Objective To investigate N-terminal pro-B-type natriuretic peptide (NT-proBNP) cutoff value for the mortality in different age groups in critically ill patients.Methods A retrospective study was conducted.295 patients admitted to the intensive care unit (ICU) of 401st Hospital of PLA from January 2011 to October 2012 were divided into two groups according to age [group with age＜65 years old (n=105) and group with age≥ 65 years old (n =190)].The concentrations of serum NT-proBNP,hematocrit (HCT),procalcitonin (PCT),C-reactive protein (CRP),serum creatinine (SCr),estimated glomerular filtration rate (eGFR),acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score and probability of survival (PS) were recorded within 24 hours.The primary outcome was ICU mortality.Receiver operator characteristic curve (ROC curve) was used to evaluate the value of NT-proBNP for predicting the mortality.Results ① There were no significant differences in the length of stay in ICU,mechanical ventilation rate,the mortality,the incidence of cardiovascular disease,digestive disease,neurologic disease,and the number of patients having received operation,HCT,PCT and CRP between the two groups (all P＞0.05).The percentage of the male,the APACHE Ⅱ score,the percentage of respiratory disease,and NT-proBNP in group with age ≥ 65 years old were higher than those of the group with age ＜ 65 years old [the percentage of the male:51.6％ vs.33.0％,x2=9.093,P=0.003; APACHE Ⅱ score:22.94 ±8.10 vs.19.44 ±8.51,Z=-3.259,P=0.001; the percentage of respiratory disease:29.47％ vs.17.14％,x2=5.472,P=0.024; NT-proBNP(ng/L):5 859.00(2 050.75,23 802.75) vs.2 882.00 (275.15,6 236.00),Z=-5.514,P=0.000]; PS,the percentage of patients having multiple injuries and other diseases and eGFR in group with age ≥65 years old were lower than those of the group with age ＜65 years old [PS:59.0 (31.5,79.0)％ vs.70.0 (40.0,84.0),Z=-3.431,P=0.001; the percentage of multiple injuries:0.53％ vs.17.14％,x2=30.987,P=0.000; the percentage of other disease:5.79％ vs.13.33％,x2=4.962,P=0.030; eGFR (ml·min-1· 1.73 m-2):81.07 (45.77,131.80) vs.95.54 (33.64,165.55),Z=-2.214,P=0.027].② The area under the ROC curve (AUC) [95％ confidence interval (95％ CI)] of NT-proBNP in patients with age＜65 years old was significantly higher than that of group with age≥65 years old and the entire group [0.825(0.738-0.892) vs.0.664 (0.592-0.731) and 0.725 (0.670-0.775),Z1 =-2.835,P1 =0.005; Z2=-1.995,P2=0.046].③ The sensitivity (76.]0％ vs.64.10％),specificity (82.35％ vs.67.12％),positive predictive value (90.0％ vs.75.8％),and negative predictive value (62.2％ vs.53.8％) with cutoff value of NT-proBNP (2 882 ng/L) in group with age ＜65 years old were significantly higher than those with NT-proBNP cutoff value (6 062 ng/L) in group with age ≥ 65 years old.Conclusion NT-proBNP cutoff value in different age groups for the prediction of mortahty in the critically ill patients maybe more objective and accurate.

Objective To analyze the surgical treatment options and its results for thoracic and thoracolumbar disc herniation.Methods From June 2004 to December 2009,thirty-one patients of thoracic and thoracolumbar disc herniation with or without ossification of ligament flavum were surgically treated,including 22 males and 9 females,with a mean age of 54 years(range,24 to 71 years).According to Anand and Regan clinical classification,there was type 2 for 1 case,grade 3a for 2,grade 3b for 3,grade 4 for 6,and grade 5 for 19.The neurological status was Frankel B for 2 cases,C for 6,D for 11,and E for 12.Anterior surgeries were performed for 18 patients without ossification of ligament flavum.Anterior decompression was performed through the resection of posterior part of vertebral body,or subtotal resection of vertebral body,followed by strut graft and internal fixation.Posterior surgeries were performed for 13 patients with disc herniation and ossification of ligament flavum.The resection of hemi-articular process and total laminectomy was performed.Results The complications of 18 patients with anterior surgery included laceration of dura mater in 1 case,nerve root sleeve injury in 1 case,intercostal neuralgia in 3 cases,atelectasis in 1 case,and femoroiliac numbness in 2 cases.The complications of 13 patients with posterior surgery included intra-canal hematoma in 1 cases,leakage of cerebrospinal fluid in 2 cases,infection of incision in 1 cases,and pneumonia in 1 case.The patients were followed for 18 months(range,6 to 48 months).At final follow-up,the neurological status and local symptom improved in all patients,with Frankel C for 3 cases,D for 7,and E for 21;and Anand and Regan type 1 for 2 cases,2 for 1,3a for 1,4 for 2,5 for 10 and no symptom for 15.Conclusion For thoracic and thoracolumbar disc herniation,anterior surgery is suitable for patients mainly suffered anterior cord compression.Resection of posterior part of vertebral body or subtotal resection of vertebral body is often needed for sufficient decompression.Posterior surgery is suitable for patients with anterior and posterior cord compression due to ossification of ligament flavum,and the decompression can be obtained by resection of hemi-articular process and total laminectomy.

According to bias in codon choice of Pichia pastoris, The phytase phyA gene from Aspergillus niger N25 was mutated without changing its amino acid sequence. The expression plasmid pPIC9k-phyAm was constructed and transformed into GS115 strain. Positive clones,of which the chromosomes were integrated with phyA gene,were identified by the phenotype and PCR. SDS-PAGE analysis suggust that the size of enzyme protein of the expression product was about 70.15kDa.Southern blotting analysis to the yeast transformants showed that phyA gene was intergrated into the chromosome genome. The phytase activity of PP-NP m-4-4 with codons optimized reached 136 000U/ml in malt wort culture medium after being induced with 36h, which was the 2.8 times of the original strain PP-NPm-8.

Objective To investigate the effect of 12-lipoxygenase (12-LO) on the angiotensinⅡtype 1 receptor(ATlR) expression in mesangial cells (MC).Methods p38 MAPK activation and ECM protein expression were determined using AngⅡ-stimulated MC derived from normal and 12-LO knockout mice.AT1R expression was determined using 12-LO product 12(S)- HETE-stimulated MC,MC transfected with 12-LO gene and microdissected glomeruli derived from 12-LO knockout mice.RT-PCR and Western blot were used for evaluating mRNA and protein expression respectively.Results AngⅡstimulation increased p38 MAPK activation and ECM protein expression in normal MC,but not in MC derived from 12-LO knockout mice.Time-dependent and dose-dependent experiment showed that 12 (S)- HETE increased AT1R protein' expression in MC. Similarly,12 (S)-HETE increased AT1R mRNA expression in MC compared with control MC (P＜0.01). Furthermore,AT1R expression was lower in glomeruli derived from 12-LO knockout mice relative to genetic controls (P＜0.01) and MC stably overexpressing 12-LO had greater AT1R protein and mRNA expression relative to control MC (P＜0.01).Conclusion 12-LO activation can upregulate ATIR expression in MC.

OBJECTIVE: To realize the application of nasal obstruction symptom evaluation (NOSE) and Epworth sleep score (ESS) before and after nasal cavity ventilation expansion techniques. METHOD: Forty-two OSAHS patients with nasal obstructive symptoms were diagnosed by clinical symptoms and polysomnography. Nasal cavity ventilation expansion technique was performed. Before and after the surgery, the NOSE and ESS were used to compare the difference. Postoperative data were obtained at least 3 months later. RESULT: Compared the data before and after operation, the NOSE and ESS were significantly decreased respectively (P<0. 05), there is no significant difference between 3 groups (P>0. 05). CONCLUSION The result suggest that OSAHS patients taking nasal cavity ventilation expansion operations showed improvement in severity of nasal obstructive symptoms and daily sleepy.
Humans ; Nasal Cavity ; surgery ; Nasal Obstruction ; physiopathology ; surgery ; Nasal Surgical Procedures ; Paranasal Sinuses ; Polysomnography ; Sleep ; Sleep Apnea, Obstructive ; physiopathology ; surgery ; Surveys and Questionnaires ; Symptom Assessment ; methods

BACKGROUND:To dynamicaly monitor the varying levels of inflammatory factors in the gingival crevicular fluid is helpful to assess the early effect of orthodontic tooth movement. Myeloperoxidase, soluble intercelular adhesion molecule-1, pentraxin 3 are proven to be closely related to inflammation, but it is unclear about the levels of these three kinds of inflammatory factors as wel as association of these three kinds of inflammatory factors with orthodontic tooth. OBJECTIVE:To detect the expression levels of myeloperoxidase, soluble intercelular adhesion molecule-1 and pentraxin-3 in the gingival crevicular fluid during maxilary canine distal movement and to assess their correlation with periodontal disease, canine movement distance and orthodontic force. METHODS:Twenty-one orthodontic patients were enroled and assigned into 150 g (n=12) or 100 g (n=9) groups according to orthodontic force. The gingival crevicular fluid samples of orthodontic patients were colected before and at 4, 12, 24 hours, 7, 14 days after maxilary canine distal movement. Levels of myeloperoxidase, soluble intercelular adhesion molecule-1 and pentraxin-3 in the gingival crevicular fluid were measured and analyzed using ELISA assay. RESULTS AND CONCLUSION: During the distal movement of maxilary canine, under orthodontic force, the level of myeloperoxidase was peaked at 4 hours and then decreased, while the expression level of soluble intercelular adhesion molecule-1 was peaked at 12 hours, and then decreased. Both myeloperoxidase and soluble intercelular adhesion molecule-1 levels returned to normal at 7 days under orthodontic force. The expression level of pentraxin-3 was increased significantly under orthodontic force, peaked at 24 hours, and then decreased gradualy to the normal level at 7 days. In addition, the expression levels of myeloperoxidase, soluble intercelular adhesion molecule-1 and pentraxin-3 in the gingival crevicular fluid were significantly higher under 150 g force than under 100 g force. These findings indicate that detecting varying levels of myeloperoxidase, soluble intercelular adhesion molecule-1 and pentraxin-3 in the gingival crevicular fluid is useful to assess the efficiency of orthodontic treatment and prevent adverse reactions.

BACKGROUND: Salvianolic acid B can ease nerve injury and promote neurogenesis, but its effects on proliferation,apoptosis and differentiation of neural stem cells in the hippocampus remain unclear.OBJECTIVE: To study the effects of salvianolic acid B on proliferation, apoptosis and differentiation of rat hippocampal neural stem cells following oxygen-glucose deprivation.METHODS: Hippocampal neural stem cells were isolated from newborn Sprague-Dawley rats, and divided into six groups, five of which were cultured in an incubator containing anaerobic mixtures (1% O2, 5% CO2 and 94% N2) for 150minutes followed by treatment with different concentrations of salvianolic acid B (0, 5, 10, 20, 40 mg/L), respectively.After 4 days of intervention, MTT was used to detect cell proliferation. After 48 hours of intervention, flow cytometry was used to detect cell apoptosis in the hippocampus. After 5 days of culture, flow cytometry was performed to evaluate the percentage of cells positive for neuron-specific enolase and glial fibrillary acidic protein. Normally cultured cells acted as controls (normoxic group).RESULTS AND CONCLUSION: Compared with the normoxic group, the proliferation of neural stem cells was decreased significantly (P < 0.01) and the rate of apoptosis was increased in the oxygen-glucose deprivation group (P <0.01). After treatment with different concentrations of salvianolic acid B, the cell viability and the ratio of neurons in total cells were increased, and the ratio of astrocytes was decreased, especially in 20 and 40 mg/L groups (P < 0.01). In conclusion, these results suggest that salvianolic acid B alleviates adverse effects of oxygen-glucose deprivation on neural stem cell proliferation, differentiation and apoptosis.

BACKGROUND:Liquiritin has the protective and nutritive effects on neural stem cells. However, the effect of liquiritin on neural stem cells from the brain of mouse embryos remains unclear. OBJECTIVE:To investigate the effects of different concentrations of liquiritin on the proliferation of neural stem cells from the brain of mouse embryos. METHODS:Neural stem cells were separated from the embryonic brain of Kunming white mice at the gestational age of 14 days. The identification of embryonic neural stem cells was performed by immunocytochemistry method. The expression of neural stem cells-special genes was determined by qRT-PCR. The cell growth curve was drawn and proliferation of embryonic neural stem cells treated with 0, 1, 2, 4 or 8 g/L liquiritin for 48 hours was measured by MTT assay. RESULTS AND CONCLUSION:(1) When cultured at day 5, al individual neural stem cells gathered together into neurospheres; with the extension of time, the neurospheres were enlarged, and gathered together into larger cell masses. (2) Results from immunocytochemistry showed that all the floating neurospheres was nestin-positive. Data from qRT-PCR revealed a higher expression of nestin mRNA, but there was no expression of neuron-specific enolase and glial fibrillary acidic protein in the neural stem cells. (4) The growth of neural stem cells was slow at the beginning. After 2-3 days, the cell proliferation quickly entered the exponential phase. After 4 days, the cell proliferation gradually slowed down, and the overall cell growth entered into the platform period. (5) The cell proliferation after treatment with 2, 4 or 8 g/L liquiritin was faster than that in the control group (0 g/L). To conclude, 2-8 g/L liquiritin could increase the proliferation of neural stem cells from the brain of mouse embryos.

AIM: To evaluate the effect of cardiac pacing with a His bundle lead on cardiac electrophysiological and haemodynamical action in dogs and the experience of location technique with His bundle pacing lead. METHODS: With opening chest operation in general-anesthetized dogs, a special lead was located at His bundle based on a typical "H" wave and narrow duration of the QRS wave recorded in ECG; Platinum leads were fixed at the epicardium of the right ventricular apex (RVA) respectively, forming HisB- VVI pacing,RVA- VVI pacing. Cardiac electrophysiological and haemodynamical parameters were compared in sinus rhythm and the different pacing models. RESULTS: The threshold of HisB pacing is similar to that of RVA pacing. Cardiac output(CO)is increased about 18.81% in HisB- VVI pacing than self. It is decreased about 5.41% in RVA- VVI pacing. SV is similar to self,but it is 25.59% higher in HisB- VVI than RVA- VVI . LVSW and RVSW in His B- VVI pacing is superior to that in RVA- VVI . CONCLUSION: His bundle pacing significantly improves cardiac function compared with the RVA- VVI pacing because it can maintain normal physiological electronic activation sequence and systolic synchrony and have a better haemodynamics effect.neral-anesthetizeddogs,as

Objective To analyze the variations of PTPS gene in patients with suspected 6-pyruvoyl-tetra hydropterin synthase deficiency (PTPSD) and to make prenatal diagnosis in high-risk families. Methods Chemiluminescence was used for phenylalanine detection in blood or dried blood spots.Patients with phenylalanine concentration over 120μmol/L were detected by urine pterin analysis, and the activity of dihydropteridine reductase (DHPR) was detected. tetrahydrobiopterin loading tests were performed in suspected patients with abnormal urinary pterin profiles. PTPS gene variation analysis was performed by direct Sanger sequencing based on PCR amplification. Prenatal diagnosis in 7 high-risk families was performed by chorionic villus sampling when the genotype was identified. Results In 656 patients with hyperphenylalanine, 22 cases were diagnosed as PTPSD clinically. 16 variations were detected in the 22 PTPSD cases. The 5 variations, p.Lys77Arg, p.Ile84Phe, c.315-2A>G, c.244-2A>T, c.187-1G>T, were identified as novel variations. Two fetuses carried the same mutation with the proband and therefore were thought to be PTPSD fetuses. Three fetuses carried only one mutant allele and thus were thought to be PTPSD carriers.