Objective To observe the dynamic changes of TNF-α,IL-1β,IL-6,IL-10,and expressions of Notch-1,NF-κB mRNA and their protein levels in the brain tissue of septic mice and intervention effects of intrathecal injection of lentiviral vector of miR-34a gene for regulating Notch-1/NF-κB signaling pathway.Methods A total of 54 mice of clean grade were divided randomly (random number) into four groups,namely sham group (n =9),in which sham-operated laparotomy was performed;CLP group (n=15),in which the cecum ligation operation (CLP) was performed;NC group (n =15),in which intrathecal injection of lentivirus 5 μL (concentration 5 × 108 TU/mL),one time per day,for 3 days,then CLP was performed on the seventh day;intervention group (n =15),in wihch intrathecal injection of miR-34a lentivirus 5 μL (concentration 5 × 108 TU/mL),one time per day,for 3 days,then CLP was performed on the seventh day.The mice of four groups were sacrificed 24 h after modeling or operation.The changes of behavior of mice was observed and the neurological scores were assessed 24 h after CLP.The levels of TNF-α,IL-1β,IL-6 and IL-10 in the brain were measured by ELISA method.The mRNA expression and protein levels of Notch-1 and NF-κB in the brain tissue were measured by real-time PCR and Western blot method,respectively.Pathological changes of brain tissue were observed under light microscope.Results The neurological scores,the cerebral TNF-α,IL-6 levels,the mRNA expression and protein level of NF-κB (P＜0.01),and IL-1β levels (P ＜0.05) in CLP group 24 h after modeling were higher than those in sham group.The cerebral IL-10 level and the mRNA expression and protein level of Notch-1 (P ＜ 0.01) in CLP group 24 h after modeling were lower than those in sham group.The neurological scores,the cerebral TNF-α and IL-1β levels,and the protein level of NF-κB (P ＜0.01),and IL-6 (P ＜ 0.05) in NC group 24 h after modeling were higher than those in sham group.The cerebral IL-10 level,the mRNA expression and protein level of Notch1 in NC group 24 h after modeling were lower than those in sham group.There were no significant difference in neurological socres,IL-1β and IL-6 levels between intervention group and CLP group (P ＞ 0.05).The IL-10 level (P ＜ 0.05) and the mRNA expression (P ＜ 0.05) and protein level (P ＜ 0.01) of Notch-1 in intervention group 24 h after modeling were lower than those in CLP group.There were no significant difference in biomarkers between NC group and CLP group (P ＞ 0.05).The degree of cerebral damage found under light microscope was also ameliorated in intervention group compared with CLP group 24 h after modeling.Conclusions The effects of miR-34a via regulating Notch-1/NF-κB signaling pathway on brain function exerts cerebral protective effects in septic mice.

In order to evaluate the left ventricular remodeling in patients with myocardial infarction after revascularization with intravenous real-time myocardial contrast echocardiography (RT-MCE), intravenous RT-MCE was performed on 20 patients with myocardial infarction before coronary revascularization. Follow-up echocardiography was performed 3 months after coronary revascularization. Segmental wall motion was assessed using 18-segment LV model and classified as normal, hypokinesis, akinesis and dyskinesis. Myocardial perfusion was assessed by visual interpretation and divided into 3 conditions: homogeneous opacification=1; partial or reduced opaciflcation or subendocardial contrast defect=2; constrast defect=3. Myocardial perfusion score index (MPSI) was calculated by dividing the total sum of contrast score by the total number of segments with abnormal wall motion. Twenty patients were classified into 2 groups according to the MPSI: MPSI1.5 as poor myocardial perfusion. To assess the left ventricular remodeling, the following comparisons were carried out: (1) Comparisons of left ventricular ejection fraction (LVEF), left ventricular end-systolic volume (LVESV) and left ventricular end-diastolic volume (LVEDV) before and 3 months after revascularization in two groups; (2) Comparisons of LVEF, LVESV and LVEDV pre-revascularization between two groups and comparisons of these 3 months post-revascularization between two groups; (3) Comparisons of the differences in LVEF, LVESV and LVEDV between 3 months post-and pre-revascularization (DeltaLVEF, DeltaLVESV and DeltaLVEDV) between two groups; (4) The linear regression analysis between DeltaLVEF, DeltaLVESV, DeltaLVEDV and MPSI. The results showed that the LVEF obtained 3 months after revascularization in patients with MPSI>1.5 was obviously lower than that in those with MPSI1.5 was obviously larger than that in those with MPSI1.5 and those with MPSI Echocardiography/*methods ; Infusions, Intravenous ; Myocardial Infarction/*diagnosis ; Myocardial Infarction/pathology ; Myocardial Infarction/*ultrasonography ; Myocardial Reperfusion ; Myocardium/*pathology ; Perfusion ; Regression Analysis ; Time Factors ; Ventricular Remodeling

The myocardial viability after myocardial infarction was evaluated by intravenous myocardial contrast echocardiography. Intravenous real-time myocardial contrast echocardiography was performed on 18 patients with myocardial infarction before coronary revascularization. Follow-up echocardiography was performed 3 months after coronary revascularization. Segmental wall motion was assessed using 18-segment LV model and classified as normal, hypokinesis, akinesis and dyskinesis. Viable myocardium was defined by evident improvement of segmental wall motion 3 months after coronary revascularization. Myocardial perfusion was assessed by visual interpretation and divided into 3 conditions: homogeneous opacification; partial or reduced opaciflcation or subendocardial contrast defect; contrast defect. The former two conditions were used as the standard to define the viable myocardium. The results showed that 109 abnormal wall motion segments were detected among 18 patients with myocardial infarction, including 47 segments of hypokinesis, 56 segments of akinesis and 6 segments of dyskinesis. The wall motion of 2 segments with hypokinesis before coronary revascularization which showed homogeneous opacification, 14 of 24 segments with hypokinese and 20 of 24 segments with akinese before coronary revascularization which showed partial or reduced opaciflcation or subendocardial contrast defect was improved 3 months after coronary revascularization. In our study, the sensitivity and specificity of evaluation of myocardial viability after myocardial infarction by intravenous real-time myocardial contrast echocardiography were 94.7% and 78.9%, respectively. It was concluded that intravenous real-time myocardial contrast echocardiography could accurately evaluate myocardial viability after myocardial infarction.
Angioplasty, Transluminal, Percutaneous Coronary ; Cell Survival ; Coronary Artery Bypass ; Echocardiography/*methods ; Models, Statistical ; Myocardial Infarction/*pathology ; Myocardial Infarction/*ultrasonography ; Myocardial Revascularization ; Myocardium/*pathology ; Perfusion ; Time Factors

OBJECTIVETo investigate the relationship between the drug resistance of Pseudomonas aeruginosa (PA) isolated from burn patients wounds and its mobile genetic elements, including plasmid, transposon, and integron.

METHODSThirty-two strains of PA were isolated from wounds exudate of hospitalized burn patients in Ningbo No. 2 Hospital. PA drug sensitivity was determined using GNS-448 drug sensitivity card and K-B tests. The genetic markers of plasmid, transposon and integron including traA, traF, tnpA, tnpU, merA, int I 1 were amplified by PCR and verified by gene sequencing.

RESULTSDrug resistant rate of 32 PA strains to gentamicin, amikacin, cefoperazone/sulbactam, ciprofloxacin was 43.7%, 32.0%, 46.8%, 49.9%, respectively. PA drug resistant rates to piperacillin, cefotaxime, ceftazidime, cefepime, aztreonam, piperacillin/tazobactam, levofloxacin, imipenem and meropenem were all above 56.0%. Seventeen out of 32 PA strains were found to carry transposon and (or) integron genetic markers. One strain was positive for both tnpA and merA, 8 strains were positive for both merA and int I 1, 1 strain was only positive for tnpA, 2 strains were only positive for merA, and 5 strains were positive for int I 1 only.

CONCLUSIONSPA isolated from burn wounds of hospitalized patients in Ningbo No. 2 Hospital is seriously drug resistant, which may relate with its high positive rate of mobile genetic elements of transposon and (or) integron.

Anti-Bacterial Agents ; pharmacology ; Burns ; microbiology ; DNA Transposable Elements ; Drug Resistance, Multiple, Bacterial ; genetics ; Humans ; Integrons ; Microbial Sensitivity Tests ; Plasmids ; Pseudomonas aeruginosa ; drug effects ; genetics ; isolation & purification

OBJECTIVENoninvasive method for estimating the pulmonary vascular resistance (PVR) was used in patients waiting for two staged Fontan procedure to observe the relationship between estimated PVR and surgical results.

METHODSThirty-three candidate patients for two staged Fontan procedures were randomly selected for this trial. Preoperative hemoglobin (HGB), hematocrit (HCT) and pulse oxygen saturation (SpO2) were measured. Estimated PVRs were then calculated by the regression equations. The cases were divided into three groups of low risk group with PVR less than 2.4 wood, high risk group with PVR between 2.4 to 3.2 wood, and extremely high risk group with PVR more than 3.2 wood. The incidences of postoperative low cardiac output and multi-organ failure were compared. Simultaneously, the cases without or with postoperative severe low cardiac output and multi-organ failure after operation were divided into two groups. The preoperative HGB, HCT and estimated PVR among the groups were analyzed.

RESULTSThe rates of postoperative severe low cardiac output and multi-organ failure were 10.0%, 32.4% and 63.6% for the patients of low, high and extremely high risk groups respectively. The difference was significant (P < 0.01). The preoperative HGB, HCT, SpO2 and PVR were all significantly different between the patients without or with postoperative severe low cardiac output and multi-organ failure. The PVR (HGB) were (2.53 +/- 0.56) wood and (3.24 +/- 0.58) wood respectively. The PVR (HCT) were (2.59 +/- 0.58) wood and (3.21 +/- 0.79) wood respectively. The PVR (SpO2) were (2.22 +/- 0.55) wood and (2.93 +/- 0.58) wood, respectively. The differences were all significant (t = 3.25, 2.52 and 3.33 respectively, P < 0.01 or 0.05).

CONCLUSIONSPreoperative estimated PVRs calculated by HGB, HCT and SpO2 were comparable with the postoperative results. Thus, the invasive preoperative estimation of pulmonary vascular resistance could be a method in estimating the surgical indication and predicting the surgical result for two stage Fontan procedure.

Adolescent ; Cardiovascular Abnormalities ; physiopathology ; surgery ; Child ; Child, Preschool ; Contraindications ; Female ; Fontan Procedure ; methods ; Humans ; Male ; Treatment Outcome ; Vascular Resistance

OBJECTIVETo evaluate the clinical value of intestinal fatty acid-binding protein (I-FABP) in full-term newborn infants with necrotizing enterocolitis (NEC).

METHODSForty-one full-term infants with a confirmed diagnosis of NEC from February 2012 to January 2014 were recruited as case group (stage I: 24 cases; stage II-III: 17 cases). Sixty-two children diagnosed with non-digestive diseases in the same period were recruited as the control group. Serum levels of I-FABP and C-reactive protein (CRP) were determined by enzyme-linked immunosorbent assay. The diagnostic value of I-FABP for NEC was assessed using the receiver operating characteristic (ROC) curve.

RESULTSStage I and stage II-III cases in the case group had significantly higher serum I-FABP levels than the control group (P<0.05), and stage II-III cases had significantly higher serum I-FABP levels than stage I cases (P<0.05). The area under the ROC curve for serum I-FABP was 0.85 (95% CI: 0.78-0.92), with the optimal cut-off point of 2.25 ng/mL. Under this cut-off point, the sensitivity and specificity were 80.49% and 70.19%, respectively. There was no significant difference in serum CRP level between the case and control groups (P>0.05).

CONCLUSIONSIn newborn infants with NEC, serum I-FABP level increases significantly in stage I , and it is correlated with the disease severity. Therefore, serum I-FABP can be used as a biomarker for the diagnosis of NEC.

C-Reactive Protein ; analysis ; Enterocolitis, Necrotizing ; blood ; diagnosis ; Fatty Acid-Binding Proteins ; blood ; Humans ; Infant ; ROC Curve

Adult ; Age Factors ; Athletic Injuries ; epidemiology ; Blood Group Antigens ; Body Mass Index ; Humans ; Male ; Military Personnel ; education ; statistics & numerical data ; Physical Education and Training

Objective To analyze the dynamic endemic situation of schistosomiasis in Yunnan Province,and evaluate the effectiveness of the prevention and control interventions.Methods Four schistosomiasis heavy endemic villages(each of 4 en-demic counties)from 2005 to 2014 and 18 villages(each of 18 counties)in 2015 and 2016 were selected as survey sites.Then,the serological screening and etiological tests were carried out in the residents and floating population.The infection status of the livestock and relevant information of field feces and Oncomelania hupensis snails were surveyed.Results The serum positive rate was 8.40％to 25.40％in the local residents,and the rate of the female was higher than that of the male,the rates of 30 to 60 year age groups were higher than those of the other age groups,and the rates of peasants were higher.The feces positive rate was 0 to 6.59％,and the corrected infection rate was 0 to 1.67％in the local residents.The serum positive rate was 0 to 25.00％in the floating population.The infection rate in the livestock was 0 to 10.29％,and the main infected animals were the cattle,buffa-lo,dog,equine and pig.Totally 1 642 feces were tested,and no positives were found.The area with snail habitats was 753.97 hm2,and the density of living snails was 0.013 9 to 0.631 5 snails/0.1 m2.A total of 64 positive snails were found.The snail con-trol rate was 100％.Totally 161 schistosomiasis patients and 269 schistosome-infected animals were treated.Conclusions The schistosomiasis epidemic situation has been effectively controlled,and is at a low prevalence status in Yunnan Province.In order to block the transmission of schistosomiasis and eliminate schistosomiasis,the comprehensive control measures should be strengthened continually.

Objective: To establish a method for the determination of manganese in urine by graphite furnace atomic absorption spectrometry (AAS) without the use of matrix modifier. Methods: The urine samples were 5 times diluted with 1% nitric acid then directly determined by AAS. Zeeman was used for background correction. Results: The linear range for determination of manganese in urine was 5~60 μg/L (urine) . The correlation coefficient was greater than 0.995 with the detection limit of 1.5 μg/L and with the lower limit of quantification of 5.0 μg/L. The relative standard deviations (RSDs) of within-run precision was between 1.1%~4.3%, the RSDs of between-run precision was between 3.3%~7.0%. The average recovery was 102.6%. The samples can be stored for 14 days at room temperature, 4℃, -8 ℃ and -35 ℃. Conclusion The method is feasible for determination of manganese in urine.

OBJECTIVEThe long-term success of intracardiac repair of tetralogy of Fallot is hampered by the occurrence of arrhythmias. The aim of the present study was to determine the incidence of arrhythmias after intracardiac repair of tetralogy of Fallot and their correlation with surgical and clinical findings.

METHODSThe study group consisted of 54 patients, 35 males and 19 females. They underwent repair at a mean age of 51 months (range 17 to 117 months). The median age at the time of study was 9.4 years (range 5 to 14 years), and the mean duration of follow-up was 4.3 years (range 2.8 to 9.0 years) after surgery. The follow-up study included routine ECG, 24 hour Holter, echocardiography and exercise testing.

RESULTSThe incidence of ventricular arrhythmia was 33 percent, and 1 patient had non-sustained ventricular tachycardia. All patients with elevated right ventricular pressure had ventricular arrhythmias, and 28% of patients with normal right ventricular pressure had ventricular arrhythmias (P < 0.05). 53% of patients had significant ventricular arrhythmias when the duration of cardiopulmonary bypass was > or = 90 minutes, as opposed to 23% when it was < 90 minutes (P < 0.05). There was no significant difference in prevalence of ventricular arrhythmias between mild pulmonary regurgitation and severe pulmonary regurgitation (21% vs 40%, P > 0.05). No significant difference was found in the incidence of ventricular arrhythmias between follow-up in five years and more than five years (32% vs 34%, P > 0.05). Age at surgery correlated with the prevalence of ventricular arrhythmias (r = -0.221, P < 0.05). Eight patients (15%) had supraventricular arrhythmias.

CONCLUSIONThe frequency of ventricular arrhythmias correlated with elevated right ventricular systolic pressure, the duration of cardiopulmonary bypass, and the age at surgery. No correlation was found between pulmonary regurgitation and the duration of follow-up. Exercise-induced frequent multiform premature ventricular complexes were associated with abnormal hemodynamic status and high risk of ventricular tachycardia.

Arrhythmias, Cardiac ; diagnosis ; physiopathology ; Child ; Child, Preschool ; Echocardiography ; Electrocardiography ; Electrocardiography, Ambulatory ; Exercise Test ; Female ; Follow-Up Studies ; Humans ; Infant ; Male ; Postoperative Care ; Risk Factors ; Tetralogy of Fallot ; surgery ; Ventricular Dysfunction ; diagnosis ; physiopathology