Objective To investigate the association betweent clinical markers of N‐terminal probrain natriuretie peptide (NT‐proBNP) ,cardiac troponin I (cTnI) and C‐reaction protein (CRP) in the patients with acute respiratory distress syndrome (ARDS) caused by severe pneumonia and to reveal the pathophysiologic process of myocardial injury after ARDS .Methods Totally 33 patients diagnosed as ARDS caused by severe pneumonia were divided into 3 groups:mild group ,moderate group and severe group according to the New Berlin definition of ARDS .Arterial blood gas analysis ,NT‐proBNP ,cTnI and CRP were observed be‐fore the treatment .Statistics were used for the analyses .Results The NT‐proBNP level in the severe group was significantly higher than that in the mild and moderate groups (P<0 .01);the NT‐proBNP level in the moderate group was also higher than that in the mild group (P< 0 .05) .Besides ,the cTnI level in the severe group was significantly higher than that in the mild and moderate groups (P<0 .01);however ,the cTnI level had no statistical difference between mild and moderate groups (P> 0 .05) .The CRP level in the severe group was significantly higher than that in the mild (P<0 .05) .Moreover ,the NT‐proBNP level of 33 patients was positively associated with the both CRP and cTnI level (P<0 .05) .Conclusion The seriously inflammatory response mediates myocardial injury probably because of ARDS .Combined NT‐proBNP and cTnI testing is important for evaluating the condition of ARDS at the early stage .

Objective To investigate the anatomical and histological features of the rat endolymphatic sac. Methods The temporal bones of the healthy,adult SD rats were removed.The morphology of the endolymphatic sac were studied.Then the decalcified samples were embeded in paraffin.The sections of the endolymphatic sac were stained with HE method and observed histologically,and then examined immunohistochemically by monoclonal antibodies against IgG,CD 3 of the rat to investigate the immunocompetent cells in endolymphatic sac of the rats. Results Simple cuboidal and squamous epithelium were the main types of the epithelium in rat endolymphatic sac CD + 3,IgG + immunoreactive lymphocytes were found mainly in the epithelium of the endolymphatic sac.Conclusion\ The morphology of the rat endolymphatic sac is similar to those of human and guinea pig endolymphatic sacs.Some immunocompetent cells were found in the endolymphatic sac,suggesting that the endolymphatic sac plays an important role in immune of inner ear.\;[

Objective To investigate the effect of tourniquet compression on axonal transport in sciatic nerve of rats.Methods Twenty-four 12-week old male SD rats weighing 250-300 g were randomly divided into 4groups according to the duration of tourniquet compression(n=6 each):1,2,4 and 12 h.The tourniquet was applied to the middle 1/3 of thigh.In each animal whether the left or right thigh was compressed was determined by a flip of coin.The tourniquet was released for 10 min after every hour of compression.A 3-cm segment of sciatic nerve was removed at the end of tourniquet compression(1.5 cm proximal and 1.5 cm distal to the site of compression).Immuno-histochemistry was used to measure the expression of insulin-like growth factor-1(IGF-1)in the sciatic nerve.The ratio of average optic density of the compressed sciatic nerve to that of control was used to estimate the degree of IGF-1 accumulation.The regression equation of the interaction between the duration of compression and accumulation of IGF-1 was analyzed.Results There was significant accumulation of IGF-1 in the sciatic nerve proximal to the compressed site.The accumulation increased with the duration of compression.There was no significant accumulation of IGF-1 in the sciatic nerve distal to the compressed site.The regression equation of the interaction between the duration of compression(X)and accumulation of IGF-1(Y)was Y=0.422X+0.887.Conclusion Tourniquet compression of sciatic nerve can inhibit axonal transport.The accumulation increases with the duration of compression.

Objective To investigate the changes of liver histology and ultrastructure in aged Beagles dogs.Methods A total of fifteen healthy Beagles,1 .5 to 10.6 years old,were divided into middle-aged group (n=8,average (2.21 ±0.94)years old)and aged group (n=7,average (8.26±1 .52) years old)according to age.After intravenous anesthesia,the liver tissues of dogs were taken to compare number and morphology of hepatocytes and extra cellular matrix (ECM)of two groups under light microscope with hematoxylin-eosin staining.The number density, morphology and area fraction of mitochondria,the morphology and area fraction of endoplasmic reticulum,the changes of number density and morphology of microbody,the thickness of hepatic sinusoidal endothelial cell as well as the density and the diameter of fenestrae,the changes of morphology and number of lipofuscin in two groups were compared under electron microscope.Independent sample t-test was performed for comparison between two groups.Results Under light microscope,hepatocytes were arranged radially around the central veins,especially obvious in the middle aged group. Hepatocytes were circular or oval,most were mononuclear or binuclear.The cytoplasma of hepatocyte in middle-aged group was dense eosinophilic pink.Vacuolar lipid droplets were small and scanty.The cell boundary was clear.In aged group, cytoplasmic vacuolization of hepatocyte was more obvious,bigger vacuolated lipid droplets were observed, eosinophillic granules were scattered in the cytoplasma,cellular boundary was blurry and the number of hepatocytes significantly decreased when compared with middle-aged group ((75 .80 ±5 .76 )/high power field (HPF)vs (97.80 ±6.45 )/HPF,t = -2.510,P =0.026 ).There were no obvious infiltration of inflammatory cells in the liver tissue of Beagles dogs in both middle-aged group and aged group.Compared with middle aged group, cell gap and ECM increased in aged group. Under electron microscope, mitochondria of normal hepatocyte was oval,round or horseshoe-shaped with double membranes,ridge was observed inside and distributed around nucleus.Compared with middle-aged group,the shape of hepatocyte mitochondria in aged group was varied,the number density of mitochondria significantly decreased (0.202±0.021 vs 0.248 ±0.040,t = -2.683,P =0.020)and the area fraction remarkably reduced (0.136 ±0.015 vs 0.202 ±0.019,t = -6.083,P <0.01 ).Endoplasmic reticulum was mesh laminated arranged,scattered flake distributed and was mostly seen around nucleus in flat or stacked shape.Compared with middle aged group,the area fraction of endoplasmic reticulum of hepatocyte in aged group was obviously reduced (0.006±0.001 vs 0.011 ±0.004,t=-3.338,P =0.005).Lipofuscin was shaped as round or irregular structure without membrane and pigment unevenly distributed inside.The number of lipofuscin in aged group was significantly higher than that in middle-aged group (0.028±0.025 vs 0.001 ±0.000,t=2.880,P =0.014).The number of microbody in aged group was slightly less than that of middle aged group and the difference was not statistically significant (P =0.603).The thickness of the liver sinusoidal endothelium in aged group significantly increased compared with that in middle-aged group ((0.242±0.047)μm vs (0.114±0.075)μm,t=3.881 ,P =0.002).The diameter and density of endothelial fenestration in aged group ((1 .895 ± 0.439 )μm and (0.260 ± 0.120 )/μm)obviously decreased compared with those in middle-aged group ((3.186±0.332)μm and (0.723±0.184)/μm,t=6.345 and -4.511 ,both P <0.01).Conclusions There were significant degradations of liver in quality and quantity among aged individuals.These degradations were the structure basis of decreased hepatic reserve function and involved directly or indirectly in high prevelance of hepatic diseases among elders.

Objective To observe the complications and mortality of hyponatremia in patients with acute exacerbation of chronic obstructive pulmonary disease.Methods The patients with acute exacerbation of chronic obstructive pulmonary disease were selected and divided into non -hyponatremia group(252 cases)and hyponatremia group(65 cases).The differences in the general status,serum ions,blood gas,APACHE Ⅱ score,complications dur-ing the hospitalization,using of ventilator and mortality between the two groups were compared,and drew the receiver operating characteristic(ROC)curve,to acquire higher serum sodium cut -off values.Results In the hyponatremia group,the body weight was (68.3 ±14.4)kg,BMI was (25.5 ±4.9)kg/m2 ,those in the non -hyponatremia group were (74.9 ±15.9)kg and (28.2 ±5.3)kg/m2 respectively,there were statistically significant differences(t =2.009,8.494,all P <0.05).The incidence rate of pneumonia in the hyponatremia group was 23.1%,which was higher than 13.1% in the non -hyponatremia group(χ2 =4.007,P =0.045).The hospital days of the hyponatremia group was (13.1 ±8.9)d,which was longer than (7.8 ±4.9)d of the non -hyponatremia group(t =15.638,P =0.000).The invasive ventilation days of the hyponatremia group was (1.1 ±0.4)d,which was longer than (0.9 ± 0.1)d of the non -hyponatremia group(t =2.885,P =0.004).The non invasive ventilation days of the hyponatremia group was (3.1 ±0.8)d,which was longer than (0.8 ±0.3)d of the non -hyponatremia group (t =2.984,P =0.003).The hospital mortality rate of the hyponatremia group was 12.3%,which was higher than 3.1% of the non -hyponatremia group(χ2 =7.189,P =0.007).The 90 -day mortality rate of the hyponatremia group was 29.2%, which was higher than 15.1% of the non -hyponatremia group(χ2 =7.017,P =0.008).When the serum sodium cut-off value was 128.8mmol/L by drawing ROC curve,the mortality rate in patients with lower than this value was 26.3%,while the mortality rate in patients with higher than the value was 3.7%.Conclusion Hyponatremia is related with the severity and prognosis of acute exacerbation of chronic obstructive pulmonary disease.It is most important to prevent and correct hyponatremia at early disease stage.

Objective To investigate the effect of aging on gastric pepsinogen secretion through observing histological changes of gastric fundal mucosa and ultrastructure of gastric chief cells in human and Beagle dogs at different ages.Methods Fifty middle-aged and elderly indigestion patients with gastroscopy were selected as study objects and divided into young and middle age group (age 20-59 years,n=19),junior elderly group (age 60-69 years,n=11),middle elderly group (age 70-79 years,n=10),and senior elderly group (no less than 80 years,n=10).In addition,nineteen healthy Beagle dogs were also selected as study objects and divided into young and middle age group (age between 1 to 5 years,n=8),junior elderly group (age six to eight years,n=5),and senior elderly group (no less than 9 years,n=6).The histology and morphology of gastric fundal mucosa of human and Beagle dogs were observed under light microscope.Then the thickness of lamina propria was measured and the number of gastric chief cells was counted.The ultrastructure of gastric chief cells was observed under electron microscope,and the area percentages of secretory granule(also called mucous granule)area in cytoplasm of chief cell was calculated.The data was analyzed by one-way analysis of variance.Results No significant histological and morphological changes of gastric fundal mucosa were observed in human and Beagle dogs at different ages.There was no significant difference in the thickness of lamina propria among different ages in human and Beagle dogs (all P＞0.05).The number of human chief cells of young and middle age group,junior elderly group,middle elderly group and senior elderly group was 71.79±16.85,52.73±16.60,57.10±20.21 and 43.70 ±16.89/high power field (HPF),respectively,which decreased as age increased (F=6.431,P=0.001).The numbers of chief cells of young and middle age group,junior elderly group,and senior elderly group of Beagle dogs were 328.38 ±32.36,341.20 ±42.49 and 225.67 ± 52.19/HPF,respectively,which decreased as age increased (F=13.647,P＜0.01).Aging-related degeneration was founded in ultrastructure of gastric chief cells in human and Beagle dogs including rough endoplasmic reticulum dilation,ribosones missing,secretory granule decreasing and so on.The area percentages of secretory granule area in cytoplasm of human chief cells of young and middle age group,junior elderly group,middle elderly group and senior elderly group were (67.28±3.79)％,(66.88±4.84)％,(65.63±7.10)％ and (56.25±8.47)％,respectively,which decreased as age increased (F=6.069,P=0.002).The area percentages of secretory granule area in cytoplasm of Beagle dogs' chief cells of young and middle age group,junior elderly group,and senior elderly group were (58.83 ± 3.07) ％,(52.34 ± 4.73) ％ and (39.89 ± 4.46) ％,respectively,which decreased as age increased (F=38.837,P＜0.01).Condusion As age increased,the ability of pepsinogen secretion of fundal gland decreased,which may be one of the reasons of functional dyspepsia in the eldly.

Background:It has been demonstrated that acid secretion-related gastric fundic structures do not degenerate in elderly individuals. As specimens obtained from human body are greatly influenced by environmental factors,the results need to be further verified by standard animals. Aims:To investigate the aging-related changes of histology of gastric fundus and ultrastructure of fundic gland in beagle dogs. Methods:Nineteen healthy beagle dogs were divided into three age groups,8 in younger group(aged 1-5 years),5 in junior elderly group(aged 6-8 years)and 6 in senior elderly group (aged ≥9 years). Gastric specimens obtained from the fundus were examined by light microscope,the thickness of lamina propria and percentage of parenchymal area of fundic gland in lamina propria were measured,and the parietal cells,chief cells and endocrine cells were counted. Ultrastructure of fundic gland cells were observed by electron microscopy,and the area percentages of related organelles were calculated. Results:The thickness of lamina propria in gastric fundus of beagle dogs showed a decline tendency with aging,but no significant differences were found among the three age groups(P >0. 05);in senior elderly group,a marked decrease in density of fundic gland was observed and with an increase of interstitial tissues. The amount of parietal cells and the area percentages of mitochondria and tubulovesicle in parietal cells showed no aging-related reduction(P > 0. 05),while the amount of chief cells,area percentages of zymogen granule in chief cells,and mucous granule in mucous neck cells were significantly decreased in senior elderly group(P < 0. 05). The amount of endocrine cells increased gradually with aging(P < 0. 05). Conclusions:Aging-related degeneration is not existed in acid secretion-related parietal cells and organelles in gastric fundus of beagle dogs. Furthermore,endocrine cells which secret histamine,gastrin,and somatostatin,etc. for stimulating acid secretion even increased. These changes might be a compensatory mechanism for acid secretion in elderly individuals.

Objective To investigate the influence of severity of obstructive sleep apnea hypopnea syndrome (OSAHS)on acute ST -segment elevation myocardial infarction (STEMI).Methods 86 STEMI patients were divided into two groups,STEMI with OSAHS(OSAHS group,n=38)and STEMI without OSAHS(control group,n=48).Clinical data about biochemical index,cardiac function index and the duration of STEMI onset were compared between OSAHS group and control group.Logistic statistic analysis was used to investigate the risk factors that influ-ence the circadian rhythm of onset in STEMI.Results A total of 86 patients met the inclusion criteria,they were divided into two groups,STEMI with OSAHS(OSAHS group,n=38)and STEMI without OSAHS(control group,n=48).The incidence rate of STEMI onset during 0600 am~1 159 am was significantly higher in OSAHS group compared to control group(20.8% vs.44.7%,χ2 =5.626,P=0.018).This variation was weaken in mild OSAHS group compared to moderate-severe OSAHS group(20.8% vs.31.3%,χ2 =0.726,P=0.394;20.8% vs.54.5%,χ2 =7.956,P=0.005).Multivariate logistic analysis showed that the severity of OSAHS was a risk factor to the STEMI onset during 0600 am~1159 am(OR=2.458,95%CI 1.110~5.439,P=0.027).Conclusion The severity of OSAHS significantly increases the STEMI onset during 0600 am~1 159 am.

Objective To investigate the independent factors influencing the efficacy of pre-hospital CPR effect. Method The data base with 1376 cases was set up with EpiData software by means of questionnaires and the information was provided by the survivals from cardiopulmonary arrest( CA)saved with cardiopulmonary resuscitation(CPR), and the data were analyzed with SPSS 13.0 software to carry out binary logistic regression. Through single factor analysis, the factors with emerged statistical significance were chosen as variances. Results With regard to the restoration of spontaneous circulation(ROSC), the rescue did by the first witness was the protective factor(PF)( OR = 2.21, P = 0.001, 95.0% CI=1.356-3.602); the male was the risk factor(RF) contrasted with the female( OR = 0. 515, P =0. 006, 95.0%0 CI = 0.320 - 0. 26) ; ages between 20 and 29 years old had higher likelihood of ROSC than group ≥81 years old( OR = 3.241, P = 0.026, 95.0%CI = 1.146 -9.138); the length of CA time before CPR was RF(OR = 0.913, P = 0.000, 95.0%CI = 0.887-0.948);ventricular fibrillation(VF) was PF compared with asystole( OR = 5.092, P = 0.000, 95.0%CI=2.927 -8.861); electric shock was PF(OR = 3.384, P = 0.000, 95.0%CI = 2.033 - 5.635); epinephrine dosage 0 - 4 mg had higher likelihood of ROSC than > 5 nag dosage( OR = 3. 255, P = 0. 001, 95.0% CI = 1. 606 -6.597). In respect of probability about victims at the tittle reached hospital alive, ages of 2- 12 and 13 - 19 years old had higher rations than ≥81 years old( OR = 12.818, P = 0.029, 95.0% CI = 1.299 - 126.508)( OR = 10.505, P = 0.036, 95.0% CI = 1.161-95.058); the length of CA time before CPR was RF(OR =0.862, P = 0.000, 95.0%CI = 0.821-0.906); VF was PF compared with asystole(OR = 7.330, P =0.000, 95.0%CI = 3.962 - 13.560). Conclusions ECG change before CPR, rescue by the first witness,electric shock, the length of CA time before CPR, epinephrine dosage, gender and age were independent influencing factors of pre-hospital CPR for the emergency of ROSC. Age, the length of CA time before CPR and ECG before CPR were influencing factors of pre-hospital CPR for patients at the time transferred to hospital alive.

Aim To study the effect of melatonin on expression and activity of myosin light chain kinase in the artery wall of atherosclerotic rabbits.Methods The rabbit model of atherosclerosis was induced by a high-cholesterol diet.The blood lipid levels were assayed in the serum of each group.MLCK expression was detected by Western blot and immunohistochemical method.MLCK activity was measured by ?-32P-ATP incorporation into myosin light chain.Results The atherosclerosis model was established successfully.The levels of lipids decreased after MLT treatment.After fed with cholesterol for twelve weeks,the expression and activity of MLCK in the artery of atherosclerotic rabbits increased markedly,whereas there was no obvious difference in expression of MLCK in the artery of atherosclerotic rabbits fed with cholesterol and melatonin for twelve weeks compared with that of control.Conclusions It was suggest that high expression and activity of MLCK in the artery might be closely correlated with the development of atherosclerosis.Melatonin played an important role in inhibiting the development of atherosclerosis by decreasing the expression and activity of MLCK.