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 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

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.

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.

BACKGROUND: A stable and exact animal model is the necessary tool and basis for studying hemorrhagic cerebrovascular diseases.OBJECTIVE: To establish and evaluate the intracerebral capsular hemorrhage models in rats.DESIGN: A randomized and controlled animal experiment.SETTING: Second Hospital Affiliated to Xuzhou Medical College; First Hospital Affiliated to Nanjing Medical University.MATERIALS: This experiment was carried out in the animal experimental center of Nanjing Medical University during May to November 2002.Totally 35 SD rats were randomized into two groups: experimental group (n=30) and sham-operation group (n=5).METHODS: ① Autoblood was injected into the intracerebral capsule of rats to create intracerebral capsule hemorrhage models with stereotaxy in the experiment group. ②Scoring was conducted according to 5-point neurological scoring criteria from ZeaLonga, somatic sensation and motor function of rats were observed. ③Somatosensory evoked potential(SEP) of rats was detected pre- and post-operation under anesthetic state. ④ After determination of SEP, the rats were sacrificed under anesthetic state. Brains were taken out to made slices, then sections were stained with haematoxylin and eosin. Changes in haematoma and histomorphology were observed at the largest focus under optical microscope.MAIN OUTCOME MEASURES: ①Nerve function scoring; ②Latent period of various waves of SEP; ③ Observation of brain tissue morphology.RESULTS: Totally 35 rats entered the stage of result analysis. ①Appearance of obvious paralysis of the rats suggested the modeling was successful. The successful rate of this experiment was 93.3%(28/30). Significant difference existed in neurological scoring between experimental group [(2.74±0.46)points] and sham-operation group (0 point)(P＜0.05). ②SEP showed that the latent periods of various waves of experimental group after operation were significantly delayed than those before operation and those of sham-operation group [P1: (15.72±0.78) ms, (10.69±0.52) ms, (10.73±0.48) ms;Nl: (17.95±1.27) ms,(13.21±1.31) ms, (13.34±1.27) ms;N2:(21.16±1.62) ms, (15.42±1.46) ms,(15.58±1.44) ms;N3:(24.86±1.58) ms, (18.72±1.76) ms, (18.99±1.67) ms,P＜0.05]. ③In the shamoperation group, a few red blood cells were scattered in the peripheral area of needle channel were found, but hemorrhagic focus was not; In the experimental group, irregular or oval blood clots presented in the left internal capsule area. In about a low-fold visual field, brain tissue in the surrounding of hemorrhagic focus was loosened and swelled, and pathological changes were obviously severer than those in the sham-operation group.CONCLUSION: Intracerebral capsular hemorrhage induced by injection of autoblood with stereotaxy is more close to clinical situation, and it is easy to operate and has good reproducibility.

Objective To investigate whether lipids and reagents would interfere the results when serum total bile acid(TBA) was measured by enzymatic cycling assay.Methods The serum TBA was measured by enzymatic cycling assay.The carry-over contaminations of high density lipoprotein(HDL-C),low density lipoprotein(LDL-C),cholesterol(TC),and triglyceride(TG)rea-gents were evaluated.In order to reduce the interference and carry-over contaminations,different washing procedures and detection sequence were set.Results By measuring the levels of TBA in pooled serums with low and high levels of lipids,the results showed that there was statistically significant difference between the groups with and without the addition of cleaning process before and af-ter TBA measurement(P <0.01).Cleaning with water might be more effective on reducing interference than those with acid solu-tion.Moreover,the mean of TBA levels in HDL-C,TC,TG and LDL-C reagents were (476.06 ± 1.88 ),(127.78 ± 1.18 ), (121.05±1.08),and (2.23±0.51)μmol/L,respectively.The stability of TBA level was greatly affected by HDL-C regents,fol-lowing by TC and TG reagents,and was little affected by LDL-C reagent.Setting up proper detection sequence and flushing proce-dures could obviously reduce the interference(P <0.01),but not completely rule out.Conclusion Analysis sequence and flushing procedures of biochemical analyzer as well as exogenous substance from reagents may seriously affect the accuracy of determination results.To ensure the accuracy and reliability of the results,it is necessary not only to set up reasonable irrigation and reaction se-quence,but also to master the instrument operation,to know the principle of test reaction and the components of reagents as well as equipment maintenance.

Objective To compare the effect of Baikerui compound lysostaphin (FE complex phosphoesterasum) disinfectant and povidone iodine in treatment of burn wound infection resulted from gram-positive (G ±) coccus.Methods The study involved 60 patients with superficial second degree burns (1％-5％ TBSA； age range of 18-50 years).All the patients received bacterial culturing of wound secretions prior to treatment.Every 20 patients were indentified with infection of staphylococcus aureus (SA),staphylococcus epidermidis (SE),and enterococcus (EC) respectively and randomized into control group and experiment group,with 10 patients per group.Patients allocated to the experiment group were covered with four-layer sterile gauze soaked into the Baikerui compound lysostaphin disinfectant,while the patients in the control group were treated with four-layer sterile gauze soaked into the povidone iodine.Dressing was changed once a day.Wound culturing was performed again at each day of the 5-day treatment.Wound healing was compared among each group.Results SA wound infection turned negative for all the 10 patients in experimental group and three patients in control group (P ＜ 0.01).SE wound infection turned negative for all the 10 patients in experimental group and six patients in control group (P ＜ 0.05).EC wound infection turned negative for nine patients in experimental group and seven patients in control group (P ＞ 0.05).Mean wound healing time was (10.87 ± 1.93) days for experimental group and (13.31 ± 2.89) days for control group (P ＜ 0.05).Conclusion Baikerui compound lysostaphin disinfectant can effectively prevent burn wound infection with common G + coccus and accelerate wound healing.