Objective To study the value of serum intestinal fatty acid binding protein(I-FABP) and calcium levels for evaluating the effect of emergency surgical on the treatment of severe acute pancreatitis(SAP). Methods A total of 68 firstly diagnosed as SAP from June 2014 to October 2016 were collected into this study. The arrest time was less than 72 h and they were underwent emergency endoscopic or laparoscopic surgery. The serum I-FABP and calcium levels were detected 12 hours after surgery and analyze the values of serum I-FABP and calcium levels in evaluating the clinical effects by receiver operating characteristic curve(ROC). Results There were 33 cases with excellence, 21 cases with availability and other 14 cases with no-effect, the total efficacy rate was 79.4%. The gender, age, arrest time, APACHE Ⅱ score, derum amylase, blood glucose and total cholesterol levels were no statistical differences in effective group and no-effect group.The serum I-FABP levels 12 hours after surgery in effective group were lower and calcium levels were higher than no-effect group(P<0.05).The evaluating accuracy was 0.856, sensibility was 86.5%,specificity was 92.2%,cut-off value was 368 ng/mL of serum I-FABP by ROC analysis. And they were 0.844,83.5%,86.7% and 1.96 mmol/L of serum calcium level by ROC analysis. Conclusion Serum I-FABP combined with calcium can be used for evaluating the effects of emergency surgical on the treatment of the patients with SAP.

AIM:To investigate the effect of Xingnaojing (XNJ) injection on the permeability of blood-brain barrier ( BBB) and zonula occludens-1 ( ZO-1) protein expression after global ischemia-reperfusion in rats.METHODS:Improved Pulsinelli four-vessel occlusion method was adopted to establish the global ischemia-reperfusion model in the rats. Male Wistar rats were randomly divided into sham group, model group, solvent group and XNJ group.The observations were conducted at the time points of 24 h, 48 h and 72 h after ischemia reperfusion.The water content of the brain tissues was determined by dry-wet weight method, while the Evans blue ( EB) content of brain tissue was detected by spectropho-tometry.The protein levels of ZO-1 in the cerebral cortex were analyzed by Western blot.RESULTS:The water contents in the brain tissues in model group, solvent group and XNJ group were significantly higher than those in sham group ( P<0.05) 24 h after ischemia reperfusion.However, the brain water contents in model group and solvent group were signifi-cantly higher than those in XNJ group and sham group (P<0.05) 48 h and 72 h after ischemia reperfusion.The EB con-tents in the brain tissues in model group, solvent group and XNJ group were entirely higher than that in sham group 24 h af-ter ischemia reperfusion (P<0.05).The EB contents in sham group and XNJ group were significantly lower than those in model group and solvent group 48 h and 72 h after ischemia reperfusion (P<0.05).The protein expression of ZO-1 in the rat cerebral cortex in model group, solvent group and XNJ group was significantly lower than that in sham group 24 h after ischemia-reperfusion (P<0.05).Similarly, 48 h and 72 h after ischemia reperfusion, ZO-1 protein level in the cortex in sham group and XNJ group was significantly higher than that in model group and solvent group (P<0.05).CONCLU-SION:At 48 h and 72 h after global ischemia-reperfusion, Xingnaojing injection play a protective role in blood-brain barri-er and this role may be associated with the increase in ZO-1 protein expression by Xingnaojing injection.

Objective To compare the efficacy of sedation with dexmedetomidine versus midazolam in mechanically ventilated patients.Methods Sixty patients aged 20-64 yr,with body mass index 21-25 kg/m2,APECHE Ⅱ score 10-25,requiring 24 h of nechanical ventilation in intensive care unit (ICU),were randomly divided into 2 groups (n=30 each): midazolam group (group M) and dexmedetomidine group (group D).A loading dose of midazolam 0.05 mg/kg was injected intravenously,followed by infusion at 0.03-0.20 mg· kg-1 · h-1 in group M.A loading dose of dexmedetomidine 1 μg/kg was injected intravenously,followed by infusion at 0.2-0.7 μg· kg-1 · h-1 in group D.Ramsay sedation score was maintained at 2-4.The satisfaction of the doctors in ICU with the sedative efficacy,hypotension and bradycardia were recorded.Delirium was recorded starting from the begging of sedation to 2 h after the end of sedation.The emergence time and occurrence of falling asleep again within 2 h after waking were also recorded.Results Compared with M group,the satisfactory level of the doctors in ICU with the sedative efficacy was significantly increased,the emergence time was significantly shortened and the incidences of falling asleep again within 2 h after waking and delirium were significantly decreased (P ＜ 0.05 or 0.01),and no significant change was found in the incidence of hypotension and bradycardia in group D (P ＞ 0.05).Conclusion The efficacy of sedation with dexmedetomidine is better than that of midazolam in mechanically ventilated patients.

Objective To investigate the role of Wnt/β-Catenin signaling pathway in the endotoxin induced acute lung injury (ALI) during the treatment by mesenchymal stem cells (MSCs).Methods Six SPF male SD rats were isolated and bone marrow mesenchymal stem cells were cultured.A total of 72 SPF male SD rats with 6-week-old were randomly (random number) divided into 4 groups:control group (n =18) in which phosphate buffered solution (PBS) used instead of lipopolysaccharide (LPS);LPS group (n =18) in which LPS used to induce acute lung injury;LPS + MSCs group (n =18) in which MSCs directly transplanted after injection of LPS;Control + MSCs group (n =18) in which MSCs transplanted after injection of PBS.And then 6 rats of each group were sacrificed at 6 h,24 h,and 48 h separately after injection of LPS.At 24 h after the modeling,lung tissue was taken and the levels of Wrnt signaling pathway components were detected by using immunohistochemistry and Western blot.In addition,quantitative realtime PCR was used to detect the expression of Wnt signaling pathway target genes.Results Compare with the PBS control group,significant decrease in lung dry-to-wet ratio and increase in arterial oxygen partial pressure (PaO2) were found in MSCS transplantation groups.According the immunohistological results,Wnt 5a was significantly increased in the LPS-induced ALI rats and decreased after MSCs transplantation.Moreover,decrease in levels of GSK-3β phosphorylation and β-catenin was found in the lung tissue after MSCs transplantation.In addition,the expressions of Wnt signaling target genes Vegf,Axin2 and Klf4 were decreased significantly after MSCs transplantation.Conclusions In the setting of ALI,the therapeutic effect of MSCs was exerted by decreasing the expressions of Wnt 5a,GSK-3β phosphorylation,β-catenin,and Wnt signaling target genes Vegf,Axin2 and Klf4.Wnt signaling implicated in the therapeutic effect of MSC in the setting of ALI.

Objective To study the impact of Xingnaojing (XNJ) injection (a preparation of Chinese herb medicine) on the permeability of blood-brain barrier and Caveolin-1 in cortex of brain after global ischemia-reperfusion.Methods Modified Pulsinelli method for four-vessel occlusion was employed to establish the global ischemia reperfusion model in rats.Male Wistar rats were randomly (random number) divided into three groups,namely sham group,model group and XNJ group.Each group was observed at 24 h,48 h and 72 h after ischemia reperfusion.The water content of brain tissue was determined by dry/wet weight ratio,while the Evans blue (EB) concentration in brain tissue was detected by spectrophotometer.Western blot was used to detect caveolin-1 level in the cerebral cortex.Results The water contents of brain tissue in model group and XNJ group were significantly higher than that in sham group 24 hour after ischemia-reperfusion (P ＜ 0.05).But at 48 h and 72 h after ischemia-reperfusion,the brain water content in model group was significantly higher than that in XNJ group and sham group (P ＜ 0.05).The EB concentrations in brain tissue in model group and XNJ group were higher than that in sham group 24 h after ischemia-reperfusion (P ＜ 0.05).EB levels in sham group and XNJ group were significantly lower than that in model group 48 h and 72 h after ischemia-reperfusion (P ＜ 0.05).Caveolin-1 levels in cerebral cortex in sham group and XNJ group were significantly higher than that in model group 24 h,48 h and 72 h after ischemia-reperfusion (P ＜ 0.05).Conclusions After global ischemia-reperfusion,Xingnaojing (XNJ) injection could protect blood-brain barrier in virtue of regulating caveolin-1 protein level.

Angiostrongyliasis, caused by Angiostrongylus cantonensis infection, is a food-borne parasitic disease. Its larvae evoke eosinophilic inflammation in the central nervous system, but can also cause pathological changes in the eyes. Among ocular angiostrongyliasis cases, the incidence of optic neuritis is low and only few sporadic reports exist. Some patients with optic neuritis developed obvious hypopsia or even vision loss, which would seriously influence the quality of life of patients. Prompt treatment of optic neuritis caused by A. cantonensis is the key factor for minimizing the incidence of serious complications of this disease. In this review, we first provide a comprehensive overview of ocular angiostrongyliasis, and then focus on the clinical features of optic neuritis caused by A. cantonensis.
Angiostrongylus cantonensis/*isolation & purification ; Animals ; Asia/epidemiology ; Eye Diseases/*epidemiology/*parasitology/pathology ; Humans ; Incidence ; Optic Neuritis/*epidemiology/*parasitology/pathology ; Strongylida Infections/*epidemiology/*parasitology/pathology

Objective:To provide evidence for the selection of fixation devices and CTV to PTV margins (M ptv) in precision radiotherapy for pelvic tumors by analyzing three fixation devices in precision radiotherapy for prostate cancer. Methods:From April 2015 to December 2020, 133 prostate cancer patients treated with pelvic drainage area irradiation in our center were retrospectively analyzed. The patients were fixed with 1.2m vacuum bag (n=39), 1.8m vacuum bag (n=44) and personalized prone plate by our center (n=50). Each patient was asked to complete our bowel and bladder preparation process before positioning and radiotherapy. The registration of CBCT to planned CT before each treatment adopted the same registration box and algorithm. Setup errors in the SI, LR and AP directions under qualified bowel and bladder conditions were recorded. Setup errors in three directions under three fixation devices and corresponding M ptv values were analyzed. The correlation between setup errors with age and body mass index (BMI) was analyzed. Results:Analysis of 3333 setup errors data showed: in the SI and LR directions, the mean setup errors of 1.2m vacuum bag (3.26mm, 2.34mm) were greater than those of 1.8m vacuum bag (2.51mm, P<0.001; 1.90mm, P<0.001), and personalized prone plate (3.07mm, P=0.066; 2.10 mm, P=0.009). In the AP direction, the mean setup errors of 1.2m vacuum bag (supine)(2.20mm) were smaller than those of 1.8m vacuum bag (3.33mm, P<0.001) and personalized prone plate (3.61mm, P<0.001). The setup errors of 1.8m vacuum bag in all directions were smaller than those of personalized prone plate (P≤0.028). According to Van Herk's expansion formula, the M ptv of 1.2m vacuum bag in three directions was approximately 4 mm. The M ptv of 1.8m vacuum bag and personalized prone plate in the SI and LR directions was approximately 3 mm, and more than 5 mm in the AP direction. The setup errors were not correlated with age or BMI. Conclusions:From the setup errors results of three devices, 1.8m vacuum bag is the best, followed by personalized prone plate. And supine position is better than prone position in the AP direction.

OBJECTIVETo investigate the dynamic changes of a group of cytokines in phosgene-induced lung injury and the function of different dose of ulinastatin through animal experiment.

METHODS104 male SD rats were randomly assigned into the control group, ulinastatin control group, phosgene treatment groups and different dose of ulinastatin intervention groups, 8 rats each group. Treatment groups were dynamic constant exposure in phosgene, and immediately injected ulinastatin intraperitoneal, and then the experimental animal, the lung tissue biopsy, lung wet/dry ratio, RT-PCR detection, the plasma for detection of Bio-Plex 18 cytokines.

RESULTSCompared with the control group, plasma concentrations of IL-1α, IL-6, GM-CSF, TNF-α, INF-γ, MIP-3α, VEGF were increased significantly first (2 h), and gradually decreased with the passage of time , the difference was statistically significant (P < 0.05). Plasma concentrations of IL-4, IL-10 were decreased earlier (2h, 6 h) and increased later (24 h) (P < 0.05). The change of plasma concentration of IL-13 was not obvious earlier (2 h) and still rising later (24h), the difference was statistically significant (P < 0.05). After drug intervention, the levels of pro-inflammatory cytokines declined and the levels of anti-inflammatory cytokines raise by different degrees at different times in ulinastatin intervention groups, the difference was statistically significant. The degree of lung injury was improved than the phosgene treatment groups and better in high dose of ulinastatin intervention group. The expression of IL-10, IL-4, IL-13-mRNA of tissue increased in accordance with plasma results.

CONCLUSIONA group of cytokines are dynamicly changed in phosgene-induced lung injury by time. High dose of ulinastatin can improved phosgene-induced lung injury, regulate the synthesis and release of inflammatory cytokines and inhibit inflammatory react in a dose-dependent manner.

Animals ; Cytokines ; metabolism ; Glycoproteins ; pharmacology ; Granulocyte-Macrophage Colony-Stimulating Factor ; Interleukin-10 ; Interleukin-13 ; Interleukin-1alpha ; Interleukin-4 ; Interleukin-6 ; Lung ; Lung Injury ; chemically induced ; drug therapy ; Male ; Phosgene ; toxicity ; Rats ; Rats, Sprague-Dawley ; Tumor Necrosis Factor-alpha