Objective To investigate the significance of acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scoring system in evaluating elderly patients with hyperglycemic hyperosmolar state. Methods Elderly patients with hyperglycemic hyperosmolar state were enrolled in the study from January 2003 to May 2008. The patients were divided into two groups according to the outcome: death group and survival group. APACHE Ⅱ scoring system was used on the day of admission and the scores were compared in the two groups. The risk factors for death were evaluated by logistic regression analysis. Results Forty patients were registered including 10 cases in death group and 30 cases in survival group. The mortality rate was 25%. There were no differences in blood glucose, serum sodium, blood osmotic pressure, serum creatinine and hemoglobin between two groups before the treatment (t=-1.50～1.53, all P>0.05). The APACHE Ⅱ scores were significantly higher in death group than in survival group on the day of admission(30.1±5.4 vs. 22.9±3.9,Z=-4.08, P<0.01). Multiple logistic regression analysis showed that APACHE Ⅱ scores on the day of admission were the independent risk factor for death. Age, sex, blood glucose, effective blood osmotic pressure, serum creatinine and hemoglobin were not related to mortality rate. Conclusions APACHE Ⅱ scoring system is a helpful method for evaluating the severity and outcome of patients with hyperglycemic hyperosmolar state.

Objective To study the effect of dexmedetomidine(DEX)intrathecal administration on formation of chronic neuropathic pain induced by chronic constriction injury(CCI)in rats. Methods One hundred and twenty healthy adult male Sprague-Dawley(SD)rats were divided randomly into four groups(each n=30):sham group, model group,30μg/kg and 60μg/kg DEX intrathecal injection group(D30 group,D60 group). The CCI model was installed by left sciatic nerve ligaturing,sham surgery was done by exposing the sciatic nerve without ligation,and 30 μg/kg,60 μg/kg DEX(each,10 μl)and 10 μl normal saline were given intrathecally in D30,D60 and model groups respectively,all kinds of injection being once a day for 7 days. Hind paw mechanical contraction reflex threshold(MWT),heat-shrinkable reflex latency(TWL)and the score of motor dysfunction of hind extremity in rats were recorded on 1 day before ligation and 1,3,7 days after operation,and before ligation and 1,7,14 and 21 days after operation,the contents of tumor necrosis factor-α(TNF-α),interleukin(IL-1βand IL-6)in intumescentia lumbalis were measured by enzyme linked immunosorbent assay (ELISA). Results Compared with before operation,there were no significant differences in values of MWT,TWL,the motor function evaluation,TNF-α, IL-1β,and IL-6 at each time points(all P>0.05);however,with the prolongation of time,MWT and TWL were decreased,and the motor function evaluation,TNF-α,IL-1β,and IL-6 were increased in all the other groups. Compared with those of the sham group,MWT and TWL were declined,and the motor function evaluation,TNF-α, IL-1β,and IL-6 were elevated in model group. Compared with those of model group,30μg/kg and 60μg/kg DEX could significantly raise MWT(g)and TWL(s),obviously improve motor function and remarkably decrease the contents of TNF-α(pg/mg),IL-1β(pg/mg)and IL-6(pg/mg)in the spinal cord of CCI rats from 1 day after operation. And the changes in 60 μg/kg DEX group were more significant than those in 30 μg/kg DEX intrathecal injection group〔postoperative 1 day MWT:39.3±1.3 vs. 20.3±2.2,TWL:10.9±0.4 vs. 8.2±1.1,motor function score:2.00±0.00 vs. 2.00±0.75,TNF-α:33±7 vs. 125±18,IL-1β:108±12 vs. 203±34,IL-6:156±39 vs. 405±75,all P<0.05〕. Conclusions The DEX intrathecal administration has certain degree of dose-dependent therapeutic effect on hyperalgesia in CCI rat models. The mechanism is related to the amelioration of inflammatory reaction at the lumbar segment of spinal cord.

BACKGROUND:Bone marrow mesenchymal stem cel s can repair intestinal ischemia-reperfusion injuny by interfering inflammatory reactions after intestinal ischemia-reperfusion to protect intestinal barrier functions. In recent years, umbilical cord blood mesenchymal stem cel s are gradual y used as a substitute source of bone marrow mesenchymal stem cel s. OBJECTIVE:To investigate the effects of umbilical cord blood mesenchymal stem cel s on acute intestinal ischemia-reperfusion injury. METHODS:Umbilical cord blood mesenchymal stem cel s were induced, isolated in vitro and tracked by CM-DiI fluorescent labeling. Sixty-three Sprague-Dawley rats were equivalently randomized into three groups:control group received normal saline enema, intestinal ischemia-reperfusion injury group with ethanol diluted trinitro-benzene-sulfonic acid and transplantation group administrated with 1×1010/L umbilical cord blood mesenchymal stem cel suspension via the tail vein at 1 hour after trinitro-benzene-sulfonic acid modeling. At 3 days after transplantation, colon tissues were removed in each group to observe pathological changes of the intestinal tract by hematoxylin-eosin staining. Besides, expression of leptin mRNA in the colon tissues and cyclooxygenase-2 in the mucosa were detected by RT-PCR and immunohistochemistry method, respectively. RESULTS AND CONCLUSION:Transplanted umbilical cord blood mesenchymal stem cel s distributed in the intestinal lymphoid tissue and among glandular epithelial cel s, suggesting that these stem cel s might be involved in the process of intestinal ischemia-reperfusion injury repair. Compared with the control group, intestinal injury in the injury group was significantly aggravated, and most intestinal epithelial cel s shed;and the transplantation group appeared to have significantly reduced intestinal damage and significantly less cel shedding. Expression of leptin mRNA was significantly higher in the injury group than the transplantation group fol owed by the control group, and there were significant differences among the three groups (P<0.05). Additional y, expression of cyclooxygenase-2 in the injury group was significantly higher than that in the control group (P<0.05);compared with the injury group, expression of cyclooxygenase-2 was significantly lower in the transplantation group (P<0.05). To conclude, leptin and cyclooxygenase-2 may be involved in acute intestinal ischemia-reperfusion injury, and umbilical cord blood mesenchymal stem cel transplantation significantly lessens intestinal ischemia-reperfusion injury, which provides an experimental basis for human treating acute intestinal ischemic injury.

Objective Two-incision video-assisted thoracic surger relieved post operative pain when compared with open thoractomy ,while it is rarely reported worldwide ,most thoracic surgeons think it is hard to finish the complicated operation and it is not safe .We compared the safety between open and two -incision VATS.Methods Bwteen Febrary 2009 to December 2011 ,a total of 334 cases with clinical early -staged lung cancer of open thoracotomy were performed ,66 cases were completely performed with 2-incision VATS,17 cases were transferred to open thoracotomy defined as two -incision VATS assisted thoracotomy .We compared and ana-lyzed open thoracotomy with two -incision VATS in operating time ,and pre,post and total period of hospitaliza-tion,postoperative chest tube removal time ,postoperative complications .Results Operating time in the left lower lobe of both traditional open thoracotomy and two -incision VATS was 162.5 ±6.5 and 185.8 ±12.8 minutes re-spectively(P=0.1228),there was no statistical significance for the remaining parts of the lobectomy ,the operat-ing time of open thoracotomy was shorter than two -incision VATS.The overall complication and perioperative mortality rate of open thoracotomy and two -incision VATS were 10.2% and 15.0%(P=0.238),and 2.0%and 0.0%(P=1.000)respectively,there was no statistical significance.Conclusion The lobectomy and lymph node dissections for 2-incision VATS in treating clinical stage I lung cancer is feasible and safe .

Objective To investigate the effect of glutamine in combination with umbilical cord blood mesenchymal stem cells ( MSCs) transplantation on intestinal ischemia-reperfusion injury in rats.Methods Umbilical cord blood mesenchymal stem cells were isolated, and were labeled with CM-DiI fluorescent dye.Eighty Sprague-Dawley rats were randomly divided into normal control group, ischemia reperfusion injury group, glutamine group, MSCs transplantation group and combined group with 15 rats in each group.The control group received saline enema.The injury group was treated with TNBS ( ethanol dilution) enema.The glutamine group at 1 h after TNBS received intravenous injection of 0.45 g/kg glutamine.The rats of MSCs transplantation group had tail vein injection of 1 ×1010/L umbilical cord blood mesenchymal stem cell suspension, and the combined group received intravenous injection of glutamine 0.45 g/kg and 1 ×1010/L umbilical cord blood mesenchymal stem cell suspension.ELISA was used to detect the midgut fatty acid binding protein (iFABP), interleukin 6 (IL-6), and superoxide dismutase (SOD) content in the rat serum.The water content of intestinal tissue was detected at 1 h and 3 h after reperfusion in each group.The expressions of NF-kB, Bcl-2 and caspase-3 mRNA and proteins in the rat intestinal epithelial cells after treated with glutamine in combination with MSCs were detected by RT-PCR and Western blot assays.Results The fluorescent tracer method revealed that the transplanted MSCs cells were distributed in the intestinal mucosal lymphoid tissues and glandular epithelial cells, indicating that MSCs might be involved in the repair process of intestinal ischemia-reperfusion injury.The content of serum IFABP and IL-6 in the injured group was significantly higher than that in the control group, while significantly reduced in the glutamine group, MSCs transplantation group and combined group, with the most obvious in the combined group.The content of SOD in the injury group was significantly lower than that in the control group, and significantly increased than that in the glutamine group, MSCs transplantation group, with the most striking in the combined group ( P<0.05 for all) .The water content of intestinal tissue in the injury group at 1 and 3 hours after reperfusion was significantly higher than that in the control group, significantly lower in the glutamine group, MSCs transplantation group and the combined group, with the most decreased in the combination group, and there was no significant difference between the glutamine group and MSCs transplantation group (P>0.05).Compared with the control group, the caspase-3 and NF-kB mRNA and protein expressions in the intestinal mucosal epithelial cells of the injury group were significantly increased, and the expressions of Bcl-2 mRNA and protein were significantly reduced ( P <0.05 ) , the expressions of caspase-3 and NF-kB mRNA and protein were significantly reduced in the glutamine group, MSCs transplantation group and combined group.The expressions of Bcl-2 mRNA and protein were significantly increased ( P<0.05) , while no significant difference was shown between the glutamine group and MSCs transplantation group (P>0.05), but there was a significant difference between these two groups and the combined group (P<0.05).Conclusions After treated with glutamine and MSCs transplantation, the degree of intestinal ischemia reperfusion injury is obviously reduced in rats.It may be mediated through inhibiting the expression of caspase-3 and NF-kB and promoting the expression of Bcl-2.

Basic aluminium 6 ? (carboxylmethyl) chitosan was prepared by reacting the solution of 6 ? (carb?xylmethyl) chitosan in water with basic aluminium chloride 〔Al(OH) 2Cl〕. The structure of product was confirmed by IR and atomic absoption spectroscopy.

Reaction of chitosan with glucose, galactose and lactose was performed in lactic acid MeOH to give corresponding schiff's base derivatives, the following reduction was carried out in the presence of sodium cyanoborohydride to prepare branched chain water soluble chitosan derivatives. The structure of derivatives were Confirmed by 1 HNMR and 13 CNMR.

Objective To test the overall characteristic curve on a computed radiography system. Methods Imaging plate was exposed by scale-time expose using conventional X-ray equipment. It was processed by CR system. Density of different optical density wedge on CR film was measured by using densimeter. Then, characteristic curve was plotted. Results (1) Overall characteristic curve of CR system was affected by gradation processing. (2) Average gradient of overall characteristic curve was 1.98, 3.10, and 3.75 when GA was 0.8,1.4, and 2.4. (3) Overall characteristic curve rotated around rotation center when rotation amount was changed. Conclusion According to the diagnostic purpose and different body position, rotation amount can be selected, and different contrast imaging can be acquired.

With the ongoing epidemic of the Coronavirus disease in China and the widespread development of radiotherapy, radiation-induced lung injury has gradually become a clinical problem that has attracted much attention. The pathogenesis of radiation-induced lung injury is complex, involving an imbalance in the polarization state of alveolar macrophages and an upregulation of alveolar epithelial cell apoptosis. Previous studies have shown that vitamin C is an important antioxidant substance, and preventive use of vitamin C can effectively treat acute lung injury. However, whether prophylactic use of vitamin C can effectively prevent or treat lung injury caused by radioactive substances, and its specific molecular mechanism remains to be studied. The purpose of this study is to investigate whether the prophylactic use of vitamin C to treat the alveolar macrophage cell line RAW 264. 7 and human lung epithelial cells BEAS-2B can effectively control the abnormal polarization of macrophages and the abnormal apoptosis of lung epithelial cells. This study found that after 4 weeks and 8 weeks of radioactive X-ray irradiation, the expression of macrophage M1 polarization state markers such as iNOS was significantly up-regulated (P< 0. 05), and preventive use of vitamin C to treat macrophages and lung epithelial cells can alleviate the polarization state disorder of macrophages and the apoptosis of alveolar epithelial cells caused by external radiation exposure, which is manifested in the down-regulation of the expression of Cleaved Caspase3. In addition, the preventive application of vitamin C treatment can inhibit the MAPK signaling pathway activated by external radiation exposure. Further experimental results showed that the inhibition of the MAPK pathway is the key to inhibiting the M1 polarization of macrophages and the apoptosis of lung epithelial cells. In summary, our findings suggest that vitamin C may play a protective role in acute radiation-induced lung injury by inhibiting macrophage M1 polarization/ promoting macrophage M2 polarization and alleviating alveolar epithelial cell apoptosis. This study will help to better understand the process and mechanism of the preventive effect of vitamin C, a common vitamin, on radiation-induced lung injury.