In this study, we selected 24 crewmen who worked in the high temperature circumstances in the engine cabin, resulting in a great loss of body water, together with a large amount of inorganic salts and nitrogen. We Proved that the loss of sodium, potassium, and calcium in sweat is greater than that in urine. The excretion of sodium is the highest, then potassium, the lowest is calcium. The body weight of the engine member has a prominent decrease after summer. It seems that the regaining of body weight can be promoted by great supply of vitamins. So, we should give a large amount of proteins, vitamins and calcium to the members who worked in the circumstance of such a high temperature. The amount of salt is already quite enough in an ordinary meal.

This paper introduces what signals are actually transmitted in every procedure of the start-up process of Mx8000 Exp double-slice spiral CT and what relevant parts are acted.Some troubles related to start-up process is briefly presented.

Objective To observe the outcomes of the modified multiple nerve transfer s combined with the late hand function reconstruction to restore the active pick-up function of the paralyzed upper extremity in patients with total brachial plexus avulsion injuries (TBPAI).Methods 33 patients suffered with TBPAI firstly underwent multiple nerve transfers,which including accessory nerve transfers to neurotize the suprascapular nerve to recover the shoulder abduction,contralateral C7 (CC7) nerve transfers via the modified pre-spinal route with direct coaptation to restore lower trunk function and the musculocutaneous nerve was also neurotized by the transferred CC7 nerve via a cutaneous nerve graft to restore the function of elbow flexion,as well as the phrenic nerve transfers to neurotize the posterior division of lower trunk to restore the function of elbow and finger extension.The patients with muscle recovery were selected to perform the hand function reconstruction at the second stage for restoring the active pick-up function.The patients were chosen as followcriterias:the degree of shoulder abduction attained 30°or more,the motor power of elbow,wrist,and finger flexion attained grade M4 or more,elbow and finger extension attained M3 or more.The methods of hand function reconstruction included wrist fusion and flexor carpal ulnaris opponensplasty,in addition to palmar capsulodesis of the metacarpophalangeal joint.Results The mean follow up was 41±7.7 (range,36-73 months) after the first procedure of multiple nerve transfers,the muscle strength of elbow and finger and wrist flexion attained M 4 as well as the elbow and finger extension achieved M3 or more in 10 patients,all of 10 patients achieved 40°-80°shoulder abduction.8 out of 10 patients had performed the second surgical procedure for hand functional reconstruction.6 of them had successfully recovered the active pick-up function.Conclusions The newly designed procedure of multiple nerve transfers could effectively restore the function of shoulder abduction,elbow,wrist,and finger flexion,as well as elbows and finger extension in patients with TBPAI,combined with the hand functional reconstruction,active pick-up function could be successfully reconstructed.

BACKGROUND:Surgical treatment is often required for fractures of the cervical vertebrae. Anterior interbody fusion technology is stil the main method for the treatment of cervical degeneration or traumatic instability. Here, the self-made oval al ogeneic bone pad can adapt to different height and width of the intervertebral space, in line with the physiological shape of the intervertebral space. OBJECTIVE:By comparison with autogenous iliac crest bone, to evaluate various types of self-designed al ogeneic bone pads on anterior cervical interbody fusion. METHODS:From January 2009 to December 2013, 58 patients with cervical disc herniation were enrol ed and subjected to cervical discectomy and anterior cervical interbody fusion. According to different bone grafts, these patients were divided into al ogeneic bone pad and autogenous iliac bone groups. The course of disease was 12 to 24 months. The postoperative effect was measured by Japanese Orthopaedic Association (JOA) score, cervical fusion rate, fusion time, operative time, blood loss and rejection rate. RESULTS AND CONCLUSION:At 6 months postoperatively, the JOA score of two groups had no significant difference at 6 months after treatment (P>0.05);the cervical fusion rates were 83.7%and 87.8%, respectively, in the al ogeneic bone pad and autogenous iliac bone groups, with no significant difference (P>0.05). Fusion time was higher in the al ogeneic bone pad than in the autogenous iliac bone group (P<0.05). The internal fixators in the two groups were firmed without loosening, and there was no rejection during the fol ow-up. Compared with the autogenous iliac crest bone, anterior cervical interbody fusion with al ogeneic bone pad can achieve satisfactory effects, which can be better for intervertebral fusion and cannot induce pain due to bone cutting.

Objective To explore the relation between vitamin D deficiency and susceptibility to spinal tuberculosis. Methods A total of 163 hospitalized patients with untreated spinal tuberculosis in Tianjin Haihe hospital were enrolled in this study from June 2013 to May 2016. A total of 170 individuals participated in health examination program at the same period were enrolled as the control group. The serum level of 25-hydroxyvitamin D [25(OH)D] was measured by enzyme linked immunosorbent assay. The 25(OH)D grading included serious deficiency group (<25 nmol/L), deficiency group (≥25 nmol/L and <50 nmol/L), insufficiency group (≥50 nmol/L and <75 nmol/L) and sufficiency group (≥75 nmol/L). Histopathological classification was confirmed by intraoperative findings. Results The serum level of 25(OH)D was significantly lower in patient group [23.99(20.55,29.54)nmol/L] than that of control group [42.94(35.68,51.04) nmol/L] (P<0.01), and which was also significantly lower in four seasons than that of controls (P<0.05). The serum levels of 25(OH)D were significantly higher in summer group than those of winter group in both patient and control groups (P<0.008 3). The proportion of patients with serious deficiency of 25(OH)D was significantly higher in spring and winter groups in patient group, which was significantly lower in summer group (P<0.01). There was no significant difference in patients with serious deficiency of 25(OH)D between four seasons (P<0.01). For control group, there was a higher proportion of cases with deficiency of 25(OH)D in four seasons, and there was no significant difference in the distribution of seasons (P>0.05). In patient group, there were 107 cases of caseous necrosis type, 56 cases of hyperplasia type, and the proportion of caseous necrosis type was significantly higher in the severe deficiency group (79.17%, 76/96) than that of deficiency group (46.27%, 31/67, P<0.01). Conclusion Excluding the effect of season, vitamin D deficiency is associated with susceptibility to spinal tuberculosis and histopathologic classification.

Objective To investigate the expression of metabotropic glutamate receptor (mGluR) in murine podocytes.Methods Conditional immortalized podocytes were used in the research.RT-PCR was used to estimate the mRNA expression.Western blotting,immunofluorescence staining and immunoelectron microscopy were employed to determine the protein production.EIA,EMSA and Western blotting were used to examine the cAMP generation and cAMP response element-binding protein (CREB) activation.Intracellular calcium was investigated using confocal microscopy.Results mGluR1 and 5 mRNA and protein were expressed in murine brain and podocytes.In glomeruli,most of mGluR1 expression located in podocytes and was expressed in the submembrane space of the podocytes.Podocytes treated with (S)-3,5-dihydroxyphenylglycine (DHPG,an agonist for mGluR1/5) rapidly generated cAMP and activated CREB.(RS)-1-Aminoindan-1,5-dicarboxylic acid (AIDA,a selective antagonist of mGluR1/5) and SQ22536 (an adenylate cyclase inhibitor),but not 2-aminoethoxydiphenyl borate (2-APB an antagonist of canonical transient receptor potential) blocked DHPG-induced cAMP generation and CREB activation.Following DHPG treatment,intracellular calcium level rose and was prevented by pre-treatment with AIDA and 2-APB.DHPG-induced calcium influx was also prevented by incubation with calcium-free medium.Conclusion Podocytes express functional mGluR1 and mGluR5.

The PTD-NPY fusion gene derived from HIV-1 TAT protein transduction domain and rat neuropeptide Y was amplified by overlap extension PCR, digested and subcloned into yeast expression vector pPICZ alpha A to construct recombinant expression plasmid pPICZ alpha-PTD-NPY. The cloned PTD-NPY fusion gene was identified by PCR and restriction enzyme digestion and sequenced. The exact recombinant plasmid was linearized by Sac I and integrated by electrotransformation into the genome of Pichia pastoris GS115 cells. Then, these positive recombinant yeast cells were induced by 10 mL/L methanol to express soluble PTD-NPY fusion protein. After 120 h of methanol induction, the SDS-PAGE electrophoresis result indicated PTD-NPY fusion protein was efficiently secreted into the medium. Western blotting analysis proved that the expressed fusion protein had specific NPY binding activity. The successful expression of PTD-NPY fusion protein in Pichia pastoris provided basis for its further application study.
Animals ; Cloning, Molecular ; Gene Fusion ; Genetic Vectors ; genetics ; Neuropeptide Y ; genetics ; Pichia ; genetics ; metabolism ; Polymerase Chain Reaction ; methods ; Rats ; Recombinant Fusion Proteins ; biosynthesis ; genetics ; Transduction, Genetic ; tat Gene Products, Human Immunodeficiency Virus ; genetics

Objective To investigate the incidence and the prognosis of acute kidney injury (AKI) and to find out the risk factors associated with the outcome for better understanding and preventing AKI among inpatients. Methods All the hospitalized patients were screened by Lab Administration Network of Renji Hospital,Shanghai Jiaotong University School of Medicine from Jan.to Dec.2009.Study cohort was comprised of all the patients with AKI defined by Acute Kidney Injury Network (AKIN) and with complete clinical data recorded.The incidence,etiology and distribution characteristics, prognosis of AKI in hospitalized patients were retrospectively analyzed.Logistic regression analysis was used to investigate the risk factors of patients and renal outcome. Results A total of 934 patients with AKI were enrolled.The incidence of AKI in hospitalized patients was 2.41％ (934/38 734).The ratio of male to female was 1.88∶1.Age was (60.82±16.94) years old.Increasing incidence could be seen with age rising.There was 63.4％ AKI found in surgical department,35.4％ in internal medicine department and 1.2％ in obstetric and gynecologic department.Pre-AKI,acute tubular necrosis (ATN),acute glomerular and renal vascular injury (AGV),acute interstitial nephritis (AIN) and post-AKI were accounted for 51.7％,37.7％,3.8％,3.5％ and 3.3％ of the causes of AKI,respectively.On day 28,the survival rate was 71.8％,complete renal recovery rate was 65.7％,partial renal recovery rate was 16.9％ and renal loss rate was 17.4％ among all the patients with AKI.The mortality of AKI with stage Ⅰ,Ⅱ and Ⅲ among inpatients was 24.8％,31.2％ and 43.7％ respectively.Multivariate Logistic regression analysis showed that renal injury drugs [odds ratio (OR)=2.313],hypotension (OR=4.482),oliguria (OR =5.267),the number of failure organs except kidney (OR =1.376) and requiring renal replacement therapy (RRT)(OR=4.221) were independent risk factors for death among AKI patients.The number of failure organs except kidney (OR=1.529) and RRT (OR=2.117) were independent risk factors for kidney loss. Conclusions AKI is one of the most common complications in hospitalized patients.The mortality is high and renal outcome is poor after AKI.The prognosis is closely associated with the severity of AKI.Renal injury drugs,hypotension,oliguria,the number of failure organs except kidney and requiring RRT are independent risk factors for death among AKI patients,while the number of failure organs except kidney and requiring RRT are independent risk.factors for renal loss.

Cross-provincial medical treatment can meet the high-quality health needs of residents and make up for the shortage of high-quality medical resources in underdeveloped areas. However, in economically developed areas with abundant medical resources, the phenomenon of residents seeking medical treatment across provinces was prominent. The author took J City as an example to present the distribution of cross-provincial medical visits, costs, and disease types in J City from 2017 to 2021 through on-site visits and surveys. Combined with in-depth interviews, the causes of residents in J city seeking cross-provincial medical treatment were explored, including the effective promotion of health integration in the Yangtze River Delta, the need to improve local medical technology, incomplete medical insurance policies, and relatively low reimbursement rates for major illness insurance. And strategic suggestions were proposed, including building local medical brand, improving the medical technology level of public hospitals, and reforming and improving medical insurance reimbursement policies.

Objective:To evaluate the techniques and short-term outcomes of pericardial autologous angioplasty for the reconstruction of mediastinal large vessels in the treatment of locally advanced malignant thymoma.Methods:We retrospectively analyzed the clinical data of 6 patients with locally advanced malignant thymoma who received autologous pericardial transplantation for mediastinal great vascular reconstruction in the same treatment group of Department of Thoracic Surgery, the Affiliated Hospital of Qingdao University from April 2017 to October 2018.Results:The operative time of malignant thymoma patients receiving autologous pericardial vascular reconstruction was(192.3±32.5)min, intraoperative blood loss was(105.0±27.5)ml, thoracic drainage time was(4.5±1.5)days, and postoperative hospital stay was(5.3±2.5)days. The postoperative quality of life of the patients was satisfactory. Angiography showed that the reconstructed vessels of the left inus vein were occluded in 1 patient 10 months after the operation, and the reconstructed vessels were unobstructed in the other patients. The average follow-up time of the patients was 34.3 months after surgery. One patient developed chest wall metastasis 23 months after surgery, and his condition was stable after receiving local radiotherapy. The other 5 patients did not occur local recurrence or distant metastasis.Conclusion:The application of autologous pericardium for the reconstruction of mediastinal great vessels in the treatment of malignant thymoma is a safe and effective method, and its clinical application prospect is worth expecting.