Lipoxin A4 is an arachidonic acid metabolite,it is an important endogenous anti-inflammatory mediators in the body,which is known as an inflammatory braking signal. Inflammatory response is an important factor for causing cerebral ischemia-reperfusion injury.Lipoxin A4 can exert neuroprotective effects by inhibiting inflammatory response.In addition,lipoxin A4 can also reduce blood-brain barrier permeability,reduce cerebral edema,and promote recovery of neurological function.This article reviews the neuroprotective roles and mechanisms of lipoxin A4 in cerebral ischemia-reperfusion.

Objective To investigate the protective effect of lipoxin A4 on diabetic rats with focal cerebral ischemia-reperfusion and its mechanisms.Methods Thirty-six adult male Sprague-Dawley rats were randomly divided into a sham operation group,a cerebral ischemia-reperfusion group,and a lipoxin A4 group (n=12 in each group).Diabetes was induced by repeated intraperitoneal injection of low-dose streptozotocin.A model of middle cerebral artery occlusion and reperfusion was induced by the intraluminal suture method.Five minutes after cerebral ischemia,lipoxin A4 0.03 nmol/5 μ1 was injected via intracerebroventricular in the lipoxin A4 group.The other groups were injected equal volume of saline.Two hours after ischemia,the suture was pulled out and reperfusion was achieved.Neurological deficit scores were performed at 24 hours.Then the rats were decapitated and their brains were taken out.2,3,5-triphenyl tetrazolium chloride (TTC) staining was used to detect infarct size.Western blotting was used to detect the expression of cortical tumor necrosis factor-α (TNF-α) and nuclear factor-κB (NF-κB).Results The neurological deficit score showed that no neurological deficit was observed in the sham operation group (score 0).The neurological deficit score in the lipoxin A4 group was significantly lower than that in the cerebral ischemia-reperfusion group (2.20 ± 1.03 vs.3.20 ± 1.03; P ＜0.05).TTC staining showed that no infarct was observed in the sham operation group.The infarct size in the lipoxin A4 group was significantly lower than that in the cerebral ischemia-reperfusion group (27.52％ ± 5.71％ vs.55.45％ ± 9.29％ ; P ＜0.05).Western blotting showed that the expression levels of TNF-α in the sham operation,cerebral ischemiareperfusion,and lipoxin A4 groups were 0.64 ± 0.16,1.85 ± 0.52,and 1.40 ± 0.34,respectively.There were significant differences among the 3 groups (F =18.868,P ＜0.001).The expression level of TNF-α in the lipoxin A4 group was significantly lower than that in the cerebral ischemia-reperfusion group (P ＜0.05).The expression levels of NF-κB in the sham operation,cerebral ischemia-reperfusion and lipoxin A4 groups were 0.79 ±0.24,2.09 ± 0.47,and 1.27 ± 0.35,respectively.There were significant differences among the 3 groups (F =16.736,P ＜ 0.001).The expression level of NF-κB in the lipoxin A4 group was significantly lower than that in the cerebral ischemia-reperfusion group (P ＜0.05).Conclusions Lipoxin A4 has certain protective effect on focal cerebral ischemia-reperfusion injury in diabetic rats,its mechanism may be associated with the inhibition of the expression of TNF-α and NF-κB.

Objective To discuss the apparatus of inspired oxygen in hyperbaric oxygen(HBO)chamber for patients after tracheotomy.Methods Many kinds of apparatus of inspired oxygen were analyzed,including composition,usage and characteristics.Results The apparatus of inspired oxygen play an active role in treating patients.But in the above apparatus,there are great differences in serving range,efficiency of inspired oxygen,curative effect,reliability and so on.Conclusions When serious patients after tracheotomy are treated in HBO chamber earlier,it is very important to select reasonable apparatus.

This paper introduces the current situation of hyperbaric oxygen (HBO) therapy, the environment characteristics in HBO chamber and the qualification of sputum aspirators. What's more, this paper also describes the construction, principles and characteristics of all kinds of sputum aspirators in HBO chamber. When critical patients are treated in HBO chamber, it is very important to select reasonable sputum aspirators.

Objective To investigate the roles of tumor necrosisfactor-α(TNF-α) and nuclear factor-κB (NF-κB) in cerebral ischemia-reperfusion injury in rats w ith diabetes mel itus. Methods Thirty-six healthy male Sprague-Daw ley rats w ere divided into a euglycemic sham operation group, a euglycemic isc hemia-reperfusion group, and a diabetes ischemia-reperfusion group (n=12 in each group) according to a random number table. A diabetes model w as induced by intraperitoneal injection of streptozotocin, and then a focal cerebral ischemia-reperfusion model w as induced by the suture method. The neurological deficit score was performed at 24 h after reperfusion. 2,3,5 triphenyl tetrazolium staining was used to measure the cerebral infarction area. Western blotting w as used to detect the expression levels of NF-κB and TNF-αon the ischemic sides. Results The neurological function scores w ere 0.00 ±0.00, 2.50 ±1.08, and 3.20 ± 1.03, respectively in the euglycemic sham operation, euglycemic cerebral ischemia-reperfusion and diabetes cerebral ischemia-reperfusion groups, and there w ere significant differences (F=38.015, P<0.001). The neurological deficit scores of the diabetes cerebral ischemia-reperfusion group w ere significantly aggravated compared with the euglycemic cerebral ischemia-reperfusion group (P<0.05). The infarct areas of the euglycemic sham operation, euglycemic cerebral ischemia-reperfusion and diabetes cerebral ischemia-reperfusion groups w ere 0.00% ±0.00%, 33.09% ±5.17%, and 55.45% ±9.29%, respectively, and there w ere significant differences among the groups (F=206.614, P<0.001), in w hich the infarct area in the diabetes cerebral ischemia-reperfusion group w as enlarged significantly compared w ith the euglycemic cerebral ischemia-reperfusion group ( P< 0.05 ). At 24 h after reperfusion, there w ere no significant differences in the expression levels of the cortical NF-κB (F=29.993, P<0.001) and TNF-α(F=28.722, P<0.001) on the ischemic sides in each group, in w hich the expression levels of NF-κB and TNF-αin the diabetes cerebral ischemia-reperfusion group w ere increased significantly compared w ith the euglycemic cerebral ischemia-reperfusion group (al P<0.05). Conclusions Diabetes may aggravate cerebral ischemia reperfusion injury. The upregulated expression of TNF-αand NF-κB may be one of the mechanisms of diabetes aggravating cerebral ischemia-reperfusion injury.

Objective To summarize the clinical experience of successful intervention in single chronic coronary actery total ocdusion (CTO) lesions by the transradial.Methods A retrospective analysis was conducted in 103 patients with single CTO lesions who got intervention treatment by the radial artery.Results ( 1 ) Of the 103 cases,57 cases had unstable angina,12 cases had stable angina,and 34 cases chronic myocardial infarction.Lesions' block time was ≤ 6 months in 83 cases,and ＞ 6 months in 20 cases.(2)The path vessels of the 103 patients have no severe tortuosity and anatomical structure variation.Fifty-one cases occurred left anterior descending occlusion,25 cases occurred left circumflex branches occlusion,and 27 cases occurred right coronary artery occlusion.Furthermore,24 cases had chronic complete occlusion,and 79 cases had chronic functional block.The side branches did not block in 91 cases,no lesions(bridge) collateral formation occurred in 87 cases,lesions length was less than 15 mm in 67 cases,and tapered lesions was observed in 81 cases.( 3 ) Final intervention rate via Judkins,XB,EBU guide catheter was 37.86％,30.10％ and 29.13％ respectively.(4)the PILOT successfully through the lesions for the series wire guided was 64.08％.(5) 1.25 mm diameter series with a balloon through the first lesions and successful expanding was observed in 57 cases (55.34％),and 1.5 mm diameter series with a balloon occurred in 38 cases(36.89％ ).Conclusion Intervention treatment by the radial of single CTO lesions is feasible for experienced performers.The successful intervention depends on path vessels unimpeded,target vessels with characteristic pathological features and reasonable choice of instruments.

Objective To investigate the role of TLR4/NF-κB signaling pathway in mediating sleep depriva-tion induced endolymphatic hydrops.Methods A total of 30 healthy sprague-dawley(SD)rats were randomly di-vided into the control group、big platform control group,and 2 w,3 w,4 w sleep deprivation group,with 6 rats in each group.Modified multiple platform method was adopted to establish the rat sleep deprivation model.Before and after the experiment,the open field and acoustic brain-stem response(ABR)was conducted to evaluate the behavior and hearing level.After ABR test,blood samples were collected from abdominal aorta,and serum levels of TNF-αand MCP-1 were detected by ELISA.The cochlea was dissected,the severity of endolymphatic hydrops was as-sessed by calculating the ratio of the cross sectional area of the membranous cochlear duct(SM)to that of the mem-branous cochlear duct+scale vestibuli(SM+SV).Positive expression of IL-1β,TNF-α,MCP-1,TLR4,NF-κB P65 in rat cochlear tissues was detected via immunohistochemical staining.After the experiment,the changes of hearing level,the severity of endolymphatic hydrops and TLR4/NF-κB signaling pathway related proteins and down-stream inflammatory factors expression level were observed.The correlation between TLR4/NF-κB signaling path-way and hearing level and endolymphatic hydropsin rats was analyzed.Results ABR results showed an increased threshold of wave Ⅱ in the sleep deprivation group compared to those of the control group and big platform control group(P＜0.05).The rate of hydrops was 0％in control and big platform control groups,16.67％in 2w sleep deprivation group and 25％in 3 w and 4 w sleep deprivation group.The concentrations of TNF-αand MCP-1 in ser-um of rats in sleep deprivation groups were higher than those in control and big platform control groups,and the 4w sleep deprivation group were statistically significant compared with control and big platform control groups.The ex-pressions of IL-1β,TNF-α,MCP-1,TLR4 and NF-κB P65 in the cochlear spiral ganglion,spiral canal,stria vascu-laris and spiral ligament of rats in sleep deprivation groups were higher than those in control and big platform control groups.Conclusion Sleep deprivation may induce endolymphatic hydrops by the TLR4/NF-κB signaling pathway.

Objective:To explore the effect of laparoscopic surgery on postoperative rehabilitation and stress response of patients with colorectal cancer.Methods:From January 2018 to September 2019, 94 patients with colorectal cancer were selected in the General Hospital of Marine Police of the Chinese People's Armed Police Force.They were divided into observation group (47 cases) and control group (47 cases) according to the random digital table method.The observation group was treated with laparoscopic surgery, while the control group was treated with open surgery.The changes of perioperative indicators, postoperative rehabilitation indicators, postoperative complications and 24-hour stress response indicators were compared between the two groups.Results:The time of lymph node dissection and operation had no statistically significant differences between the two groups (all P>0.05). The amount of bleeding of the observation group [(153.61±27.58)mL] was less than that of the control group [(271.32±23.25)mL] ( t=22.371, P<0.05). In the observation group, the exhaust time [(43.27±6.18)h] and the recovery time of bowel sounds [(20.31±3.28)h] were faster than those in the control group [(67.38±9.91)h and (34.54±5.17)h] ( t=14.153, 15.934, all P<0.05). The incidence of postoperative complications in the observation group (4.26%) was lower than that in the control group (21.28%) (χ 2=6.114, P<0.05). The serum levels of norepinephrine (NE) [(92.13±10.45)μg/L], C-reactive protein (CRP) [(17.38±3.01)mg/L] and Cor [(137.87±23.15)μg/L] in the observation group were lower than those in the control group [(136.27±15.42)μg/L, (26.73±2.34)mg/L and (185.42±27.39)μg/L] ( t=16.245, 16.813, 9.090, all P<0.05). Conclusion:Laparoscopic radical resection of colorectal cancer has good effect on patients with colorectal cancer.It can speed up postoperative rehabilitation and reduce stress response.It is worthy of popularizing.

Objective To evaluate the detection performance of common strains and the antimicrobial binding capacity of four blood culture systems made by BMX-FA/N Plus,Zhengzhou Anto,Zhuhai DIER and Chongqing Zhongyuan.Methods According to the common pathogens of clinical bloodstream infections in Wuhan No.1 Hospital,ATCC standard isolates of Staphylococcus aureus,Streptococcus pneumoniae,Enterococcus faecalis,Escherichia coli,Pseudomonas aeruginosa,Haemophilus influenzae,Stenotrophomonas Maltophil,Bacteroides tenuis and Candida glabla were chosen to explore.Prefabricated bacterial suspension and sterile horse blood were injected into different brands of blood culture systems to simulate the blood samples of patients with non-antibiotic treatment and antibiotic treatment.Six commonly used clinical antibiotics,Imipenem,Piperacillin/Tazobactam,Cefoperazone/Sulbactam,Levofloxacin,Vancomycin and Micafungine,were added to the blood samples after simulated antibiotic treatment.The performance was evaluated by recording the positive bottles and the detection time of each brand culture systems within five days with and without antibiotic.Results In the absence of antibiotic,four blood culture systems showed 100％recovery on all of the pathogens.Staphylococcus aureus,Pseudomonas aeruginosa and Haemophilus influenzae were recovered earlier in DIER aerobic bottles than BMX-FA Plus aerobic bottles,and the differences were statistically significant(t=2.608,5.547,12.247,all P＜0.05).The time to detection of Staphylococcus aureus,Streptococcus pneumoniae,Enterococcus faecalis and Haemophilus influenzae in Zhongyuan anaerobic bottles was significantly faster than that of BMX-FA Plus anaerobic bottles,with an average shortening of 1.92～10.80 h,and the differences were statistically significant(t=30.187,5.367,33.068,24.855,all P＜0.05).When antibiotics added,BMX-FA Plus culture bottle showed 100％recovery to all the detecting pathogens with the peak concentration antibiotics except Cefoperazone/Sulbactam,while the recovery in Zhongyuan blood culture bottle also was 100％with peak concentration antibiotics of Piperacillin/Tazobactam,Levofloxacin and Micafunzin.The peak concentration of imipenem antibiotics in domestic bottles was only detected in Anto anaerobic bottles,with lower positive detection rate(66.7％)lower than that of BMX-FA Plus(100％)and a later detection,and the difference was statistically significant(t=-21.000,P=0.030).Conclusion In the absence of antibiotic interference,the positive detection rate of the above pathogens are the same for four blood culture systems,and the time to detection of DIER and Zhongyuan systems is shorter than that of BMX-FA/N Plus.In the presence of antibiotic interference,the detection ability to pathogens in BMX-FA/N Plus system is the best,followed by domestic Zhongyuan system.