Objective To evaluate the effect of 6% hydroxyethyl starch 130∕0. 4 on acute kidney injury in elderly patients in a prospective, multicenter, randomized, double?blind, controlled clinical tri?al. Methods A total of 120 patients of both sexes, aged 65-82 yr, weighing 56-83 kg, of American So?ciety of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective orthopaedics and hernia surgery, were divided into either hydroxyethyl starch group ( group HES) or lactated Ringer′s solution group ( group LR) , with 60 patients in each group. Hydroxyethyl starch and lactated Ringer′s solution were infused intra?venously at a rate of 7. 5 ml∕kg during 1st hour of surgery in HES and LR groups, respectively. Lactated Ringer′s solution was then infused at a rate of 5 ml∕kg starting from 2nd hour of surgery until the end of sur?gery in both groups. Before surgery, at the end of surgery and at 1, 3 and 5 days after surgery, blood sam?ples and urine specimens were collected for determination of the concentrations of neutrophil gelatinase?asso?ciated lipocalin, interleukin?18 (IL?18), plasma creatinine, urine β2 microglobulin and urine albumin.
The estimated glomerular filtration rate was calculated. Results The level of urine IL?18 was significantly higher at each time point after surgery than before surgery and immediately after the end of surgery ( P<0.05) . There were no significant differences between the two groups in the levels of urine IL?18, plasma creatinine, plasma and urine neutrophil gelatinase?associated lipocalin, plasma IL?18, urineβ2 microglob?ulin and urine albumin and estimated glomerular filtration rate at each time point ( P>0.05) . Conclusion Compared with lactated Ringer′s solution, 6% hydroxyethyl starch 130∕0.4 does not aggravate acute kidney injury in elderly patients.

Objective To investigate the relationship remifentanil-induced hyperalgesia and func-tion of nitrated glutamate transportor-1 ( GLT-1) and glutamine synthetase ( GS) in the spinal cord of rats with incisional pain. Methods Thirty-two male Sprague-Dawley rats, weighing 260-280 g, aged 2-3 months, in which caudal catheters were successfully implanted, were divided into 4 groups (n=8 each) u-sing a random number table method: control group ( group C) , incisional pain group ( group I) , remifen-tanil group ( group R) and remifentanil plus incisional pain group ( group RI) . Normal saline was intrave-nously infused for 60 min at 0. 1 ml · kg-1 · min-1 in group C. The model of incisional pain was estab-lished, and normal saline was simultaneously infused for 60 min via the tail vein at 0. 1 ml·kg-1 ·min-1 in group I. Remifentanil was infused for 60 min via the tail vein at 1. 0 μg· kg-1 ·min-1 in group R. The model of incisional pain was established, and remifentanil was infused for 60 min via the tail vein at 1. 0μg· kg-1 ·min-1 in group RI. The mechanical paw withdrawal threshold ( MWT) and thermal paw with-drawal latency ( TWL) were measured at 24 h before infusion of remifentanil or normal saline ( T0 ) and at 2, 6, 24 and 48 h after infusion ( T1-4 ) . The rats were sacrificed after the last measuremnet of pain thresh-old, and the L4-6 segment of the spinal cord was removed for determination of the expression of GLT-1 and GS (by Western blot) and expression of nitrated GLT-1 (nGLT-1) and nitrated GS (nGS) (by Western blot) . Ratios of nGLT-1∕GLT-1 and nGS∕GS were calculated. Results Compared with group C, the MWT was significantly decreased and TWL was shortened at T1-4 , the expression of GLT-1 and GS was down-regu-lated, the expression of nGLT-1 and nGS was up-regulated, and ratios of nGLT-1∕GLT-1 and nGS∕GS were increased in I, R and RI groups ( P<0. 05) . Compared with group I and group R, the MWT was signifi-cantly decreased and TWL was shortened at T1-4 , the expression of GLT-1 and GS was down-regulated, the expression of nGLT-1 and nGS was up-regulated, and ratios of nGLT-1∕GLT-1 and nGS∕GS were increased in group RI ( P<0. 05) . Conclusion The mechanism of remifentanil-induced hyperalgesia may be related to impaired function of GLT-1 and GS in the spinal cord of rats with incisional pain.

Objective To investigate the changes in the expression of Ca2+/calmodulin-dependent protein kinase Ⅱ α (CaMK Ⅱ α) in the spinal cord and dorsal root ganglia (DRG) during remifentanil-induced hyperalgesia in a rat model of incisional pain (IP).Methods Thirty-two male Sprague-Dawley rats in which caudal vein catheter was successfully placed,aged 260-280 g,were divided into 4 groups (n=8 each) using a random number table method:control group (group C),IP group,remifentanil group (group R) and remifentanil plus IP group (group RIP).Normal saline was infused via the caudal vein for 60 min at a rate of 0.1 ml · kg-1 · min-1 in group C.Normal saline was infused via the caudal vein for 60 min at a rate of 0.1 ml · kg-1 · min-1,and the model of IP was simultaneously established in group IP.Remifentanil was infused via the caudal vein for 60 min at a rate of 1.0 μg · kg-1 · min-1 in group R.Remifentanil was infused via the caudal vein for 60 min at a rate of 1.0 μg · kg-1 · min-1,and the model of IP was simultaneously established in group RIP.Mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 24 h before infusion and 2,6,24 and 48 h after infusion (T0-4).The rats were sacrificed after the last behavioral test,and L4-6 segment of the spinal cord and DRGs were removed for determination of the expression of total and phosphorylated CaMK Ⅱ α (tCaMK Ⅱ α,pCaMK Ⅱ α) by Western blot.The ratio of pCaMK Ⅱ /tCaMK Ⅱ α was calculated.Results Compared with group C,MWT was significantly decreased,TWL was shortened,the expression of tCaMK Ⅱ α and pCaMK Ⅱ α in the spinal cord and DRGs was up-regulated,and the ratio of pCaMK Ⅱ α/tCaMK Ⅱ α was increased in I,R and RIP groups (P＜0.05 or 0.01).Compared with group IP and group R,MWT was significantly decreased,TWL was shortened,the expression of tCaMK Ⅱ α and pCaMK Ⅱ α in the spinal cord and DRGs was up-regulated,and the ratio of pCaMK Ⅱ α/tCaMK Ⅱ α was increased in group RIP (P＜0.05 or 0.01).Conclusion The mechanism by which remifentanil induces hyperalgesia may be related to upregulated expression of CaMK Ⅱ α in the spinal cord and DRGs in a rat model of IP.

In order to help improving mental attention and sensory integration ability of mental retarded children, this paper proposes an interactive eyes-brain-hands coordination training system. This system realizes the principle of seeing, thinking and moving of hands by an interactive operation between the computer software custom icons and a touch control panel, so it can improve cognitive function and activity of daily living. The results show this training platform has a high degree of application and acceptance, and provides a portable training method for mental retarded children.

Objective:To analyze the microbiological characteristics of patients with severe burns caused by blast in different periods and explore the application value of metagenomics next-generation sequencing (mNGS) in detecting pathogenic microorganisms.Methods:The retrospective observational study was applied. From June 13 to September 13, 2020, twenty-three patients (21 males and 2 females) with severe burns caused by blast who met the inclusion criteria were admitted to the Second Affiliated Hospital of Zhejiang University School of Medicine, with age of (64±5) years and total burn area of (86±14) % total body surface area. Abbreviated burn severity index (ABSI) score, revised Baux score, acute physiology and chronic health status evaluation (APACHE) Ⅱscore, and sequential organ failure assessment (SOFA) score were counted on admission. Within 7, 8-20 and 21-30 d after admission, the complications, infection source and distribution of pathogenic microorganisms in patients were recorded. The detection of pathogenic microorganisms was analyzed, and the difference in detection efficiency between microbial culture method and mNGS was compared. After admission, the infection of overall source distribution of pathogenic microorganisms in patients was analyzed, and the difference in detection efficiency between microbial culture method and mNGS was compared. Data were statistically analyzed with McNemar and Fisher exact probability test.Results:On admission, ABSI score, revised Baux score, APACHE Ⅱ score and SOFA score were (12.6±2.4), (91±22), (26±4), and (10.3±2.3) respectively. Within 7 d after admission, the main complications of patients were inhalation injury, septic shock, and hypoproteinemia. Patients were mainly infected with pathogenic microorganism on wound, blood stream, and lung. Within 8-20 d after admission, the incidence of septic shock was the highest. The incidence of inhalation injury was significantly lower than that of ≤7 d after admission ( P<0.01), the main source of infection were wound, lung, and blood stream, and the incidence of wound and blood stream infection were significantly lower than that of ≤7 d after admission ( P<0.01). Within 21-30 d after admission, the incidences of multiple organ failure and acute respiratory distress syndrome were low, the incidence of inhalation injury was significantly lower than that of ≤7 d after admission ( P<0.01), and the incidence of septic shock was significantly lower than that of ≤7 d after admission ( P<0.01) and 8-20 d after admission ( P<0.01). There were only low bloodstream infections, and the incidence of wound infection was significantly lower than that of ≤7 d after admission ( P<0.01) and 8-20 d after admission ( P<0.05), and the incidences of lung and blood stream infection were significantly lower than those of ≤7 d after admission ( P<0.01). Within ≤7 d after admission, gram-positive bacteria were mainly Staphylococcus aureus. Gram-negative bacteria were mainly Klebsiella pneumoniae and Stenotrophomonas maltophilia. The fungi contained only Candida. Within 8-20 d after admission, Staphylococcus aureus was mainly the gram-positive bacteria, and the detection rate of Enterococcus was significantly lower than that of ≤7 d after admission ( P<0.01). Pseudomonas aeruginosa and Acinetobacter baumannii were the main gram-negative bacteria, and their detection rates were significantly lower than those of ≤7 d after admission ( P<0.01).There was a new detection of Fusarium. Within 21-30 d after admission, Staphylococcus aureus was the mainly gram-positive bacteria, and the detection rates of Enterococcus and Bacillus were significantly lower than those of ≤7 d after admission ( P<0.01). Pseudomonas aeruginosa and Acinetobacter baumannii were still the main gram-negative bacteria, and increased with the extension of time after admission. The detection rate of Pseudomonas aeruginosa was significantly higher than that of ≤7 d after admission ( P<0.01) and 8-20 d after admission ( P<0.01), and the detection rate of Acinetobacter baumannii was significantly higher than that of ≤7 d after admission ( P<0.01). The detection rate of Klebsiella pneumoniae was significantly lower than those of ≤7 d after admission ( P<0.01) and 8-20 d after admission ( P<0.01). All Candida, Mould, Fusarium were detected. Within ≤7 d and 8-20 d, the consistency between mNGS and bacterial culture was high ( κ=0.659, 0.596). Within 21-30 d after admission, the consistency between mNGS and bacterial culture was moderate ( κ=0.407). In different time periods, the positive test rate of mNGS was basically constant, while that of microbial culture showed a decline with the extension time after admission. Five hundred and six strains of pathogenic microorganisms were isolated from wound, blood, sputum, and indwelling catheter, and Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae were the main pathogenic microorganisms. Pseudomonas aeruginosa and Acinetobacter baumannii were the most common in the wound samples, Klebsiella pneumoniae was more often seen in blood samples while Pseudomonas aeruginosa and Acinetobacter baumannii in sputum samples, and Acinetobacter baumannii in indwelling catheter samples were the most common. The detection rates of Pseudomonas aeruginosa in wound and sputum were significantly higher than those of blood ( P<0.05 or P<0.01) and indwelling catheter ( P<0.01), respectively. The consistency between the overall results of mNGS and microbial culture were moderate ( κ=0.556). The consistency between mNGS and microbial culture was high in samples of blood and indwelling catheter ( κ=0.631, 0.619), but those were moderate in sputum and wound ( κ=0.558, 0.528). Conclusions:The most common infections of patients with severe burn caused by blast injury were wound infection and blood stream infection. With the extension of time after admission, the main pathogenic bacterial strains of patients changed from Staphylococcus aureus, Klebsiella pneumoniae, and Stenotrophomonas maltophilia to Acinetobacter baumannii and Pseudomonas aeruginosa. mNGS showed a higher positive rate of detecting pathogenic microorganisms than conventional microbial culture.

Objective To evaluate the relationship between NR2B subunit-containing N-methyl-D-aspartate (NMDA) receptors (NR2B receptors) and Ca2+/calmodulin-dependent protein kinase Ⅱ α (CaMK Ⅱ α) in the spinal cord during remifentanil-induced hyperalgesia in a rat model of incisional pain (IP).Methods Forty male Sprague-Dawley rats in which intrathecal and caudal catheters were successfully placed,weighing 260-280 g,aged 2-3 months,were divided into 4 groups (n=10 each) using a random number table method:control group (group C),remifentanil plus IP group (group RI),NR2B antagonist Ro 25-6981 group (group Ro) and remifentanil plus IP plus Ro 25-6981 group (group RI+Ro).In group C,normal saline 0.1 ml was intrathecally injected,and 10 min later normal saline was infused for 60 min via the tail vein at a rate of0.1 ml · kg-1 · min-1.In group RI,normal saline 0.1 ml was intrathecally injected,and 10 min later remifentanil was infused for 60 min via the tail vein at a rate of 1.0 μg · kg-1 · min-1,and IP was established immediately after onset of remifentanil infusion.In group Ro,Ro 25-6981 (0.1 ml) 10 μg was intrathecally injected,and 10 min later normal saline was infused for 60 min via the tail vein at a rate of 0.1 ml · kg-1 · min-1.In group RI+Ro,Ro 25-6981 (0.1 ml) 10 μg was intrathecally injected,and 10 min later remifentanil was infused for 60 min via the tail vein at a rate of 1.0 μg · kg-1 · min-1,and IP was established immediately after onset of remifentanil infusion.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 24 h before intravenously infusing normal saline or remifentanil and at 2,6,24 and 48 h after the end of infusion (T0-4).The rats were sacrificed after the last behavioral test,and the L4-6 segment of the spinal cord was removed for determination of the expression of NR2B in total and membrane protein (tNR2B and mNR2B) and expression of CaMK Ⅱ α in total protein (tCaMK Ⅱ α) and phosphorylated CaMK Ⅱ α (pCaMKⅡα).The ratios of mNR2B/tNR2B and pCaMKⅡα/tCaMK Ⅱα were calculated.Results Compared with group C,the MWT was significantly decreased,TWL was shortened,the expression of tNR2B,mNR2B,tCaMKⅡα and pCaMKⅡα was up-regulated,and the ratios of mNR2B/tNR2B and pCaMK Ⅱ α/tCaMK Ⅱ α were increased in group RI (P＜0.05 or 0.01).Compared with group RI,the MWT was significantly increased,TWL was prolonged,the expression of tNR2B,mNR2B,tCaMKⅡα and pCaMKⅡα was down-regulated,and the ratios of mNR2B/tNR2B and pCaMK Ⅱ α/tCaMK Ⅱ α were decreased in group RI+ Ro (P＜0.05 or 0.01).Conclusion Enhanced function of NR2B can activate CaMKⅡα during remifentanil-induced hyperalgesia,which may be involved in the mechanism of remifentanil-induced hyperalgesia in a rat model of IP.

UDP-glucuronosyltransferase 1A9 (UGT1A9) is a major phase II enzyme responsible for elimination of drugs and endogenous molecules. Clinical data have shown increased elimination of UGT1A9 substrates in pregnant women or oral contraceptive users, but the role of estrogen in the regulation of UGT1A9 expression remains unknown. In this study, we investigated the effect of 17-estradiol (E2) on UGT1A9 expression and the role of ERin the transcriptional regulation of UGT1A9. E2 significantly increased UGT1A9 promoter activity in HepG2 cells in the presence of ER. UGT1A9 induction by E2 was abrogated by antiestrogen ICI182,780 in HepG2 cells that constitutively express ER. Results from transient transfection of ERmutants into HepG2 cells demonstrated that mutation at DNA-binding domain of ERabrogates increased UGT1A9 promoter activity by E2. Deletion and mutation assays of UGT1A9 promoter revealed a putative ERE located within -2262/-1987 region. Examination of healthy human liver tissues revealed significantly higher UGT1A9 expression in women as compared to men. Together, these findings provide a mechanistic basis for the previous clinical reports and may shed a light on identifying sources for inter-individual variability in UGT1A9-mediated drug metabolism.

OBJECTIVETo identify pine needles from different plant origins by microscopic and molecular approaches.

METHODSThe characteristics of pine needles of Lamb., Parl. and Franch. were investigated via plant morphology and microscopic characteristics. and were analyzed with PCR amplification and bi-directional sequencing. MEGA 6.0 was used to calculate the intra-and inter-specific Kimura-2-Parameter (K2P) distances, and the phylogenetic tree was constructed by using the neighbor-joining (NJ) method.

RESULTSThere were significant differences in the number and length of pine needles, number of vascular bundles, distribution of stomatal lines, number and distribution of resin channels among three kinds of pine needles. The lengths of sequences of Lamb., Parl. and Franch. were 470, 469 and 470 bp, respectively. The lengths of sequences in three kinds of pine needles were 553 bp. The intraspecific variation rates of Lamb., Parl. and Franch. were 0%, 0.2%, and 2.8%, respectively; and the intraspecific variation rates of sequences were 0%, 2.4%, and 1.1%, respectively. There was no significant barcoding gap in intraspecific and interspecific genetic distances of sequences. The intraspecific and interspecific distances of sequences were clearly separated in the barcoding gap test. The NJ tree based on showed that the three pine needles clustered into three separate groups, indicating that DNA marker could distinguish the Lamb., Parl., Franch. and its close relative species.

CONCLUSIONSs The three types of pine needles can be distinguished accurately and rapidly by microscopic and molecular identification. The study provides methodology and experimental basis for the quality evaluation and classification of pine needles.

Background The presence of formaldehyde, ammonia, benzene, toluene, and xylene in indoor air of public places has been confirmed to cause health damage. The employees of barber and beauty shops are exposed to relatively enclosed space for a long time, and could surfer more serious health risks from indoor air chemical pollutants. Objective To analyze the concentrations of common indoor air chemical pollutants in barber shops and beauty salons in Liaocheng City, and explore potential health risks of the pollutants for employees. Methods Using a stratified randomized sampling method, 8 to 10 barber shops and 5 to 10 beauty salons were selected in the main urban area of Liaocheng City to conduct monitoring of the sanitary conditions of public places in winter and summer every year from 2016 to 2021; the indoor air concentrations of formaldehyde, ammonia, benzene, toluene, and xylene in the selected sites were measured, and a questionnaire survey was conducted to collect exposure characteristics of indoor pollutants. The concentration distributions of the five chemical pollutants were obtained from the monitoring data for 6 consecutive years, and the health risk assessment model recommended by the U.S. Environmental Protection Agency was used to perform health risk assessment of inhalation exposure. Results In 2016–2021, the median indoor air concentrations of formaldehyde, ammonia, benzene, toluene, and xylene in the two types of sites were lower than the limits of Hygienic Indicators and Limits for Public Places (GB 37488-2019), but the concentrations of some monitoring sites were higher than the limits. The disqualification rates of the five pollutants in the barber shops were 16.8%, 2.7%, 2.4%, 6.4%, and 12.0%, respectively. The disqualification rate of formaldehyde was the highest in all pollutants (22.0%), while the disqualification rates of ammonia, toluene, and xylene were 1.3%, 2.0%, and 2.0% in beauty salons respectively. Both formaldehyde and benzene were found to have carcinogenic risks (CR) in the two types of public places. Both median values of CR were greater than 1.0×10⁻⁶, and both maximum values were greater than 1.0×10⁻⁴. Formaldehyde had the highest non-carcinogenic risk in the indoor air of barber shops and beauty salons. The median non-carcinogenic hazard quotients (HQ) of formaldehyde were both greater than 1, and the maximum values were 16.72 and 12.19 times of the standard value; ammonia and toluene had the lowest non-carcinogenic risks, and their maximum values of HQ were less than 1; the median HQs of benzene and xylene were far less than 1, but their maximum risk values of barber shop were greater than 1. Conclusion For the sake of worker's health, formaldehyde and benzene should be the indoor air pollutant control priority for barber shops and beauty salons in Liaocheng; formaldehyde poses the most serious health hazard to practitioners and should be given high attention and necessary measures to reduce the hazard; benzene poses certain carcinogenic risks, with some of its highest values exceeding 10⁻⁴, which is higher than the recommended safety threshold.