Objective To evaluate the effect for the treatment of severe asthma. Methods The data of 47 patients with severe asthma who were admitted to emergency department were retrospectively anayzed. Results Of total 47 patients ,45 were rescued, with the survival rate of 95.7%. Arterial blood gas was improved after treatment (P < 0.01). Conclusion Appropriate commencement, mode, strategy, and early weaning of mechanical ventilation, combined with the administration of bronchodilators and eorticosteroids are the important way to rescue patients with severe asthma.

Objective To Apply appropriate dose of Glutamine(Gln)(300mG/d)for patients with acute cerebral infarction,and observe its preventinG and curinG function to the stress ulcer. Methods Sixty cases patients of acute cerebral infarction were observed and divided into the conventional treatment Group( 30 cases),Glutamine treatment Group( GLU,30 cases). Gastric pH value of patients was tested before treatment and after one week treatment. The stool or vomit occult blood positive( OB+)number of patients within one week, OB( +) duration and the number of patients need blood filterinG were observed. Results There was no siGnificant difference between the conventional treatment Group and the GLU Group in the Gastric juice PH value before treatment(t=0. 647,P>0. 05). After one week treatment,the Gastric juice PH value of the GLU Group was siGnificant hiGher than the conventional treatment Group(t=5. 25,P<0. 05);the number of OB( +)of GLU Group were less than the conventional treatment Group,but there was no statistical siGnificant difference(χ2=0. 577,P>0. 05);the OB( +)duration of GLU Group was less than the conventional treatemnt Group,and there was satistical siGnificant difference(t =4. 768,P <0. 05);the number of blood filterinG of GLU to treat stress ulcer was less than conventional treatment Group,and there was satistical siGnificant difference(χ2=l. 0l6,P>0. 05). Conclusion SupplementinG appropriate dose of Glutamine in patients with acute cerebral infarction can reduce the incidence of stress ulcer,decrease medical expenses.

Objective To evaluate the predicting value of serum procaleitonin (PCT) in treatment of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) in elderly patients. Methods A total of 267 elderly patients requiring hospitalization for AECOPD were randomly assigned into 2 groups: standard therapy group (standard group, n= 135) and PCT-guided group(PCT group, n= 132). Standard group received antibiotics according to the guideline of attending physicians and PCT group were treated with antibiotics according to serum PCT levels.Length of hospitalization, clinical efficacy, costs of hospitalization and antibiotics, rate of antibiotics use, hospital mortality, rate of exacerbation and rehospitalization, frequency of exacerbation within 1 year were observed. Results Length of hospitalization, clinical efficacy, hospital mortality, rate of exacerbation and rehospitalization, frequency of exacerbation within 1 year were similar in 2 groups(all P＞0.05);costs of hospitalization and antibiotics, rate of antibiotics use of PCT group[10 882 (3808-16 651)yuan, 6934 (2390-10 660)yuan, 76.5%] were lower than those of standard group[13 637(4650-19 730)yuan, 8589(3144-12 117)yuan, 87.4%] (all P＜0.05). Conclusions PCT guidance offers an advantage over standard therapy in reducing antibiotic use and in lowering the costs of hospitalization in treatment of AECOPD in elderly patients.

To study the protective effect and the mechanism of asiatic acid (AA) from Potentilla chinensis on alcohol hepatic injury in rats. Male Wistar rats were randomly divided into six groups: the normal control group, the AA control group (8 mg · kg(-1) AA), the model group (5.0-9.0 g · kg(-1) alcohol) and high, medium and low-dose AA-treated groups (alcohol + 8, 4, 2 mg · kg(-1) AA). Each group was orally administered with the corresponding drugs once a day for 24 weeks. Approximately 1. 5 hours after the final administration, all rats were killed, and their blood samples and hepatic tissues were collected. The AST and ALT in rat serum and the contents of MPO, TNF-α, IL-1β, SOD, GSH-Px, GSH-Rd and MDA in hepatic tissues were detected. The expressions of NF-κB, TLR4, CD14, MyD88, TRIF and protein expression in hepatic tissues were measured by western blot. The pathological changes in liver tissues were observed by histological examination. The results showed that compared with the model group, the AA-treated groups showed significant decreases in serum ALT, AST and MDA and increases in the activities of SOD, GSH-Px, GSH-Rd and MPO. Moreover, AA markedly inhibited the expressions of TNF-α, IL-1β, TLR4, CD14, MyD88 and NF-κB. The histological examination showed alleviated hepatic issue ijury to varying degrees. In short, asiatic acid (AA) from P. chinensis could protect alcohol-induced hepatic injury in rats. Its mechanism may be related to the inhibition of NF-κB inactivation and the reduction of inflammatory response.
Animals ; Liver ; drug effects ; pathology ; Liver Diseases, Alcoholic ; prevention & control ; Male ; NF-kappa B ; physiology ; Pentacyclic Triterpenes ; pharmacology ; Potentilla ; chemistry ; Protective Agents ; pharmacology ; Rats ; Rats, Wistar ; Toll-Like Receptor 4 ; antagonists & inhibitors

[Objective]To investigate the disturbance between Th17 and Treg cell balance in ovarian endometriosis patients.[Methods]Case-control study comparing 40 women with histo-pathologically confirmed ovarian endometriosis and with 40 control infertility women without visible endometriosis foci ,pelvic inflammations who were subjected to laparoscopic surgery during the same period. Peripheral blood,peritoneal fluid,ovarian ectopic endometrial tissue and eutopic endometrial tissue of ovarian endometriosis patients and controls were collected during surgery. T lymphocytes subpopulations in peripheral blood were analyzed by flow cytometry using specific monoclonal antibodies recognizing CD4+,CD25+and CD127-markers and CD3+,CD8-and IL-17A+markers. Then, IL-17,IL-22,IL-10and TGF-βconcentration in the serum and peritoneal fluid was determined using enzyme linked immunosorbent assay(ELISA). Also,Q-PCR was performed to verify Foxp3 mRNA and ROR-γt mRNA expression differences in eutopic and ectopic endometrial tissue.[Results]1.The percentage of CD4+CD25+CD127-Treg cells was significantly decreased in the peripheral blood ofwomen with ovarian endometriosis compared with control women. On the other hand ,the proportion of CD3+CD8-IL-17A+Th17 cells was significantly increased in the peripheral blood of women with endometriosis compared with control wom en. 2. Comparing with the controls ,the concentration of IL-17 and IL-22 was significantly higher in the serum of women with ovarian endometriosis ,and the levels of IL-10 and TGF-β were significantly lower in the serum of women with endometriosis. On the contrast ,in the peritoneal fluid of women with ovarian endometriosis ,the concentration of IL-17 and IL-22 were lower ,and the concentration of IL-10 and TGF-β were significantly higher than the controls. 3.Foxp3 mRNA expression level was significantly elevated in ectopic endometrial tissue of patients with ovarian endometriosis compared with eutopic endometrial tissue ,while the ROR-γt mRNA expression level of ectopic endometrial tissue was significantly decreased than eutopic endometrial tissue.[Conclusion]The present study verifies the imbalance of Th17/Treg in peripheral blood ,peritoneal fluid and endometrial tissue in ovarian endometriosis patients ,which implies the immune dysregulation and the disturbance of immunity homeostasis in the establishment and progression of endometriosis.

Objective To evaluate the value of serum procalcitonin (PCT)on antibiotic use in treatment of community acquired pneumonia (CAP) in outpatient. Methods From November 2006 to February 2008, a total of 127 patients with CAP in outpatient were randomly assigned into two groups:PCT group(n=63)and control group(n =64). PCT levels of all patients were measured after study admission. On the base of similarly normal treatment, the control group received antibiotics according to the attending physicians and the PCT group were treated with antibiotics according to serum PCT levels: antibiotic treatment was applied with PCT level ≥ 0. 25 μg/L and was discouraged with PCT level < 0.25 μg/L. Clinical efficacy, rate of antibiotics use, duration courses and costs of antibiotics were observed. Results Clinical efficacy of the PCT group was similar with the control group (92.1% vs 87.5%, P >0.05) ;rate and costs of antibiotics use was lower, antibiotic duration of the PCT group was shorter than that ofthecontroigroup(P<0.05,P<0.001,P<0.001).Conclusion PCT could be used in treatment of CAP for antibiotic use in outpatient, which may reduce antibiotic use, shorten antibiotic duration and lower costs of antibiotic.

BACKGROUND:Chondrocytes may dedifferentiate when they are cultured in vitro,and the capacity of synthetizing glycosaminoglycan (GAG)is also reduced,how to delay the dedifferentiation of chondrocytes is a crucial topic in the field of tissue engineering.OBJECTIVE:To observe the performance of chondrocytes synthetizing GAG at different inoculum densities.DESIGN,TIME AND SETTING:A controlled cellular experiment was performed at the laboratory of Department of Orthopaedics in the Second Hospital of Shanxi Medical University between January 2007 and May 2007.MATERIALS:Five New Zealand rabbits of one month old were used in this study.METHODS:Articular chondrocytes were isolated from both knees and digested using 0.4% pronase enzyme and 0.025% Ⅱ type collagenase.The chondrocytes harvested from the same rabbit were divided into two sets,one was seeded at a constant density of 2×104/cm2 in primary and subculture,the other was cultured at a reduced density of 2×103/cm2 following cellular adhesion.Cellular morphology and proliferation were observed under inverted microscope.The culture media were renewed after the primary cells and passage 1 cells were confluent.MAIN OUTCOME MEASURES:GAG concentration was determined using the modified precipitation method with Alcian blue at 12,24,36,48 and 60 hours following the renewal of culture media.RESULTS:Articular chondrocytes in the primary high-density culture group were polygonal with clear boundaries,they have shown to form colony at 3-4 days.Cells around colonies were more slender than those in the center of colonies,shaping as long polygon.There was no obvious change observed in the morphology of passage 1 cells.In the low-density culture group,cells scattered at early stage and formed colonies at 7 days,cellular morphology showed no significant differences in comparison with high-density culture group.The time of primary cells becoming confluent in the low-density culture group was prolonged compared with high-density culture group.The GAG concentration in supernatants in the primary cells of low-density culture group was significantly lower than that in primary cells and passage 1 cells of high-density culture group (P＜0.001,P＜0.05).The GAG concentration showed a greater difference along with the prolonging of culture time.CONCLUSION:High-density culture is better then low-density culture to enhance the performance of chondrocytes synthetizing GAG and to retard the velocity of chondrocytes dedifferentiation,which suggests high-density culture contributes to maintain the chondrocytes phenotype and can be considered as a good way of plate culture.

Objective To investigate the inhibitory effects of overexpression of PTEN on renal epithelial-mesenchymal trans-differentiation induced by TGF-β1,and the signaling transduction mechanism.Methods HKC cells were transfected with GFP-PTEN via lipofectAMINE2000.The efficiency of transfection was detected by fluorescence microscope.The expression of PTEN protein and mRNA in the translected cells was detected by Western blot and RT-PCR respectively.The experiment was divided into four groups:normal group,TGF-β1 stimulation group,GFP-PTEN+TGF-β1 group and empty vector+TGF-β1 group.The expression of E-cadherin,a-SMA,Akt and p-Akt was detected by Western blot.Results Most ceils transfected with GFP-PTEN expressed GFP.The expression of PTEN protein and mRNA was strongly increased when HKC cells were transfected with GFP-PTEN(all P<0.05).In both TGF-β1 stimulation group and empty vector+TGF-β1 group,the expression level of E-cadherin was lower(all P<0.05),while that of p-Akt and a-SMA was higher than in normal group(both P<0.05).The expression level of p-Akt and a-SMA in GFP-PTEN+TGF-β1 group was Iower(both P<0.05),while that of E-cadherin was higher than in TGF-β1 stimulation group and empty vector+TGF-β1 group(both P<0.05).The expression of Akt was similar in the four groups.Conclusion Overexpression of PTEN can inhibit renal epithelial-mesenehymal trans-differentiation induced by TGF-β1 through suppressing the activation of PI3K/Akt signal pathway.

OBJECTIVETo investigate therapeutic strategy on septic arthritis after arthroscopic anterior cruciate ligament reconstruction.

METHODSThe clinical data of 6 cases of septic arthritis after arthroscopic anterior cruciate ligament reconstruction in our department from March 2005 to February 2014 were analyzed. All the patients were male,ranging in age from 18 to 36 years old. After operation, the knee joint became painful and swollen, and ESR and CRP were both increased. Culture of joint fluid allowed the recovery of staphylococcus epidermidis. The patients were dealt with arthroscopic debridement and infusion-drainage. The clinical results were evaluated by Lysholm rating system and range of motion.

RESULTSThe infection of all the patients was controlled. The ESR and CRP both recovered to normal level. The score of Lysholm rating system ranged from 85 to 95,and the range of motion was 120 to 135 degree.

CONCLUSIONArthroscopic debridement combined with infusion-drainage is effective in septic arthritis after arthroscopic anterior cruciate ligament reconstruction.

Adolescent ; Adult ; Anterior Cruciate Ligament Reconstruction ; adverse effects ; Arthritis, Infectious ; therapy ; Arthroscopy ; methods ; Blood Sedimentation ; C-Reactive Protein ; analysis ; Debridement ; methods ; Drainage ; Humans ; Male

Objective Through the establishment of adjacent cabin blast injury model of Beagle dog,to investigate the pathophysiological changes in the experimental animals in this scenario,then speculate on the mechanisms of injury.Methods Several adjacent cabins were built in the same size with the real warship.Seven Beagle dogs were subjected to injuries from the explosion,from whom one was selected randomly to implant intracranial pressure transducers before blast,the others were tested on the pathophysiological changes after blast.The dogs were mounted on the platform of a cabinet in the adjacent cabin,subjected to injury from 650g bare TNT explosive blast.The transducers recorded the value of space and intracranial shock wave pressure.Following blast treatment,the serum levels of IL-6,IL-8,neuron specific enolase (NSE),brain and chest CT and pathological changes of the brain tissue were observed.Results Serum levels of IL-6,IL-8 and NSE were elevated to varying degrees after blast.All of them increased significantly at different time points after blast (P＜0.05).Brain and chest CT examinations did not show any significant positive results.Pathological results showed that there was a little necrosis in the brain,some neurons had karyopycnosis,karyolysis or disappearance of the nucleoli,and the cell boundaries were blurred.The blast wave was blocked greatly by the scalp and skull (about 90％),but could still penetrate them and cause brain injuries.Conclusions Explosion in the adjacent cabin causes mainly mild traumatic brain injuries.Blast wave can be blocked by the scalp and skull greatly.