Child, Preschool ; Humans ; Influenza A Virus, H1N1 Subtype ; Influenza, Human ; complications ; virology ; Male ; Mediastinal Emphysema ; etiology ; Subcutaneous Emphysema ; etiology

Objective To investigate the neuroprotective effect of adiponectin on rats with cerebral ischemic-reperfusion injury and explore its possible mechanism.Methods Sixty-four SD rats were divided into normal group (C) and diabetic group (D) randomly.Type 2 diabetic rats model were made by high-fat diet before the middle cerebral artery occulation model (MCAO) surgery.Each group was divided into two subgroups.CAPNand DAPN groups were given exogenous recombinant globular adiponectin via jugular vein one hour after ischemic-reperfusion injury,C0 and D0 groups were given the same amount of normal saline at the same time.Body weight and blood glucose of the rats were measured before ischemia.We also evaluated the neurological function of rats 24 h after treatment according to Longa criteria and observed the morphological changes of cells in brain area via HE staining.The vascular density in ischemic-reperfusion injury area was detected through 3D confocal image system 2 weeks after the treatment.Results The body weight of diabetic rats was significantly lower than normal rats((284.06 ± 19.85)vs (220.31 ±21.87) g,t =8.634,P =0.000).Blood glucose of diabetic rats before ischemia was significantly higher than normal rats ((4.36±0.13)vs(22.92 ± 1.58) mmol/L,t =11.74,P =0.000).Compared with C0 group,the neurological function score of CAPN group was lower(2.29 ± 0.69 vs 17.0 ± 0.69,t =2.186,P =0.038).Compared with D0 group,the neurological function score of DAPN group was lower(2.89 ± 0.33 vs 2.40 ±0.51,t =2.567,P =0.018),too.HE staining showed that the neuronal injury were milder in CAPN,DAPN group,compared with C0,D0 group,respectively.Adiponectin increased the vascular density of ischemic cortex inC group ((2014.58±61.18)/0.002 mm2 vs(3211.95 ±71.64)/0.002 mm2,t =12.16,P=0.023) and D group ((502.86 ± 30.43)/0.002 mm2 vs (1426.69 ± 97.24)/0.002 mm2,t =25.64,P =0.001).Adiponectin increased the vascular density of ischemic striatum in C group (472.59 ± 4.78)/0.002mm2 vs (736.60 ±104.90) /0.002 mm2,t=7.11,P=0.007) and D group (432.04 ±4.65)/0.002 mm2 vs (1780.75 ± 74.54)/0.002 mm2,t =51.08,P =0.000).Conclusions Adiponectin exerts the neuroprotective effect on cerebral ischemic-reperfusion injury in normal and diabetic rats.And it may protect the brain through promoting angiogenesis.

Objective To investigate the effects of rosiglitazone on the proliferation,connective tissue growth factor and Smad expression in cultured cardiac fibroblasts induced by advanced glycosylation end-products (AGEs).Methods After being treated with various amounts of rosiglitazone,the cultured neonatal rat cardiac fibroblasts were incubated with AGEs.The status of cardiac fibroblasts proliferation and cell cycle were detected by 3-(4,5-dimethyhhiazol-2-yl) -2,5-diphenyl tetrazolium bromide (MTI) assay and flow cytometry.Furthermore,ELISA technique was applied to identify the level of TGF-β1.The protein expressions of CTGF and Smad in cardiac fibroblasts of neonatal SD rats were detected with Western blotting.Results The exposure of cardiac fibroblasts to AGEs at doses of 0-200 mg/L induced a dose-dependent increase in cell proliferation.At the concentration of rosiglitazooe (0.1,1,and 10 μmol/L),the cell proliferation was reduced compared with 200 mg/L AGEs group by O.823±0.072,0.785±0.060,0.601±0.081 vs 0.981±0.049,respectively (P < 0.05).The increased levels of TGF-β1 in supematants of cultured cardiac fibroblasts stimulated by AGEs were inhibited by rosiglitazone at the concentrations of 0.1,1,10μmol/L by 257.77±9.09,230.29±6.56,200.84±10.26 vs 300.68±8.56,respectively (vs 200 mg/L AGEs,P<0.01).Western blot indicated that pretreatment with rosiglitazone (0.1,1,and 10 μmol/L) inhibited CTGF protein production in a dose-dependent by 0.769±0.108,0.590±0.095,0.534±0.115 vs 1.021±0.113,respectively (vs 200 mg/L AGEs,P<0.01).It was also demonstrated that pretreatment with rosiglitazone (1 and 10 μmol/L) inhibited Smad2 protein production by 0.424±0.059,0.396±O.080 vs 0.572±0.073,respectively (vs 200 mg/L AGEs,P < 0.05 or P < 0.01).Meanwhile pretreatment with rosiglitazone (1 and 10 μmol/L) inhibited Smad4 protein production by 0.580±0.063,0.556±0.051 vs 0.672±0.059,respectively (vs 200 mg/L AGEs,P < 0.05 or P < 0.01).Conclusions The findings suggest that AGEs promote the proliferation of cardiac fibroblasts and stimulate the protein production of Smad and CTGF of cardiac fibroblasts.Rosiglitazone inhibits the above reaction.These results indicate that CTGF/Smad pathway may play an important role in the protective effect of rosiglitazone on myocardial fibrosis.

Antineoplastic Agents ; therapeutic use ; Colorectal Neoplasms ; drug therapy ; genetics ; metabolism ; Genes, ras ; genetics ; Humans ; Lung Neoplasms ; drug therapy ; genetics ; metabolism ; Molecular Targeted Therapy ; methods ; Mutation ; Neoplasms ; drug therapy ; genetics ; metabolism ; Pancreatic Neoplasms ; drug therapy ; genetics ; metabolism ; Proto-Oncogene Proteins ; genetics ; metabolism ; Proto-Oncogene Proteins p21(ras) ; Receptor, Epidermal Growth Factor ; drug effects ; metabolism ; Signal Transduction ; ras Proteins ; genetics ; metabolism

Objective To investigate the influencing factors for spontaneous bacterial peritonitis (SBP) in patients with acute-on-chronic liver failure (ACLF),and to provide a reference for clinical diagnosis and prognosis evaluation.Methods A retrospective analysis was performed for the clinical data of 667 patients with ACLF who were hospitalized and treated in our hospital from January 2009 to December 2014,and according to the presence or absence of SBP,they were divided into ACLF group(n =232) and ACLF-SBP group(n =435).The general information,laboratory markers,and incidence of complications were compared between the two groups.The t-test was used for comparison of normally distributed continuous data between groups,and the Mann-Whitney U test was used for non-normally distributed continuous data between groups;the chi-square test was used for comparison of categorical data between groups,and a logistic regression analysis was used to identify independent risk factors for ACLF complicated by SBP.Results The comparison of laboratory markers and comorbidities showed that there were significant differences between the two groups in albumin (Alb) (t =-4.110,P ＜ 0.001),alanine aminotransferase (U =-6.653,P ＜ 0.001),aspartate aminotransferase (t =-8.045,P ＜ 0.001),blood sodium (t =-2.879,P =0.006),prothrombin time activity (t =-2.140,P =0.037),international normalized ratio (t =1.453,P =0.042),hemoglobin (t =-3.446,P =0.001),upper gastrointestinal bleeding (x2 =48.252,P =0.002),hepatorenal syndrome (x2 =16.244,P =0.031),and pulmonary infection (x2 =13.564,P ＜ 0.001).The multivariate logistic regression analysis showed that there were significant differences in Alb (OR =1.119,95 ％ CI:1.052 ～ 1.189),platelet count (PLT) (OR =1.035,95 ％ CI:0.755 ～ 1.084),upper gastrointestinal bleeding (OR =1.117,95 ％ C1:0.072 ～ 1.135),and pulmonary infection (OR =2.275,95 ％ CI:0.978 ～ 5.292) (P =0.002,0.038,0.022,and 0.036).Conclusion In the treatment of ACLF patients,risk factors including low Alb,low PLT,upper gastrointestinal bleeding,and pulmonary infection should be prevented,and early diagnosis and intervention of these risk factors helps to reduce the incidence of SBP.

BACKGROUND: Nowadays, fish collagen biomedical materials still exhibit obvious deficiency in thermal stability,in vivo degradation stability and in vivo material morphology stability. To expand the application of fish source collagen, it is urgent to improve the material performance by increasing the density and collagen molecule tightness of freshwater fish collagen sponge materials using technique methods.OBJECTIVE: To optimize the reconstitute process for nasopore preparation using fish scale collagen.METHODS: The optimal process for nasopore preparation through the reconstitution of fish scale collagen was ascertained by taking tilapia fish skin as a raw material to extract enzymatic soluble collagen at a temperature lower than the collagen denaturation temperature and recombinant rate of collagen fibers as index. Optimization of the conditions for nasopore preparation was carried out using single factor test and orthogonal test. The prepared nasopore was analyzed through infrared spectroscopy and microstructure analysis.RESULTS AND CONCLUSION: The optimal conditions for nasopore preparation were determined through the single factor test and orthogonal test as follows: 20 ℃ for 10 hours at pH 7.4 using a mixture of 65 mmol/L NaCl and 1 g/L collagen, by which the reconstitute rate of collagen fibers was up to 68.6%. The prepared nasopore is characterized by a refined porous structure constituted by threadlike collagen fibers, and has complete three-dimensional spiral structure,which is a potential intracavitary hemostatic material with fine properties.

Objective To test the clinical effects of the expiration control device with mask in the treat-ment of chronic obstructive pulmonary disease. This device developed by the author. Methods A total of 102 pa-tients were treated by the device. Among them ,50 patients received positive end-expiratory pressure and 52 with expiratory flow retard and blocked function. Differences in carbon dioxide partial pressure(PaCO2),oxygen partial pressure(PaO2)and pH of the arterial blood gas analysis were compared ,as well as differences in forced vital ca-pacity(FVC),forced expiratory volume for1 sec(FEV1),tidal volume(VT)of pulmonary function before and af-ter treatment. Results (1) In the positive end-expiratory pressure group ,there were significant differences of FVC,FEV1 and VT before and after treatment(2.95 ± 0.32)L vs(3.22 ± 0.35)L,(1.88 ± 0.17)L vs(2.00 ± 0.15)L,(335.28 ± 43.59)mL vs(364.64 ± 44.28)mL,(P<0.01)differences of PaCO2,PaO2 and pH before and after treatment had statistical significance(50.42 ± 4.77)mmHg vs(48.42 ± 3.76)mmHg,(65.42 ± 4.60)mmHg vs (68.50 ± 4.69)mmHg,(7.35 ± 0.030)vs(7.37 ± 0.037)(P<0.05).(2)In the expiratory flow retard and blocked group,differences of FVC,FEV1andVT before and after treatment had statistical significance(2.93 ± 0.22)L vs (3.10 ± 0.27)L,(1.83 ± 0.14)L vs(1.91 ± 0.16)L,(335.48 ± 44.16)mL vs(362.46 ± 38.66)mL(P<0.05), differences of PaCO2,PaO2 and pH before and after treatment had statistical significance(52.39 ± 3.37)mmHg vs (50.06 ± 3.92)mmHg,(68.05 ± 3.80)mmHg vs(68.99 ± 4.57)mmHg,(7.34 ± 0.035)vs(7.37 ± 0.036)(P<0.05). Conclusion This device can improve the ventilation function in patients with COPD. It is easy to use ,safe and effective,with high clinical application value.

Objective Post-operative hypoxemia occurred frequently after extubation in patients who underwent orthotopic liver transplantation (OLT) in ICU. This study is to investigate the efficiency of hyperoxia solution in improving oxygenation. Methods Ten OLT cases, who post-operatively manifested hypoxemia after extubation, were enrolled in this study. Hyperoxia Ringer's solution (500ml) prepared by Jing-Shu-Yang (an apparatus of oxygen supply, Vanform Co., Shandong) was infused at a rate of 200ml/hr. Hemodynamic parameters, blood gas, and blood lactate were determined at the beginning, end of infusion, and 1 hour after the infusion, with recording of the following data: heart rate (HR), mean arterial pressure (MAP), pulmonary arterial pressure (PAP), and pulmonary capillaries wedged pressure (PCWP). Results Compared with the levels at the beginning of infusion, SpO2 and SvO2 increased significantly at the end of the infusion of 500 ml hyperoxia Ringer's solution, and they returned to the baselines 1 hour later, although regular Ringer′s solution was coutinuously given by the same infusion rate. HR, MAP and PCWP were kept stable with the solution infusion. Notably, PAP was decreased markedly at the end of infusion, and blood lactate level remained unchanged after the intervention. Conclusion Hyperoxia Ringer's solution infusion improved oxygenation in OLT patients who suffered from acute lung injury with hypoxemia postoperatively. PAP decreased markedly as hypoxemia was corrected.

Objective To investigate morbidity and analyze high risk factors of nosocomial infection in patients who underwent orthotopic liver transplantation (OLT) in our ICU, in order to draft possible preventive strategies. Methods The clinical data of 56 OLT patients from Apr 2002 to Dec 2004 were analyzed. Results Significantly high APACHE Ⅱ scores and total plasma bilirubin, low platelet count were found in patients with nosocomial infection. The number of patients who had received an additional operation and broad-spectrum antibiotics before OLT were greater in nosocomial infection (NI) group than in none-nosocomial infection (NNI) group. Notably, the longer the broad-spectrum antibiotics used before OLT, the higher the morbidity rate of nosocomial infection. No significant difference was found in age, Child-Pugh grade and plasma albumin level between the two groups. In addition, APACHE Ⅱ scores and total bilirubin level were significantly higher in patients acquired enterococcal infection than in those infected with other pathogenic microorganisms. Conclusions High APACHE Ⅱ score, high total bilirubin level, low platelet count and length of use of broad-spectrum antibiotics before OLT were closely associated with nosocomial infection. As an important indicator, change in total bilirubin level not only represented the liver function ,but also was one of the high risk factors to nosocomial infection in patients undergoing OLT.

0.05).61 patients received no sedatives nor analgesics showed significantly higher incidence of SUE compared with those patients received either sedatives or analgesics(73.8% vs 37.3%,P