Objective To assess the possible sequestration of remifentanil by the extracorporeal circuit.Methods Two types of extracorporeal circuits (ECCs) were used-Xijian type I (group A)and AFFINITY(R) NT(group B),while in control group (group C) a glass container was used.The ECC and glass container were filled with priming solution (6%hydroxyethyl starch 1000 ml + lactated Ringer's solution 500 ml).Remifentanil Wag then added to the priming solution with the final concentration of 100 ng/ml.The priming solution was circulated in the closed ECC or stirred the glass container.The concentration of remifentanil in the priming solution was determined at 2,5,10 and 15 min after addition of remifentanil.Results The remifentanil concentration in the priming solution decreased by 75.1%,57.9% and 18.3%at 2 min after addition of the drug in group A,B and C respectively as compared with the baseline value.The remifentanil absorption by ECC was significantly greater in group A than in group B.There was no significant difference in remifentanil concentration at the 4 time points in each group.Conclusion ECC can absorb remifentanil.The remifentanil absorption by Xijian type I is significantly greater than that by AFFINITY(R).

Objective To investigate the mechanism by which remifentanil decreases blood pressure during cardiopulmonary bypass (CPB).Methode Twenty-six ASA Ⅱ or Ⅲ patients (NYHA's classification grade Ⅱ or Ⅲ ) of both sexes and aged 20-55 years were randomized to receive remifentanil (group R, n = 13) or normal saline (group C, n = 13). Remifentanil 10 μg/kg or equal volume of normal saline was administered via a venous reservoir when cardiac arrest was induced with cardioplegic solution. The flow rate resistance (SVR) were measured and arterial blood samples were taken for determination of plasma concentrations of histamine,nitric oxide (NO) and 6-keta-prostaglandin F1α(PGF1α) before T0 and at 5, 10, 15 min (T5.10.15) after remifentanil administration.Results Remifentanil administration was associated with a significant decrease in MAP and SVR at T5 and T10 as compared with the baseline values at T0 ( P ＜ 0.05); whereas in control group, MAP and SVR were significantly increased at T5, T10 and T15 as compared with the baseline values at T0 . There were no significant differences in plasma histamine, NO and PGF1α concentrations between the two groups.Conclusion Remifentanil reduces SVR and causes a decrease in BP but without altering plasma concentrations of histamine, NO or PGl2.

Objective To investigate the protective effects of insulin like growth factor 1(IGF-1) on cortical neurons under condition of hypoxia and the possible mechanism. Methods Cerebral cortical neurons from newborn rats were cultured under the condition of oxygen and glucose deprivation (OGD) . On day 7, neurons were treated with IGF-1 or IGF-1 plus LY294002 or PD98059 under condition of OGD or normal condition. MTT assay was used to analyze the viability of neurons in each group. The expression of total Akt and p-Akt were analyzed by Western blot. Results Compared with the control, the neuron viability was significantly higher in IGF-1 treated group under normal or OGD condition (P＜0.05). The protective effects of IGF-1 were attenuated in the presence of LY294002 but not PD98059. The result of Western blot showed IGF-1 upregulated the expression of p-Akt, which was inhibited by LY294002. Conclusion PI3K pathway may play an important role in neuroprotection afforded by IGF-1.

Objective To observe the effect of ulinastatin on tumor necrosis factor(TNF-α)and interleukin-6(IL-6)in radiation-induced lung injury.Methods Severity-two female SD rats were randomly divided into 3 groups as control group,irradiation group and treatment group(administered with Ulinastatin).Rats in irradiation group and treatment group were irradiated with linear accelerator at a single dose of 25 Gy.After irradiation rats in treatment group were injected daily with ulinastatin at a dose of 100000 U-kg-1·d-1 for 7 days through caudal vein while rats in control group and irradiation group were injected with the same volume of saline.Rats were killed at 2 h,4,8 and 24 weeks.Samples of lung tissues were observed by using HE staining.Expression of TNF-α in lung was determined by Western blot and expression of IL-6 in serum was determined by ELISA.Data were analyzed by SPSS software.Results Expressions of TNF-α in lung and IL-6 in serum increased significantly after irradiated in irradiation group compared with control group,and it reached the peak at 4 weeks(q=5.63、6.21,P＜0.01).Though expressions of TNF-α and IL-6 in ffeatment group also increased compared with control group,the difference between irradiation group and treatment group was statistic significantly(q=4.97、7.42,P＜0.01).Conclusions TNF-α and IL-6 play an important role in radiation-induced lung injury.Ulinastatin could suppress the inflammatory response and radiation-induced lung injury effectively by decreasing the levels of TNF-α and IL-6.

Objective:To investigate the expression of long non-coding RNA (lncRNA) CALCOCO1 in bladder cancer tissue and its effect on the proliferation and migration of bladder cancer cells by regulating miR-200a-3p.Methods:The relative expression levels of CALCOCO1 in bladder cancer tissues and adjacent tissues were analyzed by TCGA database. Human bladder cancer cells UM-UC-3 were selected, and the cells were divided into negative control group and CALCOCO1 group, and NC plasmid and CALCOCO1 plasmid were transfected into UM-UC-3 cells respectively. The expression level of CALCOCO1 in each group was detected by quantitative real-time polymerase chain reaction (qRT-PCR). The proliferation and migration ability of UM-UC-3 cells were detected by MTT assay and Transwell migration assay. Bioinformatics technology was used to predict and dual-luciferase reporter gene experiments to verify the targeting relationship between CALCOCO1 and miR-200a-3p. The expression levels of miR-200a-3p in UM-UC-3 cells in each group were detected by qRT-PCR. Western blotting was used to detect the expression of UM-UC-3 cells proliferation and migration phenotype in each group. Measurement data were expressed as mean ± standard deviation ( ± s), t-test was used for comparison between two groups, and repeated measurement analysis of variance was used for comparison at different time. Results:Compared with adjacent tissues, the relative expression level of CALCOCO1 in bladder cancer tissues was significantly lower, the difference was statistically significant( P<0.01). The relative expression of CALCOCO1 in UM-UC-3 cells in CALCOCO1 group and negative control group was 9.66±2.51 and 1.07±0.59, respectively. The relative expression level of CALCOCO1 in CALCOCO1 group was significantly higher than that in negative control group, the difference was statistically significant ( P<0.01). Compared with the negative control group, the proliferation activity of UM-UC-3 cells in the CALCOCO1 group was decreased ( P<0.05), and the migration number of UM-UC-3 cells was significantly decreased ( P<0.01). CALCOCO1 had a binding site with miR-200a-3p ( P<0.01). The relative expression of miR-200a-3p in UM-UC-3 cells in CALCOCO1 group and negative control group was 1.02 ± 0.31 and 5.79 ± 1.68, respectively, the difference was statistically significant ( P<0.01). Compared with the negative control group, the expression levels of proliferation phenotype proteins CCNB1, CCNE1 and CCND2 in UM-UC-3 cells in CALCOCO1 group decreased, and the expression levels of migration phenotype proteins FOXC2 and Fibronectin decreased. Conclusion:The expression of CALCOCO1 is down-regulated in bladder cancer tissue, promoting the expression of CALCOCO1 can inhibit the proliferation and migration of bladder cancer UM-UC-3 cells through targeted down-regulation of miR-200a-3p expression.

Objective: To explore drug resistance of different viral loads, and investigate the relationship between drug resistance and CD4⁺T cell counts in patients with HIV antiretroviral therapy (ART) in China from 2003 to 2015. Methods: Data were extracted from the Chinese National HIVDR Surveillance database from 2003 to 2015. For this study, the data collected were as follows: having received ART for ≥12 months; 18 years or older; demographic characteristics, information of ART, CD4⁺T cell counts, viral load (VL) and HIV drug resistance of a total of 8 362 patients were collected. Multi-variables non-conditional logistic regression model was used to study the relationship between viral load, HIV drug resistance and CD4⁺T cell counts. Results: Participants with age of (41.8±10.5) years were enrolled in this study. Among them, 59.9% (5 009 cases) were men. The percentage of CD4⁺T cell counts <200 cells/μl in the total population was 17.9% (1 496 cases), the highest was in VL ≥1 000 copies/ml with drug resistance, which was 43.0% (397/923) , followed by VL 50-999 copies/ml with drug resistance, which was 31.1% (69/222), and the lowest was in VL 50-999 copies/ml without drug resistance 13.2% (273/2 068). Compared to VL 50-999 copies/ml without drug resistance, VL<50 copies/ml, VL 50-999 with drug resistance, VL≥1 000 copies/ml without drug resistance, and VL ≥1 000 copies/ml with drug resistance, the OR (95%CI) of CD4 <200 cells/μl were 0.9 (0.7-1.0), 3.2 (2.3-4.4), 2.6 (2.1-3.2), and 4.9 (4.0-5.9), respectively. Among 222 patients with VL 50-999 and HIVDR, the most frequent antiretroviral drugs were EFV and NVP, both of which were NNRTI, and whose percentage both were 94.1% (209 cases). The most frequent mutations were M184V/I (NNRTI), and the percentage was 26.1% (58 cases). The second one was K103N (NNRTI), and the percentage was 22.5% (50 cases). The percentage of V32L/E (PI) and V82A (PI) were lower, they were 0.9% (2 cases) and 0.5% (1 case) respectively. Conclusion Decreased CD4⁺T cell counts were associated with HIV drug resistance at low viraemia. In the case of low viral load, the most vulnerable were the NNRTI antiviral drugs such as EFV and NVP.

Objective:To understand the current status of clinical guidelines and consensus for lung cancer chemotherapy, evaluate and analyze the quality of lung cancer chemotherapy treatment guidelines, and provide references for the revision and improvement of lung cancer chemotherapy clinical decision-making and guidelines.Methods:Search Pubmed, EMbase, Cochrane Library (Cochrane Library), China Knowledge Network, Wanfang Database, China Biomedical Literature Database and other related databases and clinical practice guidelines related to lung cancer chemotherapy, and screen the literatures according to the established inclusion exclusion criteria. Use the appraisal of guidelines for research and evaluation Ⅱ (AGREE Ⅱ) and reporting items for practice guidelines in healthcare (RIGHT) tools to compare and evaluate the quality of the included guides and the level of reporting specifications.Results:A total of 14 guidelines were included. The assessment results of AGREE Ⅱ showed that the average score of scope and purpose was 94 points, the average score of stakeholder involvement was 60 points, the average score of rigour of development was 43 points, the average score of clarity of presentation was 88 points, the average score of applicability was 50 points, the average score of editorial independence was 61 points. Seven guidelines were evaluated as A level, 6 guidelines were evaluated as B level, 1 guideline was evaluated as C level. The assessment results of RIGHT showed that, in addition to the basic information, the included guidelines have many deficiencies in 6 areas including background, evidence, recommendation, review and quality assurance, funding, declaration and management of interests and other information, and the normative gap between domestic and foreign guides was large.Conclusions:The overall quality of clinical guidelines for lung cancer chemotherapy is high, but the standardization needs to be strengthened. There is a big gap between the quality and standardization of domestic and foreign guides. Further developments of high-quality clinical practice guidelines and guidelines consistent with our country′s actual situation are needed.

【Objective】 To explore the effects of anti-inflammatory of short-chain fatty acids in human peripheral blood mononuclear cells （THP-1） and chronic obstructive pulmonary （COPD） mice. 【Methods】 We adopted the methods of qRT-PCR， ELISA， Western blotting， HE staining and Sirius staining to detect the changes of inflammatory factors in THP-1 cells and COPD with or without short-chain fatty acids. 【Results】 The ELISA and qRT-PCR experiments showed that the serum inflammatory factors， including interleukin-6 （IL-6）， interleukin-1β （IL-1β） and tumor necrosis factor-α （TNF-α）， were higher in clinical COPD patients than in healthy people. And the THP-1 cells expressed these inflammatory factors highly after LPS stimulation. Among three short-chain fatty acids treated， butyrate could reduce the levels of inflammatory factors better than acetate and propionate. After COPD mice were treated with butyrate in the drinking water， the mRNA expressions of inflammatory factors IL-6， IL-1β and TNF-α in the lung tissue decreased， and the concentrations of IL-6 and IL-1β in plasma decreased. The protein detection results showed that the phosphorylation expression of NF-κB decreased， and butyrate might inhibit the expressions of inflammatory factors by inhibiting the NF-κB signaling pathway. 【Conclusion】 The SCFA butyrate can inhibit LPS-induced inflammatory response of THP-1 cells and have an inhibitory effect on inflammation in COPD mice.

Objective:To understand the current status of clinical guidelines and consensus for lung cancer chemotherapy, evaluate and analyze the quality of lung cancer chemotherapy treatment guidelines, and provide references for the revision and improvement of lung cancer chemotherapy clinical decision-making and guidelines.Methods:Search Pubmed, EMbase, Cochrane Library (Cochrane Library), China Knowledge Network, Wanfang Database, China Biomedical Literature Database and other related databases and clinical practice guidelines related to lung cancer chemotherapy, and screen the literatures according to the established inclusion exclusion criteria. Use the appraisal of guidelines for research and evaluation Ⅱ (AGREE Ⅱ) and reporting items for practice guidelines in healthcare (RIGHT) tools to compare and evaluate the quality of the included guides and the level of reporting specifications.Results:A total of 14 guidelines were included. The assessment results of AGREE Ⅱ showed that the average score of scope and purpose was 94 points, the average score of stakeholder involvement was 60 points, the average score of rigour of development was 43 points, the average score of clarity of presentation was 88 points, the average score of applicability was 50 points, the average score of editorial independence was 61 points. Seven guidelines were evaluated as A level, 6 guidelines were evaluated as B level, 1 guideline was evaluated as C level. The assessment results of RIGHT showed that, in addition to the basic information, the included guidelines have many deficiencies in 6 areas including background, evidence, recommendation, review and quality assurance, funding, declaration and management of interests and other information, and the normative gap between domestic and foreign guides was large.Conclusions:The overall quality of clinical guidelines for lung cancer chemotherapy is high, but the standardization needs to be strengthened. There is a big gap between the quality and standardization of domestic and foreign guides. Further developments of high-quality clinical practice guidelines and guidelines consistent with our country′s actual situation are needed.

ObjectiveTo investigate the different effects of Yunvjian with or without Achyranthis Bidentatae Radix on glucose and lipid metabolism and inflammatory response in diabetic rats with the syndrome of Yin deficiency and internal heat. MethodThe rat model of diabetes due to Yin deficiency and internal heat was established by feeding with a high-sugar and high-fat diet and injection of thyroxine and streptozotocin. The successfully modeled rats were randomized into model control， Yunvjian without Achyranthis Bidentatae Radix （11.8 g·kg^-1）， Yunvjian with Achyranthis Bidentatae Radix （12.8 g·kg^-1）， and Achyranthis Bidentatae Radix （1.0 g·kg^-1） groups （n=10）， and another 10 rats were taken as the normal control group. Each group was administrated with corresponding drugs or saline by gavage for 28 days. The fasting blood glucose （FBG）， fasting insulin （FINS）， total cholesterol （TC）， triglycerides （TG）， low-density lipoprotein cholesterol （LDL-C）， and high-density lipoprotein cholesterol （HDL-C） in rats were measured. Enzyme-linked immunosorbent assay was employed to determine the levels of cyclic adenosine monophosphate （cAMP）， cyclic guanosine monophosphate （cGMP）， triiodothyronine （T₃）， thyroxine （T₄）， interleukin （IL）-1β， IL-6， tumor necrosis factor （TNF）-α， and C-reactive protein （CRP） in the serum. The histopathological changes of the liver were observed. The expression of lipoxygenase-2 （COX-2） was detected by immunofluorescence. The mRNA levels of nuclear transcription factors-κB （NF-κB）， monocyte chemotactic protein-1 （MCP-1）， and intercellular adhesion molecule-1 （ICAM-1） were determined by real-time polymerase chain reaction （Real-time PCR）.Western blot was employed to determine the protein levels of NF-κB in hibitory protein（IκB） kinase β （IKKβ）， IκBα， and phosphorylated IκBα （p-IκBα） in the liver and the protein levels of NF-κB in the cytoplasm and nucleus. ResultCompared with the normal group， the model group showed elevated levels of FBG， FINS， insulin resistance index， TC， TG， LDL-C， cAMP， T₃， T₄， IL-1β， IL-6， TNF-α， and CRP， up-regulated mRNA levels of NF-κB， MCP-1， and ICAM-1， and up-regulated protein levels of COX-2， p-IκBα， and nuclear NF-κB （P<0.01）. Compared with the model group， Yunvjian without Achyranthis Bidentatae Radix lowered the levels of FBG， FINS， insulin resistance index， TC， TG， LDL-C， cAMP， T₃， T₄， IL-1β， IL-6， TNF-α， and CRP， down-regulated the mRNA levels of NF-κB， MCP-1， and ICAM-1， and down-regulated the protein levels of COX-2， p-IκBα and nuclear NF-κB （P<0.05， P<0.01）. Compared with the Yunvjian without Achyranthis Bidentatae Radix， Yunvjian with Achyranthis Bidentatae Radix showed lowered levels of FBG， FINS， insulin resistance index， and inflammatory cytokines， down-regulated mRNA levels of NF-κB， MCP-1， and ICAM-1， and down-regulated protein levels of p-IκBα and nuclear NF-κB （P<0.05， P<0.01）. ConclusionAchyranthis Bidentatae Radix can enhance the performance of Yunvjian in reducing blood glucose and inhibiting inflammation in diabetic rats with the syndrome of yin deficiency and internal heat by down-regulating the IKK/IκB/NF-κB signaling pathway.