Objective To survey on the condition of critically ill children in emergency room (ER) for improving the care for them.Methods Data of 374 critically ill children in emergency intensive care unit (EICU) were recorded in the respects of mode of sending them to ER,rescue during transport,length of stay in ER,blood gas,electrolytes,accuracy of assessing pediatric critical illness score/neonate critical illness score (PCIS/NCIS) and Glasgow Coma Scale (GCS),correctness of determining SIRS,sepsis and septic shock.Results Of 374 patients,neonates were 29.9％,and the mean age of children patients not including neonate was 37.4 months.The mean length of ER stay was 4.7 hours (0.42-96 hours).Of 374 patients,those with infection diseases were 47.6％,and the main vehicles for transportation of patient sent to ER were Taxi (38.3％),ambulance (28.4％) and private cars (21.5％).Total fatality was 12.3％ and ER fatality ( 15.6％ ) was higher than in - hospital fatality ( 10.3％,P ＜0.01 ).The mean PCIS/NCIS of 374 patients were 81.92 ± 9.66,and the PCIS/NCIS ≤ 90 accounted for 81％.Of assessed GCSs of 172 patients,GCS≤8,GCS 9-12 and GCS 13-15 accounted for 35.5％,21.5％ and 43.0％ respectively,and fatalities were 26.23％,10.81％ and 5.41％ correspondingly (P ＜0.01 ).The PCIS values of GCS≤8 and GCS 9-12 patients were lower than those of GCS 13-15 patients (P ＜ 0.01 ).There was no significant difference in PCIS between GCS≤8 and GCS 9-12 ( P ＞ 0.05 ).PCIS and GCS were positively correlated (r=0.454,P=0.01).Of374 patients,41.7％ had SIRS,and 25.7％ had sepsis.Of 262 children not including neonates,43.5％ had shock,and 61.4％ of these shock children were septic shock.In 374 patients,those with hyponatremia accounted for 37.2％,and those with hyperkaliemia accounted for 22.0％.The rate of hypoglycemia found in neonates was 20.91％ and rate of hyperglycemia occurred in neonates was 29.1％.The rate of hypoglycemia found in children patients was 9％ and hyperglycemia was 66.7％.Patients with pH ＜ 7.35 accounted for 67.8％ and those with pH ＜ 7.2 were 33.1％.Conclusions The majority of children patients in pediatric ER were neonates and infants.The length of ER stay was short with mean value of 4.7 hours (0.42-96 hours).ER fatality was higher than in - hospital fatality,suggesting the critically ill children patients should be admitted as early as possible.The rate of using ambulance was only 28.4％.The Emergency Medical Service (EMS) should be improved to enhance the public sense of the EMS available.PCIS/NCIS can be used in ER for assessing the conditions and prognosis of critically ill children.GCS ≤8 and GCS 8-12 patients accounted for 57％ with majority of nontrauma brain injury.The values of PCIS in GCS≤8 and GCS 9-12 patients were much lower than those in GCS 13-15 patients.Patients with GCS ＜ 13 might be in critical settings.Majority of shock patients were septic shock (61.4％).Hyponatremia,hyperkalemia,hyperglycemia and hypoglycemia often occurred in critically ill pediatric patients and hypoglycemia not excepted in the neonates should have attention paid to.The main factor of acid -base balance disorder in critically ill children was acidosis (67.8％).

Objective To observe the effect of traditional Chinese medicine (TCM) Qingshen granule on signal transduction pathway of fokal adhesion kinase-rat sarcoma-mitogen activated protein kinase (FAK-Ras-MAPK) in renal tissue of rats with renal interstitial fibrosis (RIF). Methods Forty Spargue-Dawley (SD) rats were randomly divided into normal control, model, Bailing capsule and Qingshen granule groups (each, n = 10). The rat model with RIF was reproduced by unilateral ureteral obstruction (UUO) or ligation method. The rats in Bailing capsule group were treated with Bailing capsule dissolved in 4 mL warm water, and the dosage was 0.3 g·kg-1·d-1 for intragastric administration;the rats in Qingshen granule group were treated with Qingshen granule dissolved in 4 mL warm water, its dosage was 6 g·kg-1·d-1 for intragastric administration, and equal volume of normal saline was given to normal control group and model group by gavage. After treatment for 8 weeks, the levels of blood urea nitrogen (BUN), serum creatinine (SCr), fibronectin (FN),α-smooth muscle actin (α-SMA) were determined in each groups. The renal tissue expression levels of FAK, Ras, p38MAPK, FN, α-SMA were determined in various groups by immunohistochemistry staining method. Results Compared with the normal control group, the levels of serum BUN, SCr, FN and α-SMA were significantly increased in the model group. There were no significant differences in the levels of serum BUN and SCr before administration of drugs between Bailing capsule group and Qingshen granule group (both P>0.05). The levels of BUN, SCr, FN, andα-SMA were all significantly lowered in the two treatment groups than those of the model group after administration, the descent in Qingshen granule group being more marked [BUN (mmol/L):13.18±4.91 vs. 18.56±5.59, SCr (μmol/L): 104.80±12.04 vs. 119.02±12.47, FN (mg/L): 29.72±16.75 vs. 46.38±8.63, α-SMA (kU/L):5.49±2.68 vs. 7.13±2.37, all P < 0.05]. The immunohistochemistry staining showed: the kidney tissue expression levels of FAK, Ras, p38MAPK, FN, and α-SMA in the model group were significantly higher than those of normal control group, above indexes were all significantly lower in Bailing capsule group and Qingshen granule group than those of the model group, and the descent in Qingshen granule group was more obvious (FAK: 3.00±1.41 vs. 5.28±2.21, FN: 4.25±1.04 vs. 6.29±2.06, α-SMA: 3.25±1.28 vs. 4.86±1.57, p38MAPK: 2.50±1.31 vs. 4.71±2.50, Ras:3.50±1.41 vs. 4.29±1.38, all P<0.05). Conclusion Qingshen granule can reduce serum BUN and SCr levels in rats with RIF, and inhibit the activation of FAK-Ras-MAPK signal transduction pathway in the kidney, thereby it may reduce the generation of FN andα-SMA and play a role of anti-RIF.

BACKGROUND:Recent years, fiber posts and resin cores have been widely used in repairing the endodonticaly treated teeth with satisfactory effect. Erbium:yttrium aluminum garnet (Er:YAG) laser is a new type of water power laser system, which can be used for surface treatment of fiber posts. But studies on the effect of Er:YAG laser surface treatment on the bond strength of fiber posts are rarely reported. OBJECTIVE: To evaluate the effect of surface treatment utilizing Er:YAG laser irradiation with different parameters on the bond strength of fiber posts to root canal dentin. METHODS: Fifty human maxilary central incisors that had similar dimensions were used. After endodontic treatment, removal of the crown and canal preparation, ParaPost FIBER LUX glass fiber posts were cemented into the root canals. According to the method of surface treatment, 50 teeth were randomly divided into: no surface treatment as control group; four groups undergoing surface preparation with Er:YAG laser with four different power settings (150, 250, 350 and 450 mJ at 10 Hz for 60 s at 100-μs pulse duration), named 1.5, 2.5, 3.5, and 4.5 W Er:YAG laser irradiation groups, respectively. RESULTS AND CONCLUSION: The mean bond strength values reduced from the cervical to the apical root canal, and the bond strength of the dental cervix was significantly different from that of middle and apical thirds (P < 0.05), but there was no difference between the middle and apical thirds (P> 0.05). Regardless of the different part of the root slices, the bond strength was highest in the 4.5 W Er:YAG laser irradiation group, showing significant difference from other groups (P < 0.05). These findings indicate that 4.5 W Er:YAG laser irradiation significantly increases the bond strength of the fiber posts to root canal dentin.

Objective To assess the relationship between pulse wave velocity(PWV) and carotid atherosclerosis by UltraFast imaging.Methods 476 cases from Medical Examination Center of Beijing Friendship Hospital were enrolled in this study.According to intima-media thickness(IMT) of carotid artery,all subjects were divided into two groups:IMT without thickening group (G0) of 283 cases and IMT thickening group (G1) of 193 cases.Through UltraFast imaging,carotid artery PWV was measured,including the PWV at the beginning of the systole(BS) and the PWV at the ending of the systole(ES).Carotid IMT and plaque situation were recorded under gray-scale ultrasound.BS and ES were compared between the two groups.Spearman rank correlation was used to analyse the correlation between IMT of carotid artery and BS,between IMT of carotid artery and ES.Two independent samples t test to compare BS,ES between the two groups.Results BS of G1 and G0 were (6.03 ± 1.33)m/s and (5.51 ± 1.13)m/s,t =-4.571,P =0.000;ES of G1 and G0 were (8.42 ± 2.13)m/s and (7.34 ± 2.02) m/s,t =5.619,P =0.000.BS and ES of G1 were larger those of G0 respectively.BS (r =0.192,P =0.000) and ES (r =0.249,P =0.000) were correlated with the IMT of carotid artery.Conclusions Ultrafast imaging technique can quickly measure the carotid artery PWV.BS and ES of carotid artery can be quick,convenient,safe,noninvasive parameters for evaluating carotid atherosclerosis.

Objective To evaluate the effect of dezocine on the c-fos expression in neurons in the midbrain periaqueductal gray in a rat model of incisional pain.Methods Thirty-six pathogen-free healthy adult male Wistar rats,weighing 250-300 g,were divided into 3 groups (n =12 each) using a random number table:control group (group C),incisional pain group (group I) and dezocine group (group D).A 1 cm longitudinal incision was made through skin,fascia and muscle of the plantar aspect of the right hind paw in sevoflurane-anesthetized rats.In group C,the rats were only anesthetized and underwent no operation.In group I,0.9％ sodium chloride solution 2 ml was injected via the caudal vein at 15 min before the model was established.In group D,dezocine 1 mg/kg (diluted to 2 ml in 0.9％ sodium chloride solution) was injected via the caudal vein at 15 min before the model was established.At 24 h before operation (T0) and 2,6 and 24 h after operation (T1-3),the mechanical paw withdrawal threshold (MWT) and cumulative pain score were measured.After measurement of the pain threshold at T3,the whole brain was removed for determination of the c-fos expression in neurons in the midbrain periaqueductal gray by immunohistochemistry.Results Compared with group C,the MWT was significantly decreased,cumulative pain scores were increased,and the expression of c-fos in neurons in the midbrain periaqueductal gray was upregulated at T1-3 in I and D groups (P＜0.05).Compared with group I,the MWT was significantly increased,the cumulative pain score was decreased,and the expression of c-fos protein in neurons in the midbrain periaqueductal gray was down-regulated at T1.3 in group D (P＜0.05).Conclusion Dezocine mitigates incisional pain through inhibiting the expression of c-fos in neurons in the midbrain periaqueductal gray of rats.

Animals ; Calcium ; metabolism ; Cell Line ; Cricetinae ; Cricetulus ; Dose-Response Relationship, Drug ; Fibroblasts ; drug effects ; metabolism ; Vehicle Emissions

In the present study, we have cloned the gene of human neurotrophin-3 (hNT-3) from the genomic DNA of white blood cells (WBC) by polymerase chain reaction (PCR). The amplification products were cloned into pUC19 and sequenced. Genomic sequence comparison of the cloned fragment and the reported hNT-3 (GenBank M61180) reveals 7 base differences: 1 in the signal peptide, 3 in the prepro peptide, and 3 in the mature hNT-3. Except the 2 varied bases (16th, T to G; 285th, A to C) in the signal peptide and pro-sequence resulted in the change of their encoded amino-acids (Tyr→Asp; Gln→His), the other varied bases have no influence on their respective encoded amino-acids, and all the changes have no influence on the open reading frame (ORF) of the hNT-3.

Aim To study the function of VR1 in chronic pain, to construct VR1 siRNA expression vectors and to study their silencing effect in the DRG neurons of rats were detected.Methods The hairpin sequences of siRNAs targeting VR1 gene of rat were designed, and two pairs of oligonucleotide sequence were synthesized. The annealed oligonucleotide fragments were cloned into linearized pRNAT-U6.2/Lenti expression vector and identified by PCR and DNA sequencing.Then, they were co-transfected by lipofectamine into 293T cells.The silencing effects of the lentivector-mediated VR1 siRNAs on the expression of VR1 mRNA were determined by RT-PCR after intrathecal injection in rats.Results DNA sequencing showed that the oligonucleotide fragments were correctly cloned into linearized pRNAT-U6.2/Lenti expression vector and the expression of VR1 mRNA in L4-L6 DRG neurons was inhibited significantly by pRNAT-U6.2/Lenti-siVR1 after intrathecal injection in rats.Conclusion The lentivector-mediated siRNAs are successfully constructed and they inhibit the expression of VR1 mRNA in the DRG neurons of rats, which may provide a potential tool for the further study and treatment of chronic pain.

Adult ; Epilepsy ; chemically induced ; therapy ; Humans ; Male ; Nitrobenzenes ; poisoning ; Occupational Exposure ; Poisoning ; complications ; therapy

Objective To compare the tumor sizes of primary lesions in pancreatic cancer based on CT scan and postoperative pathological analysis and measure the extent of filtration under a microscope,and to determine the CTV in radiotherapy target delineation.Methods A total of 19 patients with pancreatic cancer who were admitted to PLA General Hospital and Air Force General Hospital,PLA from 2013 to 2014 were analyzed.In 15 patients,the maximum diameters of tumor cross-section were measured based on the images of preoperative multi-slice spiral CT and postoperative gross samples,respectively.In 19 patients,the extent of tumor infiltration was measured on pathological sections under a microscope and the actual extent of infiltration was calculated.The paired t-test was applied to analyze the differences in the results of different measurement methods.Results In the 15 patients,the maximum tumor diameters measured with gross samples and CT scan were 33.6 mm and 30.1 mm,respectively (P=0.000),and the median and mean of the differences were 3.1 mm (1.2-8.0 mm) and 3.6±2.0 mm,respectively (95％ CI 1.2-6.0).In the 19 patients,the maximum actual infiltration distance and the maximum distance measured were 3.50 mm and 3.19 mm,respectively (P=0.000),and the median and mean of the differences were 0.31 mm (0.15-0.50 mm) and 0.30±0.09 mm,respectively.The maximum distance between the margin of primary lesions and the infiltrating lesions was 5.21 mm,with a median of 3.34 mm (2.19-5.21 mm) and a mean of 3.50± 0.88 mm (95％ CI 2.19-5.06).Conclusions Contrast-enhanced CT scan underestimates the actual size of primary lesions in pancreatic cancer,and an extension of 5 mm outside gross tumor volume (GTV) as CTV may not be sufficient.It is recommended to extend another 1-3 mm outside GTV as CTV.