Objective To investigate the relationship between noninvasive brachial artery blood pressure (B) and radial artery blood pressure (R) of the right arm.Methods Two hundred and ninetyfive patients with 149 males and age of (47 ± 16) years were studied.The height of patients was 163 ± 8 cm,and weight of patients was (61.2 ± 7.8) kg.The patients with peripheral vascular disease,wounds of arm skin or subcutaneous tissue infection were all excluded.Their B (with adult cuffs) and R (with infant cuffs) of the right arm were measured and analyzed after the patients under general anesthesia and stable hemodynamics.The relationships between B and R were analyzed by linear regression,the differences between B and R of each interval were compared using one-way ANOVA and then followed by SNK procedure.Results Right brachial artery blood pressure was significantly lower than radial artery blood pressure.The differences between the two varied from 13 to 18 mmHg in systolic BP (SBP),diastolic BP (DBP) and mean blood pressure (MAP).And linear regression was most applicable to describe their correlation [r=0.841 (SBP),0.808 (DBP),0.833 (MAP),all P＜0.01].Conclusions Radial artery blood pressure measured with infant cuffs can well reflect the variation of brachial artery blood pressure.

Objective To evaluate the effects of peritoneal jet ventilation on peritoneal oxygenation in pigs.Methods Twenty-four pigs of both sexes (12-16 weeks,35-45 kg) were randomly divided into 3 groups (n=8 each): sham operation group (group S) ; peritoneal regular frequency jet ventilation group (16 bpm)(group N) and peritoneal high-frequency jet ventilation group (150 bpm) (group H).Oral tracheal intubation was performed.The animals were mechanically ventilated (VT 8-12 ml/kg,RR 12-16 bpm,I:E 1.0:1.5,FiO2 100％) via airway.Endotracheal tubes were inserted into abdomen through the incisions in the left lower (for peritoneal jet ventilation) and right upper quadrant (for outlet of air).Arterial blood PaO2 and PaCO2 were measured before (baseline) and at 30,60,90,120,150,180,210 and 240 s of peritoneal jet ventilation.Peritoneal jet ventilation was started after the lungs being mechanically ventilated for 35 min.Peritoneal jet ventilation was terminated when SpO2 dropped to SpO2 ＜ 90 ％.The duration of safe apnea (DSA,from the moment of begging of peritoneal jet ventilation to the time when PaO2 ＜ 60 mm Hg).Results PaO2 was significandy higher and DSA longer in group H than in groups S and N.But there was no significant difference in PaCO2 among the 3 groups.Conclusion Peritoneal high-frequency jet ventilation can significantly enhance the efficiency of peritoneal oxygenation and prolong DSA,while peritoneal regular frequency jet ventilation has no effect on peritoneal oxygenation.

Objective To determine the baseline echocardiographic characteristics and the time course and degree of recovery of left ventricular (LV) systolic dysfunction in patients with tachycardia-induced cardiomyopathy ( TCM ) . Methods Seven hundred and fifteen patients received radiofrequency cather ablation ( RFCA ) for tachycardiarrhymias from July 2010 to July 2013 were screened in this study. Only 33 patients with reduced left ventricular ejection fraction (LVEF) (LVEF<50% and improved≥15%) were diagnosed with tachycardia-induced cardiomyopathy and were included in the study. Patients with early improvement (over 25%increase in LVEF at 1-week follow-up compared to the baseline ) were enrolled in the improved group , and the rest patients were enrolled in the improved group. All Patients received transthoracic echocardiography for LV size and function detection at 1 week and at 3,6,12 months follow-up. Results The average baseline of the LV end-diastolic diameter, and the LVEF were (55 ± 10.7)mm and (38 ± 4.6)%, repectively. Early improvement ( over 25%increase in LVEF at 1-week follow-up compared to the baseline ) in the improved group was observed in 16 patients. Patients with early improvement had higher LVEF at 12-month follow-up compared to the patients without early improvement [(69.2± 4.2)% vs (58.1 ± 6.9)%, P < 0.001]. Conclusions RFCA is proved to be a relatively safe and effecient treatment method. Atrial fibrillation related to TCM , rhythm control is superior to the rate control. The early improvement in LVEF may potentially predict the complete reversibility of LV systolic dysfunction.

Background:China's accelerating development and increasingly important role in global health engagement create a great demand for global health professionals including international consulting experts.This study reported the detailed development and evaluation of an international consulting training for global health workforce.Methods:Based on Kirkpatrick's model,a mixed-methods approach was used to evaluate the effectiveness of the training.Quantitative and qualitative data on participants' reaction,learning,and application of the learned knowledge and skills were collected by a training evaluation survey at the ending of training and a follow-up interview in three months after the training.Results:Thirty-six participants attended the training and 34 of them completed quantitative investigation.The training satisfaction evaluations were positive,for which participants rated the training program highly and over 90％ of them agreed with the usefulness of the training.About knowledge and skills change,participants showed improved consulting knowledge and skills from pre-to post-training (P ＜ 0.001).A total of 23 participants accepted follow-up interview,and most participants applied knowledge and skills learned from the training in their daily work or study.However,only 30.4％ of participants applied their learning in the consulting program.The largest barrier of application was the lack of consulting opportunities.In addition,almost all the participants reported that they would be glad to attend more training courses in the future.Conclusion:The international consulting training program was well-received,and was feasible to improve the consulting service competence of global health professionals.According to participants' feedback,it is essential to develop and expand consulting training in the field of global health.

Objective To explore the relationship between ATP content in CD4+ T lymphocytes and acute rejection after liver transplantation(LT). Methods This study contained 77 patients who received LT from February to October 2009, They were divided into AR (acute rejection) and NAR (non-acute rejection) groups while 56 healthy people were enrolled to serve as the control group.Blood specimens were collected preoperatively and at 1, 2 and 4 weeks postoperatively. For the AR group, specimens were also collected on the day when AR occurred and 1 week after steroid bump together with that of the healthy people. ImmuKnowTM test kits for immune cell function were used to assay the ATP value. Results ATP values within CD4+T lymphocytes were elevated significantly in each group compared with those preoperatively. Peak level was reached in the AR group and was significantly higher than that of the contemporary NAR group (P＜0.05). ROC curve analysis showed that the obvious elevation of the ATP value within CD4+ T lymphocytes 1 week postoperatively had better sensitivity and specificity in diagnosing AR. The ATP sensitivity rate for early AR was 84.6 %and specificity rate 81 %. The ATP value within CD4+ T lymphocytes on the day of AR occurrence had a positive relationship with the rejection acting index(RAI), while relative index (r) was 0. 876(P＜0.05). After the steroid dump treatment, AR in all the patients was reversed and the ATP value declined significantly as compared with the control group and the day when AR occurred(P＜0. 05).Conclusion During the postoperative period, the dynamic change of ATP value within CD4 + T lymphocyte had a close relationship with acute rejection after liver transplantation. Thus, it might be used as a feasible and noninvasive monitoring index for diagnosing AR and the effectiveness of the anti-rejection treatment.

Objective:To evaluate the effect of TBK1 overexpression on hypoxia-reoxygenation (H/R) injury in isolated mouse cardiomyocytes subjected to high glucose and the relationship with mitochondrial autophagy.Methods:Normally cultured log-phase HL-1 mouse cardiomyocytes were inoculated in a 6-well plate at a density of 1×10 6 cells/ml and were divided into 4 groups ( n=10 each) using a random number table method: control group (group C), high glucose group (group HG), high glucose and H/R group (group HG+ H/R), and TBK1 overexpression group (group TBK1). The cells were incubated in culture medium with 1% fetal bovine serum and 1% double antibody for 24 h when the cell density reached 50%.When the cell density reached 80%, pcDNA3.1 (+ ) was used as a vector to achieve TBK1 overexpression.The cells were cultured with high glucose medium (33 mmol/L) for 24 h, exposed to 94% N 2+ 5% CO 2+ 1% O 2 for 24 h in an incubator at 37℃ followed by 12 h reoxygenation in an incubator containing 5% CO 2 at 37°C to establish the model of H/R injury to cardiomyocytes subjected to high glucose.After reoxygenation, CCK-8 assay was used to detect cell viability, the activity of lactic dehydrogenase (LDH) in supernatant was detected using LDH kit, mitochondrial contents were determined using Mito-Tracter green fluorescent probe, and the expression of TBK1 and mitophagy-related proteins PINK1, Parkin, LC3B and P62 was detected by Western blot. Results:Compared with group C, the cell viability was significantly decreased, the activity of LDH in supernatant was increased, mitochondrial contents were decreased, the expression of TBK1, PINK1, Parkin and LC3B was down-regulated, and the expression of P62 was up-regulated in HG group and HG+ H/R group ( P<0.05). Compared with group HG, the cell viability was significantly decreased, the activity of LDH in supernatant was increased, mitochondrial contents were decreased, the expression of TBK1, PINK1, Parkin and LC3B was down-regulated, and the expression of P62 was up-regulated in group HG+ H/R ( P<0.05). Compared with group HG+ H/R, the the cell viability was significantly increased, the activity of LDH in supernatant was decreased, mitochondrial contents were increased, the expression of TBK1, PINK1, Parkin and LC3B was up-regulated, and the expression of P62 was down-regulated in group TBK1 ( P<0.05). Conclusion:The mechanism by which TBK1 overexpression reduces the H/R injury is related to restoring mitophagy in isolated mouse cardiomyocytes subjected to high glucose.

Objective To explore the effects of Qa-1 and PD-L1 loaded artificial liposomal treatment in allograft rejection and its outcomes .Methods The extracellular domains of Qa-1 and PD-L1 were loaded on liposome surface by streptavidin-biotin system . Mixed lymphocyte reaction (MLR) was performed for measuring Qa-1/PD-L1 liposome biological function .Then liposome was co-transplanted with allo-islets via portal vein .The levels of blood glucose and C-peptide were detected daily after transplantation .Also hepatic lymphocytes after transplantation were isolated for determining the proportion of activated cells and signaling pathway changes .Results Artificial liposome could be easily loaded with biotinylated peptide and its diameter was between 50 to 500 nm . Qa-1/PD-L1 liposome could significantly suppress lymphocyte proliferation , activation and secretion of IFN-γ in MLR by an activation of SHP1/2 and an inhibition of Syk pathway .Qa-1/ PD-L1 liposomes could suppress the activation of hepatic lymphocytes in vivo by activating SHP1/2 ,protecting islet allografts and maintaining a normal level of blood glucose in recipients .Conclusions Qa-1/PD-L1 loaded liposome can effectively suppress allograft rejection and improve the outcomes of islet transplantation .

Objective: To explore the safety of liver transplantation recipients with Rh blood group mismatchming. Methods: From May 2005 to December 2018, 1 546 cases of liver transplantation in our hospital were retrospectively analyzed. Among these cases, 5 cases of Rh blood group mismatched were Rh(-) recipients receiving Rh(+ ) donor liver. For each Rh blood group mismatched liver transplantation, 5 patients received the same Rh blood group liver allograft were matched according to a certain principle and were defined as Rh-mismatch group and Rh-match group respectively. The serum alanine aminotransferase (ALT), aspartate aminotransferase(AST)and creatinine(SCr)were compared between two groups at Days 7 & 14 post-operation. Serum total bilirubin(TB), gamma-glutamyl transpeptidase(GGT)were compared between two groups at Month 1, 6 & 12 post-operation. Hemoglobin (Hb)were compared between two groups Month 1, 3 & 6 post-operation. The rates of infection, vascular complications and acute rejection was also compared. Indirect antiglobulin test (IAT)was used for detecting the production of anti-RhD antibody in patients in Rh-mismatch group at Month 1, 6 & 12 post-operation. Results: At the mentioned time, no significant inter-group difference existed in serum ALT, AST, SCr, TB, GGT and blood Hb levels(all P>0.05); Also, no significant difference existed in the incidence of infection, vascular complications or acute rejection(all P>0.05). In Rhmismatch group, 4 recipients received Rh(+ )RBC transfusion during perioperative period and no hemolytic anemia occurred after operation. Rh(D) antibody was negative at all timepoints. Conclusions Taking into account the rarity of Rh-negative blood group in Chinese, it is safe and feasible to carry out Rh blood group mismatched liver transplantation when donor or recipient with the same Rh blood group is not available.

Objective:To test and evaluate the reliability and clinical effectiveness of osteoporotic thoracolumbar fracture (OTLF) scoring and classification system.Methods:A multicenter retrospective case series study was conducted to analyze the clinical data of 530 OTLF patients admitted to 8 hospitals including Honghui Hospital Affiliated to Xi'an Jiaotong University from January 2021 to June 2022. There were 212 males and 318 females, aged 55-90 years [(72.6±10.8)years]. There were 4 patients with grade C and 18 with grade D according to American Spinal Injury Association (ASIA) classification. According to the osteoporotic thoracolumbar injury classification and severity (OTLICS) score, all patients had an OTLICS score over 4 points and required surgical treatment. Among them, 410 patients had acute symptomatic OTLF (ASOTLF), including 24 patients with type I, 159 type IIA, 47 type IIB, 31 type IIC, 136 type IIIA, 8 type IIIB, 2 type IV (absence of neurological symptoms) and 3 type IV (presence of neurological symptoms), and 120 patients had chronic symptomatic OTLF (CSOTLF), including 62 patients with type I, 21 type II, 17 type III, 3 type IV (reducible under general anesthesia), 9 type IV (not reducible under general anesthesia), 1 type V (reducible under general anesthesia), 5 type V (presence of neurological symptoms), and 2 type V (not reducible under general anesthesia). Surgical procedures included percutaneous vertebroplasty (PVP), positional repositioning plus PVP, percutaneous kyphoplasty (PKP), posterior open reduction combined with bone graft fusion and bone cement augmented screw internal fixation, posterior open reduction combined with decompression, bone graft fusion and bone cement augmented screw internal fixation, and posterior open reduction combined with osteotomy and orthopedics, bone graft fusion and bone cement augmented screw internal fixation. A weighted Kappa was used to test the interobserver and intraobserver reliability of the OTLICS score, the ASOTLF classification, and the CSOTLF classification. The visual analog scale (VAS), Oswestry disability index (ODI), ASIA classification were compared before, at 1 month after surgery and at the last follow-up. Incidence of postoperative complications was observed.Results:The percentage of mean interobserver agreement for OTLICS staging was 93.4%, with a mean confidence Kappa value of 0.86, and the percentage of mean intraobserver agreement was 93.0%, with a mean confidence kappa value of 0.86. The percentage of mean interobserver agreement for ASOTLF staging was 94.2%, with a mean confidence Kappa value of 0.84, and the percentage of mean intraobserver agreement was 92.5%, with a mean confidence Kappa value of 0.83. The percentage of mean interobserver agreement for CSOTLF subtyping was 91.9%, with a mean confidence Kappa value of 0.80, and the percentage of mean intraobserver agreement was 91.3%, with a mean confidence Kappa value of 0.81. All the patients were followed up for 6-12 months [(9.0±2.1)months]. The VAS and ODI scores were significantly lower in patients with ASOTLF and CSOTLF classifications at 1 month after surgery and at the last follow-up than those before surgery (all P<0.05). The VAS scores in patients with ASOTLF types IIA, IIB, IIC, IIIA, and IV were significantly lower at the last follow-up than that at 1 month after surgery; the ODI scores in patients with ASOTLF types I, IIA, IIB, IIIA, IIIB and IV were significantly lower at the last follow-up than those at 1 month after surgery. The VAS scores in patients with CSOTLF types II, III, IV, and V were significantly lower at the last follow-up than those at 1 month after surgery, and the ODI scores in patients with all CSOTLF types were significantly lower at the last follow-up than those at 1 month after surgery (all P<0.05). Two patients with ASIA grade C recovered to grade D, and the rest recovered to grade E at the last follow-up ( P<0.01). No major vessel or nerve injury or internal fixation failure was found during follow-up. There were 18 patients with cement leakage, none of whom showed relevant clinical symptoms. There were 35 patients with new vertebral fractures, all of whom recovered well after symptomatic treatment. Conclusions:The OTLICS score, ASOTLF classification and CSOTLF classification have a high degree of reliability. Application of stepwise treatment for patients with different levels of injury according to the scoring and classification system can reduce pain, promote recovery of the spinal function, and reduce complications, which is of some significance in guiding the selection of clinical treatment.

Objective To comapre and analyze the differences and commonalities of expression profiles of serum exosomal microRNA between patients with thyroid nodules and healthy persons at different iodine levels,and then provide evidence for screening early diag-nostic markers of thyroid nodules at different iodine levels.Methods The peripheral blood samples from 10 patients with thyroid nod-ules and healthy volunteers at different iodine levels were collected.Their serum iodine levels were measured by the arsenic cerium cat-alytic spectrophotometry.Serum exosomal microRNA were extracted and the expression levels of microRNA were determined by the high-throughput sequencing technology.The differential target genes were predicted and further performed Gene ontology(GO)analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)analysis.Results Compared with healthy volunteers,there were 6 downreg-ulated miRNAs in the patients with thyroid nodules at different iodine levels,namely miR-324-5p,miR-6511b-3p,miR-9903,miR-550a-3p,miR-5001-3p,and miR-3688-3p.Differentially expressed exosomal microRNA could regulate the MAPK signaling path-way,PI3K-AKT signaling pathway,VEGF signaling pathway,and NF-κB signaling pathway.Conclusion Six differentially expressed microRNAs is identified,which may serve as biological markers for the early diagnosis of thyroid nodules at different iodine levels.