Objective To investigate the effect ofhyperventilation on cerebral blood flow,brain metabolism and cerebral perfusion in patients with traumatic brain injury by end tidal pressure of CO2 (PETCO2) monitoring.Methods Seventy patients with traumatic brain injury,admitted to our hospital from January 2009 to June 2012 and performed decompressive craniectomy,were chosen in our study; they were randomly divided into group A and group B (n=35); patients in the group A accepted PETCO2 within 20-25 mm Hg and arterial partial pressure of carbon dioxide (PaCO2) within 22-25 mm Hg,and patients in the group B received PETCO2 within 25-30 mm Hg and PaCO2 within 30-45 mm Hg.The blood gas pressure,mean artery pressure,cerebral oxygen partial pressure,cerebral perfusion pressure,cerebral oxygen supply and demand balance,and changes of neuron specific enolase (NSE),glucose and lactic acid were compared between the two groups at the beginning of craniectomy.Results The PaCO2 level,mean artery pressure,intracranial pressure,and levels of NSE,glucose and lactic acid in group A were significantly lower than those in group B (P＜0.05); while the brain oxygen partial pressure,cerebral perfusion pressure,arterial oxygen content (CaO2),venous oxygen content (CjvO2) and cerebral oxygen uptake rate (CERO2) showed no significant difference between the two groups (P＞0.05).Conclusion PETCO2 controlling within 20-25 mm Hg can effectively maintain the cerebral blood perfusion and cerebral oxygen supply and demand balance of the patients; it can also reduce the pathological metabolite effect on the brain tissue; therefore,its clinical value is worthy for attention.

Objective To investigate the distribution and antimicrobial resistance of pathogens isolated from blood specimen,and provide laboratory basis for clinical treatment of bloodstream infection. Methods Pathogens isolated from blood specimen in a hospital laboratory from January 1,2015 to December 31,2016 were identified and per-formed antimicrobial susceptibility testing.Results A total of 1 061 pathogenic strains were isolated from blood speci-men,of which gram-negative bacillus,gram-positive coccus,and fungus accounted for 53.35%(n= 566),36.10%(n=383),and 10.55%(n= 112)respectively,the major gram-negative bacillus,gram-positive coccus,and fungus were Escherichia coli(E.coli)and Klebsiella pneumoniae(K.pneumoniae),coagulase-negative Staphylococcus,and Candida parapsilosis respectively. Strains were mainly isolated from intensive care unit(ICU,n= 308,29.03%),followed by hematology department and pediatric internal medicine department. Resistance rates of E.coli and K. pneumoniae to imipenem were 2.65% and 40.12% respectively.Extended-spectrum beta-lactamase(ESBL)-produ-cing E.coli and K.pneumoniae accounted for 62.96% and 33.14% respectively. Linezolid- and vancomycmin-re-sistant Staphylococcusspp. Were not found,isolation rates of methicillin-resistant coagulase-negative Staphylococ-cus and methicillin-resistant Staphylococcus aureus were 83.61% and 45.45% respectively,one vancomycin-resis-tant Enterococcus faeciu m and one linezolid-resistant Enterococcus faecium were isolated respectively.Conclusion There are multiple species of pathogens isolated from blood specimen,distribution and antimicrobial resistance of pathogens casing bloodstream infection should be monitored regularly to guide the empiric antimicrobial therapy.

The main objective of the current study was to develop a universal method for a protein binding assay of complicated herbal components, and to investigate the possible relationship between compound polarity and protein binding using Schisadra lignans as an example. Firstly, the rat, dog and human plasma were spiked with three different concentrations of Schisandra chinensis extract (SLE), and ultramicrofiltration was used to obtain the unbound ingredients. Secondly, thirty-one Schisandra lignans in total plasma and ultrafiltered fluid were measured by LC-IT-TOFMS. Lastly, a relative exposure approach, which entailed calculating the relative concentrations of each Schisandra lignan from the corresponding calibration equation created from the calibration samples spiked with the stock solution of SLE, was applied in order to overcome the absence of authentic standards. The results showed that Schisandra lignans exhibited a high capability to bind with plasma protein, furthermore, the protein binding ratio of the lignan components increased proportionally with their individual chromatographic retention time, which indicated that the ratio of protein binding of lignans might increase accordingly with decreasing polarity. This study suggested that the compound polarity might be an important factor affecting the plasma protein binding of herbal components.
Animals ; Blood Proteins ; chemistry ; metabolism ; Chromatography, High Pressure Liquid ; methods ; Dogs ; Drugs, Chinese Herbal ; chemistry ; Humans ; Kinetics ; Lignans ; blood ; chemistry ; Male ; Mass Spectrometry ; methods ; Protein Binding ; Rats ; Schisandra ; chemistry

Objective To provide data for the control and prevention of hepatitis B and HBV surface antigen(HBsAg)status among the appliances and practitioners working in the public service places.Methods 63 beauty parlors,barber shops and bathing centers selected under stratified randomization sampling method and 682 workers were investigated through questionnaire.HBsAg from the appliances of the public service places and employee was detected by RIA.Results Two main sanitizing modes that including alcohol cleaning(34.60%)and ultraviolet light disinfection(30.79%)were used.The rates of testing on HBsAg among the appliances were 2.13% at the public service places,and were 0.63%,2.67% and 3.70% in large-.medium-and small-sized appliances respectively.The rate of testing on HBsAg on large-,medium-and small-sized appliances were statistically different(χ2=6.68,P＜0.05).The positive rates of HBsAg on the appliances of beauty parlors,barbering shops and footbath inns were 2.97%,0.61% and 3.42% respectively.People working in different service sites had different rates of HBsAg:those who worked at the‘acne needle'and the forceps were 5.13% and 4.17%.The positive rate of HBsAg among the workers in the public service places was 7.13%.The rates of HBsAg among the workers in large-,medium-and small-sized public service places were 7.34%,8.33% and 2.94% respectively.The rates of HBsAg among the workers in beauty parlors,barbering shops,footbath inns and bathing centers were 9.01%,6.37%,4.35% and 7.29% respectively.HBsAg positive rates were different among the workers working at different service sites:13.33% at tattoo business.12.68% in pedicures workers and 8.03% in massagists.Conclusion It is important to improve the sanitizing management of the appliances used in the public service places and to improve the knowledge,attitude,as well as practice of vaccination on hepatitis B among those populations.

【Objective】 To investigate the expressions of ubiquitin-conjugating enzyme(UBE2) family and ubiquitin-conjugating enzyme E2T(UBE2T) gene and their relationships with the clinicopathology in lung adenocarcinoma. 【Methods】 Based on Linkedomics database, the expression levels of UBE2C, UBE2M, UBE2S, UBE2T and UBE2V2 mRNA and their associations with the clinical characteristics of lung adenocarcinoma were collected and detected. Kruskal-Wallis H test was applied to compare the differences of pathologic stage, T stage and N stage, Wilcoxon rank sum test for M stage and Cox regression test for overall survival(OS). The expression profiles of UBE2T gene in lung adenocarcinoma and paracancerous tissues were obtained from the Cancer Genome Atlas(TCGA) database and then analyzed with independent samples t test. The Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway and the enrichment were examined by using Gene Set Enrichment Analysis(GSEA) software. 【Results】 The expressions of UBE2C, UBE2M, UBE2S, UBE2T and UBE2V2 mRNA correlated with the clinicopathological features of lung adenocarcinoma. Compared with low UBE2T expression, high UBE2T expression predicted shorter OS time and advanced TNM stage. Their differences were statistically significant(P < 0.05). The UBE2T mRNA expression level was significantly upregulated in lung adenocarcinoma(P < 0.01). The gene enrichment analysis showed that the overexpression of UBE2T was closely related to 36 signal pathways(FDR < 0.05), including cell cycle(FDR = 0), spliceosome(FDR = 0), DNA repair(FDR = 0) and the glucose metabolism. The expressions of UBE2C, UBE2M, UBE2S, UBE2T and UBE2V2 mRNA in UBE2 family correlated with the clinicopathological features of lung adenocarcinoma. UBE2T was further identified as a factor most closely related with pathological grade, prognosis in lung adenocarcinoma and glycolysis process of tumor cells. 【Conclusion】 UBE2 family correlates with clinicopathological features of lung adenocarcinoma. UBE2T mRNA could be a new biomarker for lung adenocarcinoma.

Autophagy often occurs after cells are attacked by oxidative stress, where damaged structures are phagocytic and degraded into nutrients, thereby reducing oxidative damage, promoting the survival of cancer cells and reducing the therapeutic effect of photodynamic therapy (PDT). However, excessive activation of autophagy can promote cell apoptosis. In this paper, the photosensitizer pyropheophorbide-a (Ppa) was used to produce a large amount of reactive oxygen species (ROS) to achieve the effect of killing cancer cells. At the same time, icaritin (Ica), an autophagy inducer, was used to over-activate autophagy, which transformed the protection of cancer cells into the promotion of cancer cell apoptosis, so as to improve the effect of photodynamic therapy. In this study, the interaction force between Ica and Ppa was exploited to successfully construct a self-assembled nanomedicine IP with good stability and high drug load. The synthesis method is simple, through using the drug itself as a carrier, and the loading capacity (LA) of Ica and Ppa can be increased to 83.53% and 16.45% without introducing potential biosafety risks of nanocarriers. Compared with free Ppa, self-assembled nanomedicine IP showed superior performance in cellular uptake and reactive oxygen species production. In addition, the self-assembled nanomedicine IP can reverse the protective autophagy induced by PDT by activating the autophagy of tumor cells, and facilitate apoptosis and antitumor coordination, which significantly improves the antitumor activity of PDT.

To establish the high performance liquid chromatography (HPLC) fingerprint for Digeda-4 decoction (DGD-4D), determine the contents of aesculetin, geniposide, picroside Ⅰ, picroside Ⅱ and ellagicacid in DGD-4D, and provide the scientific foundation for quality control of DGD-4D. The analysis was performed on Diamonsil(2) C₁₈ (4.6 mm×250 mm,5 μm) column, with methanol-0.1% phosphoric acid aqueous solution as mobile phase for gradient elution. The flow rate was 1.0 mL·min⁻¹; injection size was 10 μL; temperature was maintained at 30 °C, and the detection wavelength was set at 254 nm. The common mode of DGD-4D HPLC fingerprint was established, and the hidden information was analyzed by Chemometrics. Chromatographic peaks for DGD-4D were identified by HPLC and quantitative analysis was conducted for characteristic peaks. There were 17 common peaks in the fingerprints and the similarity of the fingerprints was over 0.9 in all 15 batches. The samples were broadly divided into four kinds by principal component analysis and clustering analysis. Four marker compounds were verified by partial least squares discriminant analysis, and No. 9, 12 and 14 peaks were identified as geniposide, picroside Ⅱ, and picroside Ⅰ respectively. The average recoveries were in the range of 95.91%-97.31%. The HPLC fingerprint method for content determination is reliable, accurate, rapid, simple, and reproducible, and can be used as one of the effective methods to control the quality of DGD-4D.
Chromatography, High Pressure Liquid ; Cinnamates ; Drugs, Chinese Herbal ; analysis ; standards ; Iridoid Glucosides ; Iridoids ; Methanol ; Principal Component Analysis ; Quality Control

Ocular myasthenia gravis(OMG)is an autoimmune disease caused by neuromuscular junction transmission disorders and manifested mainly as fluctuating blepharoptosis and diplopia,with the extraocular muscles as the main involveed sites.While the pathogenesis of OMG remains unclear,some antibodies,complements,and cytokines may be the contributing factors.The diagnosis and treatment of OMG have been defined in recent years.This article reviews the pathogenesis,diagnosis,and treatment of OMG.
Antibodies ; Complement System Proteins ; Cytokines ; Humans ; Myasthenia Gravis ; diagnosis ; pathology ; therapy ; Oculomotor Muscles ; pathology

Retinopathy of prematurity(ROP)is a pathological neovascularization with fibrotic changes in the fundus of premature infants.It is a major cause of preventable blindness in children in both developing and developed countries.Treatment of ROP has long been a hot research topic in ophthalmology and pediatrics.With a clearer knowledge of the pathogenesis of ROP,more basic and clinical studies have been carried out.The anti-vascular endothelial growth factor therapy and surgical treatment have become mature strategies,and a variety of therapeutic drugs including insulin-like growth factor-1,transforming growth factor-β,polyunsaturated fatty acids,and β-adrenergic receptor blockers have been developed.This article reviews the recent advances in ROP.
Child ; Humans ; Infant, Newborn ; Infant, Premature ; Neovascularization, Pathologic ; therapy ; Retinopathy of Prematurity ; drug therapy ; surgery ; Vascular Endothelial Growth Factor A ; antagonists & inhibitors

The purpose of this article is to identify Daphne genkwa and its adulterants, Wikstroemia chamaedaphne, according to the morphological and microstructure characteristics of their stem and foliage. The root of D.genkwa was studied simultaneously. The results indicated that the crude drug and processed pieces of Genkwa Ramulus were mainly composed of stems and branches where obvious opposite petiole scars and branch marks were able to be seen on their nodes. Otherwise, foliage or peduncles generally couldn't be found. Moreover, the fine silver flocculent fibers could be observed in the bark of fracture surface. The adulterants were the plant segments which were composed of stems, foliage and peduncles with spikelet-pedicel scars. There existed microstructures differences between Genkwa Ramulus and its adulterants. In the former, single thick lignified phloem fibers were interspersed in the stem phloem of the transverse section with very thick wall and unicellular non-glandular hairs could be observed on the lower epidermis of foliage. Nevertheless, in the latter, there was no thick lignified phloem fibers in cross section of stem phloem, the outer wall of epidermal cells of foliage hadthick cuticles and no non-glandular hairs in lower epidermis of foliage. The results can be used for the identification and the quality standard of the crude drug and processed pieces of D.genkwa.The characteristics of the microstructures and the transverse section can be used to identify the radix D.genkwa.