Objective To analyse effect of nalmefene hydrochloride adjuvant therapy on serum nitric oxide(NO), endothelin (ET) and cardiac troponin I ( cTnI) in patients with traumatic shock.Methods 48 patients who were diagnosed with traumatic shock were collected.All patients were randomly divided into experimental group and control group, 24 cases in each group.On the basis of conventional anti shock treatment, the control group were treated with naloxone, the patients in experimental group received nalmefene hydrochloride treatment, after treatment, the serum levels of NO, endothelin and cardiac troponin I were detected in all patients.Results After treatment, compared with control group, the serum level of NO was lower in experimental group(P<0.05);the serum level of ET was lower in experimental group(P<0.05);the serum level of cTnI was lower in experimental group(P<0.05).Conclusions Nalmefene hydrochloride adjuvant therapy could significantly reduce the serum levels of NO, ET and cTnI in patients with traumatic shock,control the development of the disease, prevent myocardial injury.

Objective To explore the effects of urokinase type plasminogen activator (uPA) gene-modified bone marrow-derived liver stem cells ( BDLSC) transplantation on hepatocyte regeneration in CCl4-induced liver fibrosis rats. Methods Ten male Fisher 344 rats were donor rats of BDLSC. The BDLSC of male rat was transfected with AduPA. Thirty-six female Fisher 344 rats were equally divided into normal group (injected subcutaneously with olive oil) , model group (CCl4 induced the model, injected through tail vein with 0. 9% sodium chloride), BDLSC group (CCl4 induced the model, injected through tail vein with BDLSC) and gene transfected group (CCl4 induced the model,injected through tail vein with gene transfected BDLSC). Liver function and area of collagen were observed. The expression of hepatic growth factor ( HGF) and its receptor c-met mRNA in rats' liver tissues were tested by semiquantitative RT-PCR. The expressions of proliferating cell nuclear antigen (PCNA) in rats' liver tissues were determined by immunohistochemistry staining. Results The areas of collagen in normal group, model group, BDLSC group and gene transfected group was 0. 12% ± 0.03%, 14. 49%±1.40%, 8. 25%±0. 82% and 5. 12%±0. 40% accordingly, there were significant differences between groups (P<0. 05). Compared with model group and BDLSC group, the liver function of gene transfected group significantly improved, the serum levels of hyaluronic acid (HA),procollagen Ⅲ (PCⅢ) and the content of hydroxyproline in liver tissues decreased dramatically. The expression of HGF and c-met at mRNA levels were up-regulated significantly, and the expression of PCNA protein in liver tissues increased obviously. Conclusion uPA gene-modified BDLSC transplantation may induce proliferation of hepatocytes, and then improve the liver functions of fibrotic rats induced by CCl4.

Objective To observe the impacts of different storage temperatures on the activities of adipose tissues and the extraction and proliferation of adipose-derived stem cells (ADSCs) situated in harvested fat.Methods Adipose tissues obtained by liposuctions in healthy females were kept in different temperature;all groups of adipose tissues were studied in context of the histomorphology and activity of GAPD as well as the extraction efficiency and proliferation of ADSCs.Results Adipose tissues cryopreserved at 4 ℃ within 24 hours could retain their activities effectively,but their activities would decrease rapidly if they preserved at room temperature.The efficiency of adipose tissues extracting stem cells and their proliferations were affected by storage temperatures and times.If adipose tissues were preserved at room temperature for over 1 hour,the extraction efficiency and proliferation of their ADSCs would be lower significantly.Conclusions Adipose tissues cryopreserved at 4 ℃ can effectively ensure their activities and their extraction efficiency and proliferation of ADSCs.It is important to preserve adipose tissues at low temperature after harvesting fat graft.

Objective To explore the curative effectiveness of transplantation of bone marrow-derived liver stem cells (BDLSCs) transfected with rat interleukin-10 (IL-10) gene in the treatment of liver fibrosis in rats. Methods β2m-/Thy-1+BDLSCs isolated from Wistar rats were transfected with adenovirus-mediated rat IL-10 gene Wistar rats were subcutaneously injected with CCl4 to induce liver fibrosis, and randomly divided into three groups as follows: (1) the model group, infused with 1 ml normal saline (NS); (2) the BDLSC group, infused with NS containing untreated β2m-/Thy-1+BDLSCs (2×105 cells); (3) the IL-10 group, infused with NS containing β2m-/Thy-1+ BDLSCs transfected with IL-10 gene (2×105 cells). Infusion was done via the portal vein. Rats subcutaneously injected with olive oil served as control (the normal group). The BDLCs labeled with diamidine phenylindole dihydrochloride (DAPI) in the liver were localized. Pathological changes and collagen area in liver tissues were observed. Liver function and blood blotting function were tested. Results β2m-/Thy-1+ BDLSCs labeled with DAPI were observed in liver tissues of rats. Significant pathological changes of liver tissues were observed in the model group. Compared with the model group, pathological changes were alleviated to some extent in the BDLSC group. The morphology of liver tissue in the IL-10 group was mostly close to that in the normal group. Collagen deposition of liver tissues was increased obviously in the model group. However, transplantations of untreated and IL-10-transfected BDLSCs both reduced collagen area. Compared with the BDLSC group, collagen deposition was significantly suppressed in the IL-10 group. Transplantation of IL-10-transfected BDLSCs suppressed obviously the levels of ALT, AST, ALP, TBIL, PT and APTT as compared with the model group (P<0. 05). The levels of ALT, TBIL, PT and APTT in the IL-10 group were significantly reduced to the normal levels as compared with those in the BDLSC group (P<0. 05).Conclusions Transplantation of BDLSCs transfected with rat IL-10 gene was effective in treating liver fibrosis in rats. This combined strategy of IL-10 gene and BDLSCs may represent a feasible, effective and safe therapy form for liver fibrosis.

Objective To investigate the efficacy of microbubble-enhanced sonothrombolysis on platelet-rich thrombi (PRT) and erythrocyte-rich thrombi (ERT) in different ages.Methods PRT and ERT in different ages were prepared both in vitro and in vivo of common carotid artery in rats.All the participants were divided into 8 groups with 4 in vitro and another 4 in vivo experiment,including PRT 3 h,PRT 24 h,ERT 3 h,ERT 24h in vitro groups and PRT 3 h,PRT 24 h,ERT 3 h,ERT 24 h in vivo groups.Microbubble-enhanced sonothrombolysis was carried out in both in vitro and in vivo experiments,and the ultrasonic images were collected.The components of PRT and ERT were identified by histopathological examination.The percentage increase of luminal cross sectional area and lytic ratio in vitro,and the recanalization rate and mean blood flow velocity of common carotid artery in vivo were mainly analyzed.Results After sonothrombolysis,both in vitro and in vivo experiment showed there was no statistically significant difference of the percentage increase of luminal cross sectional area ([121.12 ± 13.21]％ vs [130.09 ± 15.34]％),lytic ratio ([39.83± 7.09]％ vs [42.14±5.17]％),recanalization rate (83.33％ vs 91.67％) and blood flow velocity of common carotid artery ([0.21±0.02]m/s vs [0.22±0.01]m/s) between PRT 3 h group and ERT 3 h group (both P＞0.05).PRT 24 h group compared with EPR 24 h group,PRT 24 h group compared with PRT 3 h group,as well as ERT 24 h group compared with ERT 3 h group,the percent increase of luminal cross sectional area,lytic ratio,recanalization rate and blood flow velocity of common carotid artery reduced (all P＜0.05).Conclusion The efficacy of microbubble-enhanced sonothrombolysis on PRT and ERT in vitro and in vivo of of rat common carotid artery model decrease with the increase of thrombus age,especially for the PRT.

To solve the problem of imprecise positioning of feature point and of the feature data redundancy in facial expression recognition by active appearance models (AAM), the automatic adjustment of initial model for AAM fitting is proposed in this paper. The specific aims are to improve the precision of positioning and to more effectively reflect the variation of expressions by acquired features. The problem of feature selection is resolved by adopting quadratic mutual information and reducing the feature dimension. The support vector machine (SVM) classifier is used for expression recognition. The experimental results on CAS-PEAL facial expression database show that the proposed method effectively improves the performance of facial expression recognition, the maximum recognition rate being 83.33%.
Algorithms ; Computer Simulation ; Facial Expression ; Humans ; Image Interpretation, Computer-Assisted ; methods ; Models, Biological ; Pattern Recognition, Automated ; methods ; Signal Processing, Computer-Assisted

Objective To analyze the precipitating factors for,clinical manifestations of,laboratory findings in and therapeutic effect on acute urticaria.Methods Clinical data were collected from 185 inpatients with acute urticaria in Shanxi Dayi Hospital from January 2013 to December 2016.Clinical features,laboratory examination results,treatment,prognosis and adverse reactions were analyzed retrospectively.Statistical analysis was carried out by chi-square test.Results There were 63 male patients and 122 female patients in this study,with an average age at onset of 32.87 ± 14.18 years.Of the 185 patients,78 (42.2％) were able to report the aetiological agents accurately,33 (17.8％) were induced by infection or drug therapy following infection,and 82 (44.3％) had fever.Blood cell analysis showed increased white blood cell count in 132 (71.4％) cases and increased proportion of neutrophils in 128 (69.2％) cases.The level of C reactive protein increased in 118 (69％) of 171 cases.A total of 185 patients received routine anti-anaphylactic treatment.Of 183 cured patients,153 (83.6％) were treated with antibiotics,26(14.2％)with antibiotics alone,and 24(13.1％) with azithromycin.There were 127 (69.4％) patients receiving combined treatment with glucocorticoids,antibiotics,and so on,and the antibiotic used in 111 (60.7％) cases was azithromycin.Of 88 cured patients with simultaneous signs of infection,85 (96.6％) showed increased levels of part or all of infection markers (including the white blood cell count,proportion of neutrophils and level of C reactive protein),and 69 (78.4％) were treated with azithromycin.Of 95 cured patients without signs of infection,83 (87.4％) showed increased levels of infection markers,and 61 (64.2％) were treated with azithromycin.Moreover,there were significant differences in the proportion of patients with increased levels of infection markers and that of patients treated with azithromycin between the cured patients with and without signs of infection (x2 =5.164,4.476,both P ＜ 0.05).Conclusions Infection is a common cause of acute urticaria,and laboratory examinations including white blood cell count,proportion of neutrophils and level of C reactive protein are of important reference value to the diagnosis of infection in patients with acute urticaria.Patients with signs of infection or increased levels of infection markers need to be treated with combined anti-infective therapy,and in the cured patients,the proportion of patients administrating azithromycin was higher than that of those administrating other antibiotics for the treatment of acute infectious urticaria.

Objective:To explore the predictive value of systemic immune inflammation index (SII) for the risk of hospital death in critically ill patients.Methods:The basic information and clinical data of critically ill patients were extracted from the Medical Information Mart for Intensive Care database-Ⅳ (MIMIC-IV) database, including demographic data, vital signs, blood routine, Logistic organ dysfunction score (Lods), Oxford acute severity of illness score (Oasis), simplified acute physiology score (Saps-Ⅱ), acute physiology score Ⅲ (APS-Ⅲ), sequential organ failure score (SOFA) and outcome. The main outcome was hospital death, and the secondary outcomes were length of hospital stay, continuous renal replacement therapy (CRRT), invasive ventilation and 1-year mortality. Patients were divided into two groups according to in-hospital death, and the differences between the groups were compared. According to the SII tripartite for inter-group comparison, the patients were further divided into three groups for comparison, and Logistic regression model was used to analyze the odd ratio ( OR) of the three groups. Results:A total of 32 450 critically ill patients were included in the study, of which 3765 died in hospital, with a mortality rate of 11.6%. ① Compared with the survival group, the SII in the death group were significantly higher ( P < 0.05). ② The mortality for the SII tripartite grouping (<817; 817~2 151; >2 151) were 8.4%, 10.2% and 16.3%, respectively, and the differences between groups were statistically significant. ③ Further, Logistic regression model analysis showed that the risk of death increased gradually with the increase of groups (the first group was the reference group, OR of the second group was 1.38, 95% CI 1.24-1.54, and OR of the third group was 2.03, 95% CI 1.83-2.24 ( P < 0.05). Conclusions:SII has a certain value in predicting hospital death in critically ill patients. It is easy to obtain and can be used for risk stratification of critically ill patients.

Objective:To explore the optimal pulse oxygen saturation (SpO 2) range during hospitalization for patients with sepsis. Methods:A case-control study design was employed. Demographic information, vital signs, comorbidities, laboratory parameters, critical illness scores, clinical treatment information, and clinical outcomes of sepsis patients were extracted from the Medical Information Mart for Intensive Care-Ⅳ (MIMIC-Ⅳ). A generalized additive model (GAM) combined with a Loess smoothing function was employed to analyze and visualize the nonlinear relationship between SpO 2 levels during hospitalization and in-hospital all-cause mortality. The optimal range of SpO 2 was determined, and Logistic regression model along with Kaplan-Meier curve were utilized to validate the association between the determined range of SpO 2 and in-hospital all-cause mortality. Results:A total of 5?937 patients met the inclusion criteria, among whom 1?191 (20.1%) died during hospitalization. GAM analysis revealed a nonlinear and U-shaped relationship between SpO 2 levels and in-hospital all-cause mortality among sepsis patients during hospitalization. Multivariable Logistic regression analysis further confirmed that patients with SpO 2 levels between 0.96 and 0.98 during hospitalization had a decreased mortality compared to those with SpO 2 < 0.96 [hypoxia group; odds ratio ( OR) = 2.659, 95% confidence interval (95% CI) was 2.190-3.229, P < 0.001] and SpO 2 > 0.98 (hyperoxia group; OR = 1.594, 95% CI was 1.337-1.900, P < 0.001). Kaplan-Meier survival curve showed that patients with SpO 2 between 0.96 and 0.98 during hospitalization had a higher probability of survival than those patient with SpO 2 < 0.96 and SpO 2 > 0.98 (Log-Rank test: χ2 = 113.400, P < 0.001). Sensitivity analyses demonstrated that, with the exception of subgroups with smaller sample sizes, across the strata of age, gender, body mass index (BMI), admission type, race, heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, respiratory rate, body temperature, myocardial infarction, congestive heart failure, cerebrovascular disease, chronic liver disease, diabetes mellitus, sequential organ failure assessment (SOFA), simplified acute physiology score Ⅱ (SAPSⅡ), systemic inflammatory response syndrome score (SIRS), and Glasgow coma score (GCS), the mortality of patients with SpO 2 between 0.96 and 0.98 was significantly lower than those of patients with SpO 2 < 0.96 and SpO 2 > 0.98. Conclusions:During hospitalization, the level of SpO 2 among sepsis patients exhibits a U-shaped relationship with in-hospital all-cause mortality, indicating that heightened and diminished oxygen levels are both associated with increased mortality risk. The optimal SpO 2 range is determined to be between 0.96 and 0.98.

Objective:To assess the bacterial profiles and antimicrobial susceptibility patterns in uropathogens, and help to inform the empiric treatment decisions for urinary tract infection in outpatient settings.Methods:A single institutional retrospective analysis was performed on positive urine cultures from outpatient settings between January 1998 and December 2018. To analyze changes over time, trends analysis were undertaken on bacterial profiles, antimicrobial susceptibility and resistance.Results:A total of 1.172 pathogenic bacteria were isolated after exclusion of duplicate strains originated from the same patient, including 991(84.6%) Gram-negative bacterial strains and 181(15.4%) Gram-positive strains. The most common Gram-negative uropathogens were Escherichia coli (60.8%) and Klebsiella pneumonia (8.1%). Enterococcus faecalis (4.6%) was the predominant Gram-positive strain. The detection rate of Escherichia coli increased significantly, from 50.8% to 63.2% ( χ2=7.978, P=0.046), and no significant difference was observed in the distribution of major uropathogenic bacteria over the 20 years (all P>0.05). The proportion of extended-spectrum β-lactamase (ESBLs) producing strains increased significantly across the 20 years ( P<0.05). The resistance rates of Escherichia coli to amoxicillin and clavulanate potassium, aztreonam, ceftazidime, ciprofloxacin and sulbactam + cefoperazone increased significantly (all P<0.05). All the isolates sustained high susceptibility to tazobactam + piperacillin, amikacin, imipenem and nitrofurantoin (95.0%, 95.7%, 97.9% and 91.1%). Similar to those of Escherichia coli, Klebsiella pneumoniae remained a high and stable sensitivity to tazobactam+piperacillin, amikacin and imipenem during the 20 years (79.1%, 88.0% and 80.3%). However, the proportion of ESBLs producing strains increased significantly ( P<0.05). Among Gram-positive bacteria isolates, the sensitivity rates of Enterococcus faecalis to ampicillin, nitrofurantoin and penicillin G were 100.0%. No vancomycin resistant strain was detected in Gram-positive bacteria. Conclusions:From 1998 to 2018, Escherichia coli and Klebsiella pneumoniae are the most common Gram-negative bacteria uropathogens obtained in outpatient settings. Significant increases of resistance to some antimicrobial agents such as second- and third-generation cephalosporins and fluoroquinolones are observed during the 20 years and high susceptibilities to tazobactam+piperacillin, amikacin, imipenem and nitrofurantoin sustain over time. Local treatment strategies of urinary tract infections on outpatient basis should be made according to epidemiology of drug resistance and individual characteristics to control the spread and curb the prevalence of drug resistant.