Objective To investigate the microstructure and ultrastructure changes of cardiac muscle, pallium, lung, liver and kidney tissue and hemodynamic effects after the success of cardiac arrest (CA)-cardiopulmonary resuscitation(CPR) of swine. Method A total of 16 Beijing swine(weight 29 ～ 35 kg)were randomly (random number) divided into normal-control group ( n = 8) and standard CPR group ( n = 8). The swine of the former group were only given anesthetized and intubated, without ventricular fibrillation and CPR. The swine of the latter group were given standard CPR after 4 min of untreated VF, from 10 min after restoration of spontaneous cirkg) and keep for 6 h. And cardiac output (CO), left ventricular maximal rate of systolic pressure ( + dp/dtmax),maximum reduction of left ventricular diastolic velocity ( - dp/dtmax), heart rate (HR) and mean arterial pressure (MAP) of these animals before ventricular fibrillation and 0.5 h, 2 h, 4 h, 6 h after ROSC have been monitored.All swine were put to death after 6 h,and got their cardiac apex, pallium, left lung, right lobe of liver and upper pole of left kidney quickly for microstructure and ultrastructure studies. Statistical analysis was performed using two paired samples t test. Results At different time points after restoration of spontaneous circulation, the cardiac output (CO),left ventricular maximal rate of systolic pressure ( + dp/dtmax), maximum reduction of left ventricular diastolic velocity (- dp/dtmax) were significantly lower than before ventricular fibrillation, with significant difference ( P ＜ 0.05). And HR of different time points were increased significantly ( P ＜ 0.05), with no significantly difference between MAP of each time points ( P ＞ 0.05). Compared with the normal-control group, the cardiac muscle, pallium, lung, liver and kidney tissue of the swine in standard CPR group were found different degree of damages in their microstructure and ultrastructure sections. The damages of the cardiac muscle, pallium, and lung tissue were more obviously. Conclusions Sudden cardiac arrest(CA)-cardiopulmonary resuscitation(CPR) could cause different degree of damages and hemodynamic effects on the body, through our ROSC 6 h model, the damages of the cardiac muscle, pallium and lung were more severity, the damages of liver and kidney were lighter.

OBJECTIVE:To analyze one case of pericardial pain induced by drug combination of omeprazole so as to provide reference for drug combination in the clinic. METHODS:A 79-year-old male patient was admitted because of stage Ⅲ hypertension,coronary heart disease,acute attack of chronic bronchitis in Dec. 2 of 2009. He was treated with omeprazole and pericardial pain was observed during treatment. ADR caused by omeprazole were put forward in the clinic. RESULTS & CONCLUSION: Omeprazole combined with other drugs can easily cause ADR for example,pericardial pain. The universality of ADR induced by drug combination of omeprazole should be further confirmed because of limited sample.

Objective To investigate the effects of arsenic trioxide(ATO) on anti-dsDNA antibody and lymphocyte subsets proliferation in splenic cells of MRL/lpr mice.Methods MRL/lpr mice were divided into three groups: ATO group(0.4 mg/kg?d,ip),sodium chloride(NS) group(0.25 mL,ip),and cyclophosphamide(CTX) group(50 mg/kg?qw,ip).The control group consisted of 12 syngeneic normal C57/BL mice,which were sub-divided into ATO group(0.4 mg/kg?d,ip) and NS group(0.25 mL,ip).After two-month treatment,all mice were killed and their bodies and spleens were weighed.Anti-dsDNA antibody in serum were detected by ELISA.The percentage of different cell subsets was checked through flow cytometry.Results(1)The spleen index、serumlevel of anti-dsDNA antibody and the percentages of CD19+、CD3+、CD3+CD4+ lymphocytes in ATO group were much lower than those in NS group of MRL/lpr mice(P0.05). Conclusion Arsenic trioxide can inhibit the activation of T and B lymphocytes,increase the percentage of NK cell and reduce the serum level of auto-antibody.And it was of no effect in the normal mice.

Objective:Discuss and analyze the mechanisms of spine fine adjusting through the observation of the therapeutic effect in treating cervical spondylotic radiculopathy(CSR)and the conversion of cervical curvature.Methods: Randomly divide 106 CSR patients into two groups–manipulation therapy group and traction therapy group,53 for each.Judge the therapeutic effect by evaluation scales and measure the cervical curvature on X-ray photographs.Results:The symptoms and physical signs of the patients in both two groups have been improved(P

Objective To explore the effect of adipose-derived stem cells (ADSCs) on inflammatory factors in rats with lipopolysaccharide (LPS)-induced acute lung injury (ALI) and the possible mechanism of anti-inflammatory. Methods Seventy male Sprague-Dawley (SD) rats were randomly divided into normal control group (n = 10), LPS model group (n = 30), and ADSCs intervention group (n = 30) by random number table. ALI model was reproduced by intraperitoneal injection of 8 mg/kg LPS, and the rats in ADSCs intervention group received tail vein injection of 300 μL ADSCs 30 minutes after the model reproduction, the samples of normal control group were harvested immediately without any intervention, and the specimens in remained two groups were taken at 6, 24, 72 hours respectively. Arterial partial pressure of oxygen (PaO2) and lactate level in femoral artery were determined. Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum myeloperoxidase (MPO) and interleukin-10 (IL-10) in the blood of left ventricle. Lung wet/dry weight (W/D) ratio was detected by thoracotomy, and the pathological changes of lung tissue were observed under an optical microscope. Western Blot was used to detect the protein expression of nuclear factor-κB (NF-κB) in lung tissue of rats. Results Compared with the normal control group, the damage degree of lung tissue of LPS model group was significantly heavier from 6 hours, and lung W/D ratio, blood lactate, MPO, IL-10 and expression level of NF-κB in lung tissue were significantly increased respectively, while PaO2 was decreased significantly. Compared with LPS model group, the damage degree of lung tissue of ADSCs intervention group was significantly reduced from 6 hours, and lung W/D ratio, blood lactate, MPO, and NF-κB expression in lung tissue were significantly decreased, while PaO2 was increased significantly, and it became normal at 72 hours [lung W/D ratio: 5.33±0.29 vs. 5.77±0.42 at 6 hours, 5.14±0.46 vs. 5.43±0.38 at 72 hours; blood lactate (mmol/L): 3.6±1.0 vs. 5.7±1.1 at 6 hours, 3.1±1.0 vs. 3.8±1.2 at 72 hours; blood MPO (μg/L): 1.50±0.90 vs. 2.70±1.85 at 6 hours, 0.46±0.30 vs. 0.71±0.22 at 72 hours; NF-κB (gray value): 0.40±0.11 vs. 0.50±0.09 at 6 hours, 0.24±0.03 vs. 0.33±0.06; PaO2 (mmHg, 1 mmHg = 0.133 kPa): 78.0±4.1 vs. 74.5±3.2 at 6 hours, 89.3±9.4 vs. 81.9±3.4 at 72 hours; all P < 0.05]. The IL-10 level was significantly higher than that of LPS model group only at 24 hours (ng/L: 27.75±15.49 vs. 17.52±6.56, P < 0.05). Conclusion ADSCs can effectively relieve the inflammatory response of ALI induced by LPS, probably by inhibiting the expressions of NF-κB and blocking the release of inflammatory cytokines.

Objective To compare the changes in IFN-γ, IL-4, IL-10 and IL-1β expression at mRNA level in gastric mucosae of BALB/c, C57BL/6 and nude mice at different stages of Helicobacter heilmannii ( H. heilmannii) infection, and to investigate the types of induced immune responses. Methods Each kind of mice was randomly divided into two groups: infection ( n=30 ) and control ( n=6 ) groups. Those in the infection groups were intragastrically inoculated with H. heilmannii strains to establish long-term stable mouse infection models. Gastric mucosa tissues were collected at weeks 4, 8, 12, 24 and 36 and ana-lyzed by semi-quantitative RT-PCT to detect the expression of IFN-γ, IL-4, IL-10 and IL-1βat mRNA lev-el. Results In the early stage of infection (weeks 4-12), INF-γ, IL-4, IL-10, and IL-1β expression at mRNA level in the gastric mucosae of BALB/c and C57BL/6 mice were significantly increased compared with those of the control groups (P<0. 05). IL-4, IL-10 and IFN-γexpression peaked at weeks 8-12, while IL-1βexpression reached the peak at week 4. After 12 weeks, IFN-γexpression at mRNA level in BALB/c mice was significantly decreased, but showed no significant change in C57BL/6 mice. IL-4 expression at mRNA level in C57BL/6 mice at the late stage of infection (week 36) was lower than that in the correspond-ing control group (P<0. 05). Expression of IFN-γ, IL-4, IL-10 and IL-1β at mRNA level in nude mice were all higher than those in the control group, and there were significant differences in IL-1βand IL-4 ex-pression between groups (P<0. 05). Conclusions Expression of cytokines in H. heilmannii-infected mice increased over time. IFN-γ-mediated Th1 immune responses were the predominant immunity induced by H. heilmannii infection. Immune responses to H. heilmannii infection varied with the kinds of mice. C57BL/6 mice showed mainly Th1 cell immune responses, while Th1/Th2 mixed immune responses were induced in BALB/c mice.

Objective:To investigate the role of KLF4 in lipopolysaccharide induced cardiomyocyte injury.Methods:Primary rat cardiomyocytes were isolated and cultured, and randomly divided into 5 groups: control group, negative control (NC), LPS group, KLF4 overexpression group, KLF4 overexpression+LPS group. MTT method was used to detect cell activity, ROS, SOD 2, GPX and MDA were detected by kit, TNFa, IL-1 β and IL-6 were detected by ELISA. TUNEL staining was used to detect apoptosis. The protein levels of TLR4 and Nrf2 were detected by Western blot.Results:The expression of KLF4 in cardiomyocytes was significantly higher than that in the NC group ( P<0.001). The cell activity of LPS group was significantly lower than that of NC group ( P < 0.001), and that of KLF4 overexpression +LPS group was higher than that of LPS group ( P<0.001). The levels of TNFa, IL-1 β and IL-6 in LPS group were significantly higher than those in the NC group ( P<0.0001), and the levels of TNFa, IL-1 β and IL-6 in KLF4 overexpression +LPS group were lower than those in LPS group ( P<0.0001). The levels of ROS and MDA in LPS group were significantly higher than those in the control group, while the activities of SOD2 and GPX were lower than those in the NC group ( P<0.0001); the levels of ROS and MDA in KLF4 overexpression +LPS group were lower than those in LPS group, while the activities of SOD2 and GPX were higher than those in LPS group ( P<0.0001). The number of apoptosis in LPS group was significantly higher than that in the NC group, and that in KLF4 overexpression +LPS group was lower than that in LPS group ( P< 0.001). The level of TLR4 wan higher and Nrf2 protein in the nucleus of LPS group was lower than that of the NC group. The level of TLR4 was lower and Nrf2 protein in the nucleus of KLF4 overexpression+LPS group was significantly higher than that of LPS group ( P < 0.001). Conclusions:KLF4 can alleviate LPS induced cardiomyocyte injury by regulating TLR4 and NRF2 signals.

Objective:To investigate the relationship between serum cholinesterase (SChE) level and the prognosis of patients with septic shock (SS).Methods:A total of 594 patients with SS admitted to the First Affiliated Hospital of Zhengzhou University from June 2013 to June 2017 were enrolled. General data such as gender, age, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score were recorded as well as routine blood test, procalcitonin (PCT), hepatic function, renal function, coagulation function and blood gas analysis parameters within 48 hours of SS diagnosis. The patients were followed by telephone from September to October in 2019, and the outcome was recorded. The primary outcome was all-cause death 28 days after discharge. The secondary outcomes were all-cause death in intensive care unit (ICU) and 2 years after discharge, and the length of ICU stay. The patients were divided into two groups according to prognosis of 28 days: the survival group and the death group. The clinical data of the two groups were compared. Multivariate Cox regression analysis was used to screen prognostic risk factors of 28 days in patients with SS. The receiver operating characteristic (ROC) curve was used to explore predictive value of liver function parameter SChE for 28-day prognosis of patients with SS. The patients were divided into two groups according to the levels of SChE: the low SChE group (SChE ≤ 4 000 U/L) and the normal SChE group (SChE > 4 000 U/L). Kaplan-Meier survival curves were used to compare the cumulative survival rates without endpoint event of patients with different SChE levels.Results:A total of 385 patients with SS were enrolled according to the inclusion and exclusion criteria, and a total of 356 patients were followed up successfully, with a follow-up rate of 92.5% (356/385). There were 142 survival patients and 214 death patients at 28 days, with a 28-day mortality rate of 60.1% (214/356). There were 116 survival patients and 240 death patients at 2 years, with a 2-year mortality rate of 67.4% (240/356). Compared with the 28-day survival group, the patients in the death group were older and had higher APACHEⅡ score, partial hepatic and renal function parameters, higher level of blood lactate (Lac) and lower levels of white blood cell count (WBC), platelet count (PLT) and SChE with statistically significant differences. Multivariate Cox regression analysis showed that the age [relative risk ( RR) = 1.444, 95% confidence interval (95% CI) was 1.090-1.914, P = 0.010], APACHEⅡ score ( RR = 2.249, 95% CI was 1.688-2.997, P = 0.000), SChE ( RR = 1.469, 95% CI was 1.057-2.043, P = 0.022), and Lac ( RR = 2.190, 95% CI was 1.636-2.931, P = 0.000) were independent risk factors for 28-day mortality of patients with SS. The ROC curve analysis showed that SChE had a weak prognostic value for 28-day prognosis of patients with SS [the area under ROC curve (AUC) was 0.574]. However, the combined predictive value of SChE, APACHEⅡ score and Lac was greater than APACHEⅡ score or Lac alone for prediction (AUC: 0.807 vs. 0.785, 0.697), with a sensitivity of 79.9% and a specificity of 68.5%. Compared with the normal SChE group ( n = 88), the 28-day mortality of patients in the low SChE group ( n = 268) was significantly increased [63.1% (169/268) vs. 51.1% (45/88), P < 0.05], but ICU mortality [59.7% (160/268) vs. 48.9% (43/88)], 2-year mortality [69.8% (187/268) vs. 60.2% (53/88)] or the length of ICU stay [days: 4 (2, 7) vs. 5 (2, 9)] between the two groups showed no statistical significance (all P > 0.05). Kaplan-Meier survival curve analysis showed that the cumulative survival rate without endpoint event of patients in the low SChE group was significantly lower than that in the normal SChE group (Log-Rank test: χ 2 = 5.852, P = 0.016). Conclusions:Increased risk of 28-day mortality in patients with SS whose SChE is below normal. The level of SChE is an independent risk factor for 28-day death in SS patients, and it is one of the indicators to evaluate the short-term prognosis of patients with SS.

Objective: To analyze dermoscopic features of blue nevi. Methods: Clinical and dermoscopic data were collected from patients with confirmed blue nevi in the Department of Dermatology and Venereology, Wuxi People′s Hospital from January 2008 to May 2018, and analyzed retrospectively. Chi-square test was used to analyze differences between groups. Results: Totally, 65 patients with 66 skin lesions were enrolled into this study. A total of 23 skin lesions were subjected to dermoscopy, which showed homogeneous pattern in 20 (87.0%) lesions, pseudo-pigment network pattern in 2 (8.7%) lesions, and cerebriform pattern in 1 (4.3%) lesion, and the homogeneous pattern was more common than the other patterns (χ² = 8.79, P < 0.05) . Under the dermoscope, 10 lesions were monochromatic (43.5%) , 11 were dichromatic (47.8%) , and 2 were multichromatic (8.7%) . Scar-like hypopigmentation was observed in 4 lesions (17.4%) , and vascular structures were observed in 5 (21.7%) , including punctate vessels in 4 (17.4%) and linear irregular vessels in 1 (4.3%) . Papillary hyperplasia was observed in 2 lesions (8.7%) . Additionally, pigmentation around lesions, white streaks, dots/globules, blotches, comedo-like openings were observed in 1 lesion (4.3%) each. Conclusions Blue homogeneous pattern is the most common dermoscopic feature of blue nevi. Pseudo-pigment network pattern, cerebriform pattern, scar-like hypopigmentation, multiple vascular patterns, papillary hyperplasia, white streaks, dots/globules, blotches, comedo-like openings can also be observed in blue nevus lesions.

Nuclear magnetic resonance spectroscopy is one of the main analytical techniques for detecting metabolomics, which has the advantages of simple operation, rapid detection and non-invasive feature. By monitoring the changes of metabolites in the body, it is helpful to deeply understand the mechanism of disease and play a role in the diagnosis and treatment of diseases, but its clinical application has not yet been popularized. In recent years, the application of metabolomics in tumors has increasingly become a research hotspot. Therefore, in order to provide a reference for the research and clinical application of tumor metabolomics, the nuclear magnetic resonance spectroscopy and tumor metabolomics were introduced in this paper, and the application progress of metabolomics analysis based on this technique in early tumor screening, clinical diagnosis and prognosis evaluation were reviewed in this paper.