Objective To study the changes rule of serum procalcitonin (PCT) and PCT clearance rate (PCTc) in patients with severe craniocerebral injury complicated with pulmonary infection and analyze the values of PCT and PCTc in the patients' therapeutic effect and prognosis.Methods A retrospective controlled analysis was conducted, the clinical data of 58 patients with severe craniocerebral injury complicated with pulmonary infection admitted into the Department of Neurology of the Forth Hospital of Tianjin from December 2012 to December 2016 were collected, and within 24 hours after definite diagnosis (before treatment) and after treatment for 1, 3, 7 days, the levels of PCT and percentages of PCTc were measured by rapid semi quantitative method. According to the therapeutic results of treatments, including antibiotics, airway management, nutritional support, etc., the patients were divided into an effective group and a deteriorative group. The changes rule of levels of serum PCT and percentages of PCTc before treatment and 1, 3, 7 days after treatment were dynamically evaluated. The receiver operating characteristic curve (ROC curve) was drawn and the area under the ROC curve (AUC) was calculated, and the sensitivity, specificity and diagnostic accordance rate of the combined treatment were assessed.Results Of 58 cases 32 (55.2%) after active treatment had promising therapeutic results or better prognosis (effective group), and the disease situations in 26 patients (44.8%) were deteriorating(deteriorative group). With prolonged treatment in effective group, the serum level of PCT was decreased gradually, while the deteriorative group showed a tendency firstly decreased and then increased, reaching to the valley on the 1st day after treatment, on the 3rd day beginning to increase and reaching the peak on the 7th day; the levels of PCT in effective group were significantly lower than those in deteriorative group at each time point after treatment on 1, 3, 7 days (μg/L: 1 day was 2.67±0.77 vs. 3.24±0.90, 3 days was 1.38±0.63 vs. 3.31±0.85, 7 days was 0.61±0.16 vs. 3.82±1.05, allP < 0.05); The PCTc rates in the effective group were significantly higher than those in the deteriorative group at each time point on 1, 3 and 7 d [1 day was (17.53±9.94)% vs. (12.31±7.55)%, 3 days was (60.34±13.55)% vs. (8.31±4.69)%, 7 days was (82.47±15.11)% vs. (-5.82±9.60)%, allP < 0.05]. After treatment for 3 days, 7 days, the AUC of PCT were 0.532 and 0.688, and the diagnosis cut-off values were 2.42 and 1.86 respectively; on 1, 3, 7 days after treatment, the AUC of PCTc were 0.529, 0.547, 0.775, and the diagnostic cut-off values were 15.67, 35.94 and 70.55 respectively. Further the final outcome was recognized as the gold standard: after treatment for 7 days, the PCT sensitivity was 80.1%, specificity 75%, the coincidence rate 77.6%; 7 days after treatment, the sensitivity of PCTc was 92.3%, the specificity 87.5%, the coincidencerate 89.7%.Conclusion The dynamic observations on serum PCT and PCTc have relatively good evaluation values on the therapeutic effect and prognosis of patients with severe craniocerebral injury complicated with pulmonary infection.

This study investigated whether the curative effect of short-pulse gastric electrical stimulation (GES) on the vasopressin-induced dyspeptic symptoms was mediated by central opioid peptide-producing neurons. Five female beagle dogs implanted with 1 pair of electrodes in gastric serosa were used in a two-experiment study. In experiment one, the brain was scanned by positron emission tomography in 3 dogs with and without short-pulse GES, and the radioactivity in nuclei of solitary tract (NST) and hypothalamus was detected. Experiment two was composed of 4 sessions. In session one, the dogs were injected with vasopressin in the absence of short-pulse GES. With session two, the short-pulse GES was simultaneously given via the electrodes with the injection of vasopressin. In sessions three and four, naloxone and naloxone methiodide was administered respectively in the presence of short-pulse GES. Motion sickness-like symptoms were scored and compared among the different sessions. The results showed that the short-pulse GES significantly increased the radioactivity in NST and hypothalamic nuclei (P<0.05, vs control). The short-pulse GES could ameliorate the vasopressin-induced motion sickness-like symptoms in dogs. Naloxone, but not naloxone methiodide could attenuate the curative effects of short-pulse GES. It is concluded that NST and hypothalamic nuclei may participate in the mediation of the curative effects of short-pulse GES on dyspepsia-like symptoms. Central opioid peptide-containing neurons presumably mediate the therapeutic effect on dyspeptic symptoms of short-pulse GES.

Due to the characteristics and environmental factors, electrocardiogram (ECG) signals are usually interfered by noises in the course of signal acquisition, so it is crucial for ECG intelligent analysis to eliminate noises in ECG signals. On the basis of wavelet transform, threshold parameters were improved and a more appropriate threshold expression was proposed. The discrete wavelet coefficients were processed using the improved threshold parameters, the accurate wavelet coefficients without noises were gained through inverse discrete wavelet transform, and then more original signal coefficients could be preserved. MIT-BIH arrythmia database was used to validate the method. Simulation results showed that the improved method could achieve better denoising effect than the traditional ones.
Algorithms ; Arrhythmias, Cardiac ; Databases, Factual ; Electrocardiography ; Humans ; Signal Processing, Computer-Assisted ; Wavelet Analysis

Objective To investigate the protective effect of hydrogen-rich saline on lung injury associated with severe acute pancreatitis and its impact on P38MAPK and NF-κB expressions.Methods Fifty-four male Wistar rats were randomly (random number) divided into three groups:(1) hydrogen-rich saline treatment group (HRS group,n =18),in which the rats were treated with hydrogen-rich saline (6 mL/kg) administered intravenously via tail vein and HRS (20 mL/kg) administered subcutaneously at 5 min after successful modeling.(2) Severe acute pancreatitis model group (SAP group,n =18),in which rats received equivalent volume of normal saline instead of hydrogen-rich saline both intravenously and subcutaneously as in HRS group.(3) Sham operation group (SO group,n =18),in which rats were treated with sham surgery,and received equivalent volume of normal saline as in SAP group.The model of severe acute pancreatitis (SAP) was made by retrograde injection of 5％ sodium taurocholate (1 mL/kg) into cholepancreatic duct.All rats were sacrificed at 3 h,12 h,and 24 h separately after the operation (n =6 at a time).The levels of serum amylase,lipase were measured.The ratio of wet and dry lung tissues was measured.The histopathological changes of lung tissues were observed under optic microscope.The expressions of P38MAPK,p-P38MAPK and NF-κB were measured by using immunohistochemistry method.Results Compared with SAP group,there were no significant differences in levels of serum amylase [12 h (5306.7±909) vs.(5435.0 ±441.2)] and lipase [12 h (1897.8 ±149.4) vs.(1917.9± 106.8)] in HRS group (P ＞0.05),but there were significant differences in the ratio of wet and dry lung tissues [12 h (3.12 ± 0.58) vs.(1.87 ± 0.25)] and histopathology scores [12 h (2.14 ± 0.38) vs.(3.58 ±0.32)] (P ＜0.05).There was no significant difference in expression of P38MAPK in lung tissues among three groups at 12 h.Compared with SO group,the expressions of p-P38MAPK and NF-κB were significant increased in SAP group at 12 h,however,they were lower significantly in HRS group than those in SAP group.Conclusions Hydrogen-rich saline has a protective effect on lung injury associated with severe acute pancreatitis,and its mechanism may be likely related to the antioxidant effect and inhibiting the activation of P38MAPK and NF-κB.

10.3969/j.issn.2095-4344.2013.24.015

Objective Human Papillomavirus (HPV) is necessary to the development of cervical cancer.Until now,the distribution of specific HPV type has not been identified clearly yet.Besides,the relationship between age and the HPV type-specific distribution in cervical adenocarcinoma needs to be further investigated.Methods This study included 32 specimens of cervical adenocarcinoma out of a multicenter clinical study in China.The specimen blocks were sliced by sandwich method.DNA was amplified by SPF10-PCR method.DNA genotyping used LiPA method.All biopsy specimens had pathologic diagnosis.The prevalence of HPV type-specific distribution was described and the differences were analyzed statistically.Results 32 adenocarcinoma cases were included in this sttudy.HPV positive rate was 53.1％ (17/32).HPV-18 was the most prevalent type,which took up 47.4 ％ (8/17) of the total HPV positive cases,followed by HPV-16,which took up 26.3 ％ (5/17) of the total HPV positive cases.Other HPV types detected were HPV-39,HPV-45 and HPV-66.One multi-infection case was found (HPV-18 and HPV-66 co-infection).The average ages of HPV-16 and HPV-18 were 48.6 and 40.6 years old respectively,which showed statistically difference (P =0.049).When the patients younger than 50 years old were compared with the patients equal or older than 50 years old as two age groups,HPV positive rate did not show significantly statistical difference (P =0.074) between the two age groups.The prevalence of HPV-18 manifested significant differences between the two age groups in both HPV positive adenocarcinoma cases and overall adenocarcinoma cases (P =0.029and P =0.003 respectively).The prevalence of HPV-16 did not show any significant statistical difference between the two age groups in either HPV positive adenocarcinoma cases or overall adenocarcinoma cases (P =0.6 and P =1 respectively).HPV-16 and/or HPV-18 infection (at least one positive) in HPV positive adenocarcinoma cases did not have statistical significance (P =0.052),while in overall adenocarcinoma cases,HPV-16 and/or HPV-18 infection presented significant statistical difference (P =0.005).Conclusion HPV-18 and HPV-16 were two most prevalent HPV types in cervical adenocarcinoma.HPV infection and HPV-18infection were more common in young women.The prevalence of HPV-16 was more common in older adenocarcinoma cases compared with HPV-18.Those findings will provide evidence for the evaluation of HPV vaccine in preventing cervix related diseases.

Objective To explore the effects of different vitamin A(VA) levels on thyroid cells apoptosis and its gene expression of mice taking excessive iodine. Methods Kunming mice were randomly divided into 6 groups according to body weight 3 weeks after born: normal control(NI) group, high iodine(HI) group, low vitamin (LVA) group, high iodine plus low vitamin A(HI+LVA) group, high iodine plus vitamin A1 (HI+VA1) group, high iodine plus vitamin A2(HI+VA2) group. The VA was given in food(4000,4000,0,0,8000,16 000 U/kg), and the iodine was given as potassium iodate in water (I-:50,3000,50,3000,3000,3000 μg/L). The apoptosis was tested using in situ end labehng(TUNEL) method. Reverse transcription polymerase chain reaction (RT-PCR) were used to measure the level of mRNA of apoptosis gene(Fas, FasL, Bcl-2) in tissues. Results Apoptotic index measured by TUNEL method was rising along with the mice age. Compared to NI group[(14.09±5.68)%], apoptotic index was significantly increased in HI[(20.91±9.57)%], HI+LVA[(20.29±9.90)%]and HI+VA2 [(19.51±8.25)%]groups in the three months(P < 0.05). Compared to NI group[(16.80±9.90)%], apoptotic index was significantly increased(P < 0.05) in HI[(23.22±8.58)%],LVA[(22.56±6.17)%],HI+LVA [(25.99±9.62)%],HI+VA1 [(21.65±7.74)%]groups in the six months. Compared with the NI group(Fas: 1.29±0.25,1.27±0.26; FasL: 1.60±0.13,1.65±0.13), the mRNA levels of Fas and FasL in HI group(Fas: 1.57±0.36,1.49±0.35; FasL: 1.85±0.46,1.84±0.32) were increased, but the differences were not remarkable(P > 0.05) in the three and six months. Compared with the HI group, the mRNA levels of Fas in HI+ VA1, HI+VA2(1.33±0.35, 1.30±0.26) groups were decreased to the level in NI group in the six months. The mRNA levels of Fas and FasL were not different (P > 0.05) between HI+LVA(I.60±0.27,1.88±0.46) and HI groups in the three months. The mRNA levels of Bcl-2 were not remarkably differences in the three months (1.05±0.19,0.96±0.33,0.95±0.26,1.18±0.27,1.10±0.19,0.98±0.36, all P > 0.05), and in the six months (1.35±0.28,1.60±0.25,1.48±0.18,1.71±0.26,1.66±0.29,1.56±0.35, all P > 0.05). Conclusions Excessive iodine can cause thyroid cells apoptosis in mice. Supplementation of suitable amount of VA can regulate the levels of the apoptosis-related genes expression, and partly antagonize the apoptosis caused by high iodine.

Objective:To analyze clinical data of 41 patients with severe mouth floor cellulitis.Methods:Patient's gender,age, epidemiological characteristics,origin of inflammation,symptoms of the disease,primary diagnosis,concomitant diseases,complica-tions,clinical diagnosis,the use of antibiotics (type and course),operation and outcomes were reviewed.Results:The male-fe-male ratio of the patients was 2.4∶1 .Age distribution was 1 0 -93 years old(with the mean of 46.23).The cases from urban-rural area was 3∶1 ,1 4.6% of the patients'primary diagnosis was not accurate.Only 31 % of the patients went to doctors in the first 5 days from the beginning of the disease.82.9% of the mouth floor cellulites were odontogenic.35% of the cases were diagnosed to be in-fectious diffusion to parapharyngeal,pterygomandibular spaces or to be complicating with neck infection at first examination.Infec-tion of 7.5% of the cases were spread to mediastinum.All the patients were administered with antibiotics and completed the surgical drainage as early as possible,except 2 transfered to respiratory medicine for mediastinum serious mediastinal and pulmonary infection and 1 to urinary surgery for renal failure.Conclusion:Odontogenic infection is most common for mouth floor cellulitis.Accurate di-agnose,maintenance of airway and initiate suitable antibiotics are rery important for the treatment of severe cellulitis of mouth floor. Prompt surgical drainage and comprehensive treatments are also essential to prevent patients from severe complications.

Objective To investigate the methods for repairing skin defects after excision of small cutaneous malignant tumors at the lower one third part of nose and their clinical effects.Methods Lesions of small cutaneous malignant tumors at lower one third part of the nose were removed in 54 patients.Intraoperative pathology was performed to confirm the absence of survival carcinoma tissues after resection.According to the site,size,shape and neighborous skin status of defects,bilobed flaps,two-side rotation flaps and nasolabial flaps were selected to repair nasal skin tissue defects.Results There were 39(72.22%) cases of basal cell carcinoma, 9(16.67%) squamous cell carcinoma, 6(11.11%) keratoacanthoma.Skin defects after tumor removal were situated at the lower one third part of nose in all cases with less than 2.0 cm in diameter.Bilobed flaps were used to repair skin defects in 20 cases.rotation flaps in 2 cases,and nasolabial flap in 32 cases.As a result,all flaps survived and no obvious deformation of nose was observed in these cases.No recurrence occurred in a 5-year follow-up.Conclusion A satisfactory repair of skin defects at the lower one third part of nose with a diameter of less than 2.0 cm is achieved with bilobed flaps,two-side rotation flaps and nasolabial flaps.

Objective To study the effect of macrophage, its stimulating factor, granulocyte macrophage colony-stimulating factor (GM-CSF), the combination of GM-CSF and macrophage on the survival of rat deep epigastric perforator flap (DEP). Methods The stable animal model of DEP flap in Sprague-Dawley rat mimicing human deep inferior epigastric perforator flap in breast reconstruction was established. The rats were treated with subcutaneous injection of recombined rat GM-CSF or rat peritoneal macrophages, respectively, or combination of GM-CSF/ Macrophages. Normal saline was used as parallel negative control. The rats were sacrificed and flap specimens were harvested on day 7 after operation, the flaps survival area were measured by the method of rubbings and the survival proportion of flaps were calculated, Von Will brand factor were detected by immunohistochemistry and microvessel density (MVD), and were calculated with microscopic study, and collagen were stained and quantified by Masson staining. Results Survival proportion of flaps in group GM-CSF (53.08% ± 8. 76% ) was not different with that in macrophages group (47. 95% ± 4. 92% ), and both of these two groups were significantly higher than parallel negative control group (43.28% ± 5.27% ) but significantly lower than combination GM-CSF/ macrophages group ( 61.68% ± 6. 60% ). For MVD, flap in GM-CSF group ( 24. 82 ± 4. 18 ) was not significantly different with macrophages group (24.30 ± 3.02 ), and both of these two groups were significantly higher than group parallel negative control (21.37 ± 2.65 ) but significantly lower than combination GM-CSF/macrophages group ( 29. 82 ± 4. 74). Collagen deposition in the flaps in GM-CSF group (17. 25% ± 2. 85% ) were significantly higher than parallel negative control group (14.41% ± 2. 89% ), macrophages group ( 12. 69% ± 3.55% ) were lower than parallel negative control group but there was no significant difference. That in combination GM-CSF/macrophages group (20.31% ± 3.01% )was significantly higher than GM-CSF group ( P < 0. 05 ). Conclusion Treatment with rat GM-CSF or macrophage can significantly promote the survival of the flaps. Combined application of GM-CSF and macrophage could synergetically promote the survival of the flaps, the vasculogenesis and the collagen deposition.