Objective Recent studies suggest that the red blood cell distribution width ( RDW) may play a role in the diag-nosis and treatment of cardiovascular disease.The aim of this study was to investigate the correlation of red blood cell distribution width (RDW) with cardiovascular events in patients with Acute ST-segment elevation myocardial infarction (ASTEMI) in order to provide the basis for improving the diagnosis level and therapeutic effect. Methods Retrospective study was made on the clinical data of 189 patients with ASTEMI enrolled in Sichuan Provincial People′s Hospital from January 2013 to March 2014.The survival rates of patients with ASTEMI with different RDW were estimated by Kaplan-Meier and compared by Log-rank test and the prognosis factors were inves-tigated by Cox proportional hazard regression model. Results 97 patients′RDW levels were more than 13.7% and 92 patients′RDW levels were less than or equal to 13.7% in 189 ASTEMI patients. The hs-CRP, BNP, LVEF and HDL-C were significantly different be-tween two groups (P<0.05).The rates of recurrent myocardial in-farction, heart failure, sudden death cardiac in patients with highRDW were higher than that in patients with low RDW (22.7%vs 8.7%, 27.8%vs 10.9%, 15.5%vs 5.4%)(χ2 =6.915, 8.632, 5.019, P<0.05) .There were 60 patients with high RDW who experienced cardiovascular events and the 1-year cardiovascular event-free survival rate was 38.1%, and 20 patients with low RDW cardiovascular events was 79.3% in follow-up period (χ2 =30.959, P<0.001).Multivariate cox regression showed that age>65 (HR=2.43, 95%CI:1.09~5.44) and RDW>13.7%(HR=2.20, 95% CI:1.10~4.43) were risk prognostic factors. Conclusion There is a certain correlation between RDW and cardiovascular e-vents in patients with ASTEMI.The ASTEMI patients with high RDW hold higher risk of cardiovascular events and poorer prognosis.

Objective To summarize the research results at home and abroad of raltitrexed on the patients with advanced gastric cancer,and to evaluate the clinical efficacy and adverse reactions of raltitrexed. Methods Clinical controlled trials of evaluating effects of raltitrexed on the advanced gastric cancer were searched in PubMed,EMBase,Ovid,Springer,Wanfang database,VIP database and China Biology Medicine disc. Besides,references and conference abstracts were searched manually. Literature screening and data extraction were performed according to inclusion and exclusion criteria. Then Meta-analysis was performed using RevMan 4. 2. Results Forty-four studies were found and 5 clinical controlled trails including 338 patients were included in this analysis. The results of Meta-analysis showed that there was a significant beneficial effect of raltitrexed on objective effective rate for the patients with advanced gastric cancer(RR = 1. 55,95% CI:1. 21-1. 99,Z = 3. 44,P = 0. 00)compared with other treatments. The incidences of Ⅲ-Ⅳadverse reactions in raltit-rexed group such as neutropenia(RR = 1. 97,95% CI:0. 85-4. 56,Z = 1. 59,P = 0. 11),thrombocytopenia (RR = 1. 56,95% CI:0. 60-4. 07,Z = 0. 92,P = 0. 36),anemia(RR = 2. 43,95% CI:0. 61-9. 78,Z =1. 25,P = 0. 21),arthralgia(RR = 3. 20,95% CI:0. 73-13. 98,Z = 1. 55,P = 0. 12),elevated transaminase (RR = 1. 37,95% CI:0. 29-6. 48,Z = 0. 39,P = 0. 69)were higher than those in other group,with no statis-tical significance. However,the adverse reactions in raltitrexed group such as diarrhea(RR = 0. 18,95% CI:0. 03-1. 07,Z = 1. 88,P = 0. 06),nausea and vomiting(Z = 1. 79,RR = 0. 45,95% CI:0. 19-1. 08,P =0. 07),neurotoxicity(RR = 0. 07,95% CI:0. 01-0. 52,Z = 2. 59,P = 0. 01),hand-foot syndrome(RR =0. 26,95% CI:0. 04-1. 59,Z = 1. 46,P = 0. 14),alopecia(RR = 0. 57,95% CI:0. 13-2. 55,Z = 0. 73, P = 0. 46)were lower than those in other group. There were no statistical significances except neurotoxicity. Conclusion Compared with other treatments,raltitrexed-based chemotherapy has a beneficial effect on objec-tive effective rate and less adverse reactions for the patients with advanced gastric cancer,which is worthy of clinical use.

Objective:To lay background for studying rejection mechanisms in xenotransplantation, class II DQA genes of swine leukocyte antigens (SLA) of three Chinese pig strains GXP, GZP and YNP were cloned and sequenced.Methods:RT-PCR was performed to proliferate SLA-DQA genes (GXPDQA, GZPDQA and YNPDQA),which were cloned into pGEM-T Easy vector for sequencing and analysis.Results:All three allelic sequences examined, are not identical to those reported, which allows the sequences receiving their accession numbers from GenBank as AY102473, AY102474 and AY102475, which encompass an open reading frame of 765, 768 and 768 nucleotides respectively.Conclusion:Three new alleles of SLA-DQA genes were obtained. Analysis of the amino acid sequences of swine, human and mouse DQA (or equivalent) also indicated that GXPDQA, GZPDQA and YNPDQA were more similar to human DQA than mouse H-2-A?, which might provide an understanding of how the immune system evolved.

Objective To provide a new method for sacral fracture fixation by means of 3D recon-struction and reverse engineering technique. Methods Pelvis images of 3D CT scan were obtained from patients with sacral fracture. The digital data were transferred into a computer workstation. 3D models of pelvis were reconstructed using Amira 3.1 software and saved in STL format. The 3D fracture models were imported into Imageware 10.0 software. Different situations of reduction (total reduction, half reduction and no-reduction) were simulated using Imageware 10.0 software. The extract locations and the best directions of inserting iliosacral lag screws were defined using Reverse Engineering according to the 3 situations to before navigation templates were designed according to the posterior anatomic features of the ilium and the insertion channels. Exact navi-gational templates were manufactured by rapid prototyping. Drill guides were sterilized and used intraoperatively to assist surgical navigation and placement of iliosacral lag screws. Results Accurate screw placement was confirmed with postoperative X-ray and CT scanning. The navigation templates were found to be helpful and highly accurate. Conclusion The navigation template may be a useful method for mini-invasive fixation of sacroiliac joint fracture.

ObjectiveTo evaluate the safety and feasibility of the tracheal stent implantation for treatment of malignant tracheal stenosis under general anaesthesia. Methods Eighteen patients with malignant tracheal stenosis underwent preoperative 64-slice spiral CT scan and airway reconstruction. The stenotic sites were located in main tracheal trunk(5 patients),in right main bronchus( 1 patient),in trachea and left main bronchus (4 patients),in trachea and right main bronchus (3 patients),in main tracheal trunk and bilateral main bronchus(5 patients).The degree of stenosis was rated 51％ to 70％ in 7 cases,71％ to 90％ in 11 cases.All patients,17 patients of ASA grade 1V and 1 patient of grade Ⅲ,presented with severe dyspnea. Under general anaesthesia,implantation of metallic stent was performed through the sputum aspiration hole of the connecting tubing with DSA guidance.The NBP,ECG,RR,SaO2 of the patients were recorded and compared with t test during the entire procedure. At the end of the procedure,relief of dyspnea,complications related to anesthesia and operation were recorded. Results The success rate of stent placement was 18/18,and dyspnea was significantly relived in all patients. Slightly bloody sputum occurred in 7 cases.The stent was obstructed by sputum in 1case,and the patient was treated with medication.There were no severe complications.The operative course were rated 11 to 9 in 17 cases,and 6 to 8 in 1 case.All 18 patients were cooperative during the procedure.Sixteen patients rated the procedure as very comfortable and 2 rated the procedure as comfortable.Respiratory rate (RR) and heart rate (HR) decreased in all patients after the operation [ ( 37.1 ± 2.8 )/min and ( 106.5 ± 14.2 ) bpm before the operation respectively,( 18.6 ± 1.4)/min and ( 73.2 ± 7.6) bpm after the operation respectively ],t =17.81 and 3.80,P ＜ 0.01.Pulse oxygen saturation ( SaO2 ) during the operation [ ( 91.2 ± 1.8 ) ％ ]increased [ (76.3 ± 8.6 )％ before the operation ] and increased further after the operation [ (94.5 ±4.3 ) ％ ],t =2.06 and 2.26,P ＜ 0.01.Blood pressure (BP) showed no changes throughout the operation (P ＞ 0.05 ).The conprehensive assessment of operation were favorable in all patients. Conclusion With careful preoperative evaluation and planning, tracheal stent implantation under general anaesthesia in patients with malignant tracheal stenosis is feasible and safe.

Objective To investigate the ultrasound imaging findings of anatomical relationship between femoral artery and vein in children of different ages.Methods Sixty-five children aged 4 months-7 years were enrolled in this study.The children were divided into 3 age groups: group Ⅰ＜ 1 yr;group Ⅱ 1-3 yr and group Ⅲ＞ 3,≤ 7 yr.A protable ultrasound machine was used.The probe was placed at the level of inguinal ligament and 2 and 4 cm below inguinal ligament.The children were placed in supine position.The legs were placed in 2 positions:(1)extended and in standard anatomical position and(2)flexed and 45° abducted and 45° laterally rotated.Results The examination showed that at the level of inguinal ligament,the femoral vein lay behind and lateral to femoral artery in 91% of children.At the level of 4 cm below inguinal ligament,the femoral vein lay posterior and lateral to the femoral artery in all children.When the leg was placed in abducted and laterally rotated,the depth of femoral vein was reduced and the vein was less overlapped by artery in all children,especially in preschool children.Conclusion At the level of 4 cm below inguinal ligament,the femoral vein lies posterior and lateral to the femoral artery in children.When the leg is placed in abducted and laterally rotated,the depth of femoral vein is reduced and the vein is less overlapped by artery.It is indicated that femoral vein puncture should be performed at the level of 4 cm below inguinal ligament with the leg flexed and abducted in all children,especially in preschool children.

In order to solve the adhesion and the softening problems of traditional Chinese medicine extract during spray drying, a new method of adding dehumidified air into spray drying process was proposed, and the storage stability conditions of extract powder could be predicted. Kouyanqing extract was taken as model drug to investigate on the wet air (RH = 70%) and dry air conditions of spray drying. Under the dry air condition, the influence of the spray drying result with different air compression ratio and the spray-dried powder properties (extract powder recovery rate, adhesion percentage, water content, angle of repose, compression ratio, particle size and distribution) with 100, 110, 120, 130, 140 °C inlet temperature were studied. The hygroscopic investigation and Tg value with different moisture content of ideal powder were determined. The water activity-equilibrium moisture content (aw-EMC) and the equilibrium moisture content-Tg (EMC-Tg) relationships were fitted by GAB equation and Gordon-Taylor model respectively, and the state diagram of kouyanqing powder was obtained to guide the rational storage conditions. The study found that in the condition of dry air, the extract powder water content decreased with the increase of air compression ratio and the spray drying effect with air compression ratio of 100% was the best performance; in the condition of wet air, the extract powder with high water content and low yield, and the value were 4.26% and 16.73 °C, while, in the dry air condition the values were 2.43% and 24.86 °C with the same other instru- ment parameters. From the analysis of kouyanqing powder state diagram, in order to keep the stability, the critical water content of 3.42% and the critical water content of 0.188. As the water decreased Tg value of extract powder is the major problem of causing adhesion and softening during spray drying, it is meaningful to aid dehumidified air during the process.
Drug Stability ; Drugs, Chinese Herbal ; chemistry ; Humidity ; Medicine, Chinese Traditional ; Plant Extracts ; chemistry ; Powders ; Temperature

OBJECTIVETo explore efficacy enhancing and detoxification roles of Jiedu Quyu Zishen Recipe (JQZR) in treating systemic lupus erythematosus (SLE) by studying its effect on Toll like receptor 9 (TLR9) signal pathway of murine macrophage cells after JQZR stimulated CpG oligodeoxynucletide (CpG ODN).

METHODSMurine macrophage cells in vitro cultured were randomly divided into 4 groups, i.e., the blank serum group, the CpG ODN stimulus group, the CpG ODN + dexamethasone group, the CpG ODN + medicated serum group. Murine macrophage cells were collected after 24-h intervention. The expression of TLR9, myeloid differentiation factor 88 (MyD88), NF-KB, IFN-α mRNA were analyzed by RT-PCR. The expression of TLR9 and NF-κB protein were analyzed by Western blot. Changes of the NF-KB transcriptional activity were assayed by Dual-Luciferase reporter assay system.

RESULTSmRNA expressions of TLR9, MyD88, NF-κB, and IFN-α, protein expressions of TLR9 and NF-κB, and NF-κB transcriptional activities were enhanced, showing statistical difference when compared with those of the blank serum group (P <0. 05, P <0. 01). Compared with the CpG ODN stimulus group, mRNA expressions of MyD88, NF-κB, and IFN-α, the protein expression of NF-κB and the NF-κB transcriptional activities decreased in the CpG ODN + dexamethasone group with statistical difference (P <0. 01). Compared with the CpG ODN stimulus group, mRNA expressions of TLR9, MyD88, NF-κB, and IFN-α, protein expressions of TLR9 and NF-κB, and NF-κB transcriptional activities were decreased in CpG ODN+ medicated serum group with statistical difference (P <0. 01).

CONCLUSIONEfficacy enhancing and detoxification roles of JQZR in treatment of SLE might be realized through regulating TLR9 signal pathways.

Animals ; Cell Line ; Drugs, Chinese Herbal ; pharmacology ; Humans ; Macrophages ; metabolism ; Mice ; Myeloid Differentiation Factor 88 ; NF-kappa B ; RNA, Messenger ; Signal Transduction ; Toll-Like Receptor 9 ; metabolism

Objective To explore whether paraquat (PQ) can induce the formation of neutrophil extracellular traps (NETs) in human peripheral blood.Methods Neutrophils were isolated from healthy human peripheral blood,and the cells were identified by hematoxylin-eosin (HE) strain.The cells were treated with different concentrations of PQ [0 (as control),200,400,600,800,1 000 and 1 200 μmol/L],and the cell viability was measured by cell proliferation and CCK-8 cytotoxicity detection kit,and the median lethal concentration of PQ was selected.The cells were treated with the median lethal concentration of PQ (PQ poisoning group),and the untreated cells were served as the control.Immunofluorescence staining was adopted to evaluate NETs formation.PicoGreen dye was used to determine the quantitative content of circulating free DNA.Western Blot was used to determine the expressions of citrullinated histone 3(H3Cit) and myeloperoxidase (MPO) in the supernatant.Results The purity of neutrophils was about 95％ by HE staining.The cells were treated with different concentrations of PQ,and the result showed that the viability of cells was (58 ± 2)％ with 800 μmol/L PQ for treatment.The immunofluorescence showed that there were few expressions of H3Cit and MPO in neutrophils in the control group,and there was no NETs formation,which was composed of DNA,H3Cit and MPO.Compared with the control group,a large amount of NETs was generated from neutrophils stimulated by 800 μmol/L of PQ.Meanwhile,quantitative result showed that the content of cell free DNA in the supernatant was significantly increased in PQ poisoning group as compared with that of control group (μg/L:2 235 ± 462 vs.561 ± 87,P ＜ 0.01).The protein expressions of H3Cit and MPO in the supernatant were also significantly increased as compared with those of control group [H3Cit protein expression (gray value):0.23 ± 0.03 vs.0.11 ± 0.01,MPO protein expression (gray value):0.47 ± 0.05 vs.0.21 ± 0.04,both P ＜ 0.05].Conclusion 800 μmol/L of PQ can induce the formation of NETs in human peripheral blood.

Objective To investigate the current status of occupational hazards and prevention and control of occupational ， - Methods ， diseases in micro small and medium sized manufacturing enterprises in Jiangxi Province. A total of 1 034 micro - small and medium sized manufacturing enterprises in Jiangxi Province were selected as the research subjects using a stratified cluster sampling method. The exposure of occupational hazards and the implementation of occupational hazards prevention and Results ， control measures were investigated. Among the 1 034 enterprises the small and micro enterprises accounted for ， 91.5%. The enterprises with serious occupational hazards were mainly concentrated in metallurgy building materials industry ， and machinery equipment and electrical appliance manufacturing industry. The exposure rate of occupational hazard factors in ， ， （ vs the categories of occupational hazard factors from high to low was physical factors dust and chemical factors 78.9% 52.8% vs ，P ） （ ）， ， 25.0% <0.01 . The exposure rate from high to low was metallurgy and building materials industry 60.8% machinery （ ）， ， equipment and electrical equipment manufacturing industry 42.9% light industry textile and tobacco processing industry （ ）， ， （ ）（P ） 32.0% chemical petrochemical and pharmaceutical industry 21.0% <0.01 . Noise exposure accounted for 98.3% in the workers exposed to physical factors. The implementation rate of prevention and control measures for occupational hazards ， in enterprises from high to low was the staffing of occupational health management personnel the establishment of ， ， occupational health management institutions the establishment of occupational health management systems the detection ， ， of occupational hazards the evaluation of the control effect of occupational hazards of construction projects and the - （ vs vs vs vs vs ，P ） pre evaluation of occupational hazards of construction projects 32.5% 25.7% 23.7% 16.2% 6.9% 4.2% <0.01 . Conclusion The focus of prevention and control of occupational hazards in manufacturing industry in Jiangxi Province is noise ， - and dust in small and micro metallurgy and building materials industry. Most of the micro small and medium sized manufacturing enterprises have not carried out the detection of occupational hazards and evaluation of occupational hazards in accordance with the law. The situation of occupational disease prevention and control is still challenging.