The changes of the pulmonary ultrastructures of 15 dogs of respiratory distress syndrome (RDS)induced with intravenous injections of different doses of oleic acid under different methods of management (nontreated and treated with scopolamine) were observed after the animals were killed 6 hours and 24 hours after injection. The changes were similar on all the specimens except that those of the dogs killed at the earlier interval were less severe. The nontreated dogs and the dogs treated with scopolamine slso showed similar changes, which indicates that scopolamine is useless in treating the RDS produced by oleic acid.Correlating to the accumulation of neutrophils in the capillaries, the authors suggested that the injury induced by oleic acid to the capillary endothelium, besides the chemical toxic action of the drug, was also due to the complement and the toxic oxygen radicals produced by neutrophils.It was found that the hyaline membrane consisted of plasma protein granules in some cases and fibrin in others but no necrosis of the epithelial cells underneath the hyaline membrane was seen. Some authers suggested that the different constituents of the hyaline membrane were resulted from the precipitation of the edema-tous fluid protein on the surface of alveoli, but this suggestion could not be confirmed either by the electron microscopic study of othrs or by ours.There was a large amount of surfactant found in the intraalveolar space and vacuolation was seen, which indicates that no reduction of surfactant occurred in RDS but there was some alteration of its nature resulting in the loss of its activity.

Objective To evaluate clinical effects of vacuum sealing drainage ( VSD ) and conventional dressing in treatment of diabetic foot(DF)ulcers.Methods We searched PubMed, CNKI and WanFang data, and collected the Chinese and English randomized controlled studies on VSD and conventional dressing in treat-ment of DF ulcers.The retrieval time was from Jan.2000 to Jan.2014.RevMan5.2 software was used to make Meta-analysis.Results Seven papers including 646 cases met the standard and Meta analysis was conducted ac-cording to these data.The results showed that compared with conventional dressing, VSD treatment shortened the healing time, increased the complete healing rate, reduced hospital stay, and reduced hospital costs and seconda-ry amputation rates.The difference had statistical significance(P<0.05).Conclusion VSD is superior to con-ventional dressing method in terms of the healing time, healing rate, hospital stay, hospital costs and amputation rate.

An animal model of encephalitis B was successfully established with Jin Wei Yan I strain virus in mice,which made it possible to study the ultrastructural pathology as well as the morphogenesis and release of encephalitis B exerimentally.The ultrapathological changes occurring to the brain tissues especially in the neuron cells were described systematically.A preliminary hypothesis about the morphogenesis and release of encephalitis B virus (Jin Wei Yah I strain) was proposed on the basis of these changes.Replication of the virus was also found to occur in the oligodendroglia but not in the microglia,which maintained its phagocytic function.This fact evidently shows that the micrioglia is not controlled by the mRNA of the virus.According to the literature available to the authors,it seems that the ultrastructural pathological changes of encephalitis B with typical histological lesions in animals had not been reported previously.

In order to investigate the change in and relationship between endothelin 1(ET 1) and nitric oxide(NO) in hypoxic pulmonary hypertension(HPH),the content of ET 1 and NO in plasma and lung tissue homogenate, the expression and localization of ET 1, constitutive and inducible nitric oxide synthase(cNOS,iNOS) using immunohistochemistry in HPH of rats were assayed. The effect of NOS inhibitor nitro L arginine methyl ester(L NAME) on the content of ET 1 was also studied. The results showed that the content of ET 1 and NO in plasma of the HPH rats were significantly higher than that of controls; positive expression of ET 1 and iNOS were enhanced in the endothelium of vessels, the epithelium of bronchi and the smooth muscle of vessels and bronchi,but the expression of cNOS weakened The content of ET 1 in plasma and lung tissue homogenate were increased after administration of L NAME. The results indicate that in the normal animals, NO may suppress the secretion of ET 1. The increased ET 1 may play an important role in the development of HPH, and the induced iNOS may be the result of functional adaptation to chronic hypoxia.

Objective To observe the changes in gut mucosal barrier and gut-origin bacteria-endotoxin translocation in acute necrotizing pancreatitis (ANP) rats. Methods Wistar rats were divided randomly into normal group (n=6), sham operation group (n=30) and ANP group (n=39). ANP was introduced by infusion of artificial bile into biliopancreatic duct. Morphology of pancreas and intestine were observed and tight junction on ileum epithelia were assessed by cryofracture replicas electroscopy. Plasma levels of D-lactic acid and endotoxin were examined at various time points. The rates of bacterial translocation to abdominal organs were also calculated. Results Mucosal and tight junction damages of the gut were found during early stage of ANP. Simultaneously, plasma D-lactate levels increased and endotoxemia occurred. The rate of bacterial translocation to organs was 59.5% 72h after ANP occurred. Conclusions Gut barrier function can be injured in the early stage of ANP, and resulting in gut origin bacteria-endotoxin translocation, which may be the originator of systemic inflammatory reaction and secondary infection of the pancreas.

Objective To compare the accuracy of stroke volume variation (SVV),central venous pressure (CVP) and puhnonary arterial wedge pressure (PAWP) in monitoring the changes in blood volume in the patients undergoing renal transplantation.Methods Sixteen patients with chronic renal failure,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,aged 18-55 yr,scheduled for elective allograft renal transplantation under general anesthesia,were enrolled in the study.SVV was continuously monitored with the FloTrac/Vigileo monitor,and CVP,PAWP and stroke volume index (SVI) were continuously monitored with the volumetric pulmonary artery catheter during surgery.The parameters of hemodynamics were recorded at 30 min after induction of anesthesia,5 min before renal artery opening,5 and 30 min after renal artery opening,and at the end of surgery.Hydroxyethyl starch 130/0.4 electrolyte solution 6 ml/kg was infused over 15 min via the central venous catheter to perform fluid responsiveness starting from 30 min after induction of anesthesia.Positive fluid responsiveness was defined as the change in SVI ≥ 15％.The relationship between SVV and CVP and between SVV and PAWP was analyzed using the Pearson correlation analysis.The receiver operating characteristic curve for CVP,SVV and PAWP in monitoring the changes in blood volume was drawn,and the area under the curve was calculated.Results Compared with the value at 5 min before renal artery opening,SVV was significantly increased after renal artery opening (P＜0.05),and no significant change was found in CVP and PAWP after renal artery opening (P＞0.05).SVV was negatively correlated with CVP,and r=-0.82 (P＜0.01);SVV was negatively correlated with PAWP,and r=-0.77 (P＜0.01).The area under the curve of SVV in monitoring the changes in blood volume was 0.87,and of CVP and PAWP was 0.69 and 0.66,respectively.Conclusion SVV provides better accuracy than CVP and PAWP in monitoring the changes in blood volume in the patients undergoing renal transplantation.

Objective To observe the value of the high frequency color Doppler uItrasonography in emergency operation of flexor tendon injuries in the hand.Methods Totally 21 patients of flexor tendon injuries in the hand underwent surgical exploration with high frequency probe.The extent of the tendon injuries,the retracted parts of the ruptured tendon and the blood supply were observed.Results The extent of the tendon injuries,the poison of broken ends were clearly distinguished with high frequency probe.The continuous tendon fibrous of layered high echo and sheath thin layer low echo complete broke and replaced with low or no echo.Conclusion Intraoperative uhrasonography of flexor tendon iniuries is important tO shorten operation time,reduce the injury of surrounding tissues,relieve local adhesion and ensure vascular recanalization after operation.

BACKGROUND: Autologous bone graft was always applied to repair bony cavity defect produced by benign bone tumor.OBJECTIVE: Taking autogenous bone graft for repairing bony cavity defect caused by bone tumor or tumor-like pathological change as control standard, to observe transplantation of deproteined bovine cancellous bone combined with autogenous red marrow in occluding the residual cavity and the density of newly formed bone.DESIGN: A randomized grouping design, controlled observation SETTING: Department of Orthopaedics, the 175 Hospital of Chinese PLA PARTICIPANTS:We recruited 175 cases of bony cavity defect who received treatment in the Department of Orthopaedics, the 175 Hospital of Chinese PLA from July 1993 to July 1998. They were randomly assigned into two groups: experimental group and control group. There were 63 cases treated in the experimental group. The average disease-suffering time was (6.2±2.1) months and bone defect was (136±30) mm3. There were 62 cases treated in the control group. The average disease-suffering time was (6.1±2.3)months, and bone defect was (133±37) mm3.METHODS: Deproteined bovine cancellous bone combined with autogenous red marrow was transplanted in the experimental group and autologous bone graft was applied in the control group. We curetted tumor completely, cauterized the wound with alcohol of 0.95 volume fraction, then curetted the area of cauterization to make it bled. Bone graft was applied.The quantity of implanted bone should be abundant, and disposed compactly. The X-ray films of the first week after operation were used as a standard for density of new bone growth. X-ray films were taken at the 3rd,6th and 8th months postoperatively, and the X-ray films of the eighth months after operation were used as a standard.MAIN OUTCOME MEASURES: To compare the bone union in two groups with a standard of residual cavity occluding and density of bone growth.RESULTS: All patients were followed up for an average of 20 months.One case was lost six months after operation. And two cases were lost eighteen months after operation respectively in the experimental group and control group. After 8 months of operation, residual cavities of bone defect of 44 cases in experimental group and 46 cases in control group were disappeared. Palingenetic bone fused with left bone organization. Its density was the same as or higher than normal bone organization. Residual cavities of 12 cases in experimental group and 10 cases in control group were disappeared basically. The density of palingenetic bone was approximate to normal bone organization. To compare with autologous bone graft, deproteined bovine cancellous bone and an autogenous red marrow had an identical effect for repairing bony cavity defect.CONCLUSION: Bony cavity defect produced by benign bone tumor is often repaired by bone transplantation. To explore the substitutable grafting materials of autogenous bone in this study, a composite material composed of deproteined bovine cancellous bone and an autogenous red marrow (DBCAM) is applied to repair the bony cavity defect.

ObjectiveTo investigate the status of benefit finding in diabetic patients,and mediating effect of resilience between family support and benefit finding in diabetic patients.MethodsFive hundred and thirteen diabetic patients from a hospital of Harbin were recruited as investigative subjects from September 2015 to June 2016.The resilience scale,family adaptability,cohesion scale and benefit finding scale were used in the study.ResultsThe scores of benefit finding,resilience and family adaptability and cohesion were 55.67±12.87,70.65±10.39 and 104.25±15.38,separately.The total score of family adaptability and cohesion was positively related to the total score of benefit finding(r=0.389,P<0.05).The total score of resilience was positively related to the total score of benefit finding(r=0.155,P<0.05).The total score of family adaptability and cohesion was positively related to the total score of resilience(r=0.112,P<0.05).Benefit finding as the dependent variable,the results of hierarchical regression analysis indicated that family adaptability and cohesion (β=0.382,P<0.01),resilience(β=0.098,P<0.01)entered the regression equation.There was a partial mediating effect of resilience between family support and benefit finding in diabetic patients.The mediating effect was 0.011,accounted for 2.8% of the total effect.The resilience was the important protective factor for benefit finding.ConclusionFamily support has a direct influence on benefit finding and an indirect effect mediated by resilience on benefit finding.

Objective To investigate the effects of miRNA-146a on the differentiations and functions of CD4+ T lymphocytes in patients with psoriasis vulgaris.Metbods Thirty patients with psoriasis vulgaris and twenty heathy subjects were enrolled in this study.Quantitative reverse transcription polymerase chain reaction (RT-PCR) was used to detect the expression of miRNA-146a in CD4+ T lymphocytes isolated from the peripheral blood samples.The levels of IFN-γ and IL-4 in serum samples were determined by using enzyme-linked immunosorbent assay (ELISA).Mononuclear cells were isolated from human peripheral blood samples by using Ficoll-Hypaque density-gradients centrifugation,from which the CD4+ T lymphocytes were separated by magnetic-activated cell sorting.The CD4+ T cells (2× 106/ml) were seeded in culture plates with 6 wells.The CD4+ T lymphocytes were divided into 3 groups including the control group,miRNA-146a group and miRNA-146a inhibitor group.The numbers of Th1 and Th2 cells were measured by flow cytometry analysis (FACS).The expression of IFN-γRα,T-bet and GATA-3 at mRNA and protein levels were measured by using RT-PCR and Western blot assay,respectively.The levels of IFN-γ and IL-4 in culture supernatants of CD4+ T lymphocytes were detected by using ELISA.Results In comparison with the normal control group,there were significant increases in the expression of miRNA-146a in CD4+ T lymphocytes and the level of IFN-γin serum samples from patients with psoriasis vulgaris [(2.43±0.94) vs (1.05±0.23),(27.69±7.64) ng/L vs (9.75±2.81) ng/L,all P＜0.01].A positive correlation between the expression of miRNA-146a and the level of IFN-γ in serum was observed (r=0.837,P＜0.01).Results of the in vitro culture of CD4+ T lymphocytes showed that the number of Th1 cells,the expression of T-bet at mRNA and protein levels and the level of IFN-γin culture supernatant were significantly increased,while the expression of IFN-γRα protein was decreased in the miRNA-146a group in comparison with those of the control group (all P＜0.01).No significant differences in the number of Th2 cells,the expression of GATA-3 protein,the expression of GATA-3 and IFN-γRα at mRNA level and the level of IL-4 in culture supernatants were found between the control and miRNA-146a groups (all P＞0.05).The miRNA-146a inhibitor could effectively attenuate the effects of miRNA-146a on Th1 cells.Conclusion The miRNA-146a could promote the differentiation and enhance the function of Th1 cells.It might play an important role in the pathogenesis of psoriasis vulgaris.