Objective To investigate the evaluation value of oxygenation index at different times of mechanical ventilation (MV) on the prognosis of patients with acute respiratory distress syndrome (ARDS).Methods A retrospectively analysis was conducted. A total of 228 patients with ARDS admitted to Department of Emergency of China Medical University Affiliated First Hospital from February 2014 to June 2016 were enrolled. All patients underwent MV treatment, and recruitment maneuver (RM) was performed by pressure-controlled ventilation (PCV) 30 minutes after the implementation of the protective ventilation strategy. Arterial blood gas analysis was performed at MV immediately, after RM and at 6, 12, 24 hours of MV, and oxygenation index was calculated. Vital signs, laboratory data, ultrasonic echocardiography, sequential organ failure assessment (SOFA) score, duration of MV, and ventilator related parameters of patients were collected. The patients were divided into survivors and non-survivors according to the prognosis of 28 days. The survivors were subdivided into high and low oxygenation group (oxygenation index was ≥ 150 mmHg and < 150 mmHg, respectively, 1 mmHg = 0.133 kPa). Differences in clinical indicators between survivors and non-survivors were compared. The correlation between the oxygenation index after RM and the oxygenation index at each time after MV was analyzed by bivariate correlation analysis. Receiver operating characteristic (ROC) curve was plotted to analyze predictive value of oxygenation index measured at different times for the 28-day outcome of patients with ARDS.Results Among 228 patients, 99 patients died within 28 days, and 129 survived, with mortality rate of 43.4%. ① The oxygenation index after RM and at 6, 12, 24 hours after MV in survivors and non-survivors showed a continuously increased tendency, which was significantly lower in non-survivors than that in survivors (allP < 0.05). There was no significant difference in the duration of MV between high oxygenation group and low oxygenation group at MV immediately and after RM, but the duration of MV in high oxygenation group was significantly shorter than that of the low oxygenation group at 6, 12, 24 hour of MV (allP < 0.01). ② After ventilation for 24 hours, serum creatinine (SCr), brain natriuretic peptide (BNP), lactate (Lac), right ventricular internal diameter, and SOFA score in non-survivors were significantly higher than those of survivors, and arterial partial pressure of oxygen (PaO2), platelet (PLT) and right ventricular ejection fraction (RVEF) were significantly lower than those of survivors (allP < 0.05). ③ After 24 hours ventilation, positive end-expiratory pressure (PEEP), tidal volume (VT), and minute ventilation (VE) in non-survivors were significantly higher than those of survivors, and static compliance of thorax (Cdyn) was significantly lower than that of survivors (allP < 0.01). ④ It was shown by correlation analysis that the oxygenation index after RM was positively correlated with those at 6, 12, 24 hours of MV (r values were 0.856, 0.765, and 0.758, respectively, allP < 0.001). ⑤ It was shown by ROC curve that the area under the ROC curve (AUC) of the oxygenation index after RM for predicting 28-day prognosis was 0.688. When the cut-off value was 80.75 mmHg, the sensitivity was 97.7%, and the specificity was 42.4%, which could only be used for preliminary judgment of prognosis. The AUC of oxygenation index at 6, 12,24 hours of MV for 28-day survival of ARDS patients were 0.719, 0.727, 0.754, respectively. When the cut-off values were 171.50, 192.14, and 161.75 mmHg, the sensitivity was 69.8%, 67.4%, 86.0%, and the specificity was 78.8%, 78.8%, and 63.6%, respectively. It indicated that the predictive value was higher, and no significant difference was found among the oxygenation index at different time points.Conclusions The oxygenation index after the early stage of RM can preliminarily determine the prognosis of patients. The predictive value of oxygenation index after MV for 28-day survival of ARDS patients was higher, so the oxygenation index measured at 6 hours of MV may be considered to evaluate the prognosis of patients with ARDS.

Acupuncture Therapy ; Humans ; Meridians ; Muscles ; physiopathology ; Nervous System Diseases ; physiopathology ; therapy

BACKGROUND: Above curative dose, there is a dose-dependent correlation of the survival rate of fat transplantation with vascular endothelial growth factor (VEGF), the curative dose of VEGF determines the tissue volume of transplanted fat. OBJECTIVE: To investigate the changes of the blood supply rebuilding and the survival rate of the fat transplant in the microenvironment of continuous infusion of VEGF using osmotic pump. DESIGN, TIME AND SETTING: A cellular morphology observational experiment was performed from September 2007 to October 2008 in Department of Plastic Surgery at the Affiliated Hospital of Guangdong Medical College. MATERIALS: Ninety healthy SD rats were used to establish autologous fat transplantation models. Human VEGF was produced by American ONCOGEN Corporation. Type Alzet2002 mini-osmotic pump was produced by American Alzet Corporation. METHODS: Ninety rats were equally divided into 3 groups randomly. The operation control group was only processed into autologous fat transplantation; Experimental control group received autologous fat transplantation and continuous infusion of 2 000 ?L physiological saline using osmotic pump at a speed of 0.5 ?L/h for 14 days; Experimental group received autologous fat transplantation and continuous infusion of 2 000 ?L physiological saline containing 1 ?g VEGF using osmotic pump at a speed of 0.5 ?L/h for 14 days. MAIN OUTCOME MEASURES: At the 7th, 14th, 28th, 42nd, 64th days postoperation, the graft’s survival volumes were measured using mini-scale test tube; the cell morphology changes were observed with hematoxylin-eosin stain; The newly born microvessels on experimental group and control groups were researched with immunohistochemistry staining. RESULTS: At 14 days postoperation, the graft’s survival volumes of experimental group was higher than operation control group and experimental control group (P 0.05). At each time point, the vascular density of the fat transplant in the experimental group was higher than that in other groups (P 0.05). CONCLUSION: VEGF can speed up vasifaction and raise fat graft survival significantly.

BACKGROUND:Runx2 is considered to the main regulatory factor of osteogenic gene expression and be necessary for osteoblast differentiation, it plays an extremely important role in the osteoblast development, differentiation, regulation, bone calcification formation and bone repair.
OBJECTIVE:To observe the biological properties of mesenchymal stem cells from human exfoliated deciduous teeth, explore the osteogenic differentiation potential of deciduous teeth stem cells, and observe the dynamic expression of Runx2 gene at varying time points.
METHODS:The stem cells from human exfoliated deciduous teeth were isolated and cultured in vitro. The cellsurface antigen was detected with flow cytometry. The third passage cells were cultured in the adipogenic medium for 4 weeks, and oil red O staining was conducted to test lipid droplets formation. The third passage cells were cultured in the osteogenic medium for 21 days, and mineralized nodules were detected by alizarin red staining. Runx2 mRNA dynamic expression was detected with semi-quantitative RT-PCR at different time points.
RESULTS AND CONCLUSION:The stem cells from human exfoliated deciduous teeth were obtained by enzyme digestion and limited dilution methods. Flow cytometry results showed that, CD146 and STRO-1 were expressed to varying degrees. Oil red O staining revealed salmon pink positive particles. Alizarin red staining showed positive expression. RT-PCR results showed that, Runx2 expression was found at day 0, up-regulated from day 0 to day 6, and subsequently dropped with an expression bottom at day 12, after that a second expression peak occurred at day 18, fol owed by a stably regulation. The stem cells from human exfoliated deciduous teeth can be isolated and cultured in vitro, express surface antigen of mesenchymal stem cells, and have the potentials of differentiating into adipocytes and ostetoblasts. Runx2 gene profiles are dynamical y expressed during osteoblastic differentiation. Runx2 express throughout every stage of osteoblastic differentiation. The expression is up-regulated during early and later stages, and down-regulated in metaphase.

Myopia is the most important cause of visual impairment in adolescents. However, its etiology is complex. In recent years, a large number of epidemiological studies have been done on risk factors of myopia. Most of these studies is cross- sectional study, not longitudinal cohort study. Overall, the incidence of myopia is the result of the interaction between genetic susceptibility and environmental exposure. This review is about the risk factors for myopia.

Aged ; Diabetes Mellitus, Type 2 ; Exercise ; Humans ; Physical Fitness

Bone Regeneration ; Bone and Bones ; Humans ; Insulin-Like Growth Factor Binding Proteins

Objective To investigate skin manifestations and comorbidities of chronic arsenicosis due to conta?minated drinking water, and to explore their possible risk factors. Methods Data about demographic characteristics, skin manifestations and comorbidities were collected from 95 patients with chronic arsenicosis due to contaminated drinking water in Inner Mongolia, and retrospectively analyzed. A logistic regression model was established to analyze associations of skin manifestations and comorbidities with patients′ gender, age, age at onset of drinking of arsenic?contaminated water, arsenic concentrations in water and duration of arsenic exposure. Results Among the 95 patients, 77 had hyperpigmentation, 75 hypopigmentation, 93 palmoplantar keratoderma, 27 skin cancer, and 8 multiple skin cancer. Five patients were complicated by tuberculosis, 15 by hypertension, 2 by rheumatoid arthritis, 4 by cerebral infarction, 7 by coronary heart diseases, 3 by internal malignancy, 6 by hepatic cirrhosis and 2 by anemia. Logistic regression analysis revealed a significant correlation between hyperpigmentation and arsenic concentrations in water(OR=0.32, 95%CI=0.10-0.98;ORadjusted=0.27, 95%CI=0.08-0.90), between occurrence of hepatic cirrhosis and arsenic concentrations in water (OR=24.67, 95%CI=2.69-226.57;ORadjusted=22.51, 95%CI=2.38-213.11), and between occurrence of coronary heart diseases and duration of arsenic exposure(OR=6.41, 95%CI=1.09-37.88;ORadjusted=8.55, 95%CI=1.21-60.41). Conclusions There is a high incidence of aberrant pigment metabolism, palmoplantar keratoderma and skin cancer in patients with chronic arsenicosis due to contaminated drinking water. Different arsenic concentrations in water and duration of arsenic exposure seem to have different influences on the human body.

Objective:This paper aims to explore the relationship between the residents’ health and economic de-velopment to provide a scientific basis which will promote the coordinated economy and health development. Methods:Adopting the entropy method, we could calculate the comprehensive health evaluation index. In combining the co-inte-gration and error correction models, we could analyze the long-term and short-term relationships between our country residents’ level of health since 2000 and the national macro-economic development information. The Granger causality test served as a good method used in testing the casual relationships. Results: The health and economic development has a co-integration relationship which is -0. 6216 in the short-term correction. The economic development extent is the Granger cause of residents’ health status. Conclusion:There is not only a long-term equilibrium, but also a short-term relationship between the residents’ health and economic development in our country. The economic growth pro-motes residents’ health status while the promotion of residents’ health to economic growth is not obvious.

Objective To investigate the clinical effect of preoperative nutritional treatment and perioperative nutrition support for the patients with esophageal cancer.Methods According to the digital table,90 patients with esophageal cancer were divided into the control group(15 cases),preoperative nutrition group(25 cases),postoperation nutrition group(25 cases)and preoperative nutrition + postoperation nutrition group(25 cases).The postoperative quality of life and the complications were compared.Results Postoperative quality of life in the preoperative nutrition group,postoperation nutrition group and preoperative nutrition + postoperation nutrition group were all better than that in the control group(t =14.76,15.13,17.87,all P ＜ 0.05).The incidence rate of postoperative complications in patients received nutritional intervention significantly decreased than in the control group(x2 =9.17,12.13,19.18,all P ＜ 0.05).Conclusion The preoperative nutrition and postoperation nutrition can improve the postoperative quality of life and reduce the incidence rate of the complications.