Objective To observe the changes of inflammatory factors in acute lung injury (ALI) in mice induced by lipopolysaccharide (LPS), and to explore the influence of different doses of LPS on ALI onset and progress at different time points. Methods Intratracheally, LPS at the dosages of 2.5, 5.0, 7.5 and 10.0 mg/kg were administered to a total of 210 C57BL/6 mice, and according to the difference in dosage, they were divided into four groups. The ALI model was replicated by intratracheally dropping of LPS. And a normal control group and a normal saline control group were established (each, n=10). The changes of index of pathological lung tissue and lung tissue wet/dry (W/D) ratio were observed at 1, 2, 4, and 8 hours after injury, and simultaneously, the levels of norepinephrine (NE), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and protein in serum and bronchoalveolar lavage fluid (BALF) were detected. Results ①The degree of lung injury induced by LPS was dose-and time-dependent.②With the increase of LPS dosage and prolongation of time, in LPS group, the lung W/D ratio and the index of pathological lung tissue were increased;additionally, the levels of NE, TNF-α, IL-6 and protein in serum or BALF were also significantly increased. The critical occurrence point of acute respiratory distress syndrome (ARDS) with specific characteristics was at 5.0 mg/kg of LPS acting for 4 hours [lung W/D ratio: 4.97±0.41, index of pathological changes of lung tissue (score): 5.60±1.52; serum NE (ng/L): 379.99±27.65, TNF-α (ng/L): 159.15±20.62, IL-6 (ng/L): 177.15±29.13;BALF NE (mg/kg):105.85±13.66, TNF-α(mg/kg):227.22±48.01, IL-6 (mg/kg):251.55±54.08, total protein (g/L):1.59±0.37]. The injury induced by LPS acting for 8 hours in the dosage group 10.0 mg/kg was the most significant in comparisons with other groups of dosages at the same time points [lung W/D ratio:5.10±0.18 vs. 5.01±0.43, 5.01±0.19, 4.91±0.30; index of pathological changes of lung tissue (score): 9.20±1.48 vs. 8.00±1.00, 6.00±1.22, 4.40±0.89;serum NE (ng/L): 447.43±34.63 vs. 419.23±30.62, 391.16±54.91, 372.59±51.52; TNF-α(ng/L): 205.99±31.31 vs. 181.01±25.11, 161.01±13.98, 138.83±28.95; IL-6 (ng/L): 233.76±34.84 vs. 206.21±26.68, 186.58±26.54, 156.99±28.83;BALF NE (mg/kg):190.82±41.75 vs. 153.30±35.42, 122.64±25.15, 80.23±13.69;TNF-α(mg/kg):305.24±72.99 vs. 292.77±38.07, 249.60±35.20, 193.63±10.83; IL-6 (mg/kg): 354.81±67.79 vs. 303.02±54.24, 272.43±32.34, 197.64±12.35;total protein (g/L):2.31±0.30 vs. 2.02±0.26, 1.62±0.19, 1.10±0.24, P<0.05 or P<0.01]. Conclusions The severity of ALI induced by LPS in mice was positively correlated to LPS dosage and duration of its action. After administration of LPS 5 mg/kg for 4 hours, remarkable characteristic manifestations of ARDS occur in mice, reaching the critical point.

The association of interleukin 6 receptor ( IL-6R ) gene - 183 A/G ( rs4845617 ) and Asp358 Ala (rs8192284 A/C) polymorphisms with metabolic syndrome was investigated in Chinese Han population.The result showed that the frequencies of AA genotype and A allele were higher in patients with metabolic syndrome ( MS ) than those in healthy subjects ( P＜0.05 or P＜0.01 ).The risk of MS in patients with A allele was 1.643 folds of that with allele C(95％ CI 1.163-2.320,P＜0.01 ).No differences were found in the genotype and allele frequencies of -183A/G between two groups ( P＞0.05 ).The Asp358Ala polymorphism of IL-6R was significantly associated with MS in Chinese Han population.

Objective: To observe the effect of low concentration paraquat (PQ) on activation and phenotypic M1/M2 polarization of mouse microglia cells (BV2) . Methods: BV2 cells were used as model, and cultured in vitro were exposed to paraquat at designed concentrations of 0, 0.015, 0.03, 0.06, 0.12, 0.24, 0.48 μmol/L and 0.05 μmol/L 1-methyl-4-phenylpyridinium (MPP⁺) for 24 h, and cell viability was determined by CCK8 assay. After induced by 0, 0.015, 0.03, 0.06, 0.12 μmol/L PQ and 0.05 μmol/L MPP⁺ for 24 h, the contents of tumor necrosis factor-α (TNF-α) , interleukin-6 (IL-6) and IL-1β in cell culture supernatant were determined by enzyme-linked inmunosorbent assay (ELISA) . Cell migration ability was determined by transwell. Immunofluorescence (IF) and flow cytometry were used to determine the phagocytic capacity of cells. Designed concentrations of 0, 0.03, 0.06, 0.12 μmol/L PQ and 0.05 μmol/L MPP⁺ for 24 h, the protein expressions of M1 markers of BV2 (TNF-α, IL-6, IL-1β, Nitric oxide synthase-iNOS, CD86) and M2 markers of BV2 (Arginase type-1 Arg-1 and Mannose recepteor-CD206) were determined by Western Blot after PQ expourse (0, 0.03, 0.06, 0.12 μmol/L) and 0.05 μmol/L MPP⁺ induction. Results: Compared with 0 μmol/L PQ group, proliferation activity of BV2 cells was significantly increased by 0.03~0.12 μmol/L PQ while inhibited by 0.48 μmol/L PQ (P<0.05) . The cell proliferation activity of cells treated with 0.03 μmol/L PQ was significantly increased in 24 hours (P<0.05) . ELISA showed that TNF-α, IL-6 and IL-1β contents in the cell supernatant of the PQ group were significantly higher than those of 0 μmol/L PQ group, especially in 0.03 and 0.06 μmol/L PQ exposed group (P<0.05) . The results of IF and flow cytometry showed that phagocytic capacity of 0.015, 0.03 and 0.06 μmol/L PQ group was significantly enhanced compared with 0 μmol/L PQ group (P<0.05) . Transwell showed that the cell invasion ability of 0.03, 0.06, 0.12 μmol/L PQ was significantly higher than that of 0 μmol/L PQ group (P<0.05) . Western blot showed that compared with 0 μmol/L PQ group, the expression levels of M1 markers TNF-α, IL-6, IL-1β, iNOS and CD86 were significantly increased in 0.03 and 0.06 μmol/L PQ exposed group, while the expression levels of M2 markers Arg-1 and CD206 protein were decreased in 0.06 and 0.12 μmol/L PQ exposed group (P<0.05) . Conclusion Low concentration PQ can abnormally activate BV2 cell, making the transformation of BV2 cell into pro-inflammatory M1 type and inhibiting its transformation into anti-inflammatory M2 type.

Objective:To explore the association between location of lower extremity deep venous thrombosis and incidence of pulmonary embolism in patients with lower extremity fracture during hospitalization.Methods:A retrospective study was conducted of the 1,620 patients who had been treated for lower extremity fracture and deep vein thrombosis from October 2014 to November 2019 at Department of Orthopaedic Trauma, Honghui Hospital. They were 726 males and 894 females, aged from 18 to 98 years (average, 64.0 years). By the anatomical location of thrombosis, they were divided into a proximal thrombosis group and a distal thrombosis group; by the laterality of thrombosis, they were divided into a bilateral thrombosis group and a unilateral thrombosis group which was further divided into a left thrombosis subgroup and a right thrombosis subgroup. The incidences of pulmonary embolism were compared between 2 corresponding groups and subgroups.Results:Pulmonary embolism occurred in 13 of the 1,400 patients with distal thrombosis and in 12 of the 220 patients with proximal thrombosis; the incidence of pulmonary embolism in the proximal thrombosis group (5.45%, 12/220) was significantly higher than that in the distal thrombosis group (0.93%, 13/1,400) ( P<0.001). Pulmonary embolism occurred in 10 of the 337 patients with bilateral thrombosis and in 15 of the 1,283 patients with unilateral thrombosis; the incidence of pulmonary embolism in the bilateral thrombosis subgroup (2.97%, 10/337) was significantly higher than that in the unilateral thrombosis group (1.17%, 15/1,283) ( P=0.017). Pulmonary embolism occurred in 5 of the 677 patients with left thrombosis and in 10 of the 606 patients with right thrombosis; the incidence of pulmonary embolism in the right thrombosis subgroup (1.65%, 10/606) was insignificantly higher than that in the left thrombosis subgroup (0.74%, 5/677) ( P=0.129). Conclusions:In patients with lower extremity fracture, those with proximal or bilateral thrombosis are more prone to pulmonary embolism than those with distal or unilateral thrombosis, but the possibility of pulmonary embolism cannot be ignored clinically in those with distal or unilateral thrombosis.

Objective:To investigate and compare the biomechanical strength of paravertebral foramen screws (PVFS), lateral mass screws (LMS) and pedicle screws (PS).Methods:A total of 30 human cervical spine vertebrae (C 3-C 6) were harvested from 8 fresh-frozen cadaver specimens whose mean age was 45.3±11.2 years at death. The vertebrae were randomly divided into three groups for specific screws. For each vertebra, one side was randomly chosen for direct pullout strength test (speed 5 mm/s), and the other side for fatigue test (displacement ±1.0 mm, frequency 1 Hz, 500 cycles) and residual pullout strength test. 4.5 mm × 12 mm screws were used for PVFS, 3.5 mm × 14 mm screws for LMS, and 3.5 mm × 24 mm screws for PS. Results:The direct pullout strength was 327.10±17.07 N for PVFS, 305.71 ± 11.63 N for LMS, and 635.67 ± 22.82 N for PS. The residual pullout strength was 265.62 ±18.19 N for PVFS, 192.80 ±17.10 N for LMS, and 494.89 ±41.79 N for PS. The residual pullout strength of PVFS, LMS and PS respectively, compared with the direct pullout strength, decreased by 18.8%, 36.93% and 22.15% ( tPVFS=7.795 , tLMS=17.267 , tPS=9.349 , P<0.001). The direct pullout strength of PS was higher than that of PVFS and LMS( t=34.245, t=40.741, P< 0.001), as well as PVFS was slightly higher than LMS ( t=3.275, P=0.004). The residual pullout strength of PS was the highest, PVFS was the second, and LMS was the smallest ( F=314.619, P<0.001). For the fatigue test, the load at the first cycle and the first time when the set position was reached of PVFS were higher than those of LMS ( t=3.625, P=0.002; t=5.388, P<0.001) and PS ( t=2.575, P=0.019; t=2.680, P=0.015), but there was no difference between those of LMS and PS ( t=0.609 , P=0.550; t=1.953 , P=0.067). The load at the last cycle of PVFS and PS was higher than that of LMS ( t=5.341 , P<0.001 ; t=3.439 , P=0.003), while there was no difference between PVFS and PS ( t=1.606, P=0.126). Conclusion:The direct pullout strength of PVFS was slightly higher than that of LMS, and the residual pullout strength was significantly higher than LMS. The property of fatigue resistance of PVFS was similar to PS and obviously better than LMS. In summary, PVFS can be used as an effective substitute for LMS and PS.

Objective: To understand the current situation and influencing factors of scoliosis in 12-year-old students from Inner Mongolia Autonomous Region, so as to provide scientific basis for accurate prevention and control of abnormal spinal curvature. Methods: From October to November 2021, a total of 18 399 students aged 12 were selected by region and school level by stratified random cluster sampling method, and spinal curvature screening and questionnaire survey of common diseases and health influencing factors among students were carried out. Chi squared test was used for single factor analysis, and binary Logistic regression model was used for multi factor analysis. Results: A total of 397 students (2.2%) were detected with abnormal curvature of the spine, including 368 students (2.0%) with scoliosis. Among them, 205 cases were in the lumbar thoracic segment with a detection rate of 1.1%, 173 cases were in the thoracic segment with a detection rate of 0.9%, and 141 cases were in lumbar thoracic segment with a detection rate of 0.8%. Binary Logistic regression analysis showed that urban area, economic area(moderate), attending tutorial classes before primary school and class seats never changed regularly were positively correlated with the occurrence of scoliosis among 12 year old students ( OR =1.95,1.67,1.76,1.71, P <0.05). Obesity, attending an average of 3 or 4 physical education classes per week, attending physical fitness and beauty classes before primary school were negatively correlated with the occurrence of scoliosis among 12 year old students ( OR =0.69,0.31,0.36,0.71, P <0.05). Conclusion The prevalence of scoliosis among 12-year-old students in Inner Mongolia Autonomous Region is not optimistic. It should pay attention to the prevention and control of scoliosis in students before the age of 12, actively prevent the occurrence and progress of scoliosis.

Objective To evaluate the activity of the cerebral glymphatic system during recovery in ischemic stroke(IS)patients with motor dysfunction,and to explore its association with motor function scores and corticospinal tract(CST)integrity via.Methods A total of 20 patients with IS(stroke group)and 20 healthy volunteer(control group)were recruited.There was a single lesion located at the left cerebral hemisphere in the stroke group.Demographic and clinical data of all participants were recorded.All participants underwent brain MRI scans,including diffusion tensor imaging(DTI)and T2WI.Diffusion tensor image analysis along the perivascular space(DTI-ALPS)index at lateral ventricle level,fractional anisotropy(FA)and axial diffusivity(AD)of CST were calculated and the differences of each index between the two groups were compared.The correlation between DTI-ALPS index and Fugl-Meyer score and integrity of CST were analyzed in stroke group,respectively.Results The DTI-ALPS index in the stroke group was significantly lower than that in the control group(t=-3.88,P＜0.001).The DTI-ALPS index in the stroke group was positively correlated with motor function score(P=0.019),motor function grading(P=0.024)and sensory score(P=0.048),respectively.The DTI-ALPS index was negatively correlated with FA(r=-0.60,P=0.009)and AD(r=-0.67,P=0.002)of healthy side CST.Conclusion The decrease of DTI-ALPS index in patients with IS indicates the damage of cerebral glymphatic system.DTI-ALPS index may be a potential MRI biomarker for motor dysfunction in patients with IS,and a new idea is proposed for the study of the pathophysiological mechanism of IS.

Objective To explore the application value of Fast Dixon technique in MR hip joint scanning.Methods Fifty young volunteers were recruited to perform axial and coronal MR scans of the hip joint.The scanning sequence was Fast Dixon T2WI sequence and conventional Dixon T2WI sequence.A double-blind five-point scale was used to subjectively evaluate the image quality of the two types sequences.The signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of the axial image were measured at the maximum level of the bladder display.Results In the scores of"good contrast between surrounding tissue and femoral head signal"and"overall image quality",the Fast Dixon T2WI sequence was better than the conventional Dixon T2WI sequence,and the difference was statistically significant(P<0.05).There was no significant difference in the average scores of"whether bladder artifacts affected the diagnosis"and"whether the fat suppression effect was good"between Fast Dixon T2WI sequence and conventional Dixon T2WI sequence(P>0.05).In the objective image quality evaluation,the SNR and CNR of Fast Dixon T2WI sequence were better than those of conventional Dixon T2WI sequence,and the difference was statistically significant(P<0.05).Conclusion The image quality score of the hip joint of young volunteers with Fast Dixon T2WI sequence combined with multiple averaging excitation technique is significantly higher than that of conventional Dixon T2WI sequence.The Fast Dixon T2WI sequence can increase the effect of inhibiting fat and motion artifacts without increasing the scanning time,and the joint face ratio is good.Fast Dixon technique can replace the traditional Dixon technique,thus becoming an optimal choice for hip joint MR scanning.

BACKGROUND/AIMS: Chronic intestinal pseudo-obstruction (CIPO) is a serious, life-threatening motility disorder that is often related to bacterial overgrowth. Fecal microbiota transplantation (FMT) results in restoration of the normal intestinal microbial community structure. We investigated the efficacy of FMT in the treatment of CIPO patients. METHODS: Nine patients (age 18–53 years) with CIPO were enrolled in this prospective, open-label study. Patients received FMT for 6 consecutive days through nasojejunal (NJ) tubes and were followed up for 8 weeks after treatment. We evaluated the rate of clinical improvement and remission, feeding tolerance of enteral nutrition, and CT imaging scores of intestinal obstructions. Lactulose hydrogen breath tests were performed before FMT and 8 weeks after FMT to evaluate for the presence small intestinal bacterial overgrowth (SIBO). RESULTS: FMT significantly alleviated bloating symptoms, and symptoms of pain were relieved 2 weeks after FMT. Enteral nutrition administered through a NJ tube after FMT was well-tolerated by 66.7% (6/9) of patients. CT scores of intestinal obstructions were significantly reduced after FMT (P = 0.014). SIBO was eliminated in 71.0% (5/7) of patients. CONCLUSIONS: This pilot study demonstrated the safety of using FMT. FMT may relieve symptoms in selected patients with CIPO. FMT may also improve patient tolerance of enteral nutrition delivered via a NJ tube.
Breath Tests ; Enteral Nutrition ; Fecal Microbiota Transplantation* ; Humans ; Hydrogen ; Intestinal Obstruction ; Intestinal Pseudo-Obstruction* ; Lactulose ; Pilot Projects ; Prospective Studies

OBJECTIVETo evaluate the efficacy and safety of fecal microbiota transplantation (FMT) for gastrointestinal disorders.

METHODSRetrospective analysis of the clinical data of 406 patients who underwent FMT from May 2014 to April 2016 in the Intestinal Microenvironment Treatment Centre of Nanjing General Hospital was performed, including patients with constipation(276 cases), recurrent Clostridium Difficile infection (RCDI, 61 cases), ulcerative colitis(44 cases), irritable bowel syndrome (15 cases) and Crohn's disease(10 cases). Donors were completely unrelated, 18- to 50-year-old non-pregnant healthy adult, with healthy lifestyle and habits, without taking antibiotics, probiotics and other probiotics history within 3 months. There were three routes of FMT administration: patients received 6 days of frozen FMT by nasointestinal tube placed in the proximal jejunum under gastroscope (319 cases); patients received capsules FMT per day for 6 consecutive days (46 cases) or once 600 ml of treated fecal liquid infusion into colon and terminal ileum by colonoscopy(41 cases).

RESULTSClinical cure rate and improvement rate of different diseases receiving FMT were respectively as follows: RCDI was 85.2% (52/61) and 95.1%(58/61); constipation was 40.2%(111/276) and 67.4%(186/276); ulcerative colitis was 34.1%(15/44) and 68.2% (30/44); irritable bowel syndrome was 46.7% (7/15) and 73.3% (11/15) and Crohn disease was 30.0%(3/10) and 60.0%(6/10). RCDI had the best efficacy among these diseases(P<0.01). There was no significant difference between the three routes of FMT administration(P=0.829). The clinical cure rate and improvement rate of different routes were 43.3%(138/319) and 58.6% (187/319) respectively in nasogastric transplantation group, 41.5%(17/41) and 61.0%(25/41) in colonoscopy group, 37.0%(17/46) and 63.0% (29/46) in the capsule transplantation group. There was no serious adverse event during the follow-up. The most common side effects were respiratory discomfort (27.3%, 87/319) and increased venting (51.7%, 165/319) in nasogastric transplantation group. Diarrhea was the most common complication in colonoscopy group (36.6%, 15/41). The main symptoms were increased venting (50.0%, 23/46) and nausea(34.8%, 16/46) in oral capsule group. Side effect symptoms disappeared after the withdraw of nasogastric tube, or at the end of treatment, or during hospitalization for 1-3 days.

CONCLUSIONSFMT is effective for many gastrointestinal disorders. No significant adverse event is found, while the associated mechanism should be further explored.

Adult ; Clostridium Infections ; drug therapy ; Clostridium difficile ; drug effects ; Colitis, Ulcerative ; drug therapy ; Colonoscopy ; adverse effects ; methods ; Constipation ; drug therapy ; Crohn Disease ; drug therapy ; Diarrhea ; chemically induced ; Fecal Microbiota Transplantation ; methods ; statistics & numerical data ; Female ; Flatulence ; chemically induced ; Gastrointestinal Diseases ; drug therapy ; Gastroscopy ; methods ; Humans ; Intubation, Gastrointestinal ; adverse effects ; methods ; Irritable Bowel Syndrome ; drug therapy ; Male ; Middle Aged ; Nausea ; chemically induced ; Retrospective Studies ; Treatment Outcome