Objective To evaluate the effects of pulmonary recruitment (RM) in severe acute respiratory distress syndrome (ARDS) with different body position and positive end-expiratory pressure (PEEP) mode in stage of mechanical ventilation. Methods From June 2013 to June 2016, 80 cases of ICU hospitalized patients with clinical data were enrolled, and they lay in the prone or supine position (prone position group and supine position group, each of 40 cases). The hemodynamic parameters including heart rate (HR), central venous pressure (CVP) and peripheral arterial pressure, respiratory mechanics index including respiratory rate (RR), respiratory system compliance (Crs) and platform pressure (Pplate), and the changes of blood gas analysis index were monitored to observe the effects of RM in different positions with positive end expiratory pressure increasing method. Results The levels of oxygenation index and arterial partial pressure of oxygen (PaO2) were improved 3, 5 and 7 d after treatment compared with those 1 d after treatment (P<0.05), and they were improved significantly in prone position group than those in supine position group 3 and 5 d after treatment (P<0.05). The levels of RR, Crs and Pplate 15 min, 30 min, 1 h, 6 h, 12 h and 24 h after RM had significant differences compared with those before RM (P<0.01). The levels of HR, CVP, peripheral arterial pressure 15 min, 30 min, 1 h, 6 h, 12 h and 24 h after RM had no significant differences compared with those before RM (P>0.05). Conclusions For patients with severe ARDS, early implementation of prone position ventilation combined with PEEP increasing method re-expansion treatment is safe and reliable. It can effectively improve oxygenation level and help to improve the survival rate.

Objective To investigate the mammographic,galactographic,pneumographic features and their pathological basis.Methods Mammography(n=26),galactography(n=13),pneumography(n=5)and specimen radiography(n=12) in 26 cases pathologically proved,and mammographic-pathologic correlation were analyzed.Results The breast hamartomas in 26 cases were all benign,they were circumscribed and surrounded by a true capsule.The mammographic appearances could be divided into three types acording to different amount of fibroglandular and adipose tissue in tumors:prominantly fatty,prominantly fibrous(fibroglandular)and mixed fibrofatty.Conclusion A clearly containing areas of fat and fibroglandular density and a characteristic"slice of sausage"appearance can be showed on mammograms.Galactography and pneumography is of a great help to differential diagnosis of breast hamartomas.

AIMTo investigate the effects of prostaglandin E 1 on apoptosis induced by hypoxia/reoxygenation in cultured neonatal rat cardiomyocy tes. METHODSThe models of hypoxia/reoxygenation were made with t he first generation of cultured cardiomyocytes. Hypoxia/reoxygenation apoptosis in cultured neonatal rat cardiomyocytes was studied by agarose gel electrophores is and Tdt-mediated dUTP nick end labeling(TUNEL). Bcl-2 and bax mRNA were det ected by in situ hybridization. RESULTSThe results of DNA electr ophoresis in the H/R group showed the typical DNA ladder. And the DNA ladder decreased gradually corresponding to the increased dose of PGE 1. The TUNEL staining showed that the total number of apo ptotic cells in the H/R group was much biger than that in PGE 1(0 127 ?mol?L -1 ) group. The results of in situ hybridization showed that the conten t of bcl-2 mRNA in H/R group was lower than control. And the content of bax mRN A showed a reverse result as bcl-2 mRNA. Compared with H/R group, the content o f bcl-2 mRNA was significantly higher after treatment with PGE 1(0 014 ?mol ?L -1 , 0 042 ?mol?L -1 , 0 127 ?mol?L -1 ). But the content of bax mRNA in PGE 1(0 014 ?mol?L -1 , 0 042 ?mol?L -1 , 0 127 ?mol?L -1 )groups was significantly lower than H/R group. CONCLUSI ONH/R injury can induce cardiomyocyte apoptosis. PGE 1 has obvious an ti-apoptotic effects on cardiomyocyte and the mechanisms are possibly by inhibi ting the expression of bax and increasing the expression of bcl-2.hein creaseddoseofPGE1 .TheTUNELstainingshowedthatthetotalnumberofapoptoticcellsintheH

AIM To investigate whether pretreatment with prostaglandin E 1 (PGE 1) might protect myocardium against peroxidative injury in early phase and in delayed phase. METHODS Rats were pretreated with PGE 1 (25 or 150 mg?kg -1 ). Isoproterenol (ISOP)(80 mg?kg -1 ) were injected peritoneally (ip) to induce acute myocardial infarction 20 minutes (early phase) or 24 hours (delayed phase) after pretreatment. Hearts were removed punctually 24 hours after ip ISOP and were assayed for content of malonaldehyde (MDA), activity of glutathione peroxidase (GSH Px) and superoxide dismutase (SOD). RESULTS ISOP caused myocardial injury with increased MDA content and SOD activity, and decreased GSH Px activity. Pretreatment with PGE 1, at each dose and in both phase, decreased the MDA content ( P

AIM To study the protective effects of prostaglandin E 1 on hypoxia/reoxygenation injury in cultured neonatal rat myocytes. METHODS The hypoxia/reoxygenation injury model of cultured neonatal rat myocardial cells was developed. The activities of plasma superoxide dismutase (SOD) were measured by the method of xanthine oxidase and the contents of serum malonicaldehyde (MDA) were determined by the method of thiobarbituric acid. The activities of dehydrogenase in mitochondria were detected by MTT assay. The activities of LDH in culture were also evaluated. CONCLUSION PGE 1 has protective effects on the cultured neonatal rat myocardial cells injured by hypoxia/reoxygenation. The mechanisms are related to its antioxidation effects.

Objective: The purpose of this study is to investigate the anti-diabetic effects of linarin, a flavonoid extracted from Chrysanthemi Indici Flos (CIF), and its potential mechanisms. Methods: The effects of linarin on cell viability and glucose consumption in HepG2 cells were measured. Meanwhile, monosodium glutamate (MSG) mouse model was constructed to monitor the changes of insulin tolerance, glucose tolerance, triglyceride and cholesterol. The protein expression levels of p-AMPK, p-ACC, PEPCK and p-GS were detected by Western blot. Results: Linarin could increase the relative glucose consumption of HepG2 cells, improve insulin tolerance and glucose tolerance, and decrease the levels of triglyceride and cholesterol of MSG mice. Simultaneously, the expression levels of p-AMPK and p-ACC in HepG2 cells and the liver tissue of MSG mice were increased, while the expression levels of PEPCK and p-GS were decreased after treatment with linarin. Conclusion: Insulin resistance could be ameliorated by linarin in type 2 diabetes, and its mechanism may be related to AMPK signaling pathway.

Objective: To analyze the clinical symptoms and hereditary information of suspicious juvenile neuronal ceroid-lipofuscinosis (JNCL) and determine the genotype in order to explore the diagnosis clues in the patients with ophthalmologic manifestations being initial symptom. Methods: A case-control study was performed in this study.Two families were included in Eye Hospital of Wenzhou Medical in 2013 and 2017, respectively.Medical histories were collected and all participants underwent comprehensive ophthalmologic examinations, and the best corrected visual acuity (BCVA) was obtained.Fundus photography and optical coherence tomography (OCT) were used to image the retinal signs, and visual electrophysiology was recorded to evaluate the visual function.Genomic DNA of 3 patients who initially visited to ophthalmologists and 5 unaffected family members were extracted.Whole exome sequencing (WES), targeted exome sequencing (TES), Sanger sequencing and comprehensive analyses of pathogenicity were performed to determine the genetic cause of the patients.This study was approved by Ethics Committee of Eye Hospital of Wenzhou Medical University (KYK-2017-7), and written informed consent was obtained from each subject prior to any medical examination. Results: All patients presented bull eye sign and disorder of pigment on the fundus photograph, and the retinas were thinning on the OCT image, indicating the diffuse retinal pigment epithelium atrophy of macula and loss of outer layer structure of retina.Three mutations in CLN3 gene were identified by WES, TES, Sanger validation and assessments of pathogenicity, including c. 154T>C(p.Y52H), c.982G>C(p.A328P) and c. 906+ 5G>A, among which p. A328P was a novel mutation.Patients of F1 family harbored the compound heterozygous mutations c. 154T>C (p.Y52H) and c. 982G>C(p.A328P), while proband of F2 family harbored the homozygous splice site mutation c. 906+ 5G>A, which was reported to be a pathogenic mutation of JNCL.Co-segregation and comprehensive pathogenicity analysis revealed that the compound heterozygous mutations in F1 family and the homozygous mutation in a splice site in F2 family were the genetic causes of their phenotypes. Conclusions A novel mutation in CLN3 gene for JNCL is identified, which expands the mutation spectrum of CLN3 gene.Considering the high clinical heterogeneity of inherited retinal diseases, especially syndromic cases, genetic test through next generation plays a vital role in diagnosis, guiding future treatment and prognostic evaluation.

To develop a new recombinant hepatitis E vaccine, we used Hansenula polymorpha expression system to express recombinant hepatitis E virus-like particles (HEV VLPs), to construct a recombinant engineered strain HP/HEV2.3. The fermentation conditions and purification process were studied next. The first working seed lots were fermented in liquid culture, and the fermentation products were collected, then crushed, clarified, purified by ultrafiltration, silica gel adsorbed and desorbed, concentrated by ultrafiltration, purified by liquid chromatography and sterilized by filtration. The purity reached 99% with a yield of 33%. Electron microscopy analysis revealed that both the purified recombinant HEV VLPs from HP/HEV2.3 and natural hepatitis E virus particles appear identical of being 32 nm. The resulting DNA sequence obtained from VLPs is identical to the published HEV sequence. The SDS-PAGE analysis has revealed that the protein molecular weight of the HEV VLPs is 56 kDa, and the expression product HEV VLPs were accumulated up to 26% of total cellular protein. The expression level is 1.0 g/L. Western blotting, enzyme-linked immunosorbent assay (ELISA) results of the protein and ED₅₀ of the vaccine showed that the HEV VLPs have good antigenicity and immunogenicity. In summary, the recombinant HEV VLPs from Hansenula polymorpha can be used in the manufacture of a new genetically engineered vaccine against hepatitis E.