Aim To investigate the effects of panax nonstaining saponins ( PNS ) on the apoptosis of renal cells induced by cisplatin through the path of mitochon-drion . Methods Male Sprague-Dawley( SD) rats were randomized divided into normal control group, cisplatin model group and the cisplatin+PNS group,with 12 rats of each group. Animals were sacrificed to determine the N-acetyl-β-D-Glucosaminidase ( NAG ) in urine, blood urea nitrogen ( BUN) and serum creatinine ( Cr) concentrations after 8d of intraperitoneal injection. HE-staining was employed to observe renal pathologies. Transmission electron microscopy ( TEM ) was em-ployed to observe the mitochondria of the rats′ injured kidney region. TUNEL staining was employed to detect the distribution of apoptotic cells. Immunnohistochem-istry was used to detect Bax and caspase-9 expression, and expression of Bcl-2 protein was detected by West-ern blot. Results Compared with the normal control group, contents of BUN, serum Cr and urinary NAG levels of rat in the cisplatin model group were increased ( P <0. 01 ) , and some mitochondria of the epithelial cells of renal tubules got injured seriously. The apopto-sis rate of kidney cell was increased ( P<0. 01 ) . The expression of Bax,caspase-9 and Bcl-2 proteins was in-creased ( P < 0. 01 ) . Compared with the cisplatin model group, contents of BUN, serum Cr and urinary NAG levels of rats in the cisplatin model group were decreased ( P <0. 01 ) , and some mitochondria of the epithelial cells of renal tubules were significantly im-proved. The apoptosis rate of kidney cell was decreased ( P<0. 01 ) . The expression of Bax and caspase-9 pro-tein was decreased (P<0. 01),but Bcl-2 protein was increased ( P < 0. 01 ) . Conclusion PNS may in-crease the expression of Bcl-2 protein and decrease the expression of Bax and caspase-9 proteins, which may play a protective role in cisplatin nephritic damage.

0.05).In control group,Cx43 expression was 11.92?1.26,significantly lower than that of the preoperative value(P

OBJECTIVE:To systematically review the related evidence-based guidelines of purulent meningitis in children,and to provide evidence-based reference for clinical treatment. METHODS:Retrieved from PubMed,EMBase,CBM,Wanfang Data-base,CJFD and VIP,NGC,GIN,TRIP and websites of domestic and international medical associations and industry bodies,the treatment guidelines about purulent meningitis in children were collected. Evidence-based evaluation was performed after data extrac-tion and quality evaluation. RESULTS:Finally 3 guidelines were enrolled in total,with development time ranging from 2004 to 2012,from USA,Britain and Australia,respectively. All of the recommendations were level B,scope and purpose and clarityshowed the higher scores in AGREEⅡ,more than 70%,and applicability showed generally low scores. Penicillin and cefotaxi-me were recommended in purulent meningitis of neonates,and vancomycin combined with cefotaxime or ceftriaxone were recom-mended for infants and children(it was combined with vancomycin when Streptococcus pneumoniae infection was suspected). The dose and duration of each guideline were certain different,and the period of treatment should be longer in neonates. In addition, the glucocorticoid was recommended in all guidelines. CONCLUSIONS:The recommendations of medicines for the treatment of pu-rulent meningitis are basically unanimous,with no regional difference,but there are some differences about dose and the course of treatment. In addition,the classification criteria of the levels of evidence and recommendation are still suboptimal,which needs fur-ther improvement. And guidelines on purulent meningitis should be improved inrigourandapplicabilityin future.

Objective To evaluate the effect of mouse nerve growth factor on fracture healing.Methods Cochrane library, Pubmed, EMbase, CNKI,VIP,Wanfang Data and CBM were searched for the randomized controlled trials(RCTs)of mouse nerve growth factor on fracture healing from the date of establishment of the databases to May 2014.Three independent rese archers evaluated the included studies using GRADE,according to recommend classification method of GRADE system by three researchers,crtical evaluated and data extracted of the quality of the included studies,which conform to the quality standard of RCT was analyzed by Meta analysis.The extracted data were analyzed by RevMan 5.0 and GRAED proiler.Results A total 5 trials were discovered and all of these were in Chinese.Compared with conventional treatment was improved a lot[MD =-8.74,95%CI( -9.79,-7.68),P<0.0001].However, adverse drug reaction in patients with mouse nerve growth factor were increased[OR =14.66,95%CI(1.89, 113.99),P=0.01].The both outcomes were low quality in the GRADE system.Conclusion Mouse nerve growth factor can improve fracture healing and the side effects will also increase.

Objective To compare the characteristics of lymph nodes on 18F-FDG imaging in patients with NHL and widespread lymph node metastases carcinoma (WLNMC) for helping the differential diagnosis.Methods A total of 40 NHL patients(22 males,18 females,average age 51 years) and 42 WLNMC patients (19 males,23 females,average age 61 years) confirmed by histopathology from November 2010 to May 2015 were included in this retrospective study.The regions and the metabolism features of the lesions on PET/CT images were observed and recorded with routine visual method.Two-sample t test and x2 test were used for statistical analysis.Results Lymph nodes of NHL were kidney-shaped (47.2％,142/301),which was significantly different from that of WLNMC with circular form (47.6％,140/294;x2 =36.261,P＜0.05).Lymph nodes of NHL mostly showed homogeneous density with no necrosis (51.8％,156/301);however,that of WLNMC showed uneven density (20.4％,60/294) or with necrosis (32.3％,95/294;x2 =26.266,P＜0.05).Both of the two kinds of lymph nodes showed the characteristic of fusion (30.6％ (92/301) vs 36.1％ (106/294);x2 =2.019,P＞0.05).The ratios of lymph nodes with clear boundary in NHL and WLNMC were significantly different:28.2％(85/301) vs 19.4％(57/294);x2 =6.413,P＜0.05.Lymph nodes with symmetric distribution were more in NHL patients (52.5％,158/301)than that in WLNMC patients (42.2％,124/294;X2=6.347,P＜0.05).Sizes of lymph nodes in NHL patients and WLNMC patients were not significantly different:(2.08±0.65) cm vs (1.97±0.81) cm;t=0.316,P＞0.05.SUVmax of lymph nodes in NHL patients (9.02±3.97) was much higher than that in WLNMC patients (6.92± 1.34;t=0.370,P＜0.05).Conclusions Some characteristics of lymph nodes on 18F-FDG PET/CT imaging,such as the distribution,morphology,density and glucose metabolism features,are different in patients with NHL and WLNMC.Those differences may be helpful for the differential diagnosis.

AIM: To investigate the effect of ischemic preconditioning (IP) on myocardial Bcl-2 expression and mitochondrial structure during heart valve replacement surgery under cardiopulmonary bypass. METHODS: Fifty-four patients were prospectively randomized to receive or not ischemic preconditioning (IP) before cold cardioplegic arrest. Ischemic preconditioning in the IP patients (n=22) was induced by a single 2-min ischemia followed by 3-min reperfusion just before aortic clamping and cold crystalloid cardioplegia for myocardial protection. The control group (n=32) received no ischemic preconditioning before cold cardioplegic arrest. The levels of ejection fraction (EF), fractional shortening(FS) and stroke volume (SV) in both groups were measured and compared. troponin T (c-TnT) level, Bcl-2 protein expression and microscopic changes of myocardial mitochondrial structure were recorded for each group before and after surgery. RESULTS: The level of EF, FS and SV in IP group was higher than those in control group (P<0.05). No significant difference in preoperative c-TnT levels between two groups was observed. The level of c-TnT in IP group was lower than that in control group and with a declining trend over time of 6 h, 24 h, 48 h, 72 h and 5 d after surgery, respectively. The preoperative positive unit of Bcl-2 expression between two groups showed no statistical difference (P> 0.05). Postoperatively, the positive unit of Bcl-2 expression in IP group was 19.85±5.88, significantly increased as compared to the preoperative value (P<0.05). In control group, the positive unit of Bcl-2 expression was 14.17±3.39, showed no statistically significant difference to the preoperative value (P>0.05). Postoperative Bcl-2 expression between two groups showed a significant difference (P<0.05). In the control group, microscopic observation revealed swollen mitochondrion, with a hardly visible or disrupted membrane for some mitochondrion;mitochondrial crista were obviously dissolved and loose with a large number of vacuoles formation. However in IP group, myocardial mitochondrion appeared with intact membrane, concentrated mitochondrial cristae with high electron density and no vacuoles formation was observed. CONCLUSION: IP may up-regulate the expression of myocardial anti-apoptotic protein Bcl-2 to protect the mitochondrion, thus protecting cardiocytes and cardiac functions.

Objective To compare the 18F-FDG PET metabolic characteristics and VHRCT morphological characteristics between invasive and non-invasive adenocarcinoma presenting as pure ground-glass nodules(pGGN).Methods Fifty-one patients with pGGN from October 2010 to June 2016 were retrospectively enrolled in this study.There were totally 52 lesions with sizes of no more than 30 mm and were grouped depending on pathological and follow-up diagnosis (31 lesions in the invasive adenocarcinoma group and 21 lesions in the non-invasive group).Clinical and imaging features were analyzed including age,gender,lesion location,size,density,SUVmax T/N,spiculation,lobulation,pleural indentation,vascular connection signs,vacuole sign and the air bronchogram.T test or x2-test was used in the comparison of different manifestations between the two groups.Logistic regression analysis on clinical parameters was applied.The ROC curve was used to find the cutoff of T/N.Results In the invasive adenocarcinoma group,T/N,SUV density and size were 1.97±0.71,1.16±0.54,-(431±104)HU,(18.48±5.65)mm,respectively.In the non-invasive group,T/N,SUVmax density,size were 1.20±0.28,0.64±0.20,-(533± 109)HU,(12.05±5.04)mm,respectively.The differences of T/N,SUVmax density and size had statistical significance between the two groups (t=-5.40,-4.87,-3.39,-4.21,P＜0.05).Lobulation and vascular connection signs in the invasive adenocarcinoma group were found in 21 and 13 cases respectively,while in the non-invasive group,they were present in 2 and 1 case,respectively,which showed significant differences between the two groups(x2=17.85,7.01,P＜0.05).T/N,lobulation,and vascular connection signs were the independent factors for the differentiation of benign and malignant lesions.The ORs were 52.547,8.375,72.206,respectively.When T/N=l.62,the area under the ROC curve was 0.885.The sensitivity,specificity and accuracy were 77.42％,90.48％,82.69％,respectively.Conclusions Pulmonary pGGNwith T/N no less than 1.62,lobulation and vascular connection sign indicates an invasive adenocarcinoma.

Objective To enhance the cognition about the adult contagious atypical pneumonia for an expectation of earlier diagnosis, prevention and treatment.Methods We analyzed and summarized X-ray lung and clinical characteristics of 34 patients with contagious atypical pneumonias who were admitted to our hospital from Feb to April. 2003.Results X-ray findings of lung were characterized by mostly involving unilateral and presenting ill defined cloud or patches-form opacities. These lesions progressed and varied rapidly. The clinical manifestations were characterized by the onset of fever (34/34), mostly associated with systemic and joint aching pains (29/34) and dry coughs (29/34). Leucocyte counts showed normal or lower than normal. Patient with a continuing high fever might tend to develop ARDS (2/34). All the 34 patients recovered after combined therapies (anti-inflammation, anti-virus and promoting immunity ) and were discharged from hospital. The average in-hospital days were (10.6?4.2) days. Conclusion X-ray examination is the main method for the early diagnosis and observing state-variation. The predominant clinical features of this disease are fever, dry cough, aching pain in extremities, unconspicuous pulmonary signs as well as hemogram not rising, a continuing high fever may lead to the tendency of ARDS.

Post-stroke cognitive impairment (PSCI) refers to a clinical syndrome that occurs after a stroke and meets the diagnostic criteria for cognitive impairment, lasting for more than 6 months, and seriously affecting the daily life of patients. The complement system has been confirmed to be associated with PSCI. This article reviews the correlation between complement system and PSCI, as well as the possibility of complement system as an intervention target for PSCI.

Objective To develop a model of malignant risk prediction of solitary pulmonary nodules(SPN) with the metabolic characteristics of the lesion.Methods A total of 362 patients (291 malignant cases and 71 benign cases;194 males,168 females;median age:61 years) who underwent PET/CT imaging from January 2013 to July 2017 were analyzed.The diagnosis of malignant SPN was based on pathological results,and that of benign SPN was based on pathological or follow-up results.Differences of clinical/imaging characteristics in patients with benign and those with malignant SPN were analyzed.Risk factors were screened by multivariate non-conditional logistic regression analysis.The self-verification of the model was done by the receiver operating characteristic (ROC) curve analysis,out-of-group verification was performed by k-fold cross-validation.Results There were statistically significant differences in age,maximum standardized uptake value (SUVmax),size,lobulation,spiculation,pleural traction,vessel connection,calcification,vacuole,and emphysema between patients with benign and malignant nodules (all P＜0.05).The risk factors for malignant nodules included age,SUVmax,size,lobulation,calcification and vacuole.The odds ratio (OR) values (95％ CI) were 1.040(1.007-1.075),1.612(1.287-2.017),1.149(1.074-1.230),4.650(2.138-10.115),0.216(0.085-0.548),and 3.043(1.302-7.111),respectively.The logistic regression model was as follows:P=1/(1+e-x),x=-5.583+0.039×age+0.477×SUVmaxx+0.139×size+1.537×lobulation-1.532×calcification+ 1.1 13×vacuole.The estimated area under the curve (AUC) for the model was 0.915(95％ CI:0.883-0.947),sensitivity was 89.7％,specificity was 78.9％.K-fold cross-validation showed that the training accuracy was 0.899±0.011,the predictive accuracy was 0.873±0.053.Conclusions The risk factors for malignant nodules included age,SUVmax,size,lobulation,calcification and vacuole.After verification,the model has a satisfactory accuracy.It may help clinics make accurate decisions.