0.05).The correlation of reduction of intra-disc pressure and accumulation of ablation time was positive.Compared with intra-disc pressure in control group,the pressure change of all ablation groups was statistically significant(P

Objective To investigate the effect of different doses of lidocaine on expression of the high mobility group box 1 protein (HMGB1) in small intestine in septic rats.Methods Fifty adult male Wistar rats weighing 200-250 g were randomly divided into 5 groups ( n =10 each):sham operation group (group S),sepsis group( group Sep ) and different doses of lidocaine group (group L1～3 ).Group S were not applied cecal ligation and puncture (CLP).Sepsis intestinal damage model was performed in group Sep by CLP.Group L1～3 were given intraperitoneally lidocaine in a dose ofS,10 and 20 mg/kg at immediately,1 and 2 h after CLP,respectively.Isometric normal saline was given intraperitoneally in group S and group Sep.The small intestine tissues were taken at 24 and 48 h after CLP.The small intestine morphology was observed with optical microscope.The expression of the HMGB1 mRNA were examined by PCR and the activity of diamine oxidase (DAO) were determined by ELISA.Results Compared with group S,the expression of HMGB1 mRNA was increased and the activity of DAO decreased in group Sep and groups L1～3 at 24 and 48 h after CLP ( P ＜ 0.05 ).Compared with group Sep,the expression of HMGB1 mRNA was decreased and the activity of DAO increased in a dose-dependent manner in groups L1～3 ( P ＜0.05),The injury of pathology of small intestine was slighter in groups L1～3 than in group Sep.Conclusion Lidocaine can reduce samll intestine injury through inhibiting HMGB1 expression in septic rats by a dose-dependent manner.

Objective To investigate the effect of vasoactive intestinal peptide (VIP) and methylprednisolone (MP) on Toll-like receptor (TLR)2/4 mRNA expression in endotoxin (lipopolysaccharide,LPS) induced shock.Methods Ninety Sprague-Dawley rats were randomly divided into LPS group (n =20),LPS + VIP group (n =20),LPS + MP group (n =20),LPS + VIP + MP group (n =20) and control group (n =10).LPS group injected intravenously LPS (E Coli O55B5) 10 mg/kg.LPS + VIP group,LPS + MP group and LPS + VIP + MP group were injected intravenously VIP 5 nmol/kg,MP 3 mg/kg and VIP 5 nmoL/kg + MP 3 mg/kg after LPS 10 mg/kg injection.The control group injected normal saline intravenously instead of LPS.The rats were sacrificed at 6 h and 24 h after injection and the intestine samples were collected.Pathological changes of the intestine were observed by microscopy.RT-PCR was used to detect the intestinal TLR2 mRNA and TLR4 mRNA expressions.Results Intestinal mucosa showed edema or necrotic change with structure of the microvilli disappeared after LPS injection.The inestinal lesions in VIP,MP and VIP + MP groups were milder than LPS group.At 6 h after LPS injection,TLR2 mRNA and TLR4 mRNA expressions were significantly up-regulated in LPS group,LPS + VIP group,LPS + MP group and LPS + VIP + MP group (TLR2 mRNA:1.14 ±0.38,1.17 ±0.42,1.16 ±0.41,0.92 ± 0.29;TLR4 mRNA 1.21 ±0.18,1.04 ± 0.38,1.11 ± 0.34,1.01 ± 0.20) compared with the control group (0.32 ± 0.20,0.24 ± 0.17) (P ＜ 0.01).But there was no significant difference between LPS group,LPS + VIP group,LPS + MP group and LPS + VIP + MP group (P ＞ 0.05).At 24 h after LPS injection,TLR2 mRNA and TLR4 mRNA expressions in LPS + VIP group,LPS + MP group and LPS + VIP + MP group (TLR2 mRNA:0.63 ± 0.12,0.59 ± 0.13,0.52 ±0.19;TLR4 mRNA 0.67 ±0.09,0.64 ±0.09,0.51 ±0.13) were significantly lower than LPS group (1.04 ± 0.38,0.82 ±0.18) (P ＜0.01) (P ＜0.05).Conclusion VIP and/or MP can mitigate intestinal injury induced by LPS shock.The gastrointestinal protection of VIP and glucocorticoids were related to downregulation signaling TLR2 mRNA and TLR4 mRNA expression.But VIP/MP and VIP + MP have no significant effect on expression of intestinal TLR2/4 mRNA until 24 h after LPS shock.

Objective To investigate the changes of thyroid hormones in patients with peripartum car-diomyopathy. Methods Seventy-two patients with peripartum cardiomyopathy were consecutively enrolled and 72 healthy women who had normal delivery were regarded as control. Among all the subjects , free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) in the serum and high sensitive C-reactive protein (hs-CRP), interferon-gamma (IFN-γ) and interleukin-4 (IL-4) in the plasma were measured. Results The levels of serum FT3 and FT4 in peripartum cardiomyopathy group were significantly higher than those in control group (P < 0.05). And the level of serum TSH in peripartum cardiomyopathy group was significantly low-er than that in control group (P < 0.05). There were 24 cases with hyperthyroidism in peripartum cardiomyopa-thy group while no patient in the control group had hyperthyroidism (P < 0.05). The levels of plasma hs-CRP and IFN-γ in peripartum cardiomyopathy group were significantly higher than those in the control group (P <0.05). And the level of IL-4 in peripartum cardiomyopathy group was significantly lower than that in the control group (P < 0.05). Conclusions Serum thyroid hormones elevated in patients with peripartum cardiomyopathy and its mechanism might be related to abnormal immune reaction.

Objective To examine the levels of fractional exhaled nitric oxide in bronchial asthma and the cor-relation between fractional exhaled nitric oxide and pulmonary function tests as well as the value of pulmonary function tests in curing the children with bronchial asthma. Methods Seventy - two asthmatic children came from Guiyang Ma-ternal and Child Health Hospital were studied. They were divided into 2 groups:mild - to - moderate asthma group(36 cases)and serious asthma group(36 cases). Fractional exhaled nitric oxide level and the lung function were measured and the correlation analysis was analyzed by SPSS 13. 0 software. Results The fractional exhaled nitric oxide concen-tration of the serious asthma group was significantly higher than that of the mild - to - moderate asthma group[(47 ± 26)ppb vs(29 ± 15)ppb,t = 3. 543,P ﹤ 0. 01],1 - second rate,maximum mid - expiratory flow(MMEF),and peak expiratory flow(PEF)in mild - to - moderate asthma group were significantly higher than those in serious asthma group[(99. 74 ± 9. 81)% vs(87. 17 ± 13. 30)% ,(87. 12 ± 35. 61)% vs(68. 90 ± 30. 88)% ,(99. 97 ± 10. 83)% vs (94. 31 ± 17. 69)% ](P ﹤ 0. 01,0. 05,0. 05). No correlations were found between fractional exhaled nitric oxide level and the lung function parameters,including forced expiratory volume in 1s(FEV1),1 - second rate,MMEF and PEF in the mild - to - moderate asthma group(r = 0. 073,0. 087,0. 242,0. 326,all P ﹥ 0. 05). However the level of fractional exhaled nitric oxide was negatively correlated with the lung function parameters,including FEV1,FEV1 / FVC,MMEF and PEF in serious asthma group(r = - 0. 354,- 0. 573,- 0. 478,- 0. 471,P ﹤ 0. 05,0. 001,0. 005,0. 005),respec-tively. Conclusions Monitoring of fractional exhaled nitric oxide and the lung function parameters can effectively indi-cate the state of illness of asthmatic child,which plays a key role in the treatment.

The high performance liquid chromatography-fluorescence micelle assay (HPLC-FMA) method for the content determination of polysorbate 80 in monoclonal antibody drugs was validated to study its applicability and transferability between various laboratories, and the feasibility to be included in the Chinese Pharmacopoeia. Both J.T. Baker and Nanjing Well-sourced polysorbate 80 was used in the collaborative validation of polysorbate 80 content analysis in seven different laboratories. The results show that when the protein concentration was no more than 20 mg·mL^-1 and the concentration of polysorbate 80 ranged from 0.05 to 0.5 mg·mL^-1, the method had good specificity. The recovery rates of the spiked samples ranged from 92.20% to 117.70% for J.T.Baker and from 93.90% to 117.20% for Nanjing Well. The intra-laboratory precision (%RSD) was less than 4.30% for J.T. Baker, and less than 2.60% for Nanjing Well, while the overall precision was less than 5.45% for J.T. Baker, and less than 6.70% for Nanjing Well. The linear correlation coefficient was more than 0.98 for J.T. Baker and more than 0.99 for Nanjing Well. The results of the collaborative validation prove that the HPLC-FMA method has good accuracy, precision, linearity, and specificity, and could be used for release control analysis of polysorbate 80 content in monoclonal antibodies across different laboratories.

Objective To study critical hemophagocytic syndrome (HPS) or macrophage activation syndrome (MAS) presented with multiple organ dysfunction syndrome (MODS) in pediatric intensive care unit (PICU),including clinical features and outcomes In order to explore the effect of bedside continuous hemodialysis/hemofiltration (CBP) as adjuvant treatment for severe HPS/MAS.Methods A total of 19 children with HPS/MAS were hospitalized met the diagnostic criteria for HPS from January,2009 to December,2012.Twelve cases were treated with CBP by continuous venin-venin hemodialysis/hemofiltration (CVVHDF) or high-volume hemofiltration (HVHF) following conventional anti-inflammatory therapy.The replacement liquid dose was 50-75 ml/ (kg · h).The organs function were evaluated and laboratory biomarkers including blood 、electrolytes,ferritin changes were measured before and after CBP treatment.Results Ninteen cases of HPS were acute onset and developed to MODS rapidiy after admission to PICU.The main clinical features were the irregular fever or high fever,hepatosplenomegaly and significant liver damage,nervous system dysfunction and disseminated intravascular coagulation (DIC).Eight cases were death and mortality rate was 42.1％,and all death occurred in those aged less than 3 years old.The mortality rate were 25％ (3/12) and 71.4％ (5/7) in CBP group and non-CBP group respectively.After CBP for 6-24 hours,the fever returned to normal range and blood electrolytes improved.The serum ferritin,serum alanine aminotransferase (ALT) and lactate dehydrogenase (LDH) reduced significantly.Serum creatinine (sCr),blood urea nitrogen (BUN) level improved.Four cases with acute respiratory distress syndrome (ARDS) improved and the ventilator parameters were downregulated.Conclusions Our findings indicate that HPS/MAS complicated with MODS is life threatening with high mortality rate.CBP therapy can lower the fever within a short time,correct electrolyte imbalance,stable circulatory function,improve the lung,liver,and brain function.It is suggested that CBP may be the potential effective therapy in severe HPS/MAS with MODS in children.

Objective To investigate the effects of different doses of lidocaine on acute liver injury in septic rats.Methods Fifty male Wistar rats,weighing 200-250 g,aged 8-10 weeks,were randomly divided into 5 groups(n =10 each):sham operation group(group S),sepsis group(group CLP),and different doses of lidocaine groups(groups L1-3).Sepsis was induced by cecal ligation and puncture(CLP)in anesthetized rats.At 0,1 and 2 h after CLP,lidocaine 5,10 and 20 mg/kg(in normal saline 0.5 ml)were injected intraperitoneally in groups L1-3 respectively,while normal saline 0.5 ml was given in groups S and CLP.At 24 h after CLP,blood samples were taken for determination of the plasma alanine aminotran sferase(ALT)concenlralion.The rats were then sacrificed,and the liver was removed for microscopic examination and determination of the hepatic high-mobility group box 1 protein(HMGBI)mRNA expression.Results Compared with group S,the plasma ALT concentration was significandy increased and hepatic HMGBI mRNA expression was up-regulated in groups CLP and L1-3(P ＜ 0.05).Compared with group CLP,HMGBI mRNA expression was down-regulated in groups 14-3,while the plasma ALT concentration was decreased in groups L2 and L3(P ＜ 0.05),The plasma ALT concentration was significantly decreased and HMGBI mRNA expression was down-regulated in groups L2 and L3 com pared with group L1,and in group L3 compared with group L2(P ＜ 0.05).The microscopic examination showed that the pathologic changes were attenuated in groups L1-3,and the changes were least severe in group L3.Concluslon Lidocaine can reduce acute liver injury in septic rats,this effect is dose-related,and inhibition of hepatic HMGBI mRNA expression is involved in the mechanism.

ObjectiveTo investigate the effects of sleep deprivation on expressions of Mir-132,mir-134 in the different regions of rat brain.MethodsAll the male SD rats were divided into control group ( normal sleep group),sleep deprivation (SD).The modified multiple platform method (MMPM) was used to establish sleep deprivation model.Mir-132,mir-134 level was detected by real time PCR.ResultsMir-132 were significantly increased in SD groups in hippocampus compared with the control groups ( 51.87 ± 8.13 vs 67.25 ± 7.59 ) (P ＜0.01 ).Mir-134 were significantly decreased in SD groups compared with the control groups( 1.82 ±0.15 vs 1.45± 0.12 )(P ＜ 0.01 ).There were no statistically significant differences in cortex and thalamus (P ＞ 0.05 ).Cortex mir-132 level in SD group and control group was 1.57 ±0.10,1.48 ±0.11 respectively,and it was 1.37 ±0.09,1.36 ±0.11 in thalamus;Cortex mir-134 level in SD group and control group was 98.26 ± 5.17,100.80 ±4.15respectively,and it was 97.56 ± 6.28,91.01 ± 4.07 in thalamus.ConclusionThe upregulation of mir-132 and downregulation of mir-134 implies that two miRNAs did opposite actions in the processes of sleep deprivation.This findings indicate that hippocampus mir-132,mir-134 levels in the SD rat may reflect associated depressive patho-physiological processes.

Objective To explore the clinical features and diagnostic methods of tuberculosis infection in PICU,and improve the understanding of tuberculosis.Methods We analysed the clinical features and diagnostic methods of severe tubercle bacillus infectious diseases in PICU from Jan 2009 to Dec 2012.Severity of disease was graded by pediatric critical illness score.The diagnosis of the pulmonary tuberculosis was in accord with the diagnostic criteria of paediatric pulmonary tuberculosis established by Chinese Medical Association paediatrics branch.And the diagnosis of tuberculosis meningitis and tuberculosis peritonitis based on the clinical physical examination,laboratory examination and pathologic finding.Results Among 22 cases enrolled in this study,totally 16 cases were pulmonary tuberculosis,6 cases were extrapulmonary tuberculosis,and 3 cases were tuberculosis meningitis.The clinical feature of severe tuberculosis infection in PICU was accompanying with one or multiple organ dysfunction besides tuberculosis infection symptom,among them,respiratory dysfunction occurred in 16 cases,cardiovascular dysfunction was observed in 2 cases,and central nervous system dysfunction was found in 3 cases,even 1 patient experienced cardiovascular system dysfunction,respiratory disorder as well as gastrointestinal system dysfunction simultaneously.Sixteen cases of pulmonary tubercle bacillus infection manifested respiratory failure besides fever,cough,shortness of breath and tuberculosis toxicosis symptom,2 cases of them developed into acute respiratory distress syndrome,8 cases needed mechanical ventilation.Two cases of pericardial effusion presented cardiac tamponade.The level of adenosine deaminase elevated in 12 cases,and the positive result of enzyme-linked immunospot assay for tubercle bacillius was observed in 14 cases.Conclusion It is very important to be aware of that severe tubercle bacillus infection exist in critically ill patients admitted in PICU,measuring the level of adenosine deaminase and taking enzyme-linked immunospot assay for tubercle bacillius test are important accessory examination for tuberculosis diagnosis in children.