Objective To discuss the efficacy and relative factors that affect the sequential therapy of invasive and non-invasive mechanical ventilation in treating severe respiratory failure.Methods We analyzed the clinical data of the patient who was hospitalized in Respiratory Department of the Sixth Hospital of Luohe on 3th February 2008.Results The patient received invasive mechanical ventilation for 4 days,then changed to mask non-invasive positive pressure ventilation for 10 days,while receiving comprehensive treatment of anti-infection and bronchial expansion,etc.Then the patient was recovered.Conclusion The sequential therapy of invasive and non-invasive mechanical ventilation in treating severe respiratory failure is effective.The efficacy depends on the optimum converting time between invasive and non-invasive mechanical ventilation,the choice of ventilator and the patient′s compliance.

OBJECTIVE:To observe the effects of different regimens of tranexamic acid on perioperative bleeding and postoper-ative compliance of simultaneous bilateral total knee arthroplasty(TKA). METHODS:A total of 70 patients undergoing simultane-ous bilateral TKA in our hospital were randomly divided into control group and observation group,with 35 cases in each group. Control group was given Tranexamic acid injection 15 mg/kg 30 min before surgery. Observation group was given Tranexamic acid injection 15 mg/kg,30 min before surgery and 30 min before suturing incision. The operation duration,total blood loss,intraopera-tive blood loss,postoperative drainage as well as the levels of FIB,PT,APTT before trectment and 3 d after surgery,the occur-rence of postoperative compliance and ADR were observed and compared between 2 groups. RESULTS:There was no statistical significance in operation duration,intraoperative blood loss and rate of ADR between 2 groups (P>0.05). The total blood loss, postoperative drainage and the incidence of complications of observation group were significantly lower than those of control group,with statistical significance(P<0.05). There was no statistical significance in coagulation indexes(FIB,PT and APTT)be-tween 2 groups before treatment and 3 d after surgery,with statistical significance(P>0.05). CONCLUSIONS:The application of tranexamic acid 30 min before simultaneous bilateral TKA and 30 min before the end of surgery can reduce perioperative bleeding and postoperative venous thromboembolism with good safety.

Objective To study the effect of foot motor imagery on lower extremity motor function in hemiplegics after stroke. Methods 72 hemiplegics were randomly divided into two groups: the experiment group and the control group. Normal rehabilitation was performed in the both groups and motor imagery was added in the experiment group. They were assessed with lower extremity Fugl-Meyer Assessment (FMA) and gait analysis. Results The scores of FMA in knee, ankle and lower extremity, gait frequency and speed improved in experiment group more than in controls（P<0.05）. Conclusion Foot motor imagery can improve lower extremity motor function.

Objective To investigate the effects of a novel synthetic immunostimulator CH2b containing thiazolidin-4-one on the function of invariant nature killer T (iNKT) cells isolated from patients with active rheumatoid arthritis (RA).Methods Peripheral blood mononuclear cells (PBMCs) isolated from patients with active RA were in vitro cultured with α-Galcer and IL-2.The iNKT cells were separated by using magnetic activated cell sorting (MACS) method.The effects of CH2b on the proliferation of iNKT cells were analyzed by using MTT assay.MILLIPLEX MAP Human Cytokine/Chemokine kit was used to measure the levels of IFN-γ and IL-4 in the supernatants of iNKT cell culture.The expressions of IFN-γand IL-4 at mRNA level in iNKT cells were analyzed by RT-PCR.Western blot assay was used to detect the levels of T-bet and GATA-3 in iNKT cells.Results CH2b significantly enhanced the proliferation of IL-2 activated iNKT cells isolated from the patients with active RA.CH2b promoted the secretion of IL-4,resulting in a decrease in the ratio of IFN-γ/IL-4.Moreover,CH2b promoted the expressions of GATA-3 and IL-4 at mRNA level in iNKT cells.Conclusion The novel immunostimulator,CH2b,might enhance the immunoregulatory effects of iNKT cells by promoting the GATA-3 pathway-mediated secretion of Th2-1ike cytokines and inducing the differentiation of Th0 to Th2 cells.

BACKGROUND:Previous ankle fracture surgery mainly uses the internal fixation materials such as metal screws or Kirschner wire, which can achieve a strong internal fixation, but al need to be taken out in the secondary surgery. In recent years, elastic modulus of biodegradable absorbable screw is identical to that of cancel ous bone, and has been widely used in clinic. OBJECTIVE:To compare the biocompatibility and functional recovery of ankle joint in the repair of ankle fractures with absorbable screws and metal screws. METHODS:100 patients with ankle fractures were selected, including 70 males and 30 females, at the age of 19 to 55 years old. Fifty patients were repaired with absorbable screws and fifty patients were repaired with metal screws. Clinical efficacy, Kofoed score, fracture healing time and adverse events were observed between the two groups after repair. RESULTS AND CONCLUSION:Patients were fol owed up for over 6 months in both groups, showing good bony cal us, good contraposition and alignment at the fracture end. No delayed union or nonunion occurred. The excel ent and good rate of clinical effect was 96%and 94%in the absorbable screw group and metal screw group, respectively, showing no significant difference. There was no significant difference in ankle Kofoed score, fracture healing time and incidence of adverse events between the two groups (P>0.05). These results suggest that absorbable screw fixation for ankle fractures had good biocompatibility and could effectively restore ankle function;its effects are similar to that of traditional metal screws.

Objective:To investigate effects of a novel synthetic immunostimulator CH1b containing thiazolidin-4-one on the immunoregulation funotion of iNKT ( invariant nature killer T ) cells in active RA patients in vitro.Methods: Peripheral blood mononuclear cells( PBMCs) isolated from active RA patients were cultured with stimulation of α-Galcer and IL-2 in vitro and iNKT cells were then separated by using magnetic activated cell sorting( MACS) method with iNKT isolation kit.The cells were divided into three groups:control group (IL-2),α-Galcer group (IL-2+α-Galcer),CH1b group(IL-2 +CH1b).The effects of CH1b on the proliferation of iNKT cells in active RA patients were analyzed by using MTT assay.MILLIPLEX MAP Human Cytokine/Chemokine kit was used to evaluate the secretion of IFN-γand IL-4 in iNKT cells culture media.The expressions of IFN-γmRNA and IL-4 mRNA in iNKT cells were analyzed by RT-PCR.Results: Compared with control and α-Galcer group,the proliferation of iNKT cells of CH1b group were significantly higher( P<0.05).Compared with control,the ratio of IFN-γ/IL-4 in iNKT cells culture media in active RA patients of CH1b group were significantly lower (P<0.05).Compared with control,expressions of IFN-γmRNA and IL-4 mRNA were higher inα-Galcer group;compared with control,expressions of IL-4 mRNA were higher in CH1b group,while there were no obvious difference on expressions of IFN-γmRNA.Conclusion:CH1b was found to significantly stimulate the actived iNKT cells in active RA patients proliferation,promote the secretion of IL-4,and increase the ratio of IFN-γ/IL-4,promote the expression of IL-4 mRNA in iNKT cells in active patients.

This article was aimed to study the immunomodulatory effect of ethanol sediments of the seeds of Descurainia sophia(L.) Webb. ex Prantl. both in vitro and in vivo. The lymphocyte proliferation test in vitro was carried out to explore the effect of the ethanol sediments on the proliferation of T cell and B cell in the spleen of normal mice. And, the carbon clearance test, serum hemolysin test, and delayed-type hypersensitivity test were used to investigate the influence of fraction on non-specific immunity, humoral immunity and cellular immunity in the immunosuppressive mice induced by cyclophosphamide. Besides, the immunosuppressive model was used to evaluate the effect of fraction on immune organs and content of cellular factors in blood serum. The results showed that the ethanol sediments promoted Concanavalin A (Con A) induced T cell and Lipopolysaccharides (LPS) induced B cell (P < 0.01). It increased the carbon clearance index K, phagocytic index α, half value hemolysis (HC50), and swelling degree of auricula (P < 0.05 or P < 0.01). It reduced the body weight and atrophy of thymus and spleen index (P < 0.05 or P < 0.01). It increased the contents of IL-2, IFN-γ and IL-4 in serum in immunosuppressive mice (P < 0.05 or P < 0.01). It was concluded that ethanol sediments of the seeds of D. sophia(L.) Webb. ex Prantl. can boost the lymphocyte proliferation, protect the immune organs, and enhance the non-specific and specific immunity in immunosuppressive mice, which indicated that it had immune-promotion effect.

Objective To investigate the alterations of invariant nature killer T( iNKT) cells in peripheral blood samples from patients with rheumatoid arthritis ( RA) and to clarify the correlation between the percentage of iNKT cells and the ratio of IFN-γ/IL-4 in order to further understand the significance of iNKT cells in the development of RA.Methods Peripheral blood mononuclear cells ( PBMCs) were isola-ted from 70 patients with RA and 40 healthy subjects.Among them, thirty patients in the stage of inactive RA were involved in a follow-up study.Fluorescence activated cell sorting ( FACS) was used to detect the percentage of iNKT cells.PBMCs were cultured in vitro for analysis of cytokine production.The dynamic changes of iNKT cells in percentages were analyzed by FACS.MILLIPLEX MAP Human Cytokine/Chemo-kine kit was used to measure the secretion of IFN-γand IL-4 in serum samples and culture media of PBMCs. The expression of IFN-γand IL-4 in iNKT cells at mRNA level were analyzed by RT-PCR.Results Com-pared with the healthy subjects, the patients with active RA showed the delayed proliferation of iNKT cells and the decreased percentages and proliferation rates of iNKT cells (P<0.05).The percentages and prolif-eration rates of iNKT cells in patients with active RA were significantly lower than those in patients with inac-tive RA (P<0.05).No statistical significant differences with iNKT cells were found between healthy sub-jects and patients with inactive RA (P>0.05).The ratios of IFN-γ/IL-4 in serum samples and culture media of PBMCs were increased in patients with active RA as compared with those in patients with inactive RA and healthy subjects (P<0.05).No statistical significant differences with the ratios of IFN-γ/IL-4 were observed between healthy subjects and patients with inactive RA (P>0.05).Compared with healthy subjects and patients with inactive RA, patients with active RA showed increased transcriptional level of IFN-γand decreased transcriptional level of IL-4.No significant differences with the expression of IFN-γand IL-4 in iNKT cells at mRNA level were observed between healthy subjects and patients with inactive RA.The per-centage of iNKT cells was negatively related to the IFN-γ/IL-4 ratio in patients with RA (P<0.05).Con-clusion Decreased percentage and impaired function of iNKT cells were detected in patients with RA. iNKT cells were closely related to the development and disease activity of RA.

Objective: To establish the aortic regurgitation model in Chinese miniature pigs under echocardiography guidance. Methods: The animal models were established by following steps: general anesthesia, measuring body weight and then receiving echocardiography examination to exclude aortic valve lesions; carotid artery was exposured by surgery, catheter was sent to aortic sinus with stiff guide wire penetrates and the position of catheter was adjusted to obtain aortic valve damage. The aortic valve injury and regurgitation were evaluated by ultrasound; then the pigs were killed and the heart was taken to observe aortic valve damage. Results: A total of 7 pigs were used including 4 male and 3 female with the mean body weight of (24.7 ± 3.6) kg. Aortic regurgitation model was successfully established in 5 pigs including 1 mild, 1 mild-moderate, 2 moderate, 1 severe aortic valve regurgitation, and 4 were with valve lealfets perforation and 1 with lealfets tearing. Conclusion:①Echocardiography can smoothly guide wire go through aortic valve and make valve damage at different degrees, it is reliable to establish aortic valve regurgitation model in experimental pigs.②Echocardiography may clearly identify the position and degree for aortic valve injury.

ObjectiveTo investigate the effects of nicotine exposure and ethanol-preferring behavior on mRNA expression of some nAChR subunits in the rat ventral tegmental area(VTA) and to explore possible mechanisms of dependence on tobacco and alcohol.Methods39 male Wistar rats,35-day-old,were randomly divided into an experimental group (group N,n=20) and a control group (group C,n=19).Rats in group N were treated with nicotine ( 1.0 mg · kg -1 · d -1 ) by subcutaneous injection while in group C with saline both for 10 days,after which 6 rats (respectively group NE,n =6,group CE,n =6 )were drawn randomly from each group and killed by cutting off the head.mRNA was extracted from the VTA tissue,and the expression of nAChR subunits,including α4,α5,α7 and β2,were examined by Real Time-PCR.Other rats both in groups N and C ( respectively group NA,n=14,group CA,n=13) were induced for 69 days to establish two-bottle free choice alcohol-preferring behavior model by Samson sucrose fading program from 60-day-old on.The same indexes mentioned above were detected by the same methods in the VTA tissue.Results① The factor analysis showed that both the two factors,nicotine and alcohol-preferring behavior,showed regulating effects on the expression of nAChR subunits α4 and α5 ( respectively F was 6.13,5.407,5.186,7.132,P ＜ 0.05 ),and the factor,alcohol-preferring behavior,on subunit β2 (F =5.896,P＜0.05) ; the two factors exhibited strong interaction on the expression of subunit α7 (F=13.894,P＜0.001 ),and some interaction on subunits α5 and β2 (respectively F was 6.149,4.222,P＜0.05 ).② The mRNA expression of nAChR subunits α4,α5,α7,and β2 were significantly up-regulated by different degrees in group NA compared to group CA ( respectively Fwas 7.941,13.517,17.438,9.272,respectively P ＜ 0.05,P ＜ 0.05,P ＜ 0.01,P ＜ 0.01 ),the expression level of subunits α4,α5,α7 and β2 were significantly higher in different degrees in group NA than in group NE( respectively F was 5.293,8.500,6.149,4.837,P ＜0.05) ; while subunit α7 was significantly down-regulated in group CA compared to group CE (F =12.750,P ＜0.01 ).ConclusionNicotine and ethanol co-affect on the nAChR subtype comprised of subunits α4,α5,α7 and β2.