Objective To investigate the effects of exogenous pulmonary surfactant(PS)on the inflammatory response in rats with ventilator-induced lung injury(VILI).Methods Twenty-eight adult male Wistar rats weighing 310-388 g were randomly divided into 4 groups(n =7 each):normal control group(group C),group VILI,group PS and air control group(group A).VILI was produced by high-pressure ventilation(HPV)with peak inspiratory pressure(PIP)40 cm H2 O,respiratory rate(RR)20 hpm and without positive end-expiratory pressure(PEEP)for 20 min.The rats were sacrificed by exsanguination immediately after anesthesia and after VILI in groups C and VILI,respectively.In groups PS and A,PS 100 mg/kg(50 mg/ml)and the equal volume of air were injected into the trachea via the airway after the tracheal edema fluid was removed respectively,and the rats were mechanically ventilated(Vr 10 ml/kg,RR 45 bpm and PEEP 7.5 cmH2O)for 120 min and then sacrificed by exsanguination.The blood samples were taken from femoral artery for determination of the plasma levels of IL-6,IL-10,MIP-2 and TNF-α by ELISA.The tracheal edema fluid was collected to determine the protein concentration by Bradford method.The lungs were removed for microscopic examination and the number of neutrophils was counted under microscope.Results There was no significant difference in the plasma levels of TNF-α among the four groups(P ＞ 0.05).Compared to group C,the plasma levels of MIP-2,IL-10 and IL-6 were significantly increased and the number of neutrophils was significantly enlarged in group VILI(P ＜ 0.05).The number of neutrophils was significantly smaller in group PS than in group A(P ＜ 0.05).There was no significant difference in the plasma levels of MIP-2,IL-10 and IL-6 between groups PS and A(P ＞ 0.05).The inflammatory damage in lung tissues was observed obviously in groups VILI,A and PS.Conclusion When exogenous PS is used to treat the rats with VILI,PS reduces neutrophil recruitment,but can not inhibit the release of inflammatory cytokines.

Objective To establish the high myopic choroidal neovascularization (CNV) in guinea pigs and to investigate the role of (matrix metalloproteinase-2,MMP-2) and tissue inhibitor-2 of metalloproteinase (TIMP-2) in high myopic CNV.Methods Seventy-two 2-week-old guinea pigs were randomized into control group (n =36) and high myopia group (n =36).Right eyes were indued form deprivation high myopia for 6 weeks.Thirty guinea pigs were randomly selected in each group,and CNV were induced in the right eyes br the 532 nm laser.MMP-2 and TIMP-2 expressions were investigated by immunohistochemistry pre-laser and 7,14,21,28,35 days after laser induction,respectively,while MMP-2 and TIMP-2 relative expression levels in retinal pigment epithelium (RPE)-choroid-sclera complex were detected by real-time PCR.Integral opitical density (IODs) of positive expression and mRNA relative expression levels of these factors were performed by statistical analyses.Results The expressions of MMP-2 and TIMP-2 were up-regulated in the two groups after laser photocoagulation through immunohistochemistry and real-time PCR examinations.Expression of MMP-2 peaked at 21 d and TIMP-2 at 28 d,respectively.IODs of positive expression and mRNA relative expression levels of MMP-2 were higher in high myopia group than those in control group at each inspective time point,and the differences were statistically significant (P ＜ 0.05).TIMP-2 expression was significantly reduced in high myopia group compared with control group before laser photocoagulation (P＜0,05),while there was no significant difference between the two groups at each time point after laser photocoagulation.Conclusions MMP-2 and TIMP-2 were closely related to the formation of high-myopic CNV.Balance disorders of MMP-2 and TIMP-2 might participate in the occurrence and development of high-myopic CNV.

Objective To explore the TCM pathogenesis regularity of nonalcoholic fatty liver disease (NAFLD);To provide basis for clinical syndrome differentiation and treatment. Methods A cross-sectional study was used. The clinical observation form of NAFLD was used to collect the patient data. Factor analysis and singular value decomposition methods were used to study the internal factors of the four diagnostic characteristics. The differences between the various analytical methods were compared. Results Factor analysis used the α factor analysis method, the principal component method, and the image factor method. The results of α-factor analysis were the best. The first three factors had the highest explanatory rates of data, namely spleen-dampness factor, kidney deficiency factor and qi deficiency factor, which constituted the basic pathogenesis factor of NAFLD. The singular value decomposition method obtained 3 singular values, namely spleen and kidney qi deficiency, liver and kidney yin deficiency, and qi and yin deficiency, also highlighted the spleen and kidney deficiency in the pathogenesis of NAFLD. Conclusion Spleen-kidney deficiency plays an important role in the pathogenesis of NAFLD. Treatment based on deficiency for nonalcoholic fatty liver disease has great clinical significance.

OBJECTIVE： To determine the concentration of fentanyl in human plasma by HPLC with ultraviolet detection METHODS： External standard method was used The eluation of fentanyl was carried out by shim－ Pack CLC－ ODS（ 6 0mm× 150mm， 5μ m） column with 0 015mol/L NaH2PO4 acetonitril－ H2O（ 30∶ 70， v/v） as the mobile phase， and detection wavelength was 195nm RESULTS： Calibration curve for fentanyl was linear in the range of 2 0～ 100ng/ml（ r=0 999）  The detection limit was 1 0ng/ml The within－ day RSD was （ 6 50± 2 79） ％ ， the between－ day RSD Was （ 6 70± 3 04） ％  The method recovery was （ 91 70± 4 70） ％  The extraction recovery was （ 97 38± 3 69） ％  CONCLUSION： This method was quick and accurate for the determination of fentanyl in human plasma and useful for pharmakinetic study of fentanyl

Objective To recommend the safety guidelines for workplace violence on health care sector according to the incidents of violence status on medical workplace.Methods A pilot study was conducted using a two-round Delphi method to study out the safety guidelines for hospital violence.Results In two subsequent rounds,the group discussed and screened out 50 entries from 51 items in the six modules as safety guidelines for hospital violence.Conclusions Establishment of safety guidelines for hospital violence on health care sector using Delphi method requires further clinical validation.

Objective To investigate the stress reaction of the medical staff who suffered workplace violence,and provide reference for nursing interventions.Methods 13 medical staff who suffered work-place violence were interviewed through semi-constitutional formula,the data were analyzed by phenomenological method of qualitative research.Results The psychological stress of medical staff mainly included 3 themes:complex emotions,eager to help; psychological adjustment required internal and external integration; different stress reaction affected the psychological state.Conclusions The medical staff suffer seriously from the workplace violence both on the physical and mental health,individuals should learn how to deal with it correctly,and the relevant departments should pay full attention to the humane care to victims of violence,guide them to view the stress correctly,and to take effective measures to prevent and control workplace violence.

Objective To provide the scientific basis for realizing the inter-accreditation of laboratory electrolyte detection results by comparing the electrolyte detection results in 5 grade 3A hospitals of Zhuhai city .Methods Each 10 serum samples with low , middle and high concentrations of electrolyte were collected for simultaneously detecting the electrolyte kalium (K) ,natrium (Na) and chlorinum (Cl) .The detection results were performed the statistical analysis and comparison .The mutual bias within 1/2 of al-lowable error of CLIA′88 indicated that the detection results were mutually accredited ,if the mutual bias exceeding 1/2 of allowable error ,the detection results could not be mutually accredited .Results The difference of electrolyte detection results in 5 hospitals accorded with the stipulation requirement of CLIA′88 .Conclusion The electrolyte detection results of 5 hospitals could be mutually accredited .

Objective To evaluate the usefulness of MR imaging in follow-up of osteosarcomas treated with high intensity focused ultrasound (HIFU). Methods The images of nonenhanced and multiphase gadolinium-enhanced MR imaging before and after HIFU treatment in 16 patients with osteosarcomas pathologically confirmed were interpreted prospectively and correlated with the results of ~ 99mTc-MDP bone scan. Results The results of HIFU in 14 osteosarcomas were evaluated correctly. Before HIFU, 16 osteosarcomas demonstrated hypointensity on T1WI and heterogenous hyperintensity on T2WI and obvious enhancement during capillary and delayed phases and abnormal radioactivity accumulation were detected.One to Four weeks after HIFU treatment, the osteosarcomas became slightly hyperintense on T1WI and heterogenously hyperintense on T2WI, and no enhancement during capillary and delayed phase was noted. There was a clear boundary presenting between the targeted and untreated areas, and abnormal radioactivity accumulation disappeared. Both the signal intensity on T2WI and the tumor size reduced gradually after HIFU treatment 3 to 25 months. Conclusion HIFU is an effective local therapy for osteosarcomas, and MRI can accurately evaluate the efficacy of HIFU.

ObjectiveTo investigate the relationship between syndrome differentiation types and the objective indexes of fatty liver.MethodsA cross-sectional study was adopted. Clinical observation table of fatty liver for TCM diagnostic performance was used to collect the data of patients and cluster analysis was adopted for syndrome differentiation. The difference of the objective indexes among different syndromes was studied.ResultsFatty liver showed more severity in spleen Qi deficiency and dampness group compared with heart and liver yin deficiency group(χ2=8.218,P=0.041). Patients in the spleen and stomach Qi deficiency group had less smoking history(χ2=8.416,P=0.038). Patients in the spleen Qi deficiency and dampness group had higher AST, TP, ALP and WHR indexes and lower Alb.ConclusionsDifferences of objective indexes in different fatty liver syndromes can be used for enriching syndrome differentiation contents, and provide the basis for microcosmic syndrome differentiation of fatty liver.

Objective To investigate the effects and mechanisms of sorafenib on hepatic stellate cell viability and activation in the microenvironment of liver tumor.Methods The effects of LX2 cells on HepG2 cell proliferation were observed by coculture of LX2 and HepG2 cells.MTT assay was used to observe the effects of sorafenib on LX2 proliferation,and expression of α-smooth muscle actin (α-SMA) was measured immunocytochemically in LX2 cells treated with different concentrations of sorafenib.Changes in PDGF-BB and TGF-β1 concentrations were detected in LX2 supernatant using ELISA.Expression of ERK1,ERK2,and AKT signaling pathways were measured using Western blot.Furthermore,LX2 cells were cocultured with HepG2 cells for 24 hours to observe their effects on the invasive ability of HepG2 cells.Result After coculture of LX2 and HepG2 cells,HepG2 cells increased in the experimental group more than those of in the control group.After treatment with various concentrations of sorafenib for 12,24,36 or 48 hours,the viability of treated LX2 cells was lower than the controls in a concentration-and time-dependent manner.As sorafenib concentration and time of exposure increased,α-SMA expression became weaker in treated cells.PDGF-BB and TGF-β1 concentrations decreased with higher sorafenib concentrations and with longer exposure under the same concentration.ERK1,ERK2 and Akt expression was identical between treated and control groups,but their phosphorylated expression decreased with increased concentrations of sorafenib.The invasive ability of HepG2 cells induced by LX2 gradually decreased as sorafenib concentrations increased.Conclusions Sorafenib suppressed α-SMA expression,inhibited PDGF-dependent signaling pathways in HSCs,downregulated PDGF-BB and TGF β1 expression in the supernatant of HSCs,and restrained the viability and activation of HSCs.Sorafenib treatment therefore resulted in suppressed proliferation and invasion of HepG2 cells.