Objective To investigate the effects of inverse ratio ventilation with positive end expiratory pressure (PEEP) on pulmonary function and inflammatory cytokine in patients undergoing pulmonary lobectomy during one-lung ventilation.Methods Eighty patients with one-lung ventilation,52 males,28 females,aged 37-65 years,BMI 21-29 kg/m2,ASA grade Ⅱ,were randomly divided into inverse ratio ventilation (IRV) group and conventional ventilation (CV) group (n=40 each).Patients were all implemented into the program of general anesthesia,and ventilated with different modes.The IRV group were ventilated with a actual tidal volume (VT) of 7 ml/kg,respiratory rate of 12 breaths/min,I:E of 2:1,PEEP 5 cm H2O;in CV group with I:E of 1:2.Respiratory parameters were recorded at baseline (T0),5 min after anesthesia (T1),initiate of one-lung ventilation (T2),45 min of one-lung ventilation (T3) and the end of surgery (T4).Arterial blood was collected to analyze blood gas at T0 and T3 respectively.Meanwhile,oxygenation index was calculated.The concentrations of IL-6,IL-8 and IL-10 in bronchoalveolar lavage fluid (BALF) were measured with fiberoptic bronchoscope by enzyme-linked immunosorbent assay (ELISA).Results Compared with CV group,PaO2was significantly increased and levels of IL-6,IL-8 and IL-10 in BALF were significantly decreased at T3 in IRV group (P<0.05);Ppeak and Pplat were significantly decreased at T1-T4 in IRV group (P<0.05);PEEP,Pmean and CL at T1-T4 were significantly increased at T1-T4 in IRV group (P<0.05).Two cases (5.0%) of hypoxemia were found in CV group,one case (2.5%) of hypoxemia was found in IRV group,but there were no statistically significant differences in both groups.Two groups were not seen to complications such as delay,atelectasis and pneumothorax.Conclusion The oxygenation and hypoxemia were improved and inflammatory cytokine was released in patients with one-lung ventilation.

Objective To detect the expression and correlated significance of inducible nitric oxide synthase and p53,Bax in benign and malignant diseases of gallbladder. Methods In 16 cases of chronic cholecystitis,11cases of chronic cholecystitis with adenomyoma and 24 cases of gallbladder adenocarcinoma,the expression of iNOS,p53 and Bax in gallbladder's wall was detected by SP immunohistochemistry. Results 1^Inducible NOS and Bax expressed in both benign and maligmant diseased gallbladders' wall,compared with benign diseased gallbladders,the expression of iNOS and Bax in adenocarcinoma was decreased(P

Objective To investigate the relationship between bile amylase (BA) elevation and biliary tract disease in patients with normal pancreaticobiliary junction (NPBJ). Methods The bile juice was collected from bile duct in 202 consecutive cases who underwent therapeutic endoscopic retragrade cholangiopancreatography (ERCP) for biliary diseases ( biliary bile group), and from gallbladder (GB) in 73 consecutive cases who underwent percutaneous transbepatic cholecystoscopy for extraction of GB stone ( GB bile group). In biliary bile group, in addition to the measurement of BA, the level of lipnse (n =68), bacteria culture ( n = 149 ), manometry of Oddi's sphincter ( n = 27 ) and bile duct ( n = 38) were also performed. In GB bile group, additional GB biopsy was taken in 31 cases. No patient with pancreaticobiliary maljunction, history of cholangiojejunostomy or post-endoscopic sphincterotomy was included in the study. Results In biliary bile group, BA level was elevated in 95 patients (47. 0% ), in which there was no significant difference between neoplastic and non-neoplastic cases ( 56. 9% vs. 43.7%, P > 0. 05 ), although BA was elevated in most patients with hiler cholangiocarcinoma (7/9). The level of BA was correlated with bile lipase (r =0. 561 ), but not with pressure of Oddi's sphincter or bile duct. No significant difference in positive rate of bile bacteria culture was detected between patients with normal BA level and those with elevated level. In GB bile group, BA level was elevated in 25 patients (34. 3% ), in which the frequency of GB epithelium dysplasia is 87.5%, which was significantly higher than that from patients with normal BA level ( P < 0. 001 ). Conclusion The patients with biliary tract disease and NPBJ have high incidence of reflux of pancreatic juice into bile duct. In patients with elevated BA level, there was no significant difference between incidences of neoplastic or non-neoplastic disease, while the frequency of GB epithelium dysplasia and hilar cholangiocarcinoma were higher than those from patients with normal BA level.

OBJECTIVETo observe blood uric acid levels and Goldstein grading, as well as their correlation in Wilson's disease (WD) patients with different Chinese medical syndrome types.

METHODSTotally 906 WD patients in line with inclusive criteria were assigned to 6 groups, i.e., the heart spirit confused by phlegm group (HSCP, 26 cases), the phlegm-fire disturbing heart group (PFDH, 90 cases), the retention of damp-heat group (RDH, 113 cases), deficiency of qi and blood group (DQB, 168 cases), the deficiency of Gan-yin and Shen-yin group (DGYSY, 327 cases), the deficiency of Gan and Shen group (DGS, 182 cases) due to different Chinese medical syndrome types. Recruited were another 160 healthy subjects having similar ages and diet structures, who came for medical examinations, as the healthy control group. Venous blood was collected from the medial cubital vein of each-patient on an empty stomach in early mornings to detect blood uric acid levels. Results Blood uric acid levels were lower in each syndrome type group than in the healthy control group (146.08 +/- 67.24 micromol/L in the HSCP group; 157.08 +/- 69.77 micromol/L in the PFDH group; 162.58 +/- 97.72 micromol/L in the RDH group; 156.20 +/- 62.63 micromol/L in the DQB group; 161.83 +/- 111.23 micromol/L in the DGYSY group; 194.41 +/- 90.01 micromol/L in the DGS group; 242.39 +/- 87.55 micromol/L in the healthy control group, P < 0.01). Blood uric acid levels were higher in the DGYSY group than in the other 5 syndrome groups (P < 0.01). Correlation analyses between Goldstein grading and blood uric acid showed that, along with increased Goldstein grade (that was aggravating disease conditions), WD patients' blood uric acid levels decreased (P < 0.01).

CONCLUSIONSWD patient's blood uric acid levels decreased more. Blood uric acid levels and Goldstein grading were different in various Chinese medical syndrome types. Blood uric acid levels had certain value in assessing the severity of WD.

Asian Continental Ancestry Group ; Heart ; Hepatolenticular Degeneration ; blood ; classification ; diagnosis ; Humans ; Medicine, Chinese Traditional ; Syndrome ; Uric Acid ; blood

OBJECTIVETo compare the clinical effects of interlocking intramedullary nail and micro-invasive internal fixation with plate for the treatment of multiple segmental tibiofibular fractures.

METHODSThe clinical data of 39 patients with multiple segmental tibiofibular fractures received treatment from January 2010 to June 2013 were retrospectively analyzed. In the 39 patients, 18 cases were treated by the interlocking intramedullary nail (intramedullary nail group), there were 12 males and 6 females with the mean age of (40.6 ± 9.7) years old (ranged, 24 to 60 years);7 cases were type C2.1, 11 were type C2.2 according to the AO classification. The other 21 cases were treated by micro-invasive internal fixation with plate(plate group), there were 13 males and 8 females with the mean age of (41.7 ± 8.1) years old (ranged, 22 to 52 years), 7 cases were type C2.1, 13 were type C2.2, 1 was type C2.3. Preoperative preparation time, operation time, intraoperative blood loss, postoperative complications, fracture healing time were compared between two groups. Johner-Wruhs evaluation criteria was used to evaluate the clinical effect at last follow-up.

RESULTSAll the patients were followed up from 10 to 28 months with an average of 15.2 months. Operative time, intraoperative blood loss in intramedullary nail group were (62.1 ± 5.8) min, (70.9 ± 7.1) ml, respectively; in plate group were (64.3 ± 7.7) min, (74.1 ± 8.5) ml,respectively. There was no significant difference in operation time and intraoperative blood loss between two groups (P > 0.05). However, preoperative preparation time, fracture healing time in intramedullary nail group were (5.3 ± 0.7) days, (11.1 ± 1.9) months, in plate group were (7.1 ± 0.8) days, (14.1 ± 2.2) months, respectively. No postoperative complications were found in intramedullary nail group, and five cases developed with complications in plate group. There was significant difference in preoperative preparation time, postoperative complications and fracture healing time between two groups (P < 0.05). According to Johner-Wruhs criteria at last follow-up, 11 cases got excellent results, 4 good, 3 fair in intramedullary nail group; 11 excellent, 5 good, 2 poor in plate group.

CONCLUSIONInterlocking intramedullary nail has advantages of shorter preoperative preparation time, less postoperative complications and faster fracture healing time in treating multiple segmental tibiofibular fractures. But the application scope of interlocking intramedullary nail was inferior to micro-invasive internal fixation with plate , and its indications should be strictly controlled.

Adult ; Bone Plates ; Case-Control Studies ; Female ; Fibula ; injuries ; surgery ; Fracture Fixation, Internal ; instrumentation ; Fracture Fixation, Intramedullary ; methods ; Fracture Healing ; Humans ; Male ; Middle Aged ; Operative Time ; Retrospective Studies ; Tibial Fractures ; surgery

Objective To study the effective composition of Aster ageratoides Turcz for relieving asthma and its toxicity . Methods Seventy‐two qualified male guinea pigs ,body mass(300 ± 20)g ,were randomly divided into the control group ,aminophyl‐line group(0 .047 g/kg) and different ratio group of total saponins and total flavonoids (8∶1 ,4∶1 ,2∶1 ,1∶1 ,1∶2 ,1∶4 ,1∶8) . Every group received at dose of 0 .38 g/kg once a day for 3 days by intragastric administration .The effect of relieving asthma was taken as the indicators for the optimization of compositions ,which was detected by observing the latent period of asthma induced by acetylcholine‐histamine in guinea rats .The relaxation percentage of smooth muscle retracted by acetylcholine was detected by Pow‐erlab biological signal collecting system when aminophylline(1 .25 mg/mL) and different matching drugs(0 .02 g/mL) were added in Krebs′solution .The acute toxicities of total saponins ,total flavonoids and mixture of total saponins with total flavonoids (ratio of 1∶2) were detected by classical acute toxicity test of mice .Results Compared with the control group ,aminophylline group ,each group latent period of inducing asthma significantly or very significantly prolonged (P<0 .05) ,among them ,1∶1 ,1∶2 ,1∶4 group and other matching group were significantly different(P<0 .05) ,but 1∶2 group cited the longest incubation period .Aminophylline group and the ratio could significantly relaxe guinea pig tracheal smooth muscle retracted by acetylcholine .Aminophylline group di‐astolic percentage was the largest(24 .12 ± 1 .20)% ,all the groups were less than the percentage of diastolic aminophylline group (P<0 .05) ,but in 1∶2 group with the closest .Aster ageratoides Turcz ,tatarian aster total saponins ,total flavonoids and the ratio of 1∶2 to mice maximum tolerance was respectively 300 ,345 ,325 g/kg .Conclusion For the same total dosage ,the relieving asth‐ma effects of proportions of 1∶2 Aster ageratoides Turcz were obvious .There are no abnormal changes in the acute toxicity trila with total flavonoids ,total saponins ,as well as the ratio of 1∶2 ,safety is relatively good .

Objective To detect the expression of inducible nitric oxide synthase (iNOS) and heme oxygenase-1(HO-1) in human colon of irritable bowel syndrome(IBS), aim at finding out the role of gas messenger molecule such as nitric oxide(NO) and carbon monoxide(CO) in the pathogenesis of IBS. Methods The expression of iNOS and HO-1 in human colonic tissue specimen of enteroscope was detected by En vision and SABC immunohistochemistry each in 34 cases of IBS and 16 cases of normal control group. Results The expression of iNOS and HO-1 expressed mainly in the colonic mucous membrane epithelia, and the expression in IBS group was higher than that in normal control group(P

Objective To evaluate and analyze relationship of plasma level of N-terminal probrain natriuretic peptides (NT-proBNP) and serum level of cystatin C (CysC) with cardiac and renal functions in patients with chronic heart failure (CHF) , and explore significance of CysC measurement in early diagnosis for renal damage in patients with CHF. Methods Totally, 162 patients with CHF and 150 normal healthy (controls) undergone routine physical check-up at, Taizhou People's Hospital, Jiangsu were enrolled in the study. Their plasma level of NT-proBNP and serum level of CysC, as well as serum levels of creatinine ( SCr) , urea nitrogen ( BUN) were measured and echocardiography was performed. Glomerular filtration rate (eGFR) was evaluated by modification of diet in renal disease (MDRD) study group formula. Results Compared with the control group, blood levels of NT-proBNP, CysC, SCr, BUN and left ventricular end diastolic diameter ( LVEDD) all elevated, both eGFR and left ventricular ejection fraction ( LVEF) decreased (P <0. 05 or P <0. 01 ) in CHF group, and CHF patients were prone to complicate with renal dysfunction (P<0. 01). Blood levels of NT-proBNP and CysC elevated significantly and LVEF lowered significantly in CHF patients with NYHA functional classes II , III and IV than those in control group. There was significant difference in blood levels of NT-proBNP and CysC between patients with varied NYHA functional classes (P<0. 05). Blood levels of NT-proBNP and CysC reversely correlated with LVEF (r = -0. 36, P < 0. 01 and r = - 0. 39, P < 0. 01) . Blood level of CysC correlated with that of NT-proBNP ( r = 0. 87 , P < 0. 01). Results of logistic regression analysis showed that elevated blood levels of NT-proBNP and CysC were risk factors for mortality during hospitalization in patients with CHF. Conclusions Patients with CHF were more likely to complicate with renal dysfunction than controls, with main manifestations of more severe damaged eGFR, more severe heart failure and more obviously renal damage. Blood levels of NT-proBNP and CysC can be used as indicators for evaluating exacerbation of chronic condition, and serumlevel of CysC can be used as marker for early diagnosing renal damage in patients with CHF.

Objective To establish a specific fluorescence quantitative method for determining the mRNA expression of Toll-like receptor3(TLR3)in peripheral blood mononuclear cells(PBMCs).Methods Using the Beacon Designer 2.1 software,specific primers and Taqman-MGB probe were designed.The plasmid pMD18-T-TLR3 was constructed as calibrator and the amplified fragment was obtained by reverse- transcript-PCR(RT-PCR).RNA quantification based on cycle threshold values(Ct)was used to establish the standard curve.According to which,the TLR3 mRNA levels in 30 normal individuals,20 patients with primary biliary cirrhosis(PBC)and 20 ones with chronic liver cirrhosis induced by HBV were calculated automatically by software after the fluorescence of PCR product was detected continuously during amplification.Results The linear detection range of the assay for TLR3 gene and ?-actin was 10~2-10~8(r= -0.9974)and 10~3～10~8(r=-0.9984),respectively.The coefficient of variation of both intra-and inter- assay reproducibility for high concentration sample were 6.7% and 8.7%,respectively,and those for low concentration sample were 12.3% and 14.0%.The TLR3 mRNA expression level ranges from 3.46?10~2- 4.51?10~3 copies/?g RNA,4.92?10~2-1.42?10~4 copies/?g RNA and 2.58?10~2-7.17?10~3 copies/?g RNA for 30 healthy individuals,20 PBC patients and 20 ones with chronic liver cirrhosis induced by HBV, respectively.Conclusion We have successfully set up a FQ-RT-PCR method for detecting TLR3 mRNA, which may be used as an excellent tool for the clinic and basic study on the expression of TLR3 gene.

Antigens, Surface ; blood ; Diagnosis, Differential ; Glutamate Carboxypeptidase II ; blood ; Humans ; Male ; Neoplasm Staging ; Prostate-Specific Antigen ; blood ; Prostatic Hyperplasia ; pathology ; Prostatic Neoplasms ; etiology ; metabolism ; pathology ; Racemases and Epimerases ; analysis