Cytokine storm plays an important role in the pathogenesis of liver failure.It is closely related to hepatocyte necrosis in the clini-cal course and the prognosis of this disease.With Kupffer cells as a clue,it is elucidated that related cells and cytokines influence each other and jointly function in the development and progression of liver failure,leading to serious liver tissue damage and necrosis.Cytokine -based research can help improve early diagnosis,disease assessment,and individualized treatment for liver failure.

In this paper, we studied the kinetics of nitochondrial lactate dehydrogenase (LDH) and solubilized mitochondrial LDH in the rat liver. The apparent Km values of mitochondrial LDH and solubilized mitochondrial LDH for substrate pyruvate were 50.0 ?mol/L and 33.8 ?mol/L, and those for NADH were 35.3?mol/L and 21.4 ?mol/L, respectively. The apparent Km values of mitochondrial LDH were greater than those of solubilized nitochondrial LDH. The mitochondrial LDH in the rat liver was mainly LDH-5, which could be solubilized by 0.15 mol/L NaQ solution.

In this paper, the effect of asolectin liposome on the activity of rabbit skeletal muscle lactate dehydrogenase (LDH) is reported. The results suggested that asolectin liposome could inhibit LDH activity, KC1 could restore the enzyme activity, and NAD+ and NADH could protect the enzyme from being inhibited by asolectin liposome.

Objective In order to overcome the problems that bone rongeur and Kirschner forcep's less function and easy damage, trivial and inefficient, bulky volume, bone and needle broken edge is not neat,needle tail easy spatter wounding and other defects, integrated"U"shaped cutting edge rongeurs of pruning finger-toe and bending-truncating pin is desigened. Methods Pruning-truncating rongeurs set the trimming, bending and shearing,straight and twisting, loading and unloading, filing and stripping, string devices, aintenance functions and other functions in one, compare with bone rongeurs in clinical application. Results Pruning-truncating rongeurs are molding once, manipulation convenient, light and safe, anti damage and maintenance free, cost-effective. Conclusion Pruning-truncating rongeurs are highly integrated and portable anti-lost, preparation instrument swift, man-machine coordination, sharp instrument injury prevention, to improve the operation efficiency.

Objective To discuss the influence of different ways of low-dose corticosteroids infusion on hemodynamics, changes in blood glucose level and prognosis in patients with refractory septic shock. Methods A prospective single-blind randomized controlled trial was conducted. Refractory septic shock patients admitted to the Department of Critical Care Medicine of Jiangxi Provincial People's Hospital from April 1st, 2013 to October 31st, 2014 were enrolled for the study. The patients were divided into control group and research group by random number table. Besides conventional treatment for septic shock, patients in control group were given 200 mg/d hydrocortisone intravenous infusion lasting for 2 hours, while those of research group were given 8.33 mg/h hydrocortisone per hour with an intravenous pump. Treatment lasted for 5 continuous days for both groups. The changes in heart rate ( HR ), mean arterial pressure ( MAP ), central venous pressure ( CVP ) and arterial blood lactic acid in both groups were observed at the time of enroldment and 6 hours, 24 hours, 48 hours, and 5 days after the treatment. With a dynamic blood glucose monitor, mean blood glucose ( MBG ) level, largest amplitude of glycemic excursions ( LAGE ), glucose variability ( GV ), and the ratio of hyperglycaemia time were recorded. The duration of shock, length of intensive care unit ( ICU ) stay, total length of hospital stay, and 28-day mortality of both groups were recorded. Results Seventy-nine septic shock patients were assigned to the treatment, with 41 in control group, and 38 in research group. Compared with control group, 6-hour MAP in research group was obviously lowered [ mmHg ( 1 mmHg=0.133 kPa ):66.31±4.38 vs. 68.58±4.86, t=1.062, P=0.033 ], but there were no significant differences in HR, MAP, CVP, lactic acid clearance and norepinephrine ( NE ) utilization rates at other time points between two groups. No significant difference in MBG was found between research group and control group ( mmol/L:8.69±2.14 vs. 9.95±3.87, t=1.771, P=0.080 ), but LAGE, GV, the ratio of hyperglycemia time in research group were significantly lower than those of the control group [ LAGE ( mmol/L ): 17.18±8.97 vs. 22.71±11.80, t = 2.331, P = 0.022; GV ( mmol/L ): 2.57±1.05 vs. 3.16±1.37, t=2.136, P=0.036;the ratio of hyperglycemia time:( 43.1±11.7 )%vs. ( 49.4±15.3 )%, t=2.044, P=0.044 ]. There was no statistical difference in the following features between research group and control group, such as the duration of shock ( days:3.47±0.98 vs. 3.61±1.07, t=0.605, P=0.547 ), length of ICU stay ( days:8.74±3.12 vs. 9.97±3.37, t = 1.543, P = 0.120 ), total length of hospital stay ( days: 18.34±9.27 vs. 19.58±9.83, t = 0.576, P = 0.566 ) and 28-day mortality rate ( 23.68%vs. 26.83%,χ2=0.103, P=0.748 ). Conclusions Compared with slow intravenous infusion, a continuous intravenous supplementation of small amount of hydrocortisone to patients with refractory septic shock could stabilize blood glucose levels and maintain metabolic balance efficiently. However, in both groups there was no significant difference in the efficiency in stabilizing hemodynamics, shortening shock duration, reducing ICU or hospital days and decreasing 28-day mortality.

Objective To explore the influence of different positive end-expiratory pressure (PEEP) levels on cerebral blood flow (CBF) and cerebrovascular autoregulation in patients with acute respiratory distress syndrome (ARDS).Methods A prospective study was conducted.Moderate or severe ARDS patients admitted to Department of Critical Care Medicine of Jiangxi Provincial People's Hospital from January 1st,2013 to October 1st,2013 were enrolled.The changes in hemodynamics,respiratory mechanics and gas exchange under different levels of PEEP were observed.CBF velocity of middle cerebral artery (MCA) was measured using transcranial Doppler (TCD),and breath-holding index (BHI) was also calculated.Results 35 patients with ARDS were included.The oxygenation index (OI),peak inspiratory pressure (PIP),plat pressure (Pplat) and central venous pressure (CVP) were markedly elevated [OI (mmHg,1 mmHg=0.133 kPa):324.7± 117.2 vs.173.4± 95.8,t=5.913,P=0.000; PIP (cmH2O):34.7 ± 9.1 vs.26.1 ± 7.9,t=4.222,P=0.000; Pplat (cmH2O):30.5 ± 8.4 vs.22.2 ± 7.1,t=4.465,P=0.000; CVP (mmHg):12.1 ± 3.5 vs.8.8 ± 2.2,t=4.723,P=0.000] when PEEP was increased from (6.4 ± 1.0) cmH2O to (14.5-± 2.0) cmH2O (1 cmH2O=0.098 kPa).But no significant difference in the heart rate (beats/min:85.5 ± 19.1 vs.82.7 ± 17.3,t=0.643,P=0.523),mean arterial pressure (mmHg:73.5 ± 12.4 vs.76.4 ± 15.1,t=0.878,P=0.383) and CBF velocity of MCA [peak systohc flow velocity (Vmax,cm/s):91.26 ± 17.57 vs.96.64 ± 18.71,t=1.240,P=0.219; diastolic flow velocity (Vmin,cm/s) 31.54 ±7.71 vs.33.87 ±8.53,t=1.199,P=0.235; mean velocity (Vmean,cm/s) 51.19 ± 12.05 vs.54.27 ± 13.36,t=1.013,P=0.315] was found.18 patients with BHI＜0.1 at baseline demonstrated that cerebral vasomotor reactivity was poor.BHI was slightly decreased with increase in PEEP (0.78 ± 0.16 vs.0.86 ± 0.19,t=1.905,P=0.061).Conclusions Some of moderate or severe ARDS patients without central nervous system disease have independent of preexisting cerebral autoregulation impairment.However,independent of preexisting cerebral autoregulation may not further be impaired when a high PEEP was chosen.

Objective To analyze the potential etiologies and risk factors of childhood stroke. Methods This study retrospectively reviewed the clinical data of 159 children who were admitted from Jan.2006 to Jan.2014. Results The 159 children were composed of 100 boys and 59 girls , with median onset age of 1.8 years (ranged from 1 day to 12 years old) and median peak age of 0.9 years (ranged from 3 months to 2.8 years old). Their initial symptoms included limb hemiplegia,language dififculties and convulsion. The common causes included infections found in 46 cases (central nervous system infection in 32 cases, respiratory and gastrointestinal tract infection in 14 case), head injury in 42 cases, vitamin K deifciency in 29 cases, Moyamoya disease in 8 cases, heart diseases in 11 cases, spontaneous hemorrhage in 11 cases and 12 cases of unknown reason. Infectious diseases were the most common cause of children acute ischemic stroke in toddler period;and vitamin K1 deifciency were the most common cause of children hemorrhage stroke in infancy. The most common region of infarction is basal ganglia and middle cerebral artery in neuronal imaging. The median age at the time of diagnosis was 1.4 days. The median time of inhospital was 28 days. The median apex time was 4.3 days. Conclusions Among 159 cases, acute ischemic stroke is much more common than hemorrhagic stroke in children stroke, and the major risk factors are infections and head injury;Vitamin K1 deifciency is a major risk factor in infants with hemorrhagic stroke.

[ ABSTRACT] AIM:To study the effect of thrombopoietin ( TPO) on chemical hypoxia-induced apoptosis of the Rattus norvegicus adrenal pheochromocytoma (PC12) cells.METHODS:The cultured PC12 cells were randomly divided into normal control group, cobalt chloride ( CoCl2 ) group, CoCl2 +TPO group and TPO group.The cell viability was mea-sured by MTT assay.The effect of TPO on CoCl2-induced cell apoptosis was analyzed by flow cytometry with Annexin V/PI double staining.The intracellular reactive oxygen species ( ROS) were detected by fluorescence microscopy, and the chan-ges of the mitochondrial membrane potential ( MMT) were determined by flow cytometry and fluorescence microscopy.RE-SULTS:Chemical oxygen agent CoCl2 significantly inhibited the growth of PC12 cells (P<0.01).The apoptotic rate in CoCl2 group was obviously higher than that in control group ( P<0.05) , while the apoptotic rate in CoCl2 +TPO group was obviously lower than that in CoCl2 group (P<0.05).TPO decreased the production of ROS, and inhibited the decrease in MMP induced by CoCl2(P<0.01).CONCLUSION: TPO has a protective effect against CoCl2-induced apoptosis of PC12 cells by decreasing the production of ROS and inhibiting the decrease in MMP.

Objective To study the mechanism of increased sensitivity to cisplatin by nm23-H1.Methods The plasmid,pCMV-BamH1-Neo-nm23-H1,was transfected to cell line Tca8113 by lipofection strategy and was selected by G418 for 5 weeks.The stable products of nm23-H1 gene were identified by Immunohistofluorescence and Western-blotting.Using MTT and flow cytometer,we detected the changes of cell mortality rate,apoptosis and mitochondrial membrane potential.Results We successfully established the cell line of stable overexpression of nm23-H1.In vitro,the cell mortality rate and apoptosis were increased significantly in stable expression cell line of nm23-H1,compared with those in Tca8113 cell line of non-transfection;this effect could be inhibited by oubain which is an inhibitor of Na(+)/K(+)-ATPase.Mitochondrial membrane potential was decreased significantly in stable expression cell line of nm23-H1.Conclusion Nm23-H1 can increase the sensitivity of cisplatin on Tca8113 cell line;The mechanism may be the mitochondrial membrane potential is decreased by nm23-H1 so that intracellular platinum are increased to finally cause the apoptosis and necrosis of cells.

Objective To investigate the role of interleukin-17A (IL-17A) in acute paraquat (PQ)-induced lung injury in mice.Methods A total of 120 healthy SPF grade ICR male mice were randomly (random number) divided into three groups (n =40 in each):normal saline control group (NS),PQ poisoning group (PQ) and antibody neutralization group (PQ + Ab).Mice of PQ group and PQ + Ab group were given 5 mg/mL PQ by one gavage in a dosage of 25 mg/kg body weight,and 5 μg IL-17A neutralizing antibody intra-peritoneally administered immediately after PQ poisoning in PQ + Ab group;Equivalent volume of normal saline instead of PQ was given to mice of NS group.Six survival mice from each group were taken for experiment at 8 h,1 d,3 d,5 d,7 d after PQ poisoning:Wet to dry ratio (W/D) of lung was determined in mice of each group.HE staining of lung tissue was used to observe the histopathological changes under the light microscope and the pathological scores were graded;Serum interleukin-17A (IL-17A),interleukin-22 (IL-22),interleukin-6 (IL-6),transforming growth factor-β (TGF-β) were detected with enzyme linked immunosorbent assay (ELISA);Expression of interleukin-23 receptor (IL-23R) in lung tissue was determined with immunohistochemical;real-time fluorescence quantification PCR (qRT-PCR) was used to detect the expression of retinoic acid related solitary nuclear receptors' mRNA in lung tissue.Results After administration of PQ,W/D ratio increased (P ＜ 0.01),lung injury was observed in mice of PQ and PQ + Ab groups,levels of cytokines (IL-17A,IL-22,IL-6 and TGF-β) in serum elevated (P ＜0.05),and the expressions of IL-23R mRNA and RORγt mRNA increased (P＜0.01).But in PQ +Ab group,W/D ratio decreased (P ＜0.05),lung injury was alleviated,the levels of cytokines (IL-17A,IL-22,IL-6 and TGF-β) decreased (P ＜ 0.05),and the expressions of IL-23R mRNA and RORγt mRNA reduced (P ＜ 0.05).Conclusions Since IL-17A involves in the lung injury of the mice induced by acute paraquat poisoning,blockade of IL-17A significantly alleviates the acute lung injury in mice.