Objective To explore the necessity of inferior vena cava(IVC) filter implantation during catheter directed thrombolysis (CDT) for acute deep vein thrombosis (DVT). Method Ninety-three patients with acute DVT were reviewed from Nov. 2006 to Dec. 2008. There were 35 men and 58 women, age averaging at (60 ±29) year old, treated with CDT followed by percutaneous transluminal angioplasty ( PTA). The course of DVT was from 5 h ～ 15 d (6. 28 ±7.08) d with 80 left lower limbs and 13 right lower limbs involved. Results There were 30 patients with prior IVC filter implanted compared with 63 patients without filters (67. 7% ,63/93). Among the patients without filter, there were 93. 6% (59/63) left lower limbs. DSA was redone after thrombolysis. Seventy-seven iliacfemoral thrombosis was resolved completely and stenosis or occlusion of the iliac vein were found in 90. 9% (70/77) cases. Endovascular treatment was performed in 57 patients. There was no patients suffering from symptomatic pulmonary embolism (PE). PE was found in 3 cases with a filter and 1 case without filter was suspected of PE on pulmonary CTA after treatment. Conclusion It is not necessary to routinely place an IVC filter during CDT for treating DVT on left lower limb when the thrombosis is not involing the IVC.

The expression of heat shock proteins(HSPs) can protect against acute lung injury(ALI).However,HSPs are restrained from clinical application due to the toxicity of most of the former inductors.Glutamine,which also has the ability to induce the expression of HSPs,can protect against ALI and sepsis,and may serve as a candidate for clinical application.

Objective To investigate the in vivo effects of glutamine(Gln) on inflammatory cytokine release in murine peritoneal macrophages during sepsis. Methods Sixty Kunming mice were randomly divided into sham-operation group(Sham group,n=20),operation control group(Con group,n=20) and Gln-treatment group(Gln group,n=20).Sepsis was induced by cecal ligation and puncture in Gln group and Con group,and Gln(0.75 g/kg) or saline was immediately administered via single tail vein injection.Serum was collected and macrophages were harvested from peritoneal lavage at 6 h in these three groups.Intracellular and serum cytokines of tumor necrosis factor-?(TNF-?),interleukin(IL)-6 and IL-10 were detected by ELISA.The expression of TNF-? mRNA in macrophages was analyzed by RT-PCR,and the expression of heat shock protein(HSP) 72 in macrophages was evaluated by Western blotting. Results Gln group demonstrated significantly lower intracellular TNF-? and IL-6 levels than Con group(P0.05).The serum TNF-? level was significantly lower in Gln group than in Con group(P

Background5-Nitro-2-(3-styrene-acrylic amine) benzoic acid ( NPPB),a chloride channel inhibitor,has a promoting effect on cell apoptosis in myocardial ischemia and reperfusion of domestic rabbit.The CIC chloride channel has been found in the ocular trabecular cells.However,the effect of NPPB on the shape and function of trabecular cells is unclear. Objective This study was performed to investigate the effect of NPPB on the proliferation,cell cycle progression and apoptosis of human trabecular meshwork cells.MethodsThe immortalized human trabcular cell strain was cultured,and logarithmic-phase cells were incubated in 96-well plates at a density of 1 ×106/ml.Different concentrations of NPPB (10,50,100 μ mol/L) were added to the medium,and the MTT assay was used to assess the growth and proliferation of the cells.Flow cytometry was used to evaluate the cell cycle.Then,100 mg/L 5-FU or 100 mg/L 5-FU + 100 μmol/L NPPB was used to induce cell apoptosis,which was assessed by Annexin V-PI.The membrane potential of mitochondria was examined using rhodamine 123 (△ψm).Results After 48 hours of treatment with NPPB,the abosorbency (A value) of the cells was gradually lowered with the increasing dose of NPPB,with significant differences among the 4 groups (F =7.230,P =0.006).Compared with the 10 μmol/L NPPB group,the A values were significantly declined in the 50 and 100 μmol/L NPPB groups (t =1.610,P =0.025 ;t =12.270,P =0.001 ).Forty-eight hours after exposure to NPPB,the percentage of cells in G0/G1 phase was increased and that in the S phase was decreased.The percentages of cells in different phases of cell cycle were significantly different in comparison with their control groups (without NPPB)( P＜0.05 ).Twenty-four and 48 hours after the treatment with 100 mg/L 5-FU,the apoptosis rates of the cells were raised in the 100 mg/L 5-FU group and 100 mg/L 5-FU + 100 μmol/L NPPB group compared to the without NPPB group (t24h =2.130,P =0.023;t48h =4.810,P=0.011 ) ;while that in the 100 mg/L 5-FU+100 μmol/L NPPB group was higher than the 100 mg/L 5-FU group ( t24 h =1.980,P =0.037 ; t48 h =1.290,P =0.028 ),and the mitochondrial membrane potential was lowered ( t24h =1.580,P =0.029 ; F48 h =6.200,P =0.015 ).Conclusions NPPB suppresses the proliferation of human trabecular cells and promotes the cells to enter S phase via the G1/S check point.In addition,ClC might be involved in an anti-apoptosis mechanism through the internal mitochondrial pathway.

Objective: To establish a method for determination of methone and pulegone in Herba Schizonepetae. Methods: The contents of menthone and pulegone were determined by GC (equipped with FID) with HP-5 fused capillary column (5% phenyl methyl siloxane 30m?0.32mm?0.25?m) after the samples were extracted by the solvents. Results: The linear ranges were 0.002-5.0g/L (r=0.9999) for menthone and 0.002-5.0g/L (r=0.9996) for pulegone, the recoveries of menthone and pulygone were 96.30%-103.9% and 95.7%-102.5%, respectively. Conclusion: The method was simple and accurate, which could be applied to the determination of menthone and pulegone in Herba Schizonepetae.

Objective To analyze the setup error during tumor radiotherapy by linear accelerator cone beam CT(CBCT),and to determine the presence of correlation between subcutaneous fat thickness and setup error. Methods From May 2016 to June 2017 59 patients with pelvic tumors underwent CT scan after body positioning with thermoplastic model,CBCT images were obtained before treatment and registered automatically and manually along with localizable CT images. The displacement data at X(left-right), Y(head-foot) and Z(front-back) directions as well as pelvic subcutaneous fat thickness were recorded,and SPSS 18.0 was used for data statistics.Results The 59 patients had the mean setup errors at X,Y and Z directions being(1.07±2.18),(-0.07±5.00)and(1.15±2.38)mm respectively,and the subcutaneous fat thickness ranging from 0.3 to 2.9 cm with a mean value of 1.6 cm.Spearman analysis showed the correlations between the absolute value of the errors and the subcutaneous fat thickness being 0.15, 0.11 and 0.20 respectively at X, Y and Z directions, and there were no significant differences between the correlations(P>0.05).Conclusion The setup method verifies its feasibility by restraining its errors at X, Y and Z directions between -5 and +5 mm, and there is a weak correlation between the setup error and subcutaneous fat thickness.[Chinese Medical Equipment Journal,2018,39(5):64-67]

Objective To compare the efficacy of different target concentrations of sufentanil target-controlled infusion used to supplement topical anesthesia for fiber-optic bronchoscopy (FOB)-assisted awake nasotracheal intubation in patients with obstructive sleep apnea syndrome (OSAS).Methods Forty-five ASA physical status Ⅱ or Ⅲ patients with OSAS,aged 28-60 yr,with body mass index of 30-40 kg/m2,scheduled for elective surgery,were randomly assigned into 3 groups (n =15 each):control group (group C) and sufentanil with the target plasma concentration of 0.4 ng/ml (group S1) and 0.6 ng/ml groups (group S2).Naso-pharyngeal and laryngeal mucous membrane was sprayed with 2％ lidocaine mixed with 1％ ephedrine for topical anesthesia in both groups.In addition 1％ tetracaine 3 ml was injected into trachea through cricothyroid membrane.FOB-assisted awake nasotracheal intubation was performed after the target concentration was achieved.The degree of airway obstruction was scored during intubation.The highest values of MAP and HR,rate-pressure product ＞ 12 000,decreased respiratory rate and hyoxemia were recorded during the period between induction of anesthesia and 3 min after intubation was completed.The changes in MAP and HR as percent of baseline values were calculated.Before topical anesthesia (T0),when target concentrations were reached (T1),and at 1 and 3 min after intubation (T2,3),blood samples were taken to determine the plasma concentrations of epinephrine (E),norepinephrine (NE) and cortisol.Results Compared with group C,the airway obstruction score was significantly decreased in group S1,the incidence of changes in MAP and HR ＞ 30％ of baseline values and rate-pressure product ＞ 12 000 was decreased,the plasma concentrations of E,NE and cortisol were decreased in S1 and S2 groups,and the incidence of the respiratory rate was decreased and hypoxemia was increased in group S2 (P ＜ 0.05).Compared with group S1,the airway obstruction score were significantly decreased,and the incidence of respiratory rate was decreased and hypoxemia was increased in group S2 (P ＜ 0.05).Compared with the baseline value at T0,the plasma concentrations of E,NE and cortisol were significantly increased at T2,3 in group C,while decreased at T1 in S1 and S2 groups (P ＜ 0.05).Conclusion Compared with pure topical anesthesia,sufentanil with the target plasma concentration of 0.4 ng/ml does not induce respiratory depression,maintains hemodynamics stable,attenuates the stress responses and provides better intubation conditions when used to supplement topical anesthesia for FOB-assisted awake nasotracheal intubation in patients with OSAS.

Objective To evaluate the relationship between the lung volume (LV) in inspiration and expiration,pulmonary function tests(PFT),and other CT measurements of emphysema index (EI) and mean lung density (MLD) in patients with chronic obstructive pulmonary disease (COPD).Methods Seventy-six patients with COPD were included.Three-dimension analysis was performed to obtain the following CT parameters on the inspiratory and expiratory phases:EI,MLD,LV.The ratios and differencesof MLD and LV between the two phases were calculated(ΔMLD,ΔLV,MLDex/in,LVexin).Not only the linear correlations between the lung volume parameters and PFT but also the correlations of lung volume parameters with the other CT parameters were tested by the Spearman rank correlation test and multivariant step wise regression.Results LVex/in had negative correlations with forced expiratory volume in 1 second ％ predicted [FEV1 ％,(54.32 ± 7.11)] and the ratio of forced expiratory volume in 1 second to forced vital capacity [FEV1/FVC,(49.12 ±8.01)％] (r =-0.69,-0.56,P ＜0.01),but it had the positive correlation with the ratio of residual volume to total lung capacity [RV/TLC,(58.03 ± 8.55) ％,Spearman coefficients 0.66,P ＜ 0.01].LV/exin (0.67 ± 0.12) was positively correlated with MLDex/in (0.89 ± 0.04,r =0.88,P ＜0.01).The further multivariate step wise regression denonstrated that EI,LV and MLD could introduce a regression equation with R2 =0.77 and 0.73,respectively (P ＜ 0.01).Conclusions There is an association between LVex/in and the parameters of routine PFT,which can reflect the collapsibility of lung.Moreover,LVex/in can be considered to be equivalent to MLDex/in.Taking into account the impact of scanning parameters on MLDex/in,LVex/in may play a complementary role in the assessment of pulmonary function.

Objective To investigate the correlation between the paired inspiratory and expiratory quantitative CT and pulmonary function tests (PFTs) in patients with chronic obstructive pulmonary disease (COPD).Methods A total of 84 patients with COPD were enrolled.For each patient,CT scan was performed in deep inspiration and expiration.Using automatic post-processing software,a three-dimension quantitative measurement was employed to assess the CT parameters of emphysema and air trapping.The correlation between CT and PFT was evaluated by the Spearman rank correlation test and multivariate linear regression analysis.Results The percent 1 [Perc1,(-984.28 ± 17.93) HU] and percent 15 [Perc15,(-948.35 ± 22.26) HU] from the CT parameters of emphysema were positively correlated with the forced expiratory volume in 1 second predicted (FEV1％,48.69 ± 23,47),the ratio of forced expiratory volume in 1 second over forced vital capacity [FEV1/FVC,(45.89 ± 15.36)％,r =0.454.-0.67,P ＜0.01],was negatively correlated with the ratio of residual volume to total]ung capacity [RV/TLC,(61.32 ±14.48)％].The other CT parameters of emphysema index (EI) and the parameters of air trapping,the change in relative lung volume with attenuation values from-860 to-950 HU [RVC-860--950,(17.66 ±22.36)％],the expiration to inspiration ratio of mean lung density (MLDex/in,0.93 ± 0.06),the expiration to inspiration ratio of lung volume(LVex/in,0.71 ± 0.14) had negative correlations with logFEV1 ％,FEV1/FVC (r=-0.48--0.69,P＜0.01) and positive correlations with RV/TLC (r =0.41-0.66,P ＜0.01).The further univariate linear regressions showed that EI,Perc1,Pere15,RVC-860--950,MLDex/in,LVex/in were correlated with the parameters of PFTs (R square values of the regression equation,ranged from 0.27 to 0.66,P ＜ 0.01).After the pairwise combinations of the parameters of emphysema and air trapping,multivariate stepwise regressions showed better R square values from 0.66 to 0.85.Conclusions CT parameters of emphysema and air trapping can reflect pulmonary function in COPD patients.The combinations of the two types of CT parameters are more correlated with the PFTs parameters.

Objective To investigate the association between polymorphisms of thyroid-stimulating hormone receptor(TSHR)gene intron 1(rs179247, rs12101261)and Graves′ disease(GD)in the China Han population from Xuzhou city, Jiangsu Province. Methods Total 1 066 GD patients and 1 107 control subjects were recruited for genotyping by Taqman probe technique on Fluidigm EP1 platform. Meanwhile, serum concentrations of thyroid hormone and TSH receptor antibodies(TRAb)were determined. Results The rs179247_A, rs12101261_T were significantly associated with GD risk(OR=1.35, 95%CI 1.19-1.54, P=5.92×10-6; OR=1.32, 95%CI 1.16-1.50, P=2.22×10-5). Logistic regression identified that rs179247 was an independent susceptibility locus of GD. Serum TRAb concentration showed a significant difference(P=0.015)among rs179247_AA, AG, and GG genotypes. Conclusion rs179247 and rs12101261 in TSHR intron 1 are both associated with GD, and rs179247 may contribute risk to GD independently. The polymorphism is associated with TRAb, but not with serum concentration of thyroid hormones, age of onset, diffused thyroid goiter, ophthalmic signs, and relapse.