Mechanical ventilation is not only an important treatment method of acute respiratory distress syndrome (ARDS),but also one of the basic treatments in the intensive care unit (ICU).However,mechanical ventilation itself can cause or aggravate acute lung injury,which is called ventilator-induced lung injury (VILI).Currently,clinical pathogenesis of VILI includes four categories such as barotrauma,volutrauma,atelectrauma and hiotrauma.The pathogenesis of mechanical injury has been widely accepted,but the biological injury pathogenesis is unclear.With further research,we found that in the late stage VILI patients occured proliferation of puhnonary fibrosis,which may be formed by partial epithelial-mesenchymal transdifferentiation (EMT).Further study of specific pathogenesis of biotrauma and ARDS pulmonary fibrosis proliferation could provide new ideas for the clinical treatment of VILI.

Acanthopanax sessiliflorus fruit is a traditional Chinese drug, which mainly contains triterpene, lignans, coumarin and flavonoids etc. It has such pharmacological activities as anti-inflammatory analgesic, antioxidant, anti platelet aggregation and so on. The article summarized the chemical constituents, quality control and pharmacological activities of Acanthopanax sessiliflorus fruit to provide reference for the further research and development of the traditional Chinese drug.

Objective To investigate the effect of exogenous protectin DX (PDX) on acute lung injury in septic mice.Methods Thirty male C57BL/6 mice,aged 6-8 weeks,weighing 20-25 g,were randomly divided into 3 groups (n =10 each) using a random number table:sham operation group (Sham group),sepsis group (S group) and PDX group.Sepsis was produced by cecum ligation and puncture (CLP) in the mice anesthetized with pentobarbital sodium.At 1 h after CLP,PDX 300 ng was injected intraperitoneally in PDX group,and the equal volume of normal saline was given in Sham and S groups.At 24 h after CLP,the mice were sacrificed,and the broncho-alveolar lavage fluid (BALF) was collected for determination of interleukin-1beta (IL-1β),tumor necrosis factor-alpha (TNF-α),IL-6 and IL-10 concentrations,and the lungs were removed for microscopic examination and for determination of the myeloperoxidase (MPO) activity,wet/dry lung weight ratio (W/D ratio) and phosphorylation of nuclear factor-kappa B (NF-κB) p65.Lung injury scores were calculated.Results Compared with Sham group,the lung injury score,MPO activity,W/D ratio,phosphorylation of NF-κB p65,and concentrations of protein and inflammatory factors in BALF were significantly increased in S and PDX groups (P＜0.05).Compared with S group,the lung injury score,MPO activity,W/D ratio,phosphorylation of NF-κB p65,and concentrations of protein,IL-1β,TNF-α and IL-6 in BALF were significantly decreased,and the concentration of IL-10 in BALF was significantly increased in PDX group (P＜0.05).Conclusion Exogenous PDX can alleviate acute lung injury through inhibiting NF-κB activity in the lung tissues of septic mice.

Object To study the pharmacokinetics of cinnamic acid in BAOXIN PILL * in rat. Methods Plasma concentration of cinnamic acid was determined by HPLC under the following conditions: column: Hypersil ODS C 18 (150 mm?4.6 mm, 5 ?m); column temperature 30 ℃; mobile phase methanol-1% acetic acid (45∶55); flow rate 0.5 mL/min; detection wavelength 273 nm; aliquot injected 10 ?L. Results A method for the determination of plasma cinnamic acid concentration by HPLC was established. Regression equation of cinnamic acid peak area (Y) and plasma concentration (X) was found to be: Y= 4 973.534 8 +42 867.96 678 X; correlation factor r=0.999 8; rate of cinnamic acid recovery from plasma=97.50% and RSD=1.33%; detection limit=0.15 ng; minimal dectable concentration in rat plasma=75 ng/mL. Absorption pattern of cinnamic acid after ig does showed linearity, corresponding to a first order absorption and elimination of open chamber model. The t 1/2 (K a)=7.12 min; t max =53.29 min, C max =0.20 ?g/mL, and t 1/2 (Ke)=340.74 min. Conclusion The pharmacokinetic parameters obtained in this study may be attributed to the combined action of cinnamic acid and other constituents in the compound preparation of BAOXIN PILL.

ObjectiveTo investigate the effect of sivelestat sodium on the prognosis in patients with acute lung injury (ALI) and acute respiratory distress syndrome (ARDS).Methods Databases including PubMed, EBSCO, Springer, Ovid, Wanfang data, CNKI and China Biology Medicine (CBM) were searched to identify randomized controlled trials (RCTs) regarding sivelestat sodium treatment for ALI/ARDS published from 1985 to December 2014. The patients in treatment group received intravenous infusion of sivelestat sodium, and those in control group received normal saline. The items for analysis were 28-day mortality, duration of mechanical ventilation, length of intensive care unit (ICU) stay, and oxygenation index on day 3. According to the evaluation method of Cochrane system, data extraction and quality assessment from the literature were carried out. Meta-analysis was performed using RevMan 5.3. The publication bias was analyzed with funnel plot.Results Five RCTs with a total of 780 participants were included, with 389 patients in sivelestat sodium group, and 391 in control group. Meta analysis showed: compared with control group, sivelestat sodium could not lower the 28-day mortality [odds ratio (OR) = 0.91, 95% confidence interval (95%CI) =0.66-1.26,P = 0.58], or shorten the duration of mechanical ventilation or length of ICU stay [duration of mechanical ventilation: mean difference (MD) = -0.02, 95%CI = -0.29 to 0.24,P = 0.87; length of ICU stay:MD = -9.63, 95%CI =-23.34 to 4.08,P = 0.17], but it could improve oxygenation index on day 3 (MD = 0.88, 95%CI = 0.39 to 1.36, P = 0.000 4). Heterogeneity was not significant for the main analysis and no publication bias was shown on funnel plot. Conclusion Sivelestat sodium gave rise to a better oxygenation on day 3, but did not change the length of mechanical ventilation and ICU stay, and it did not improve 28-day mortality in ALI and ARDS.

Objective To study the effects of two different methods of high-pressure injections on imaging quality of synchronous left axillary artery and vein by using volume CT.Methods Forty seven patients who underwent left axillary vein and artery CTA examination study were analyzed retrospectively according to the contrast agent injection scheme and was divided into two groups A and B.Group A of 25 patients used protocol A,adopted clinical routine delay scanning method,via right elbow vein inject contrast medium.Group B of 22 patients used protocol B,adopted artery delayed imaging combined with vein direct imaging method,via right elbow vein,left radial vein inject contrast agent,respectively.Both values of CT and contrast to noise ratio (CNR) of two groups were compared,objective image quality was compared by two blinded readers.Mann Whiteny U test was used.Results The median of CT values for left axillary artery in group A was 151.9 HU.The median of CNR values for left axillary artery in group A was 7.4.The median of CT values for left axillary vein in group A was 116.0 HU.The median of CNR values for left axillary vein in group A was 3.83.The median of CT values for left axillary artery in group B was 348.8 HU.The median of CNR values for left axillary artery in group B was 25.3.The median of CT values for left axillary vein in group B was 497.0 HU.The median of CNR values for left axillary vein in group B was 35.4.Both values of CT and CNR in two groups showed significant difference (Z=-5.735,-5.799,-5.863 and-5.863,P＜0.01).All of the median scores in group B were greater than in group A(P＜0.01).Conclusion The enhancement effect of protocol B in the left axillary arteriovenous synchronous imaging is significantly higher than those of protocol A,and demonstrates clear image quality and clearer anatomic relationship.

BACKGROUND: There is no effective method to identify liver cancer stem cells until now, which has become one of the major challenges in this field. OBJECTIVE: To explore a more effective and suitable way for the identification of liver cancer stem cells in hepatocellular carcinoma cell lines. METHODS: Firstly, the single cell separation technique was used to obtain single cells, which were seeded into 96-wel plates one by one. Secondly, cell sublines derived from single cell colonies (tumorigenic colonies) were selected and obtained. At last, the cells from these clones were transplanted into the forelimb armpits of nude mice to observe the tumorigenic ability. RESULTS AND CONCLUSION: The number of holes of single cells obtained was 371 by the single cell separation technique, and the success rate was 96.4%. According to the growth of cell clone, tumorigenic colonies were selected to be transplanted to the forelimb armpits of nude mice, and the tumor formation rate of the colonies was 100%. The identification model of single-cell-transplant-tumorigenic-test for liver cancer stem cells is confirmed to be preliminarily established, which lays the technology and methodological basis for the follow-up research.

Objective: To investigate the community promotion feasibility of superficial needling plus club swing for post-stroke motion impairment of the shoulder joint. Methods:A total of 180 cases (duration <1.5 years) with post-stroke motion impairment of the shoulder joint were recruited from three community health centers in Changning District, 60 from each community. They were randomly allocated into an observation group (n=90) and a control group (n=90). Patients in both groups received standard internal and rehabilitation care. Patients in the observation group received additional superficial needling plus club swing. The visual analogue scale (VAS) was conducted before and 60 d after the treatment to evaluate the severity of shoulder pain. The active movement of the shoulder joint and activities of daily living (ADL) were also observed. Results:There were no between-group statistical differences before the treatment (allP>0.05). After a 60-day treatment, the shoulder pain severity, active range of motion of the shoulder joint and ADL in the observation group were significantly improved than those in the control group (allP<0.01). In addition, no adverse events were reported by participants in the observation group. Conclusion:Superficial needling plus club swing plays a positive role in improving post-stroke motion impairment of the shoulder joint. This safe, reliable and economical therapy has good patient compliance and is suitable for community promotion.

BACKGROUND:Until now, little has been reported on establishment of pancreatic stem cell strains and lines,and the purification of pancreatic stem cells is difficult since the cell line establish rate is low.OBJECTIVE:To explore a more rational and effective technique of in vitro separation and continuous passage of pancreatic stem cells, with the hope to establish cell strains and even cell lines and to lay the foundation for the follow-up study of pancreatic stem cells in the treatment of diabetes.METHODS:Firstly, Percoll discontinuous density gradient centrifugation method was applied to separate the mouse pancreatic endocrine portion from the exocrine portion, then to obtain cell strains with highly proliferative ability and low differentiation from pancreatic endocrine portion-the islet. We used mouse embryonic fibroblasts treated with mitomycin C as a feeder layer, for in vitro continuous culture of islet-derived pancreatic stem cells under feeder layer conditions until they were transferred to the 30th passage to establish cell lines. Then pancreatic stem cell line derived from pancreatic islet was detected and identified by a series of tests including growth characteristic test, morphological observation, related molecular marker identification and differentiation characteristic identification.RESULTS AND CONCLUSION:In the continuous process of passage, pancreatic stem cells showed active proliferative ability, and maintained the typical morphological characteristics of stem cells and expression of pancreatic stem cell marker-Nestin. After induction, pancreatic stem cells showed insulin gene expression,reflecting their differentiation potential. Therefore, under the condition of feeder layer, the pancreatic stem cell line derived from Kunming mice was successfully established and the related identification was completed,which lays the foundation for the following research.

Objective To discuss the relationship between body mass index(BMI)and flag_raising syncope ( PS)and micturition syncope(MS)in children and adolescents. Methods One hundred and six children and adoles_cents with PS or MS diagnosed at the Department of Dediatric Cardiovasology,Childrenˊs Medical Center,the Second Xiangya Hospital,Central South University from January 2003 to September 2017 were studied,including 51 males and 55 females,and their ages ranged from 5 to 18 years. There were 63 cases in the PS group(21 males and 42 females) and 43 cases in the MS group(30 males and 13 females). One hundred healthy children and adolescents including 50 males and 50 females who had routine healthy examinations at the hospital in the same period were selected as control subjects(healthy control group). Body length and body mass were measured,and BMI was calculated. Statistical inves_tigations were conducted with SDSS 22. 0 software. Results (1)The body mass and BMI in the PS group were lower than those in the MS group[(36. 33 ± 9. 85)kg vs.(42. 85 ± 12. 44)kg;(16. 56 ± 2. 41)kg∕m2 vs.(18. 48 ± 3. 04) kg∕m2],and the differences were statistically significant(F﹦7. 529,12. 411,all P〈0. 05). There was no difference in body length among the PS group,the MS group and the healthy control group[(146. 62 ± 12. 89)cm vs.(150. 79 ± 12. 78)cm vs.( 149. 75 ± 16. 02 )cm,F ﹦1. 314,P 〉0. 05 ]. No differences were found in age,frequency,body length,body mass and BMI between the PS syncope group and the MS group with different genders(all P〉0. 05).(2) The number of BMI_underweight children increased in the PS group(82. 53%,52∕63 cases)compared with that of the MS group(58. 14%,25∕43 cases)and that of the healthy control group( 52. 00%,52∕100 cases),and the difference was statistically significant(χ2 ﹦14. 556,P〈0. 01).(3)The positive rate by head_up tilt test(HUTT)was 72. 64%(77∕104 cases),and HUTT of the PS group was higher than that of the MS group[82. 53%(52∕63 cases)vs. 58. 14%(25∕43 cases)],and there was a significant difference statistically(χ2 ﹦7. 656,P〈0. 01). Conclusions Low BMI is prone to PS in children and adolescents.