Endotoxemia is due to the infection of bacteria or lesions which release a lot of toxins into the blood,or the infusing of large amount of endotoxin-contaminated liquid.It can cause systemic inflammatory response syndrome,sepsis,or multiple organ dysfunction syndrome.Endotoxemia is a common and complex problem in modern emergency medicine.Early diagnosis and timely blocking not only can prevent further infection but also plays a positive role in the prevention and treatment of sepsis and its complications.In recent years,progresses have been made in the treatments of endotoxemia by hemoporfusion.The direct adsorption of endotoxin and inflammatory cytokines in blood can quickly reduce their concentration.This can not only weaken their own activity but also inhibit the release of other harmful cytokines,so as to improve the symptoms of infection.So far,the specific hishaffinity adsorbents having the clinical value are still at the exploratory stage.Although these materials were found effective in the treatments of endotoxemia,in-depth study need to be carried out on their clinical criteria in order to acquiremore satisfied results.

Objective To investigate the therapeutic effects of embryonic dopaminergic neurons,mesencephalon-derived neural stem cells with or without pre-differentiation as grafts in the treatment of Parkinson's disease(PD) in SD rats.Methods Forty SD Parkinsonian rats were randomly assigned to four groups as follows: normal saline grafted group(A),mesencephalon-derived neural stem cells without pre-differentiation grafted group(B),embryonic dopaminergic neurons grafted group(C) and mesencephalon-derived neural stem cells with pre-differentiation grafted group(D).Normal saline and different cells were transplanted into the rat's striatum by stereotactic technique.Therapeutic effects were evaluated based on the improvement of rat's rotation behavior at 2nd,4th and 8th week after operation and survival of tyrosine hydroxylase(TH)-immunoreactive(TH-ir) cells at 8th week after operation.Results No obvious amelioration in number of rotation was found in group A(F=0.294,P=0.830).In group B,the number of rotation was decreased after operation,but the difference was not significant compared with that before operation(F=0.335,P=0.800).The numbers of rotation were obviously decreased in group C(F=26.838,P=0.000) and group D(F=14.571,P=0.000) at 8th week after operation,but no significant difference was found between the two groups(P=0.764).TH immunohistochemical staining showed that the number of TH positive cells was 665?264 in group D,679?286 in group C,80?36 in group B,and 0 in group A,and no significant difference existed between group C and D(P=0.548).Conclusion As grafts,both embryonic dopaminergic neurons and mesencephalon-derived neural stem cells with pre-differentiation can improve the rotational behavior and cellular morphology of Parkinsonian rats after neural cells transplantation.

BacKground:RectaI carcinoid is a rareIy seen neuroendocrine tumor. TiII now,there is controversiaI for the treatment modaIities of rectaI carcinoids with diameter between 1-2 cm. Aims:To study the expression of Ki-67 in rectaI carcinoids and the efficacy and safety of endoscopic resection. Methods:A totaI of 83 rectaI carcinoid patients with tumor diameter Iess than 1. 5 cm were enroIIed. AII patients were pathoIogicaIIy diagnosed and underwent endoscopic mucosaI resection from Jan. 2008 to Dec. 2013 at Chongqing Three Gorges CentraI HospitaI and Wuhan Tongji HospitaI. The medicaI records were retrospectiveIy reviewed and expression of Ki-67 in tumor tissue was assessed by immunohistochemistry. Results:AII patients underwent preoperative endoscopic uItrasonography. Tumors were Iimited to mucosa or submucosa, and no muscuIaris propria invoIvement or metastasis was seen. The mean foIIow-up duration was 38 months,and no recurrence or metastasis occurred. Ki-67 was IowIy expressed in aII rectaI carcinoids(0. 84% ± 0. 67%). When tumors were grouped by size,no significant differences in gender,age,tumor site and Ki-67 expression IeveI were seen between <1. 0 cm group and 1. 0-1. 5 cm group(P >0. 05). Furthermore,when tumors were grouped by a cutoff vaIue of mean Ki-67 index 0. 84%,differences in cIinicopathoIogicaI parameters between the two groups were not significant either( P >0. 05 ). Conclusions:Ki-67 is IowIy expressed in rectaI carcinoids Iess than 1. 5 cm in diameter enroIIed in this study,which denoted an inactive proIiferation. For rectaI carcinoids with diameter Iess than 1. 5 cm,with Iow Ki-67 expression and without muscuIaris propria invoIvement and metastasis, IocaI endoscopic excision is an effective and safe treatment modaIity.

Objective:To explore the feasibility of mesencephalon progenitor cells as dopamine neuron's graft in treatment of Parkinson disease(PD) in rats. Methods: Animal model of PD were established in SD rats by 6 hydroxydopamine. Mesencephalon progenitor cells were obtained from 13 day old fetal rats. After in vitro proliferation and differentiation, the cells were planted into PD rat striatum. Results: Progenitor cells were expanded in an undifferentiated state with endothelia growth factor and basic fibroblast growth factor as mitogens. IL 1 and striatal culture media further increased the number of TH immunoreactive cells. Transplantation of these neurons relieved the rotation symptom of PD rats. Conclusion: Transplantation of mesencephalon progenitor cells has certain effects on PD rats.

Intravenous thrombolysis is the only treatment that has the evidence of evidence-based medicine in acute ischemic stroke. However, the narrow time window has limited the treatment opportunities of many patients. Transcranial ultrasound thrombolysis is a very promising thrombolysis-assisted method, and transcranial ultrasound plus microbubble-assisted thrombolysis is the research hotspot in recent years. At present, more suitable ultrasonic instruments for thrombolysis and a number of ways of ultrasound-assisted thrombolysis are being developed.

Objective: This research is conducted to analyze the background, the main practices and the results of the synergistic service of health institutions in Changzhou city, as well as to provide references for promoting the construction of integrated medical and health service system.Methods: This paper uses qualitative interviews and questionnaires to collect information and analyzes the data based on synergetic management theory.Results:Changzhou city has tentatively achieved the synergy of its health institutions by introducing relevant policies, setting up healthcare unions at the municipal level, integrating internal resources among healthcare unions, establishing health information platform and feedback mechanism, etc.Conclusion: The regional synergistic service of health institutions can be effectively promoted by introducing policies at the municipal level, promoting the mutual sharing and communication on information, and integrating internal resources among healthcare unions.But, as there still exist problems such as the distribution of benefits is not perfect, the degree of synergy is not close, etc., thus, the government is suggested to expand the implementation scope of the close-type medical service synergy and further improve the distribution policy of benefits.

Objective To preliminarily investigate the effect and possible mechanisms of Senecio cannabifolius Less.Ⅱ(FHC-Ⅱ) on perfluoroisobutylene (PFIB) inhalation-induced acute lung injury. Methods Totally 156 rats were randomly assigned to three groups: the control group, the PFIB group and the FHC-Ⅱ prevention group, with 32, 62 and 62 rats in each group respectively. The FHC-Ⅱprevention group were given FHC-Ⅱthree times per day at the dosage of 340 mg/kg before PFIB exposure. 1 h after the last time of FHC-Ⅱ administration, the FHC-Ⅱ prevention group were exposured to gaseous PFIB (0.2 mg/L) for 10 minutes in a static whole-body exposure inhalation system. The survival rate of the rats were recorded at 1, 2, 4, 8, 16, 24, 48 and 72 h post PFIB exposure;the lung index and total protein content in bronchoalveolar lavage fluid (BALF) were measured at 1 h, 2 h, 4 h, 8 h, 16 h and 24 h; IL-1β and IL-8 in sera were assayed by enzyme-linked immunosorbent assay (ELISA) at 1, 2, 4, 8 and 16 h post PFIB exposure and the histopathological examination of the lung tissue was performed at 8 h post PFIB exposure. Results FHC-II significantly reduced the content of the total protein in BALF, lung index and the levels of IL-1β and IL-8 in aera as well, and dramatically alleviated the histopathological changes in the lung tissue. Conclusion FHC-Ⅱ demonstrates some preventive effect on PFIB inhalation-induced acute lung injury in rats.

Objective To analyze and discuss the negative effects of atomization inhalation in mechanical ventilation patients in intensive care unit. Methods A retrospective study of all the mechanical ventilation patients in the general ICU of our hospital was carried out from Aprilto December 2015. The risk of multidrug-resistant organisms(MDROs)colonizationin the lower respiratory tract and ventilation associated pneumonia(VAP)in mechanical ventilation patients were analyzed. Results A total of 922 patients were monitored, 160 of whom had atomization inhalation, 92 for MDROs colonizationin the lower respiratory tract and 18 for VAP. The rates ofatomization inhalation in patients with and without MDROs colonizationin the lower respiratory tract were 30.4%(28/92)and 15.9%(132/830)with statistical difference (χ2=12.193, P=0.000). And those in patients with and without VAP were 50.0%(9/18) and 16.7%(151/904), with statistical difference (χ2=11.420, P=0.000). Atomization inhalation was the independent risk factor both of MDROs colonizationin the lower respiratory tract(OR=1.917, 95%CI1.163-3.159, P=0.011) and VAP(OR=4.613, 95%CI 1.773-12.002, P=0.000) in mechanical ventilation patients. Conclusions Atomization inhalation may increase the risk of MDROs colonizationin the lower respiratory tract and VAP in mechanical ventilation patients. Thus unnecessary and too frequent operations of atomization inhalation should be decreased.

Objective To observe the effect of momordicin on tumor necrosis factor-?(TNF-?) level,mRNA transcription,and protein expression in myocardium of viral myocarditis caused by coxsackievirus B3(CVB3),and explore its therapeutic mechanism on viral myocarditis in Balb/c mice.Methods Fifty Balb/c mice were randomly divided into 3 groups as follows:momordicin treatment group(20 cases),vehicle control group(20 cases) and normal control group(n=10).Mice in the vehicle control group and the momordicin treatment group were intraperitoneally inoculated with CVB3,as for the nomal control group,equal amount of culture fluid was given instead.Momordicin[25 mg/(kg?d)] was administered intraperitoneally daily from day 0 to 6.Myocardial histopathology,cardiac TNF-? antigen,protein and mRNA expression were detected on day 15 after CVB3 inoculation,respectively.Results As compared with model group,in mice treated with momordicin,the histological myocardial lesion was significantly reduced [(3.26 ?0.84) vs(1.56?0.48),t=3.90 P

Objective To observe the therapeutic effect of astragaloside on chronic coxsackievirus B3(CVB3)myocarditis in Balb/c mice.Methods Eighty Balb/c mice were randomly divided into 3 groups:astragaloside treatment group(n=30),model of viral myocarditis group(model group)(n=30),and control group(n=20).Mice in the model group and the astragaloside treatment group were monthly intraperitoneally inoculated with CVB3,but equal amount of culture fluid was given instead in control group.The model group and control group were fed with drinking water,astragaloside treatment group were fed with drinking water containing astragaloside at concentration of 300 mg/L for 3 months.Survival rates were determined,myocardial histopathology,collagen volume fraction(CVF) and apoptosis of heart tissue,and CVB3 RNA levels were detected on 3 months later respectively by semiquantitative RT-PCR.Results Compared with model group,in astragaloside treated group,the survival rate on 3 months was significantly improved(59.7% vs 76.7%,?2=4.26 P