manifestations and pathogenic gene mutation sites of familial cavernous hemangioma by a pedigree study of this disease.Methods:A family of cerebral cavernous hemangioma who was admitted to the Department of Neurology of the First Affiliated Hospital of Henan University of Science and Technology in April 2019 was diagnosed as cerebral cavernous hemangioma type 1 based on clinical manifestations and head magnetic resonance imaging (MRI), diffusion weighted imaging and susceptibility weighted imaging screening. According to Zabramski classification criteria, the family′s clinical data were collected and genes were sequenced.Results:A 58-year-old female proband had dizziness and headache as the main symptoms, her daughter and son had no clinical symptoms, and her granddaughter had clinical manifestations of cerebral hemorrhage and seizures. The proband and her family members showed multiple cavernous hemangioma on cranial MRI,and the p.L436fs mutation in the KRIT1 gene of familial cerebral cavernous malformation type 1 was confirmed through genetic examination, which was consistent with the Zabramski typing results based on head MRI. The mutation site of the familial spongiform malformation type 1 pathogenic gene was found to be p.L436fs in KRIT1 gene, which has not been reported in familial cerebral cavernous hemangioma type 1 until now.Conclusion:A new p.L436fs mutation of KRIT1 gene was found in familial cerebral cavernous malformation type 1, which expands understanding of the clinical manifestations and pathogenic gene mutation sites of familial cavernous hemangioma.

Objective:This study aimed to investigate the change of the position of the tongue before and after combined treatment of maxillary expansion and orofacial myofunctional therapy in children with mouth-breathing and skeletal class Ⅱmalocclusion. Methods:A total of 30 children with skeletal class Ⅱ malocclusion and unobstructed upper airway were selected. The 30 children were divided into mouth-breathing group（n=15） and nasal-breathing group（n=15） and CBCT was taken. The images were measured by Invivo5 software. The measurement results of the tongue position of the two groups were analyzed by independent samples t-test. 15 mouth-breathing children with skeletal class Ⅱ malocclusion were selected for maxillary expansion and orofacial myofunctional therapy. CBCT was taken before and after treatment, the measurements were analyzed by paired sample t test with SPSS 27.0 software package. Results:The measurement of the tongue position of the mouth-breathing and nasal-breathing groups were compared, the differences were statistically significant（P<0.05）. The measurement of the tongue position showed significant difference after the combined treatment of maxillary expansion and orofacial myofunctional therapy in children with mouth-breathing and skeletal class Ⅱmalocclusion（P<0.05）. Conclusion:Skeletal class Ⅱ malocclusion children with mouth-breathing have low tongue posture. The combined treatment of maxillary expansion and orofacial myofunctional therapy can change the position of the tongue.
Child ; Humans ; Myofunctional Therapy/methods* ; Mouth Breathing/therapy* ; Palatal Expansion Technique ; Tongue ; Malocclusion/therapy*