Objective To evaluate the effect of mechanical stretch preconditioning on pathological stretch-induced activation of γ-aminobutyric acid (GABA) signaling pathway in human type Ⅱ alveolar epithelial cells (AEC Ⅱ).Methods AEC Ⅱ cell line (A549 cells) culturedin vitro were divided into control group (group C), pathological stretch group (group P1) and mechanical stretch preconditioning group (group P2). In group C, A549 cells were cultured routinely. In group P1, A549 cells were exposed to 20% cyclic stretch for 6 hours. In group P2, A549 cells were exposed to 5% cyclic stretch for 60 minutes, and then exposed to 20% cyclic stretch for 6 hours. The cells were harvested for determination of the cell viability by methyl thiazolyl tetrazolium assay, lactate dehydrogeuase (LDH) release was determined by colorimetric method, the levels of interleukin (IL-1β and IL-6) and tumor necrosis factor-α (TNF-α) were determined by enzyme linked immunosorbent assay (ELISA), the mRNA expressions of IL-1β, IL-6 and TNF-α were determined by reverse transcription-polymerase chain reaction (RT-PCR), and the protein expressions of glutamic acid decarboxylase (GAD) and γ-aminobutyric acid A receptor (GABAAR) were determined by Western Blot.Results Compared with group C, the cell viability of group P1 was significantlydecreased (A value: 0.196± 0.071 vs. 0.886±0.107), the release rate of LDH was significantly increased [(12.3±2.4)% vs. (1.9±0.5)%]; the contents and mRNA expressions of IL-1β, IL-6 and TNF-α in cell culture medium were significantly increased [IL-1β (ng/L): 138.6±19.7 vs. 32.7±7.4, IL-6 (ng/L): 196.5±31.7 vs. 55.4±13.8, TNF-α (ng/L): 111.3±21.8 vs. 20.8±7.6; IL-1β mRNA (2-ΔΔCT): 2.79±0.44 vs. 0.83±0.12, IL-6 mRNA (2-ΔΔCT): 1.99±0.25 vs. 0.56±0.11, TNF-α mRNA (2-ΔΔCT): 2.54±0.37 vs. 0.72±0.09]; the protein expressions of GAD and GABAAR were significantly decreased [GAD (gray value): 0.38±0.12 vs. 1.75±0.45, GABAAR (gray value): 0.29±0.09 vs. 1.68±0.39; allP < 0.05]. Compared with group P1, the cell viability of group P2 was significantly increased (A value: 0.523±0.132 vs. 0.196±0.071),the release rate of LDH was significantly decreased [(6.9±1.7)% vs. (12.3±2.4)%]; the contents and mRNA expressions of IL-1β, IL-6 and TNF-α in cell culture medium were significantly decreased [IL-1β (ng/L): 79.2±11.6 vs. 138.6±19.7, IL-6 (ng/L): 89.6±15.6 vs. 196.5±31.7, TNF-α (ng/L): 55.9±11.4 vs. 111.3±21.8; IL-1β mRNA (2-ΔΔCT): 1.92±0.36 vs. 2.79±0.44, IL-6 mRNA (2-ΔΔCT): 1.09±0.18 vs. 1.99±0.25, TNF-α mRNA (2-ΔΔCT): 1.77±0.25 vs. 2.54±0.37]; the protein expressions of GAD and GABAAR were significantly increased [GAD (gray value): 1.26±0.33 vs. 0.38±0.12, GABAAR (gray value): 1.04±0.15 vs. 0.29±0.09; allP < 0.05]. Conclusion The mechanism by which mechanical stretch preconditioning attenuates pathological stretch-induced injury in human AECⅡ is related to the activation of GABA signaling pathway.

Objective To establish and test the reliability and validity of the disease related psychological pressure scale of pregnant women with chronic HBV infection,so as to provide mental stress assessment tool for the pregnant women.Methods Item pool was developed after the interview and comprehensively retrieved literatures,then after expert review and rebuilt,the scale items were fixed.Totals of 368 pregnant women with chronic HBV infection disease were investigated and the reliability and validity of scale were test.Results The scale had 5 factors and 24 items,and the correlation coefficient between each factor score and total score was 0.712 - 0.894.The correlation coefficient among each factor was 0.409 - 0.631 which was significantly lower than that between each factor score and total score ( P ＜ 0.01 ).The cumulative contribution rate of 5 factors was 64.055％,and tes-retest reliability of 5 factors was 0.856,0.887,0.828,0.813.The Cronbach' s α of internal consistency of 5 factors was 0.788 - 0.865,and the Cronbach' s α of scale was 0.932.Conclusions The scale has good reliability and validity,and can be used for measuring the disease related pregnancy psychological pressure for chronic HBV infection pregnant women.

Objective This study was to assess the three-dimensional gross tumor volume(GTV)motion of lung cancer caused by respiration using four-dimensional computed tomography(4DCT),and to analyze the influenee factors.Methotis Four-DCT scans of 22 lung focuses in 21 patients with lung cancer were analyzed.The gross tumor volume was contoured in all 10 respiration phases of 4DCT scans.The changes in volume of GTV,the 3D motion of the centroid,boundary of GTV and the 3D spatial motion vectors were calculated and the irdluenee factors were analyzed.Results The average change in volume of GTV was+14.3%(0.2%.42.5%)/-8.4%(0.4%-38.6%),the average movement amplitude of GTV centroid and GTV boundary were(0.18±0.12)cm,(0.20±0.16)cm,(0.53±0.59)cm and(0.42±0.23)cm,(0.41±0.22)cm,(0.57±0.70)cm in medio-lateral,vertro-dorsal,cranio-caudal(CC) direction,respectively.The CC movement was larger than other directions(Z=-2.12,P=0.034;Z:-2.10,P=0.035),and no significant difference was observed in 3D motion of GTV boundary(Z=-0.81.P=0.417;Z=-0.86,0.391).The CC motion of GTV eentroid in lower lobe was larger than that in upper lobe[(0.87±0.64)and(0.35±0.49)cm,(t=-2.12,P=0.047)],and no significant difference was found in other directions[(0.23±0.10)and(0.19±0.18)em(t=-0.49,P=0.629),(0.21±0.13)and(0.17±0.11)cm(t=0.76,P=0.460)].There was no correlation of the 3D movement and 3D spatial motion vector of GTV to the volume of GTV(r=-0.306,-0.062,-0.279,-0.300;P=0.189,0.796.0.234,0.199).Conclusions GTV motion of patients with lung cancer is individual,the CC movement is the moat obvious,using 4DCT to assess is comparatively accurate.The motion amplitude of lower lobe focuses is larger.No significant correlation of the GTV motion to the volume was observed.Larger sample study is needed to analyze the influence of adjacency to the GTV motion.

Female ; Gastroenteritis ; complications ; Humans ; Infant ; Male ; Nitric Oxide ; physiology ; Rotavirus Infections ; complications ; Seizures ; etiology

OBJECTIVE To enhance the rational usage of antibiotics by comprehensive interventional measures in clinics.METHODS Several interventional measures have been adopted in our hospital since January 2001: to(establish) expert team on antibiotics usage and administration consultation;constitute antibiotics use criteria(suitable) for each clinical specialty;train and examine the usage of antibiotics;censor the distribution of pathogen and drug-resistance variance.Then 10% of the discharged medical records in 2000,2002 and 2004 were drawn out respectively to analyze the usage of antibiotics and the isolation of pathogen from nosocomial infection cases.(RESULTS) The proportion of the patients with prophylactic and remedial indications was increased remarkably((P

OBJECTIVETo observe the effect of Gengnianchun Recipe (GNC) on bone mineral density (BMD), bone biomechanical parameters and serum lipid level in the bilaterally ovariectomized (OVX) rats and to explore the prophylactic and therapeutic action of GNC on ovariectomy induced osteoporosis and hyperlipidemia.

METHODSOVX SD rats, 10 - 12 months old, were divided into different groups and fed with GNC 2 g/d, GNC 1 g/d and Nilestriol 0.125 mg/week, respectively for 4 months to observe the change of BMD and bone biomechanical parameters of the lumbar vertebrae, and the serum levels of total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C), and to compare the effect of the two drugs on the morphology of the uterus.

RESULTSThere was marked reduction in BMD and biomechanical parameters in lumbar vertebrae (P < 0.01) and increase of serum TC and LDL-C levels (P < 0.01) in rats after OVX. GNC or Nilestriol significantly improved the decreased BMD and biomechanical parameters of the lumbar vertebrae (P < 0.05 or P < 0.01), and reduced the serum TC and LDL-C levels (P < 0.01). In the Nilestriol group, the wet weight of uterus got increased obviously (P < 0.01), the number of uterine glands increased, uterine columnar epithelium thickened, and the mitotic figures in the epithelial stroma and myointimal cells augmented. But no such effect in wet weight and morphology of uterus was found in the GNC group.

CONCLUSIONGNC could increase the BMD and biomechanical parameters of the lumbar vertebrae, reduce the serum TC and LDL-C levels, yet produce no adverse reaction in stimulating proliferation and hypertrophy of uterus.

Animals ; Biomechanical Phenomena ; Bone Density ; drug effects ; Bone and Bones ; drug effects ; Cholesterol ; blood ; Cholesterol, HDL ; blood ; Cholesterol, LDL ; blood ; Drugs, Chinese Herbal ; pharmacology ; Estriol ; analogs & derivatives ; pharmacology ; Female ; Lipids ; blood ; Ovariectomy ; Quinestrol ; analogs & derivatives ; Rats ; Rats, Sprague-Dawley ; Triglycerides ; blood ; Uterus ; cytology ; drug effects

Objective To evaluate the accuracy of variation of the end-tidal pressure of carbon dioxide (△PETCO2) in predicting the fluid responsiveness in patients undergoing resection of gastrointestinal tumor.Methods Forty-six patients of both sexes,aged 40-64 yr,with body mass index of 20-24 kg/m2,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,undergoing elective resection of gastrointestinal tumor with general anesthesia,were enrolled in the study.When the change in mean arterial pressure was less than 10％ within 5 min after anesthesia induction,250 ml Ringer's solution was rapidly infused over 10 min via the peripheral vein.Increase in cardiac index after volume expansion ≥ 15％ was considered to be a positive response.The receiver operating characteristic curve for △PETCO2 in determining fluid responsiveness was drawn.Results The results of receiver operating characteristic curve analysis showed that the area under the curve for △PETCO2 in determining fluid responsiveness (95％ confidence interval) was 0.826 (0.730-0.942,P＜0.05),the critical value 21.9％,sensitivity 76.5％,specificity 90.9％.Conclusion △PETCO2 can accurately predict the fluid responsiveness in patients undergoing resection of gastrointestinal tumor.

OBJECTIVETo explore the effects of obesity on the peak level of luteinizing hormone (LH) in the gonadotropin-releasing hormone (GnRH) agonist test and obesity-related hormones in girls with central precocious puberty (CPP).

METHODSThree hundred and thirty-three girls with CPP who underwent the GnRH agonist test between 2012 and 2014 were classified into three groups: normal weight (n=123), overweight (n=108), and obesity (n=102), according to body mass index (BMI). The sexual development indices were compared between the three groups. Twenty girls were randomly selected from each group for evaluation of the serum levels of leptin, sex hormone binding globulin (SHBG), neurokinin B, and kisspeptin. The correlation of BMI with the levels of various hormones was assessed using Pearson correlation analysis.

RESULTSThere was no significant difference in mean age at diagnosis between the three groups; however, the bone age was significantly higher in the overweight and obesity groups than in the normal weight group (P<0.05). The peak level of LH in the GnRH agonist test and SHBG level in the normal weight group were significantly higher than those in the overweight and the obesity groups, while the serum levels of leptin and neurokinin B were significantly lower in the normal weight group than in the overweight and the obesity groups (P<0.05). BMI was negatively correlated with the peak level of LH in the GnRH agonist test and SHBG level (P<0.05), and positively correlated with the levels of leptin and neurokinin B (P<0.05).

CONCLUSIONSThe effects of BMI on the result of the GnRH agonist test and levels of obesity-related hormones should be taken into account in girls with precocious puberty.

Body Mass Index ; Child ; Female ; Gonadotropin-Releasing Hormone ; agonists ; Humans ; Leptin ; blood ; Luteinizing Hormone ; blood ; Neurokinin B ; blood ; Obesity ; blood ; Puberty, Precocious ; blood ; Sex Hormone-Binding Globulin ; analysis

OBJECTIVETo investigate the dosimetric benefit of 4D-CT in the planning target volume (PTV) definition process compared with conventional PTV definition using general margin in radiotherapy of lung cancer.

METHODSA set of 4D-CT images and multiphase helical CT scans were obtained in 10 patients with lung cancer. The radiotherapeutic plans based on PTV determined by 4D-CT and in addition of general margin were performed, respectively. The 3D motion of the centroid of GTV and the 3D spatial motion vectors were calculated. The differences of the two kinds of PTVs, mean lung dose (MLD), V5,V10,V15,V20 of total lung, mean heart dose (MHD), V30 and V40 of heart, D99 and D95 were compared, and the correlation between them and the 3D spatial motion vector was analyzed.

RESULTSThe PTV4D in eight patients were smaller than PTVconv, with a mean reduction of (13.0 ± 8.0)% (P = 0.018). In other two patients, whose respiration motion was great, PTV4D was larger than PTVconv. The mean 3D spatial motion vector of GTV centroid was (0.78 ± 0.72)cm. By using 4D-CT, the mean reduction of MLD was (8.6 ± 9.9)% (P = 0.037). V5, V10, V15, V20 of total lung were decreased averagely by (7.2 ± 10.5)%, (5.5 ± 8.9)%, (6.5 ± 8.4)% and (5.7 ± 7.4)%, respectively (P < 0.05 for all). There was a significant positive correlation between PTV4D/PTVconv and the 3D spatial motion vector of the GTV centroid (P = 0.008). A significant inverse correlation was found between D994D/D99conv and the 3D spatial motion vector of the GTV centroid (P = 0.002). D994D/D99conv, (MLDconv-MLD4D) /MLDconv, total lung (V5conv-V54D)/V5conv, total lung (V10conv-V104D)/V10conv, (MHDconv-MHD4D)/MHDconv, heart (V30conv-V304D)/V30conv were inversely correlated with PTV4D/PTVconv (P < 0.05 for all).

CONCLUSIONS4D-CT can be used to evaluate the respiration motion of lung tumor accurately. The 4D-CT-based PTV definition and radiotherapeutic planing can reduce the volume of PTV in patients with small respiration motion, increase the intra-target dose, and decrease the dose of normal tissue sequentially. For patients with large respiration motion, especially those more than 1.5-2 cm, this method can avoid target miss, meanwhile, not increase the dose of normal tissue significantly.

Four-Dimensional Computed Tomography ; methods ; Humans ; Lung ; physiopathology ; Lung Neoplasms ; radiotherapy ; Movement ; Radiometry ; Radiotherapy Planning, Computer-Assisted ; methods ; Respiration ; Tomography, X-Ray Computed ; methods

Objective To evaluate the changes in activation of γ?aminobutyric acid(GABA)sig?naling pathway during ventilator?induced brain injury in rats. Methods Thirty?six pathogen?free adult male Sprague?Dawley rats, weighing 280-320 g, were divided into 3 groups(n=12 each)using a random number table: low tidal volume group(LV group), ventilation with high tidal volume for 2 h group(HV1 group)and ventilation with high tidal volume for 6 h group(HV2group). The rats were mechanically ven?tilated for 2 h with the tidal volume set at 10 ml∕kg and the respiratory rate 40 breaths∕min in group LV. The rats were mechanically ventilated for 2 h with the tidal volume set at 40 ml∕kg and the respiratory rate 40 breaths∕min in group HV1. The rats were mechanically ventilated for 6 h with the tidal volume set at 40 ml∕kg and the respiratory rate 40 breaths∕min in group HV2. Blood samples were collected at the end of ven?tilation for determination of serum neuron?specific enolase(NSE)and S100β protein concentrations by en?zyme?linked immunosorbent assay. Six rats were then sacrificed and their brains were removed for determi?nation of interleukin?1β(IL?1β)and tumor necrosis factor?α(TNF?α)contents(by enzyme?linked im?munosorbent assay)and expression of glutamic acid decarboxylase(GAD)and GABAAreceptors(by Western blot). Morris water maze test was performed on 2nd day after the end of ventilation. Results Compared with group LV, the serum concentrations of NSE and S100β protein and contents of IL?1β and TNF?α were significantly increased, the expression of GAD and GABAAreceptors was up?regulated, the es?cape latency was prolonged, and the percentage of swimming distance at the original platform was decreased in HV1and HV2groups(P<0.05). Compared with group HV1, the serum concentrations of NSE and S100β protein and contents of IL?1β and TNF?α were significantly increased, the expression of GAD and GABAAreceptors was up?regulated, the escape latency was prolonged, and the percentage of swimming distance at the original platform was decreased in group HV2(P<0.05). Conclusion Activation of GABA signaling pathway is enhanced during ventilator?induced brain injury, which may be involved in the patho?physiological mechanism of ventilator?induced brain injury in rats.