Objective To analyse the imaging characteristics of solitary pulmonary nodules(SPNs) with the spiral CT, and detection clinical values of the definitive diagnosis to SPNs. Methods 32 cases of SPNs were identified by spiral CT, 9 cases of them were examinated by enhancement scanning. The diffrentical imaging features were analyzed. Results 24 cases were malignant in imaging(18 cases were identified), 8 cases were benign in imaging(6 cases were identified). 15 cases of malignant SPNs by clinical identified were smooth at edge; 6 cases of benign SPNs by clinical identified. 5 cases of them were anomaly;4 cases of them were burr;2 cases of them were bronchial sign and vesiclat sign.6 cases of the SPNs were calcified. 6 cases of SPNs(9 cases with contrasting) were benign in imaging, 3 cases of them were malignant in imaging. Conclusion The differential diagnostic of SPNs is difficult by spiral CT, but enhancement scanning and epidemiology combined with spiral CT is very valuable for definitive diagnosis.

Accessory navicular source flatfoot is one of the foot deformity of clinical common disease,its treatment method is more controversial, differences in clinical efficacy of different surgical methods, according to accessory navicular source flatfoot symptoms of surgical treatment,there is no uniform standard, around a pair of accessory navicular excision how to reconstruct the arch produced a series of operation methods, the clinical curative effect of different operative methods produce also different, how to develop the operation strategy, choose operation method, and after acessory navicular excision whether to rebuild posterior tibial tendon, how to rebuild, the problems such as how to rebuild is the research hotspot and difficulty, looking forward to further research.
Flatfoot ; diagnosis ; surgery ; Foot Diseases ; surgery ; Humans ; Reconstructive Surgical Procedures ; methods ; Tarsal Bones ; abnormalities ; surgery

Objective To investigate the protective effect of ischemia preconditioning(IPC)on apoptosis in-duced by renal ischemia - reperfusion(IR)and relations to the changing expressions of Bcl - 2,Bax in rat kidney. Methods Ischemia models were induced by clipping bilateral renal pedicles for 30 min by using the artery clamp;IPC group was induced by clipping bilateral renal pedicles for 15 min,4 days later IR was performed again by clipping bila-teral renal pedicle for 30 min. Rats were randomly divided into 5 groups with 5 animals in each group:control group(C group),sham - operation group(S group),IR group,IPC group(IPC ﹢ IR group),sham IPC group(S ﹢ IR group),all groups were randomly divided into 9 sub groups(0 h,3 h,6 h,12 h,24 h,48 h,3 d,5 d,7 d)except C group according to the time points after reperfusion. Occurrence of apoptosis was detected by terminal deoxynuleotidyl transferase media-ted dUTP nick end and labeling(TUNEL)method;the mRNA expression and protein levels of Bax and Bcl - 2 were de-tected by reverse transcriptase - polymerase chain reaction and quantitave immunohistochemisty. Results (1)Com-pared with S group and S ﹢ IR group,serum creatinine,blood urea nitrogen,kidney pathological damage scores in IR group gradually increased after IR,and peak point was 24 h after reperfusion;among all the subgroups there was a sig-nificant difference(all P ﹤ 0. 01). The expression of Bax,Bcl - 2 mRNA raised sharply in IR group after reperfusion, peaking at 6 h,24 h of reperfusion respectively,2. 66 ± 0. 12,2. 70 ± 0. 10,and among all the subgroups there was a sig-nificant difference(all P ﹤ 0. 01);the expression of Bax,Bcl - 2 protein had significant difference(all P ﹤ 0. 05). TUNEL immunofluorescence staining showed C group and S group had no obvious apoptosis cells in renal tubular epi-thelium;epithelial cell apoptosis after IR gradually increased in IR group,peaking at 24 h of reperfusion[(25. 07 ± 2. 29)% ].(2)Compared with IR group and S ﹢ IR group,pathological injury was significantly decreased in IPC ﹢ IR group;the expression of Bax,Bcl - 2 mRNA and protein,apoptosis cells were significantly decreased in IPC ﹢ IR group (all P ﹤ 0. 05). Conclusions Bax,Bcl - 2 are closely associated with kidney injury induced by IR. IPC may regulate acute kidney injuries by regulating Bax/ Bcl - 2.

Objective To investigate the expression and significance of microRNA - 21(miR - 21)in acute kidney injury mice model at the different time points following ischemic/ reperfusion. Methods C57BL/ 6J mice were divided into 3 major groups:the control group(C group),sham operation group(S group)and ischemia - reperfusion group(IR group). Later 2 groups were divided into 9 sub - groups respectively according to the time following reperfu-sion. Automatic biochemical analyzer detected serum creatinine(Scr),blood urea nitrogen(BUN)level. HE staining detected renal pathological damage. Renal tubulointerstitial pathological score accessed pathological damage. Real time - PCR tested the expression of miR - 21 and mitogen - activated protein kinase kinase 3(MKK3)mRNA in renal respectively. Immunohistochemistry staining tested expression of MKK3. Results IR group's Scr,BUN levels gradually increased following reperfusion,24 h reached its peak,then gradually declined. The Scr,BUN level had statistically sig-nificant difference between IR group and S group at the same time subgroup from 3 h to 168 h following reperfusion(all P ﹤ 0. 01). The change of kidney damage and pathological changes of interstitial and tubular injury score consensus with renal function. miR - 21 increased gradually in renal ischemia after reperfusion,24 h peaked and then stabilized at this high level. miR - 21 was positively correlated with pathological tubulointerstitial injury from 0 h to 168 h after reperfu-sion(r = 0. 969,P ﹤ 0. 05). IR group's MKK3 mRNA and protein expression rose sharply following ischemia/ reperfu-sion,24 h peaked,and then gradually decreased. From 3 h to 168 h,the expression of MKK3 mRNA and proteins had significant difference at each same time points subgroups between IR group and S group(all P ﹤ 0. 01). Conclusions miR - 21 increases gradually in renal ischemia after reperfusion,24 h peaked and then stabilized at this high level. miR - 21 is positively correlated with pathological tubulointerstitial injury,which may be associated with the negative regulated relationship between miR - 21 and MKK3.

OBJECTIVETo observe the effect of platelet derived growth factor receptor β (PDGFR-β) transfected endothelial progenitor cells (EPCs) on vascular regeneration.

METHODSSpleen-derived mononuclear cells (MNCs) were isolated using density gradient centrifugation and induced with special culture medium. EPCs transfection was performed with Lipofectamine(TM) 2000 reagent according to the instruction manual. Carotid artery injury was induced in splenectomized mice. EPCs were injected by tail vein immediately and at 24 h after endothelial injury of the carotid artery. Evans blue staining was performed to evaluate reendothelialization at 7 days after endothelial injury of the carotid artery.

RESULTSMost adherent cells were LDL and UEA-I double positive. Laser scanning confocal microscopy showed that transfection efficiency was about 50%-60%. The reendothelialized area in the PDGFR-β-EPCs group was significantly larger than that in EGFP-EPCs group.

CONCLUSIONTransplantation of PDGFR-β over-expressed EPCs can promote reendothelialization in the early phase after carotid artery injury.

Animals ; Carotid Artery Injuries ; pathology ; surgery ; Cells, Cultured ; Disease Models, Animal ; Endothelial Cells ; cytology ; metabolism ; transplantation ; Endothelium, Vascular ; cytology ; Male ; Mice ; Mice, Inbred C57BL ; Receptors, Platelet-Derived Growth Factor ; genetics ; metabolism ; Regeneration ; Stem Cell Transplantation ; Stem Cells ; cytology ; metabolism

OBJECTIVETo prepare sustained-release capsules of cinnamon oil with stearic acid, polyethylene glycol 6000 and gluceryl monostearate.

METHODSAfter the solid dispersion of cinnamon oil was prepared by melting method, the effects of the process variables and formulation variables on solid dispersion and dissolution were investigated. The formulation and preparation process of cinnamon oil solid dispersion were optimized by orthogonal design, and Fourier-transformed infrared (FTIR) spectroscopy was employed to detect the possible molecular interaction between cinnamon oil and the adjuvants.

RESULTSThe in vitro release percentage of the optimized formula complied with the Higuchi equation, and the preparation allowed drug delivery for 12 h. Analysis with FTIR spectroscopy revealed interactions between cinnamon oil and the adjuvents and formation of the solid dispersion.

CONCLUSIONThe solid dispersion capsules prepared through this simple and well reproducible process allow obviously sustained release of cinnamon oil.

Capsules ; Cinnamomum zeylanicum ; chemistry ; Delayed-Action Preparations ; chemistry ; pharmacokinetics ; Drug Compounding ; Drugs, Chinese Herbal ; chemistry ; pharmacokinetics ; Oils, Volatile ; chemistry ; pharmacokinetics ; Technology, Pharmaceutical

Objective: To explore age, gender, and regional differences in physical activity among children and adolescents in China, and to provide a scientific reference for enhancing physical activity promotion. Methods: A total of 4 269 children and adolescents aged 7 to 18 years were selected from six administrative regions of China (East China, Northwest China, North China, Central China, Southwest China and South China) using a stratified random cluster sampling method from September to December 2018. A questionnaire was administered to evaluate the physical activity level of Chinese children and adolescents aged 7 to 18. Results: The overall detection rate of MVPA insufficiency in children and adolescents in China was 53.8%, of which the detection rate of MVPA insufficiency was 50.8% among boys and 57.1% among girls. Gender differences were statistically significant ( χ 2= 17.10 , P <0.05). Among the different age groups, the lowest detection rate of MVPA among 10-12 year olds was 43.6%, whereas the highest rate among 16-18 year olds was 63.0%, with significant differences between gender ( χ 2=4.33, 30.79, P <0.05). The P 50 values of total physical activity(TPA), light intensity physical activity(LPA), moderate intensity physical activity(MPA), vigorous intensity physical activity(VPA), moderate to vigorous physical activity(MVPA) were 92.9,24.3,41.4,7.1 and 55.7 min/d , respectively. The P 50 values of physical exercise, housework activities, entertainment activities and transportation activities were 34.3 , 2.1, 2.3 and 30.0 min/d, respectively, and the difference in age groups was statistically significant( H =95.03, 74.99, 300.26 , 64.16, P <0.05). There was a statistically significant difference in the detection rate of insufficient MVPA among children and adolescents in different regions ( χ 2=83.91, P <0.05). The lowest rate was 44.0% in North China, and the highest was 65.9% in East China. Conclusion The detection rate of MVPA insufficiency among Chinese children and adolescents firstly decreased and then increased with age. Boys participated in higher levels of physical activity than girls.

OBJECTIVETo investigate the effects of different anesthesia depth on stress response in elderly patients undergoing elective laparoscopic surgery for colorectal cancer.

METHODSA total of 105 ASA I-III patients aged 60-91 years undergoing elective laparoscopic surgery for colorectal cancer with general anesthesia were randomized into 3 groups, namely group A with a target Narcotrend index (NI) maintained at D0 level, group B with a NI at D2 level, and group C with a NI at E1 level. The anesthetics (profopol and remifentanil) were adjusted according to Narcotrend monitoring results to maintain the specified anesthesia depth. The patients' heart rate (HR) and mean artery pressure (MAP) were recorded before anesthesia (T0), before intubation (T1), immediately after intubation (T2), at 2 min before pneumoperitoneum (T3), 2 min after pneumoperitoneum (T4), at the end of the surgery (T5) and extubation (T6). Serum levels of cortisol, adrenocorticotropic hormone (ACTH), endothelin-1 (ET-1), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and C-reactive protein (CRP) were measured by standard ELISA and radioimmunoassay before anesthesia (Ta), at the end of the surgery (Tb) and 1 day after the surgery (Tc).

RESULTSHR and MAP in group A increased significantly at T2, T4, and T6 compared to those at T0 (P<0.05), and were higher than those in group B and group C (P<0.05). The MAP in all the 3 groups all decreased at T1 and T3 (P<0.05 or P<0.01), and was markedly lower in group C than in groups A and B (P<0.05). The incidence of hypertension was significantly higher in group A than in groups B and C (P<0.05), while the incidence of hypotension was much higher in group C (P<0.01). There were no obvious differences in serum levels of cortisol, ACTH, CRP, IL-6, TNF-a, or ET-1 among the groups at Ta (P>0.05). The serum levels of ACTH in the 3 groups all significantly increased at Tb and Tc (P<0.01). CRP, IL-6 and TNF-a levels in group A were increased at Tb and Tc (P<0.05 or P<0.01) and significantly higher than those in groups B and C (P<0.05 or P<0.01). Cortisol in groups A and B increased at Tb and Tc (P<0.05) to a significantly higher level than that in group C (P<0.01). ET-1 level in group C at Tb and Tc was lower than those in groups A and B (P<0.05 or P<0.01).

CONCLUSIONSMaintaining the anesthesia depth for a NI at the D2 and E1 level can both attenuate the stress response in elderly patients undergoing laparoscopic surgery for colorectal cancer, but the hemodynamic stability can be better at a D2 level.

Adrenocorticotropic Hormone ; blood ; Aged ; Aged, 80 and over ; Anesthesia, General ; methods ; Blood Pressure ; C-Reactive Protein ; metabolism ; Colorectal Neoplasms ; surgery ; Elective Surgical Procedures ; Endothelin-1 ; blood ; Heart Rate ; Humans ; Hydrocortisone ; blood ; Interleukin-6 ; blood ; Laparoscopy ; Middle Aged ; Piperidines ; administration & dosage ; Propofol ; administration & dosage ; Tumor Necrosis Factor-alpha ; blood

OBJECTIVETo compare the 2-DE profiles for serum proteins of different pathological stages during hepatocarcinogenesis.

METHODSSera from hepatocellular carcinoma patients, cirrhosis patients, chronic hepatitis patients and healthy controls were collected. After sonication, albumin and immunoglobulin (IgG) depletion, and desalination, sera were subjected to 2-DE, the differential protein spots were identified by MALDI-TOF-MS. Western blot was used to validate these differentially expressed proteins.

RESULTS2-DE sera protein profiles were obtained from the patient suffering from HCC, liver cirrhosis, chronic hepatitis, healthy controls in each group. From optimized 2-DE gel images of the above groups, 96 protein spots with more than 2-fold difference in intensity between the two groups were selected by image master 6.0 software, differential proteins including haptoglobin, SAA1 and SP40 were identified by MALDI-TOF-MS/MS. 7 different spots within more than 30 protein spots belonged to the same haptoglobin family. The differential expression of haptoglobin was confirmed by western blot.

CONCLUSIONSFour protein expression patterns have been identified during the pathological stages of hepatocarcinogenesis. Haptoglobin is significantly increased from liver cirrhosis to HCC. It implies that haptoglobin might be a potential biomarker in the early diagnosis of liver cancer.

Adult ; Biomarkers, Tumor ; blood ; Blood Proteins ; analysis ; Blotting, Western ; Electrophoresis, Gel, Two-Dimensional ; methods ; Female ; Haptoglobins ; analysis ; Hepatitis, Chronic ; blood ; pathology ; Humans ; Liver Cirrhosis ; blood ; pathology ; Liver Neoplasms ; blood ; pathology ; Male ; Middle Aged ; Proteome ; metabolism ; Proteomics ; methods ; Young Adult

The epidemic of coronavirus disease 2019 (COVID-19) puts higher demands on critical care medicine. Lots of studies have been conducted to solve COVID-19-related problems. Therefore, we reviewed the annual progress for COVID-19-related issues including antivirals threapies, respiratory support and immunomodulatory therapies and other critical issues, including the effect of antibiotic on mitochondrial damage and its relationship with sepsis, the goal and direction of antimicrobial de-escalation, drug prophylaxis of constipation, bleeding in gastrointestinal disorders and management of critical illness in the informalization era and so on. We hope to provide reference for clinical and scientific research work of the intensivists.