Objective To explore the effect of nBiPAP on ET-1 of patients with overlap syndrome.Methods Levels of ET-1 in plasma of 25 cases of OS,20 cases of COPD were analysed by radioimmunoassay,and ET-1 in OS was measured before and after treatment.The relationship between ET-1 with SaO_2 during sleep was analyzed. Results (1)The ET-1 levels in plasma of OS group were significantly higher than those of COPD group before treatment(P

Objective To evaluate the effects of different concentrations of dexmedetomidine on large-con-ductance Ca2+-activated K+ (BKca) channels in the rat mesenteric arterial smooth muscle (MASM) cells.Methods Sprague-Dawley rats of both sexes,weighing 180-220 g,were used in this study.Single MASM cell was freshly isolated from mesenteric arteries in two steps.Ten cells were chosen and studied.When holding potential was 40 mV and the concentration of free calcium ions was 10-7 mol/L,inside-out patch-clamp technique was used to record the single BKCa channel current before and after application of different concentrations of dexmedetomidine (0,10-9,10-8,10-7,10-6,10-5 mol/L).Total open probability (NPo),amplitude (Am),mean open time (To) and mean close time (To) of single BKca channel were observed and recorded.Results Compared with the baseline value,dexmedetomidine 10-7,10-6 and 10-5 mol/L increased NPo in a concentration-dependent man-ner,and dexmedetomidine 10-9,10-8,10-7,10-6,10-5mol/L shortened Tc (P ＜0.05 or 0.01).Compared with the value obtained when the concentration of dexmedetomidine was 10-9 mol/L,Tc was significantly shortened when the concentration of dexmedetomidine was 10-8 mol/L (P ＜ 0.05),and no significant change was found in Am and To obtained when different concentrations of dexmedetomidine were applied (P ＞ 0.05).Conclusion Dexmedetomidine 10-7,10-6 and 10-5 mol/L activate BKca channels in rat MASM cells in a concentration-depen-dent manner,which is one of the mechanisms of decrease in blood pressure by dexmedetomidine.

Objective To evaluate the efficacy of transarterial interventional therapy (TAIT) in treating patients with metastatic liver cancer, and to investigate the factors influencing the prognosis of patients. Methods From January 1997 to June 2000, 470 patients with metastatic liver cancer had undergone TAIT 1231 times in the Cancer Hospital of the Chinese Academy of Medical Sciences. The clinical data of the patients were retrospectively analyzed. The short-term and long-term efficacy and the side effect of TAIT were assessed. The potential factors influencing the prognosis of the patients were determined by Cox regression analysis. Results Complete remission was observed in 94 patients, and partial remission in 143. The total effective rate was 50.4% (237/470). The median survival time was 13.5 months. The O. 5-, 1-, 2-, 3-, 5-year survival rates were 86.4%, 66. 8%, 35.6%, 16.9%, 7.3%, respectively. No severe complication occurred. The factors influencing the prognosis of the patients were: the resection of the primary tumor, blood supply of the tumor, multiple metastases of liver cancer, thrombus in the portal vein, adjuvant chemotherapy after TAIT, tumor originated from breast cancer, tumors invading multiple lobes, concurrent metastasis in other sites (X2= 17. 322, 12. 593, 8.721, 8.573, 8.492, 7. 838, 5. 623, 5. 463, P < 0.05). Conclusions TAIT is an effective palliative therapy for metastatic liver cancer which cannot be resected. The factors mentioned above influence the prognosis of patients after TAIT.

Objective To study the function of Bak in mitochondrial signaling pathway and interaction between Bax and Bak during apoptosis.Methods Bax/Bak double knock out(Bax-/- and Bak-/-)MEF cells from mouse embryo fibroblasts(MEF) and Hela cells were divided into four groups according the cell different genotypes(wild type,Bax-/-,Bak-/- and double knock out) and treated with different chemical reagents after co-transfection with Bax,Bak,Mito-Red and empty pEGFP vector.Apoptosis,mitochondrial morphology and cytochrome C release were detected with confocal microscope,immunofluoresence and Western blotting techniques.Results There were correlations between the percentage of Hela cell apoptosis and mitochondrial fission(%) as well as cytochrome C(%)(P

This study examined the relationship between PDGF-induced proliferation of vascular smooth muscle cells (VSMCs) and Nur77 expression and the effect of atorvastatin on VSMC proliferation and Nur77 in PDGF-treated VSMCs. Rat VSMCs were isolated and cultured. After incubation with atorvastatin or Nur77 siRNA, the cells were stimulated with PDGF and detected for BrdU incorporation to measure the proliferation of the VSMCs. Quantitative PCR and Western blotting were used to determine the Nur77 protein and the CREB phosphorylation level, to observe their relations with PDGF-induced VSMC proliferation. Our results showed that PDGF increased the BrdU incorporation in VSMCs, suggesting that it induced the proliferation of the cells. The VSMC proliferation was associated with increased Nur77 expression and elevated CREB phosphorylation. Atorvastatin inhibited the PDGF-induced VSMC proliferation, suppressed Nur77 expression. After silencing of Nur77 gene, the PDGF-induced VSMC proliferation was decreased. It was concluded that PDGF-induced VSMC proliferation was related to the Nur77 expression and CREB phosphorylation. Atorvastatin reduced the Nur77 expression and, at the same time, inhibited the VSMC proliferation.

Objective To investigate the mechanism of PBEF in pulmonary vascular endothelial permeability increasing after car-diopulmonory bypass ,in order to provide the basis for a better lung protective measures during cardiopulmonary bypass .Methods Animal models were established ,group A :the rats were transfected with the lentiviral AD-PBEFshRNA ;group B :the rats were took 30 min deep hypothermic circulatory arrest ;group C :the rats were took 30 min deep hypothermic circulatory arrest ,then trans-fected with the lentiviral AD-PBEFshRNA ;control group :the rats were anesthetized and established CPB tube ,without CPB by-pass .Lung tissue was detected with Western blotting and ELISA .Results PBEF ,phosphorylation of P38MAPK ,ERK ,MLC ,VE-cadherin ,FAK in group C had significant difference with group A ,B and the control group(P<0 .05) .VEGF ,MMP2 ,MMP9 ,W/D in group C had significant difference with group A ,B and the control group(P<0 .05) .The pathological results showed that rat lung tissue of the control group was normal ,while in group C ,it had severe pathological damage ,the pathological damage degree in group A ,B reduced compared to group C .Conclusion PBEF can through MAPK/PI3K-Akt/VEGF signaling pathway ,increase pulmonary vascular endothelial permeability .

Objective: To observe the clinical efficacy of warm needling moxibustion plus spine subtle adjusting manipulation for cervical radiculopathy. Methods: A total of 70 patients with cervical radiculopathy were randomized into an observation group and a control group, with 35 cases in each group. The observation group was treated with warm needling moxibustion plus spine subtle adjusting manipulation, while the control group was treated with warm needling moxibustion alone. The treatments were performed three times a week, and for four weeks in total. The visual analog scale (VAS) was scored before and after treatment. And the clinical efficacy of the two groups was compared after treatment. Results: The total effective rate was 97.1％ in the observation group, versus 88.6％ in the control group. The difference between the two groups was statistically significant (P<0.05). After treatment, the VAS scores in both groups significantly decreased (P<0.01), and the score in the observation group was significantly lower than that in the control group (P<0.05). Conclusion: Warm needling moxibustion plus spine subtle adjusting manipulation has a better effect in the treatment of cervical radiculopathy than warm needling moxibustion alone.

OBJECTIVETo explore the operation methods and clinical effects of transfer of the medial half of the coracoacromial ligament to reconstruct the coracoclavicular ligament in treating complete acromioclavicular joint dislocation.

METHODSFrom January 2006 to June 2012,26 patients with acute complete acromioclavicular joint dislocation underwent surgery. Transfer of the medial half of the coracoacromial ligament to reconstruct the coracoclavicular ligament, additional clavical hoot plate and Kirschner wires fixation, were performed in all the patients. Among the patients, 18 patients were male and 8 patients were female, with an average age of 36.7 years old (ranged from 25 to 51 years). The duration from injury to operation was from 3 to 12 days with an average of 5 days. According to the Rockwood classification, 4 cases were grade III and 22 cases were grade V . Clinical manifestation included local swelling, tenderness with snapping, limitation of shoulder joint motion. In preoperative bilateral shoulder joint X-rays, the injured coracoclavicular distance was (16.2 ± 5.0) mm which was significantly wider than that of uninjured sides (7.6 ± 1.0) mm. Clinical results were evaluated according to X-rays and Constant-Murley score.

RESULTSAll incisions obtained primary healing after operation without complication of infection, internal fixation breakage, redislocation. All the patients were followed up from 12 to 30 months with an average of 18 months. Kirschner wires and internal fixation plate were removed at 1 month and 8-10 months after operation, respectively. At final follow-up, the motion of shoulder joint recovered to normal and a no pain joint was obtained. According to Constant-Murley score, 24 cases got excellent results and 2 cases good. There was no significant difference after operation between the injured coracoclavicular distance and the uninjured contralateral side [(7.7 ± 1.2) mm vs (7.6 ± 1.0) mm), P > 0.05].

CONCLUSIONTransfer of the medial half of the coracoacromial ligament to reconstruct the coracoclavicular ligament, additional fixation using hook plate and Kirschner wires is the effective surgical method in treating complete acute acromioclavicular joint dislocation.

Acromioclavicular Joint ; injuries ; Adult ; Female ; Humans ; Joint Dislocations ; surgery ; Ligaments, Articular ; surgery ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods

Objective To investigate the basic status of healthcare-associated infection(HAI)in a hospital,and provide evidence for strengthening HAI management.Methods A cross-sectional study was conducted to investi-gate the prevalence rates of HAI in all hospitalized patients at 0 ∶00 -24∶00 of May 7,2014.Results A total of 2 262 patients were supposed to be investigated,while 2 253 (99.60%)patients were actually investigated,586 of whom (26.01%)came from pulmonary hospital(specialized in tuberculosis)affiliated to the general hospital.53 patients devel-oped 58 times of HAI,prevalence rate and case prevalence rate was 2.35% and 2.57% respectively;1 073 patients devel-oped 1 265 times of community-acquired infection (CAI),prevalence rate and case prevalence rate was 47.63% and 56.15% respectively.Rates of HAI and CAI were high in intensive care unit(ICU,21.28%)and pulmonary hospital (99.49%)respectively;the main infection site was lower respiratory tract,which accounting for 46.55%(n =27)and 69.72%(n=882)respectively.The major pathogens causing HAI were gram-negative bacteria(n = 19),and the major pathogens causing CAI were Mycobacteria(n=141)and fungi (n=89).The rate of antimicrobial usage and etiological ex-amination was 34.80%(n=784 )and 81.48%(n=550 )respectively.Conclusion In order to prevent cross infection of tuberculosis and reduce the incidence of HAI,lower respiratory tract and ICU should be one of the key infection sites and departments of HAI surveillance,treatment and management of patients with tuberculosis should be stand-ardized,professional precaution of health care workers should be enhanced.

Objective To observe the phosphorylation of Smad3 in hyperplastic scar fibroblasts (HSFs) induced by hematoporphyrin monomerthyl ether (HMME) followed by photodynamic therapy (PDT).Methods Fibroblasts were isolated from the hypertrophic scar tissues of 10 patients and subjected to culture in vitro.After 3-5 passages,the HSFs were divided into 4 groups:control group receiving no treatment,PDT group pretreated with HMME of 4 μg/ml followed by PDT,HMME group induced by HMME alone,and laser group irradiated with laser alone.Fluorescence microscopy was used to observe the expression of Smad3 after immunofluorescent staining with anti-Smad3 antibody,and Western blot to detect the expression of Smad3 and phosphorylated Smad3 in these HSFs.Paired t test was conducted to compare the difference in Smad3 and phosphorylated Smad3 expression between these groups.Results The total fluorescence intensity of Smad3 was similar between these groups,but the intranuclear fluorescence signal was significantly weaker in the PDT group than in the control group.The level of phosphorylated Smad3 was statistically decreased in the PDT group compared with the control group (0.20 ± 0.02 vs.0.92 ± 0.15,P ＜ 0.05),but no significant difference was observed between the HMME group and laser group (P ＞ 0.05).Conclusion PDT may inhibit the proliferation of HSFs via attenuating the phosphorylation of Smad3.