Objective To investigate the relation between hepatic function of mothers and prognosis of fetuses in intrahepatic cholestasis of pregnancy(ICP).Methods 166 patients with ICP were retrospectively studied.Results The incidences of meconium passage and fetal distress were perfectly high in mothers of high serum transaminase and bilirubin.The birth weight and Apgar scores of neonate were related to the levels of bilirubin and we could predict the fetal prognosis by analysis of mother's serum bilirubin level.The serum total bile acid(TBA) levels and other hepatic indexes were not related to the incidences of meconium passage and fetal distress.Conclusions The fetal prognosis of mothers with high-level serum transaminase and bilirubin is bad,so they must be taken great aware of.The prognosis of fetuses can be bettered by cesarean section at proper time.

Aim To study the characteristics of the binding reaction of Troxetutin with bovine serum albumin (BSA) by fluorescence and ultra violet-visible absorption spectra.Methods The quenching mechanism of the fluorescence of BSA by troxerutin was studied with fluorescence.To determine the dynamic quenching constants and static binding constants,the Stern-Volmer equation and the double reciprocal Lineweaver-Burk equation were applied. The number of binding site was calculated with double logarithmic equation and the main binding force was discussed by thermodynamic equations. The binding distance and energy transfer efficiency between donor (BSA) and acceptor (troxerutin) were obtained effectively quenched fluorescence of BSA via static quenching processes. The binding constant Ka was calculated to be in the order of 106,indicating a strong interaction between Troxerutin and BSA. The number of binding site was approximately equal to 1,the binding distance was 1.97 nm,the energy transfer efficiency was 0.529,and the binding force was mainly hydrophobic force.Conclusion Troxerutin effectively quenchs the intrinsic fluorescence of BSA via static quenching mechanism,and the binding is mainly driven by the hydrophobic interaction.

Objective To evaluate ketamine-induced cerebral protection in mice with traumatic brain injury (TBI) by magnetic resonance imaging (MRI).Methods Thirty-two pathogen-free healthy male C57BL/6 mice,aged 8 weeks,weighing 26-30 g,were divided into 4 groups using a random number table:control group (group C,n=7),ketanine group (group K,n=7),TBI group (n=9) and TBI plus ketamine group (group TBI+K,n =9).TBI was produced with a pneumatically driven controlled cortical impact device.Ketamine 150 mg/kg was intraperitoneally injected at l h after operation in TBI+K and K groups,while the equal volume of normal saline was given instead in TBI and C groups.Open field test was conducted at 24 h,72 h and 7 days after operation.The animals in TBI and TBI+K groups were scanned by T1-weighted MRI at 6,24 and 72 h after operation,the animals in C and K groups were scanned by MRI at 24 h after operation,and the development of cerebral edema was observed.Results MRI scan showed no cerebral edema in C and K groups,and different degrees of cerebral edema were found in TBI and TBI+K groups.Compared with group C,the locomotor distance was significantly shortened at 24 and 72 h after operation in group TBI (P＜0.05).Compared with group TBI,the size of cerebral edema was significantly decreased,and the locomotor distance was prolonged at 24 and 72 h after operation in group TBI+K (P＜0.05 or 0.01).Conclusion MRI method further clarifies that ketamine can produce cerebral protection to some extent in mice with TBI.

Objective To assess the value of color Doppler ultrasonogarphy in the diagnosis of subacute thyroiditis (SAT). Methods Sixty-eight patients of SAT and 30 patients with thyroid papillary carcinoma were included, and their imaging features were retrospectively reviewed. Results All the patients with SAT had either focal or diffuse hypoechogenicity of the thyroid lobes with rich blood supplying in the diseased region, among them 52 patients (76.47%, 52/68) had tenderness on palpation. Diffuse and focal lesions were found in 40 (58.82%, 40/68) and 28 patients (41.18%, 28/68). The boundary and shape of focal lesions had no diagnostic characteristics compared with those of thyroid papillary carcinoma. Punctate calcification and resistance index (RI) in the nodule were significant different between the SAT and thyroid papillary carcinoma (P＜0.05). Conclusion Color Doppler ultrasonography can display the features of SAT and is an effective method for the diagnosis of SAT.

Objective To establish and evaluate unstable atherosclerotic plaque model in abdominal aorta induced by cold stress. Methods Sixty male New Zealand white rabbits were randomly divided into three groups:cold stress group fed with high fat diet and followed by balloon induced arterial wall injury of abdominal aorta at week 2 and exposed to cold (4℃) for 1 h per day except for the first postoperative week,balloon-injury group treated by high fat diet plus balloon-injury, control group fed a normal chow without any treatment. Pathological changes of atherosclerotic plaques among these groups were evaluated at 20 weeks. Meanwhile, serum concentrations of blood lipid,oxidized low density protein(ox-LDL),hypersensitive C-reaction protein (hs-CRP)and interleukin (IL)-8 were determined. Results There was no difference in blood lipid level between cold-stress and balloon-injury groups.Serum concentrations of ox-LDL[(56.1 +14.3)mg/L vs.(42.9± 13.8)mg/L],hs-CRP[(149.1+78.3)mg/L vs. (94.5±57.3)mg/L],IL-8 [(97.6±17.9)μg/L vs.(57.5±18.3)μg/L]and macrophage infiltration[(30.9±5.6)％ vs,(18.7±4.8) ％] were significantly higher in cold stress group than in balloon-injury group (t =2.78,6.91,14.94,6.88,all P＜0.05). Higher angiogenesis rate of atherosclerotic plaque in cold-stress group (23/31,74.1％) was observed in comparison with group balloon-injury(5/25,20,0％)(x2=16.26,P＜0.05). Conclusions Establishment of rabbit unstable atherosclerotic plaque model induced by cold stress in synergy with high fat diet and balloon-injury is feasible, which is superior to conventional method through high fat diet plus balloon-injury surgery.

OBJECTIVETo investigate biological effect of hematoporphyrin derivative (HpD) photodynamic therapy (PDT) on in vitro cultured nasopharyngeal carcinoma (NPC) cell lines CNE2 and C666-1.

METHODSCNE2 and C666-1 cells cultured in vitro were incubated in a medium containing HpD at different concentrations (0.5, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, and 4.0 microg/ml) for 4 h followed by exposure to different light doses (2, 5, 10, and 20 J/cm2) using a diode laser at 630 nm with power density of 20 mW/cm2. After 24 h of incubation with HpD-PDT, the survival rate of CNE2 and C666-1 cells were analyzed by MTT assay.

RESULTSHpD-PDT produced effective killing of CNE2 and C666-1 cells cultured in vitro, and the killing effects were positively correlated with HpD concentration and the irradiation dose. Exposure of CNE2 and C666-1 cells to irradiation dose of 20 J/cm2 resulted in the IC50 of 0.7 and 1.2 microg/ml, respectively (P<0.01). With the same HpD concentration and irradiation dose, the survival rate of C666-1 cells, however, was significantly higher than that of CNE2 cells (P<0.05).

CONCLUSIONHpD-PDT may result in effective killing of CNE2 and C666-1 cells cultured in vitro, although C666-1 cells are less sensitive to HpD-PDT than CNE2 cells.

Antineoplastic Agents ; pharmacology ; Cell Line, Tumor ; Cell Survival ; drug effects ; radiation effects ; Dose-Response Relationship, Drug ; Dose-Response Relationship, Radiation ; Hematoporphyrin Derivative ; pharmacology ; Hematoporphyrin Photoradiation ; methods ; Humans ; Nasopharyngeal Neoplasms ; pathology ; Photochemotherapy ; methods ; Photosensitizing Agents ; pharmacology

Objective:To determine the risk factors of extubation failure and its effect on the prognosis of patients who had successfully passed a spontaneous breathing trial (SBT).Methods:The clinical data of patients with mechanical ventilation more than 24 hours who passed SBT admitted to department of intensive care unit (ICU) of First Hospital of Qinhuangdao from November 2018 to November 2019 were retrospectively analyzed. According to the outcome of weaning within 48 hours after weaning, patients were divided into weaning success group and weaning failure group. The baseline data, the presence of basic cardiopulmonary diseases, B-type natriuretic peptide (BNP), fluid balance, albumin and hemoglobin within 24 hours before weaning, the time of mechanical ventilation before weaning, rapid shallow breathing index (RSBI) during SBT, oxygenation index, cough peak flow at the end of SBT, and prognostic indicators were collected. The outcome of weaning was taken as the dependent variable, and the observation factors were taken as the independent variable for univariate analysis. The factors with statistical significance in univariate analysis were analyzed by binary Logistic regression to determine the influencing factors of weaning failure.Results:Of the 204 patients, 167 (81.9%) were successfully weaned, and 37 (18.1%) failed. Compared with the weaning success group, the total duration of mechanical ventilation and the length of ICU stay in the weaning failure group were significantly longer [days: 13.0 (7.5, 23.5) vs. 5.0 (3.0, 8.0), 17.0 (12.5, 31.0) vs. 10.0 (6.0, 15.0), both P < 0.01], and the tracheotomy rate and mortality were significantly higher (32.4% vs. 0%, 51.4% vs. 0%, both P < 0.01). Univariate analysis showed that there were significant differences in age, proportion of patients with cardiopulmonary diseases, BNP and cough peak flow between weaning failure group and weaning success group [age (years old): 70.65±15.78 vs. 62.69±15.82, cardiopulmonary diseases: 62.2% vs. 24.6%, BNP (ng/L): 416.87 (32.70, 1 225.80) vs. 45.36 (10.00, 273.60), cough peak flow (L/min): 59.89±9.06 vs. 83.84±16.52, all P < 0.01]. However, there were no significant differences in gender, acute physiology and chronic health evaluationⅡ (APACHEⅡ) at admission, mechanical ventilation time before weaning, albumin, hemoglobin, oxygenation index, RSBI and fluid balance 24 hours before weaning between weaning failure group and weaning success group [male: 51.4% vs. 68.3%, APACHEⅡ: 16.70±6.65 vs. 15.67±6.28, mechanical ventilation time before weaning (days): 6.0 (2.5, 11.0) vs. 5.0 (3.0, 8.0), albumin (g/L): 27.78±4.15 vs. 27.76±4.46, hemoglobin (g/L): 102.43±15.80 vs. 100.61±17.19, oxygenation index (mmHg, 1 mmHg = 0.133 kPa): 359.33±79.83 vs. 365.75±78.23, RSBI (times·L -1·min -1): 50.73±24.97 vs. 46.76±15.53, positive fluid balance: 70.3% vs. 69.5%, all P > 0.05]. The results of binary Logistic regression analysis showed that age ≥ 75 years old [odds ratio ( OR) = 3.099, 95% confidence interval (95% CI) was 1.003-9.574, P = 0.049], presence of cardiopulmonary diseases ( OR = 3.599, 95% CI was 1.126-11.498, P = 0.031), BNP within 24 hours before weaning ( OR = 1.002, 95% CI was 1.000-1.003, P = 0.005) were the risk factors of extubation failure, while cough peak flow at the end of SBT was the protective factor ( OR = 0.869, 95% CI was 0.823-0.917, P = 0.000). Conclusions:For patients who had successfully passed SBT, age ≥ 75 years old, the presence of cardiopulmonary diseases and an increased level of BNP within 24 hours were the risk factors of extubation failure. In addition, the higher the cough peak flow at the end of SBT, the lower the risk of weaning failure will be.

BACKGROUND:Distal tibial tuberosity-high tibial osteotomy is a surgical treatment for knee osteoarthritis,but there is still a lack of clinical studies on its effect on ankle joints. OBJECTIVE:To observe the effects of distal tibial tuberosity-high tibial osteotomy on ankle angle on coronal plane of the radiography of the full length of lower limb in weight loading. METHODS:Data of 40 patients(41 knees)with distal tibial tuberosity-high tibial osteotomy from March 2021 to March 2022 were retrospectively analyzed,including 31 females and 9 males,20 left knees and 21 right knees,aged 49-75 years,mean(63.44±6.57)years.The radiographic data of the full length of the lower limb in weight loading were collected before,week 2 and week 48 postoperatively.Hip-knee-ankle angle,talar tilt angle,tilt angle of the ankle,tibiocrural angle,and tibial articular surface angle were measured before and after surgery. RESULTS AND CONCLUSION:(1)Hip-knee-ankle angle improved from(-6.24±3.69)° before operation to(2.59±3.49)° week 2 postoperatively and(2.15±3.49)° week 48 postoperatively.The tilt angle of the ankle changed from(-7.90±3.11)° before operation to(-2.51±2.59)° week 2 postoperatively and(-2.46±2.42)° week 48 postoperatively,with statistically significant difference(P<0.001).(2)There was no significant difference in talar tilt angle,tibiocrural angle,and tibial articular surface angle before and week 2 postoperatively.(3)No significant difference in the angle changes was detected between week 2 and week 48 postoperatively.(4)It is indicated that distal tibial tuberosity-high tibial osteotomy can not only correct genu varus but also improve ankle angle.This result remains stable after 48 weeks of weight-bearing activities.

To investigate the effect of long-term indwelling gastric tube on the prevention and treatment of esophageal stenosis after endoscopic submucosal dissection (ESD) for esophageal circumferential superficial cancer, data of patients with esophageal circumferential superficial cancer who underwent ESD in the First Affiliated Hospital of Nanjing Medical University from January 2018 to December 2021 were retrospectively analyzed. There were 15 patients with gastric tube placement (GTP) after ESD (the GTP group ), and 23 patients without GTP (the non-GTP group). The general information, lesion location, pathological stage, postoperative complications, degree of esophageal stenosis (water intake), pain conditions, number of hospitalizations and medical expenses were compared between the two groups. The results showed that there was no significant difference in age, gender, lesion location or postoperative pathological stage between the two groups ( P>0.05). Compared with the non-GTP group, the rate of water intake in the GTP group was significantly higher (11/15 VS 6/23, P<0.05), the frequency of pain was less in the GTP group (7.3±3.1 times VS 10.7±3.6 times, t=3.00, P<0.05), and the number of hospitalizations and the medical expenses after ESD to before and after stent placement were significantly lower in the GTP group than those in the non-GTP group ( P<0.05). There were no significant differences in the incidence of delayed bleeding and perforation, or time of the first stenosis after ESD between the two groups ( P>0.05). The results of the study initially showed that long-term indwelling gastric tube after ESD can reduce the degree of esophageal stenosis with good safety for esophageal circumferential superficial lesions.

Objective To investigate the current situation in Chinese rheumatologic physicians' clinical diagnosis and evaluation of Takayasu's arteritis (TA).Methods Nineteen rheumatology experts and three vascular surgery specialists in China were invited to make the nationwide investigation for the first time about the diagnosis and disease activity evaluation of TA in China,through the questionnaire survey on the internet.Weighted average was used to calculate the average scores of corresponding problems.Results Chinese experts mainly adopted 1990 American College of Rheumatology (ACR) classification criteria for clinical diagnosis of TA.In details,symptoms of age,limb claudication and amaurosis,signs including pulselessness or pulse weakening,vascular bruits,increasing bilateral pulse pressure and hypertension and acute phase reactants (APR) were critical to the clinical diagnosis of TA.Besides,noninvasive imaging examinations,such as computed tomography angiography (CTA),magnetic resonance angiography (MRA),vascular ultrasonography,and positron emission tomography (PET) were also of great importance.In the aspect of disease activity assessment,Chinese experts mainly used Kerr scoring tool.APR and noninvasive radiological examinations were considered with vital value.Some TA patients with carotid artery involvement were recommended using vascular ultrasonography,while others with pulmonary artery and thoracic/abdominal aorta trunk involvement were preferred CTA other than MRA.Conclusions APR and noninvasive imaging examinations were thought with great help to make clinical diagnosis and evaluation of TA for Chinese physicians.