Acute lung injury(ALI) and acute respiratory distress syndrome(ARDS) are common,life-threatening causes of acute respiratory failure that arise from a variety of local and systemic insults.The pathogenesis of ALI/ARDS is complicated and not yet completely interpreted today.The role of altered coagulation and fibrinolysis in the pathogenesis of ALI/ARDS has been investigated.This review will summarize the current understanding of coagulation and fibrinolysis in human ALI/ARDS with emphasis on pathways that could be potential therapeutic targets.These pathways include the tissue factor pathway,the protein C pathway and modulation of fibrinolysis via plasminogen activator inhibitor-1.

Objective To investigate the clinical value of laparoscopic treatment of myoma in the broad uterine ligament.Methods A retrospective comparison was made on clinical data between 26 patients who had received laparoscopic enucleation of myoma in the broad uterine ligament and 12 patients who had received traditional open resection in the same period.Results Both laparoscopic and traditional operations were successfully completed.As compared with open surgery,the laparoscopic surgery had longer operative time(92.5?15.8 min vs 63.0?15.8 min;t=5.350,P=0.000),similar blood loss during operation(99.2?32.9 m1 vs 91.7?30.7 m1; t=0.667,P=0.509),and shorter time of postoperative hospital stay(4.5?0.7 d vs 7.7?0.9 d;t=-11.960,P=0.000),respectively.Conclusions Laparoscopic enucleation of myoma in the broad uterine ligament is safe and effective and offers a rapid postoperative recovery.

Objective In this study,the phenotype heterogeneity of 2 male patients with X-linked Alport syndrome from one family was analyzed and the likely reasons were discussed by reviewing the literature.Methods The clinical data at the time of diagnosis and during 5 years follow-up of 2-male patients with X-linked Alport syndrome from one family were collected.The α5 (Ⅳ) chain expression in the epidermal basement membrane was detected by indirect immunofluorescence method.COL4A5 gene mutations in skin fibroblasts and genomic DNA were detected by using reverse transcription polymerase chain reaction and direct sequencing and PCR sequencing methods from skin fibroblasts and genomic DNA,respectively.Results The diagnostic age of patient Ⅲ 1 was 14 years old.He had only microscopic hematuria,and proteinuria was negative.A negative α5 (Ⅳ) chain staining pattern was detected in his epidermal basement membrane.After 5 years follow-up without drug treatment,he was 19 years old,had persistent microscopic hematuria and normal renal function.The urinary microalbumin was 19.2-31.8 mg/L.The diagnosis age of patient Ⅱ 4 was 29 years old.The hematuria and proteinuria were found at 22 years old.He was treated with tripterygium wilfordii for 1 year.His disease progressed to an end stage of renal disease and he received hemodialysis therapy at 24 years old.He had the renal transplantation surgery at 29 years old,just 2 months before he came to hospital.And his renal function was restored.After 5 years follow-up,his urine examination and renal function were normal.Both patients had a missense mutation c.3650G ＞ A(p.G1217D) in exon 41 in COL4A5 gene.Conclusions The different phenotypes of 2 male patients from one family with X-linked Alport syndrome were reported.The most possible reason for this is somatic mosaic variants in COL4A5 gene based on literature review.Physicians should be alert to phenotype heterogeneity in male X-linked Alport syndrome despite having the same gene mutation.

Objective To discuss the relationship between and value of Leptin with disorder of lipid metabolism in gestational diabetes mellitus. Method Research objects are divided into three groups including GDM group, normal glucose tolerance group (NGT group), normal non-pregnant group. Blood lipid, fasting blood glucose, fasting insulin, serum leptin and placental leptin levels were detected and HOMA-IR was calculated. Result (1) Serum leptin, TC, TG, placental leptin and HOMA-IR in GDM group were higher than those of NGT group and TC, serum leptin and HOMA-IR of NGT group were higher than those of control group. There were statistical significances (P<0.05). (2)Serum leptin levels were positively correlated with BMI, HOMA-IR, TC and TG respectively (r = 0.593, 0.688, 0.722, 0.492 respectively, P < 0.05). Conclusion Leptin may cause lipid metabolism disorders, and together they participate in the pathogenesis of GDM. Maternal serum leptin level is expected to become an observation index of GDM.

After the digital resources in 8 famous domestic medical academic libraries were investigated, the status quo and characteristics of digital resources development and the use of different social networking tools in these libraries were analyzed, the crowd-sourcing concept was used to guide the users to participate in the development of digital resources using the social networking tools, and a platform for users participating in information organization and integration was constructed by making use of mobile communication/WeChat.

Objective: To evaluate the clinical effectiveness of multi-directional mechanical traction (MT) for the treatment of patients with lumbar disc herniation (LDH) compared with longitudinal traction (LT) as control. Method: This prospective, single-blind, randomized clinical trial was performed in Qi Lu Hospital, Shandong University from January 2008 to December 2008. One hundred and twenty outpatients with LDH were randomly divided into MT group or LT group. MT group was treated with computer-controlled multi-directional mechanical traction.LTgroupwastreatedwithlongitudinaltraction.RolandMorrisLowBackPainandDisability Questionnaire (RMDQ), visual analogue scale (VAS), and straight leg raising (SLR) angle were measured for every patient pre-, 4 weeks post-, and 1 year post-treatment.Result: The results of clinical observations showed significant improvements inRMDQ, VAS, and SLR angle assessments (all P＜0.05) in both groups 4 weeks post- and 1 year post-treatment compared with pre-treatment. Score of RMDQ in MT group was significantly lower than that in LT group(P＜0.05), however, there was no significant difference between two groups in VAS score and SLR angle (P＞0.05). The differences in improvement ratios between two groups were not significant (all P＞0.05). The clinical outcomes were negatively correlated with patient's age and disease duration.Conclusion: The effect of MT is equivalent and probably superior to that of LT in improving the symptoms and clinical findings of patients with LDH.

Objective To explore the diagnosis and treatment of Dent’s disease.MethodsThe clinical characteristics, treatment process and disease-causing gene mutation were retrospectively analyzed in 6 pediatric patients with Dent’s disease misdiagnosed of nephritic syndrome from January 2014 to August 2015.ResultsIn these 6 male patients aged 4.5-9.8 years old, the main clinical manifestations were nephropathy-level of proteinuria and transient low serum albumin (26-30 g/L) without obvious edema or high serum cholesterol. In 4 patients who had renal biopsy, 2 cases showed mesangial proliferative glomerulonephritis and other 2 cases showed focal segmental glomerulosclerosis. All of 6 patients were treated with at least one immunosuppressive agent after resistance to full dose of hormone and no changes in proteinuria were observed. After admission, the indexes of early renal damage and urinary protein electrophoresis pointed to low-molecular proteinuria. The ratio of alpha 1 micro albumin (α1-MG) / micro albumin (MA) (the early renal damage index) was?>?1, there was hypercalciuria, and renal function was normal. The B ultrasonography showed renal calciifcation in 2 patients. The ifndings in all the patients were in accord with the clinical diagnosis of Dent’s disease. Further genetic analysis conifrmed the presence ofCLCN5 gene mutation in these 6 patients.ConclusionAs a type of rare inherited renal tubular disorder, Dent’s disease is easily misdiagnosed, to which pediatricians need to pay attention. The early renal damage index, α1-MG/MA?>?1, can be regarded as one of the diagnostic criteria of renal tubular proteinuria.

To review and analyze the pharmacological effect and underlying mechanism of Chinese lobelia. Methods:The references from home and abroad on the pharmacological effect and mechanism of Chinese lobelia in recent years were summarized and analyzed. Results:Chinese lobelia had wide range of pharmacological effects, such as anti-tumor, endothelial cells regulation, an-algesic and anti-inflammatory effect, inhibition against alpha glycosidase enzymes and myocardial ischemia reperfusion et al. Conclu-sion:A large number of effective compositions are in Chinese lobelia and the biological activity is extensive. The mechanism of biologi-cal activity should be further studied in-depth.

BACKGROUND: Adipose tissue-derived mesenchymal stem cells (ADMSCs) have the multilineage differentiation potential, and are relatively easier to be obtained, thus they have attracted more and more attention as a new seed cell for cell engineering.OBJECTIVE: To observe the in vitro culture conditions of ADMSCs isolated from rat's subcutaneous adipose tissue, and identify them using immunohistochemical staining.DESIGN: An animal experiment.SETTING; Department of Cardiology, the General Hospital of Chinese PLA.MATERIALS: One healthy male Wistar rat of clean degree, 4 months old, weighing 200 g, was used. DMEM, fetal bovine serum were from GIBCO; Monoclone antibodies of rabbit-anti-rat CD13, CD34, CD44, CD45, CD105, D-related human leucocyte antigen (HLA-DR), factor-Ⅷ, vov Willebrand factor (VWF), Myosin, SABC kits and DAB staining kit from Wuhan Booster Biological Engineering, Co.,Ltd; Adeno-associated virus encoding green fluorescent protein from Vector Gene Technology Company Limited (Beijing).METHODS: The experiments were carried out in the Department of Internal Medicine, the General Hospital of Chinese PLA in October 2006. ① Cell isolation and culture: 0.3 g adipose tissue was cut from subcutaneous adipose tissue of Wistar rat's groin under aseptic condition, then minced and digested before culture, DMEM was changed at 2-3 days after plenty of fusiform-shap ed attached cells were observed under microscope, and the cell growth was observed. The cell concentration was adjusted to 2×107 L-1, then seeded into 96-well plate, and 100 μL for each well. From the second day, 3 wells were randomly selected every day, the cells were released with tripsin, and counted with blood cell counting chamber under inverted microscope. ② Cell viability assay: ADMSCs of passages 3 to 8 were added to DMSO freeze medium, and thawed after 2-4 weeks, and the cell viability was assessed by trypan blue dye exclusion. ③Immunohistochemical staining and identification: 2 ×107 L -1 cells were seeded to culture plate, then the immunohistochemical (SABC method) identification and Oil red O staining were performed to determine the cell surface antibodies of CD13, CD34, CD44, CD45, CD105, HLA-DR, factor-Ⅷ, HLA-DR and VWF. ④Lineage-specific differentiation and identification: The ADMSCs were plated on multi-well chamber and induced with lineage-specific media supplementation at least two weeks and identified by histologic/immunohistochemical assay of Oil red O for adipogenisis, alkaline phosphatase (ALP) stain for osteogenisis and Myosin monoclonal antibody for myogenisis. ⑤Transfected adenovirus carried green fluorescence protein (AD-GFP) medium: The fourth generation of ADMSCs were seeded on 96-well plate, 3 000 cells for each well, serum-free DMEM was changed after 24 hours, and added by AD-GFP at the same time, then transfected with different multiplicity of infection (MOI) of 1∶50, 1∶100, 1∶150 and 1∶200respectively, and then the transfection was observed.MAIN OUTCOME MEASURES: ① Results of cell isolation and culture; ② Cell viability after freezing and thawing; ③Results of immunohistochemical staining and identification; ④ Results of lineage-specific differentiation and identification;⑤ Results of transfected adenovirus carried AD-GFP.RESULTS: ① About 3.6×105 attached cells were obtained from 0.3 g subcutaneous adipose tissue, and these cells could be subcultured for passages in vitro with stable population doubling time. ② The cells were thawed after freezing for 2-3 weeks, and the trypan blue staining showed that the cell viability was above 90%. ③ The immunocytochemical staining showed that CD13, CD44, CD105 were positive and CD45, factor-Ⅷ, HLA-DR and VWF negative in different generations. ④ From the second generation, a few Oil red O positively stained cells were observed, which were obviously increased after prolonging the refreshing. After lineage-specific differentiation, the cells were all positive by Oil red O staining, ALP staining and Myosin immunohistochemical staining. ⑤ 72 hours after transfection, it was observed under fluorescence microscope that most cells were green fluorescence when the MOI value was 1∶200, the transfection was successful, and it was generally determined that the transfection rate was above 90%.CONCLUSION: A large number of ADMSCs with multilineage differentiation potential can be easily obtained from rat adipose tissue, osteoblast, myoblasts, they can be expanded in large quantity and stored in vitro for long time, AD-GFP were also successfully transfected.

Objective:To compare the steam distillation( SD) and supercritical CO2 ( SFE-CO2 ) method in the extraction of vola-tile constituents from such 3 traditional Chinese drugs as cnidium monnieri, radix sileris and atractylodes lancea in compound Kuhuang prescription. Methods:Essential oil was extracted from the 3 traditional Chinese drugs by SD and SFE-CO2 method, respectively. The components were identified by GC-MS, and their relative contents were calculated with peak area normalization method. Results:To-tally 36 components were isolated and identified using SD extraction and 31 components were identified using SFE-CO2 extraction, a-mong them, 22 components were the same and their relative molecular weight mainly concentrated within 200-230. Conclusion: SFE-CO2 method can extract effective components from the 3 traditional Chinese drugs in compound Kuhuang prescription with higher selec-tivity, which is the more suitable extraction method for essential oil from the prescription.