AIM To observe the hypotensive effect of melatonin (MT) on two-kidney one-clip renal hypertensive (2K1C) rats and to explore its aortic mechanism. METHODS 2K1C rats were obtained by narrowing the left kidney artery; systolic blood pressure was measured by use of tail-cuff method; vascular actions of MT were measured using isolated blood vessel method. RESULTS MT reduced blood pressure of 2K1C rat significantly 〔(23.45?2.40) kPa versus (19.81?2.78) kPa, P

Objective To study the effect of continuous blood purification on inflammation and nutritional status in patients with sepsis, and to study relationship between inflammatory, malnutrition and illness. Method Forty-eight patients with severe sepsis were randomly divided into two groups: continuous renal replacement treat-ment (CRRT) group (n=27) and control group (n=21). The flowing biomarkers including albumin, preallbu-min, transfenin, insulin-like growth factor-1 (IGF-1), tumor necrosis factor (TNF-α) and C reactive protein (CRP) were determined before,and 1 week and 2 weeks after treatment. Results Compared with control group, levels of albumin, prealbumin and IGF-1 in treatment group increased significantly at 14 days after CRRT (P<0.05), and levels d CRP and TNF-α decreased significantly (P<0.05), resulted in increase in survival rate, shortened me-chanical ventilation time and decreased SOFA scores (P<0.05). The IGF-1 and prealbumin had a negative cor-relations with CRP and TNF-a in both groups (P<0.05). The survivors in both groups had significantly higher levels of IGF-1,prealbumin and TNF-α than the deads before trearment(P<0.05). Conclusions Continuous blood purification can effectively attenuate inflammation and improve nutritional status in patients with severe sep-sis.Maybe IGF-1 and prealbumin act as prognostic markers more sensitive in severe sepsis.

BACKGROUND:Both osteopontin and hyaluronic acid involve in the pathological process of osteoarthritis, resulting in the abnormal expression levels of various cytokines and enzymes. However, the relationship between the high expression of osteopontin and hyaluronic acid in chondrocytes remains unclear.
OBJECTIVE:To investigate the effect of osteopontin on the expression of hyaluronic acid in human knee osteoarthritic chondrocytes in vitro by modulating the level of osteopontin.
METHODS:Chondrocytes from human knee osteoarthritic cartilage were cultured in vitro, and were then divided into three groups:blank control group without any treatment;osteopontin group and and pontin siRNA group were treated with 1 mg/L recombinant human osteopontin and osteopontin siRNA, respectively. Expression levels of osteopontin, hyaluronic acid synthase 1, 2 and 3 mRNA were detected by real-time PCR, and the levels of hyaluronic acid were measured using ELISA.
RESULTS AND CONCLUSION:Compared with the blank control group, the mRNA expressions of hyaluronic acid synthase 1, 2 and 3 were remarkably increased in the osteopontin group, while siRNA made the significantly inhibitory effects on the hyaluronic acid synthase 1, 2 and 3 mRNA expressions (P<0.05). The level of hyaluronic acid in chondrocytes in the osteopontin group was significantly higher than that in the other two groups (P<0.05). Our results suggest that osteopontin induces the synthesis of hyaluronic acid in osteoarthritic chondrocytes through upregulating the hyaluronic acid synthases expression levels.

Objective To compare the diagnostic efficacy of digital mammography,ultrasonography and MRI for breast non-mass enhancement (NME).Methods The digital mammography,ultrasonography and MRI data of 1 1 6 patients with 123 NME lesions on MRI were analyzed retrospectively.Results 99 lesions were malignant and 24 lesions were benign according to the pathologiacl result.The sensitivity of digital mammography,ultrasonography and MRI was 72.73%,65.66%,and 84.85%,respectively;The specificity was 66.67%,79.1 7%,and 79.1 7%,respectively;The accuracy was 71.54%,68.29%,and 83.74%,respectively;The positive pretictive value was 90.00%,92.86%,and 94.88%,respectively;The negative pretictive value was 37.21%,35.85%,and 55.88%,respectively.The sensitivity,specificity,accuracy,positive pretictive value and negative pretictive value of MRI were obviously higher than those of digital mammography and ultrasonography (P <0.05).The difference between the combinations and MRI alone were no statistically significant.Conclusion MRI have better diagnostic value,and could be used as the first choice examination for breast NME lesions.

Multiple organ dysfunction syndrome (MODS) is one of the leading causes of death in ICU patients.However,there have been few studies on the role of MODS as a cause of death in patients with acute myocardial infarction (AMI),particularly in those at advanced age.Our study aimed to investigate the incidence and to identify the predicting factors of MODS in elderly patients with AMI.Methods We identified consecutive patients with AMI who were discharged from the Chinese PLA General Hospital between January 1993 to June 2006.Medical records of 800 consecutive patients aged 60 years or over were analyzed retrospectively.Multivariate logistic regression was used to determine factors predicting in-hospital development of MODS.Results Twenty-seven (3.4%) patients developed MODS within 30 days after AMI.Compared with patients without MODS,patients with MODS had higher in-hospital mortality rates (55.6% vs 11.6%,P＜0.001 ) and more frequent complications of cardiogenic shock (25.9% vs 6.2%,P＜0.001),heart failure (HF) (59.3% vs 18.2%,P＜0.001 ),cardiac arrhythmia (44.4% vs 26.4%,P＜0.05) and pneumonia (55.6% vs 16.3%,P＜0.001).Multivariate logistic regression analysis showed the major predictors for the occurrence of MODS secondary to AMI were advanced age (≥ 75 years,odds ratio 2.64,95% confidence interval [CI] 1.13 to 6.61),heart rate/＞ 100 bpm on admission (odds ratio 1.74,[CI] 1.14 to 2.64),in-hospital complication of HF (odds ratio 3.03,[CI] 1.26 to 7.26) and pneumonia (odds ratio 2.82,[CI] 1.18 to 6.77).Conclusions MODS is not the uncommon complication in elderly patients with AMI and is associated with poor prognosis.Advanced age,heart failure and pneumonia are predictors of the development of MODS in patients with AMI.(J Geriatr Cardiol 2008;5:199-202)

Objective:To investigate the changed functional connectivity (FC) of the visual network in patients with migraine without aura (MwoA).Methods:Clinical data of thirty-three patients with MwoA(MwoA group) who visited neurology department from July 2019 to July 2020 were collected, and twenty-two healthy volunteers were recruited as healthy controls (HCs group). All subjects underwent resting-state functional magnetic resonance imaging scans, and the RESTplus software package was used to analyze the resting state function data.The visual network was extracted based on independent component analysis to compare the differences in visual cortex.Subsequently, seed-base FC analysis was used to investigate the changed FC between the visual network and rest of whole brain.Results:Compared with the HCs group, the FC of left fusiform gyrus, right lingual gyrus and right superior occipital gyrus (SOG) within the visual network in MwoA group were significantly increased.MowA group showed increased FC between the left fusiform gyrus and the right superior frontal gyrus (SFG) and left anterior cingulum cortex (ACC), between the right lingual gyrus and left thalamus, left middle frontal gyrus (MFG) and right SFG, and between the right SOG and the SFG, as well as the decreased FC between the left fusiform gyrus and the left inferior occipital gyrus (IOG). Moreover, the changed FC between the left fusiform gyrus and left ACC was positively correlated with disease duration ( r=0.365, P=0.047), and the changed FC between the left fusiform with right SFG was negatively correlated with headache severity ( r=-0.424, P=0.020). Conclusion:The FC of inter- and intra-visual network in MwoA patients is changed, with parts of brain regions are associated with some neural circuits.Additionally, the compensatory period translates to the worse period along with disease progression in MwoA.

BACKGROUND:Pain after arthroscopic treatment can not only affect the patient’s life quality, and is not
conducive to the early reasonable exercise and functional recovery of the patients after treatment. Up to 2012, there are 18 randomized placebo-control ed trials on intra-articular injection of bupivacaine for analgesia after arthroscopic surgery, but the results are different.
OBJECTIVE:To examine the efficacy and safety of intra-articular injection of bupivacaine in the management of pain after arthroscopic surgery through randomized placebo-control ed trials.
METHODS:The MEDLINE database, Cochrane Central Register and Google Scholar database were retrieved for the randomized control ed trials on intra-articular injection of bupivacaine in the management of pain after
arthroscopic surgery up to April 2012. The key words were“bupivacaine, intra-articular, arthroscopic, postoperative pain, placebo”.
RESULTS AND CONCLUSION:Eighteen studies (n=934) were included (461 cases in bupivacaine group and 473
cases in the placebo control group). The Meta-analysis results showed the visual analog scale score of the bupivacaine group was lower than that of the placebo control group (weighted mean difference:-1.39, 95%confidence interval:-2.17 to-0.61, P<0.000 01), and the number of patients required supplementary analgesia was less than the placebo control group (relative risk:0.84, 95%confidence interval:0.62 to 1.66, P=0.010). The time from first supplementary analgesia to postoperative intra-articular injection in the bupivacaine group was longer that in the placebo control group (weighted
mean difference:157.72, 95%confidence interval:16.43 to 299.01, P<0.000 01). There was no significant difference in the incidence of side effect between two groups (relative risk:0.64, 95%confidence interval:0.29 to 1.44, P=0.48). On the basis of the currently available literature, the intra-articular of bupivacaine after arthroscopic surgery can significantly relieve pain without increasing the adverse reactions when compared with the placebo control group.

Objective To explore the clinical application of antibiotics Ceftazidime(CAZ) and Cefotetan(CTT)by analysis susceptibility and scatter of the CAZ adn CTT against Escherichia coli(ECO) and Klebsiella pneumoniae(KPN).Methods The drug sensitivity analysis of 1 311 strains of ECO and 898 strains of KPN isolated from 2012 to 2015 and the relationship between CAZ and CTT was analyzed by using the Whonet 5.6 software.Results The resistance rate of ESBL+ KPN to CAZ was 41.2％ and the rate to CTT was 14.1％,the difference was statistically significant(P<0.05).The resistance rate of ESBL+ ECO to CAZ was 34.6％ and the rate to CTT was 1.1％,the difference was statistically significant(P<0.05).The average value of MIC of CAZ was highest in group of ESBL+KPN,it was 6.39 μg/mL.And it was lowest in group of ESBL-KPN,it was 1.37 μg/mL.The average value of MIC of CTT was highest in group of ESBL+KPN,it was 6.8 μg/mL.And the lowest was in group of ESBL-KPN.The range of MIC of CAZ was 1-64 μg/mL,and the range of CTT was 4-64 μg/mL in all groups.The cross sensitivity of CAZ and CTT was more than 90.0％.The cross resistance was less than 5.0％.The cross sensitivity of CAZ and CTT was less than 70.0％ in ESBL+ group.And the cross resistance was up to 13.4％.Conclusion The cross resistance and cross sensitivity of the two antibiotics is very important in guiding clinical antibiotic selection or replacement.

BACKGROUND:Progressive fracture of the cartilage is considered the characteristic lesion in later osteoarthritis, the expression of osteoarthritis-related factors such as hyaluronic acid, osteopontin and CD44 in osteoarthritic cartilage is increased.
OBJECTIVE:To investigate the effect of hyaluronic acid on the expression of osteopontin mRNA and CD44 mRNA of chondrocytes in the in vitro cultured chondrocytes of patients with knee osteoarthritis.
METHODThe cartilage samples obtained from osteoarthritic patients were cultured and purified into acquire chondrocytes in vitro, and the cells were divided into three groupblank control group, hyaluronic acid (100 mg/mL) group and hyaluronidase (200 mg/mL) group. After 48 hours of cellculture, real-time quantitative polymerase chain reaction assay was used to detect the expression of CD44 mRNA and osteopontin mRNA. The difference of the expression levels before and after the intervention of hyaluronic acid was compared and analyzed using SPSS 17.0 software.
RESULTS AND CONCLUSION:Compared with the blank control group, hyaluronic acid (100 mg/mL) upregulated osteopontin mRNA expression in the chondrocytes, hyaluronidase (200 mg/mL) also reduced osteopontin mRNA expression in the chondrocytes. The CD44 mRNA expression in the chondrocytes of hyaluronic acid (100 mg/mL) group and hyaluronidase (200 mg/mL) group was lower than that in the blank control group. Hyaluronic acid can upregulate the expression of the osteopontin mRNA expression in the osteoarthritic chondrocytes;the biphasic effects of hyaluronic acid on CD44 mRNA expression in osteoarthritic chondrocytes might be associated with the molecule weight of hyaluronic acid.