Objective To evaluate protective ventilation(PV) versus conventional ventilation(CV) for surgery in the prone position.Methods We searched PubMed, Embase, the Cochrane Library, WanFang Data and other Chinese databases to collect the randomized controlled trails (RCTs) on intraoperative PV in comparison with CV for surgery in the prone position.Two authors independently identified the studies, performed data extraction and assessed the risks of bias in the included studies according to the Cochrane Handbook for Systematic Reviews of Interventions.The reviewers conducted data analyses with RevMan software.Results A total of 9 RCTs involving 449 participants were included.The results showed that the incidence of postoperative pulmonary complications (RR 0.30, 95% CI 0.12~0.73, P<0.01) and peak pressure (MD-3.52, 95% CI-6.93~-0.11, P<0.05) were lower in the PV group.Intraoperative PaO2/FiO2 was higher (MD 37.28, 95% CI 22.67~51.89, P<0.001) and alveolar-arterial oxygen difference was lower (MD-45.50, 95% CI-61.35~-29.65, P<0.001) in the PV group.Conclusions Low tidal volume ventilation in combination with positive end-expiratory pressure (with or without recruitment maneuver) decreases postoperative pulmonary complications,reduces peak pressure and improves oxygenation for surgery in the prone position.

Objective To systematically review the effect of discontinuation of antiplatelet therapy for postoperative bleeding in carotid endarterectomy(CEA) patients by meta-analysis.Methods We searched the PubMed, Embase, Cochrane library, CNKI, China Biology Medicine (CBM), Wanfang Database and VIP, and collected all the randomized controlled trials (RCTs) about this topic.The quality of the included studies was evaluated using the method recommended by Cochrane Collaboration.Meta-analysis was conducted using RevMan 5.3 software.Results Four RCTs involving 514 patients were included, 256 in the control group and 258 in the intervention group.All outcome measures were not heterogeneous (P>0.1, I2<50%), fixed effect model was used to analyze the outcomes.The results of meta-analysis showed that discontinuation of preoperative antiplatelet therapy could significantly reduce the risk ratio of postoperative stroke (RR=0.30, 95%CI 0.11-0.83, P=0.02).There was no significant difference in the risk of 30 d (RR=0.23, 95%CI 0.04-1.32, P=0.1) and 1-year mortality (RR=0.49, 95%CI 0.24-1.02, P=0.06), postoperative major bleeding (RR=1.40, 95%CI 0.54-3.59, P=0.49), postoperative bleeding complications (RR=1.02, 95%CI 0.15-6.96, P=0.98) and TIA (RR=1.08, 95%CI 0.47-2.49,P=0.86) between the two groups.Conclusion Discontinuation of preoperative aspirin therapy could significantly reduce the rate of postoperative stroke without increasing bleeding risk.

Humans ; Infant, Newborn ; Lower Extremity ; pathology ; Lymphedema ; congenital ; Male

Background Arresting the overexpression of vascular endothelial growth factor (VEGF) will be a new approach to the inhibition of neovascularization.RNA interference (RNAi) can inhibit the expression of specific gene,and its application in eye has little interference to other gene expression.Objective This study was to investigate the effect of small interference RNA (siRNA) targeting VEGF on the expression of VEGF and retinal neovascularization in oxygen-induced retinopathy (OIR) model.Methods psi-HITM/enhanced green fluorescent protein (EGFP)/VEGF siRNA was designed and prepared in vitro.Mouse endothelioma (EOMA) were cultured in DMEM without antibiotic and divided into 5 groups.The cells were incubated in DMEM only in the blank control group;while 1 μl of LipofectamineTM 2000 + psi-HITM/EGFP,1 μl LipofectamineTM 2000 + 40,50 or 60 nmol/L of psi-HITM/EGFP/VEGF siRNA was added into DMEM in the negative control group and siRNA groups,respectively.The expression of VEGF mRNA and protein was detected by real time PCR (RT-PCR) and Western blot.The optimal effective concentration of VEGF siRNA was assessed.OIR models were established in 48 7-day-old C57BL/6J mice by raising them at an oxygen concentration of (75±2) ％ for 5 days and then to normal air.The mice were randomized into the model group,null vector group and VEGF siRNA group.1 μl of a mixture of psi-HITM/EGFP or VEGF siRNA (60 nmol/L) and LipofectamineTM 2000 was intravitreally injected,respectively,in the null vector group and VEGF siRNA group.The normal mice were used as the normal control group.Expression of VEGF mRNA and protein in the mouse retinas was detected by RT-PCR and Western blot,respectively,and FITC-dextran stretched retinal preparation was examined to evaluate the neovascularization,and retinal sections were examined to quantify the number of vascular endothelial cell nuclei extending beyond the internal limiting membrane (ILM).Results The in vitro transfection test showed that the expression of VEGF mRNA and protein in the EOMA cells was significantly different among the blank control group,negative control group and 40,50,60 nmol/L VEGF siRNA groups (F =148.890,P ＜ 0.001; F =306.960,P ＜ 0.001),and the expression of VEGF mRNA was lower in different concentrations of VEGF siRNA groups than that in the blank control group (t=73.950,119.890,156.480,all at P＜0.001).Also,the expression of VEGF protein was less in different concentrations of VEGF siRNA groups than that in the blank control group (t =15.452,23.344,42.119,all at P＜0.001).The optimal inhibitory concentration of VEGF siRNA was 60 nmol/L.In vivo study determined that compared to the model group and null vector group,the non-perfusion zones and neovascular net in the retina were decreased,and the number of vascular endothelial cell nuclei extending beyond the ILM was less in the VEGF siRNA group.The relative expression level of VEGF mRNA in the retinas was 1.23±0.18,4.02±0.16,3.98±0.19 and 1.98±0.12 in the normal control group,model group,null vector group and VEGF siRNA group,respectively,with a significant difference among them (F=369.780,P＜0.001),and the relative expression levels of VEGF mRNA in the model group and null vector group were higher than that in the normal control group (t=37.880,37.336,both P＜0.001),and the expression of VEGF mRNA in the VEGF siRNA group declined by 50.8％ (t=10.183,P＜0.001).The difference in the expression levels of VEGF protein also was assayed among the various groups (F=408.980,P＜0.001),and VEGF level in the retina was lowered by 68.0％ in the VEGF siRNA group compared to the model group (t =11.473,P＜0.001).However,VEGF level in the VEGF siRNA group remained at a high level in comparison with the normal control group (t =2.422,P＜0.001).Conclusions Intravitreal injection of VEGF siRNA can attenuate retinal neovascularization by effectively downregulate the expression VEGF mRNA and protein in the retina.

OBJECTIVETo observe the effect of Huanglian Jiedu Decoction (HLJDD) in in vivo regulating differentiation of monocytes in an apolipoprotein E knockout (ApoE(-/-)) mouse model, and to observe the effect of HLJDD-containing serum in in vitro regulating differentiation of macrophages and foam cells.

METHODSFifteen apoE(-/-) mice were randomly divided into the common diet group, the hyperlipidemia group, and the hyperlipidemia +HLJDD treatment group, 5 in each group. Mice in the common diet group were fed with a chow diet. Mice in the hyperlipidemia group were fed with high cholesterol wild diet (WD). Those in the hyperlipidemia +HLJDD treatment group were fed with high cholesterol WD supplemented with HLJDD. All mice were fed for 4 weeks. Five C57BL/6 wild types were recruited as the wild common diet control group. HLJDD was administered to mice in the hyperlipidemia + HLJDD treatment group by gastrogavage at the daily dose of 5 g/kg. Equal volume of purified water was given by gastrogavage to mice in the rest 3 groups. Four weeks later, subtypes of monocytes in the peripheral blood were detected by FACS. HLJDD administered to another 30 SD rats by gastrogavage at the daily dose of 5 g/kg, once for every 12 h for 5 times in total, thereby preparing 5% HLJDD containing serum to intervene the differentiation of in vitro primary bone marrow-derived macrophage (BMDM) and foam cells. The M2 subtype surface receptor CD206 of macrophages and foam cells were detected by FACS. The expression of Nos2 and Arg1 genes were assayed by Real-time PCR.

RESULTSThe ratio of inflammatory subset of monocytes (Ly6C(high)) increased in the peripheral blood after ApoE(-/-) mice were fed with high fat diet for 4 weeks. HLJDD significantly decreased the ratio of inflammatory subset of monocytes (P < 0.05). Compared with the vehicle serum, 5% HLJDD containing serum significantly increased differentiation of CD206 + M2 BMDM (P = 0.034). Results of real-time quantitative PCR showed that the expression level of Arg1 mRNA could be up-regulated by HLJDD containing serum (P < 0.05), and that of Nos2 mRNA down-regulated (P = 0.017). ox-LDL induced the differentiation of M2 subtype foam cells from BMDM, and HLJDD containing serum could further elevate the ratio of CD206 + M2 foam cells and increase the Arg1 mRNA expression level (both P < 0.01). HLJDD containing serum could inhibit the inversion of M2 subtype of foam cells to M1 subtype induced by Th1 factors, significantly elevate the Arg1 mRNA expression level, and decrease the Nos2 mRNA expression level (all P < 0.01).

CONCLUSIONSHLJDD could lower hyperlipidemia induced inflammatory monocyte subtype ratios in the peripheral blood of ApoE(-/-) mice. HLJDD containing serum promoted in vitro differentiation of M2 macrophages and foam cells. HLJDD attenuated and inhibited the occurrence and development of atherosclerosis induced by hyperlipidemia possibly through regulating the functional differentiation of monocytes, macrophages, and foam cells.

Animals ; Apolipoproteins E ; genetics ; Cell Differentiation ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Female ; Foam Cells ; cytology ; drug effects ; Macrophages ; cytology ; drug effects ; Mice ; Mice, Inbred C57BL ; Mice, Knockout ; Monocytes ; cytology ; drug effects

OBJECTIVETo study the effect of breastfeeding quality improvement on the breastfeeding rate in very low birth weight (VLBW) and extremely low birth weight (ELBW) infants in the neonatal intensive care unit (NICU).

METHODSA retrospective analysis was performed for the clinical data of VLBW and ELBW infants who were admitted from July 2014 to July 2015 (pre-improvement group) and those who were admitted from August 2015 to June 2016 after the implementation of breastfeeding quality improvement measures (post-improvement group). The parameters including condition of breastfeeding (breastfeeding rate, breastfeeding amount, and breastfeeding time), duration of parenteral nutrition, time to enteral feeding, and incidence of feeding intolerance were compared between the two groups.

RESULTSThe implementation of breastfeeding quality improvement measures significantly increased breastfeeding rate and amount, significantly shortened time to addition of human milk fortifier, duration of parenteral nutrition, and time to enteral feeding, and significantly decreased the incidence of feeding intolerance.

CONCLUSIONSBreastfeeding quality improvement measures can increase breastfeeding rate in the NICU and decrease gastrointestinal complications in preterm infants.

Breast Feeding ; statistics & numerical data ; Enteral Nutrition ; Female ; Humans ; Infant, Extremely Low Birth Weight ; growth & development ; Infant, Newborn ; Infant, Very Low Birth Weight ; growth & development ; Intensive Care Units, Neonatal ; Male ; Parenteral Nutrition ; Quality Improvement ; Retrospective Studies ; Weight Gain

Random amplified microsatellite polymorphism (RAMP) markers were used to access the genetic diversity among 112 samples of nine populations of Dendrobium officinale Kimura et Migo. Using 16 informative primers, 123 bands were amplified and 86 (69.92%) were polymorphic. The polymorphic bands from three to eight could be detected for each RAMP primer, with a mean of 5, indicating abundant genetic diversity among populations. Genetic similarity coefficients ranged from 0.250 to 0.813. UPGMA dendrogram illustrated 9 populations clustered into 3 groups, and the cluster pattern showed correlation with the locations of the D. officinale populations. These results were supported by the previous conclusions that were achieved by other molecular markers, and RAMP is proved to be effective for evaluating the genetic diversity of wild populations of Dendrobium officinale.
Cluster Analysis ; DNA Primers ; DNA, Plant ; genetics ; Dendrobium ; genetics ; Genetic Variation ; Microsatellite Repeats ; Phylogeny ; Plants, Medicinal ; genetics ; Polymerase Chain Reaction ; methods ; Polymorphism, Genetic ; Random Amplified Polymorphic DNA Technique ; methods

OBJECTIVESome research has shown that hyperbaric oxygen (HBO) can decrease the rate of mortality and disability caused by hypoxic-ischemic encephalopathy (HIE) in neonates. However, the HBO pressure used in the clinical reports and the efficacy of HBO are different. This study was designed to investigate the efficacy of HBO therapy under different pressures by observing the changes of peroxidation, antioxidant levels and brain vasomotor regulation factors as well as the score of neonatal behavioral neurological assessment (NBNA) in neonates with HIE after HBO therapy.

METHODSSixty neonates with HIE were randomly administered with 1.4, 1.5 or 1.6 atmosphere absolute (ATA) of HBO, once daily for seven days. Serum levels of malondialdehyde (MDA), superoxide dismutase (SOD), nitric oxide (NO) and nitric oxide synthase (NOS) were measured before and after HBO therapy. Meanwhile, NBNA and eye ground examination were performed.

RESULTSSerum SOD level increased and serum levels of MDA, NO and NOS decreased significantly after HBO therapy in the three HBO therapy groups (P<0.01). Serum SOD level was significantly higher and serum levels of MDA, NO and NOS were significantly lower in the 1.6 ATA HBO group than those in the 1.4 ATA group after therapy (P<0.05). The 1.6 ATA HBO group also showed increased SOD and decreased MDA levels compared with the 1.5 ATA HBO group after therapy (P<0.05). NBNA scores in the three groups increased significantly after HBO therapy (P<0.05). None of the three HBO therapy group patients showed abnormal eye grounds after therapy.

CONCLUSIONSHBO therapy with 1.4, 1.5 or 1.6 ATA is safe and effective for neonatal HIE. The antioxidant capacity increases with the increasing HBO pressure in neonates with HIE.

Female ; Humans ; Hyperbaric Oxygenation ; Hypoxia-Ischemia, Brain ; drug therapy ; physiopathology ; Infant, Newborn ; Male ; Malondialdehyde ; blood ; Nitric Oxide ; blood ; Nitric Oxide Synthase ; blood ; Pressure ; Superoxide Dismutase ; blood

Simple sequence repeat (SSR) was used to investigate the genetic diversity and structure of Dendrobium officinale. A total of 15 primer pairs with stable and repeatable polymorphism were screened out from 60 SSR primer pairs developed by the method of microsatellite enrichment by magnetic beads. Forty-eight samples of Dendrobium officinale were analyzed in genetic polymorphism. These loci were polymorphic and displayed 3 to 9 alleles per locus with a mean number of 6.1. The observed and expected heterozygosities ranged from 0.60 to 0.85 and from 0.49 to 0.85 respectively. The polymorphic information content (PIC) of each SSR locus varied from 0.437 to 0.829 with an average of 0.702. Fifteen primer pairs were used in Dendrobium cross-species amplification and totally 13 primer pairs were proved to have the transferability in D. officinale related species. In addition, 500 tissue culture plantlets of D. officinale were tested for purity identification by means of PCR amplification with four SSR primer pairs. The results showed that SSR technique is a feasible, simple and inexpensive method for determining adulterants in germplasm identification.
DNA Primers ; DNA, Plant ; genetics ; Dendrobium ; genetics ; Genetic Variation ; Microsatellite Repeats ; Plants, Medicinal ; genetics ; Polymerase Chain Reaction ; methods ; Polymorphism, Genetic ; Sequence Analysis, DNA ; Species Specificity

Objective To explore the relationship between the course of disease and glycolipid metabolic parameters in drug-naive schizophrenia patients. Methods All 186 drug-naive schizophrenia patients,admired to our hospital from March 2010 to October 2011,were chosen in our study; relative glycolipid metabolic parameters at baseline were tested and Positive and Negative Syndrome Scale (PANSS) was performed on these patients; and the relationships between relative glycolipid metabolic indexes and both the course of disease and manipulated variable (age,gender,education level and severity of the disease) were assessed.Results Gender might play a significant role to some glycolipid metabolic parameters (waist-hip ratio [WHR]:β=0.364; high-density lipoprotein [HDL]:β=-0.248; triacyiglycerol [TG]:β=0.167 and lysophosphatidic acid (LPA):β=-0.198,P＜0.05); age might play an important role to some glycolipid metabolic parameters (body mass index [BMI]: β=0.213; WHR: β=0.286 and apolipoprotein B 100 [apoB100]:β=0.221,P＜0.05).Simultaneously,the severity of disease appeared to affect some glycolipid metabolic parameters (BMI:β-0.167; WHR:β=-0.150 and fasting blood-glucose [FBG]:β=0.172, P＜0.05). The course of disease hardly affected the majorities of relative glycolipid metabolic indices of drug-naive schizophrenia but LPa (β=0.173, P＜0.05). Conclusion The high metabolic abnormality incidence in schizophrenia patients maybe result from multi-factor interactions.