Objective To assess the role of intervention of dexmedetomidine in lung tissue and plasma of septic rats induced by lipolysaccharide.Methods Forty SD rats weighing 250-300 g were divided into 4 groups:control group (n =10)with saline (1 ml·kg-1·h-1 )infused through the tail veins of rats for 6 h;dexmedetomidine (DEX)group (n =10)with dexmedetomidine,injected 6.5 μg ·kg-1·h-1 for 10 min followed by 5 μg·kg-1·h-1 ,continuously infused through tail veins for 6 h;li-polysaccharide (LPS)group (n = 10 )with lipolysaccharide (7.5 mg/kg)infused through the tail veins of rats;LPS+DEX group (n =10),after infusion of LPS,rats were treated with dexmedeto-midine (bolus 6.5 μg·kg-1·h-1 ,10 min;5 μg·kg-1·h-1 ,continuous infusion)through the tail veins for 6 h.ELISA and Western blot were performed to assess the protein expression of IL-1,IL-6, TNF-αand TLR4;the wet/dry ratio (W/D)of lung tissue in each group was measured and the injury scores were recorded through the Murakami method.Results There was no statistical significance between the control group and DEX group in plasma level of inflammatory factors,pulmonary TLR4 expression,wet/dry ratio and injury score of lung tissues,however,compared to the control group, there was a significant elevation in the above-mentioned biomarkers,W/D and injury score of lung tis-sue (P <0.01).Compared to the control group,there was no statistical significance in the LPS+DEX group.Compared to the LPS+DEX group,the biomarkers mentioned above,W/D and injury score of lung tissues were significantly elevated in the LPS group (P <0.01).Conclusion The irrita-tion of LPS can trigger the elevation of inflammatory factors in plasma,TLR4 expression in lung tis-sues in rats,while the intervention of dexmedetomidine can significantly alleviate this tendency. Dexmedetomidine can suppress the inflammatory reaction and pulmonary edema in septic rats.

Objective To investigate the impact of pancreatic duct stenting as a preventive measure for post-ERCP pancreatitis in patients with repeatedly non-selective pancreatic duct cannulation.Methods Clinical data of 64 patients with biliary tract disease from January 2008 to December 2015 was prospective analyzed. All the patients were randomly divided into observation group and control group. Patients in observation group received pancreatic stent placement, while patients in control group was not received pancreatic stent placement and nasal duct. Postoperative monitoring items included abdominal pain, blood amylase. Then record and compare the incidence of acute pancreatitis, pancreatitis severity rating, abdominal pain score, Ranson score, amylase recovery time between the two groups.Results Observation group had ifve cases of PEP, the rate was 15.6 %, including mild four cases (12.5 %), medium one case (3.1 %); the control group had 13 cases of PEP, the rate was 40.6 %, including mild six cases (18.8 %), medium four cases (12.5 %), severe three cases (9.4 %). PEP observation group was signiifcantly lower than the control group (P < 0.05). Mild, medium and severe PEP were lower than the control group, in which the severe PEP was signiifcantly lower than the control group (P < 0.05). Ranson score of the observation group was (1.2 ± 0.4), significantly lower than the control group (2.5 ± 1.2) (P < 0.05); the observation group amylase average recovery time was (3.0 ± 0.6) d, it is also signiifcantly lower than the control group (5.8 ± 1.4) d (P < 0.01). No bleeding and perforation complications occurred.Conclusion Pancreatic stenting can effectively prevent the incidence of PEP, reduce postoperative pain, improve patient recovery.

OBJECTIVE: To eludicate the risk factors of mechanical ventilation and prolonged mechanical ventilation in patients with severe multiple injuries. METHODS: Consecutive patients with severe multiple injures who were treated in Peking University People's Hospital Trauma Medical Center between December 2016 and December 2019 were enrolled in this restropective chart-review study. According to mechanical ventilation and ventilatory time, the patients were divided into mechanical ventilation (MV) group and non-mechanical ventilation (NMV) groups, prolonged mechanical ventilation (PMV) group and shortened mechanical ventilation (SMV) groups. Clinical data such as gender, age, base excess, mechanism of injury, Glasgow Coma Scale (GCS), abbreviated injury scale (AIS) and injury severity score (ISS) were collected. To indentify the risk factors of mechanical ventilation and prolonged mecha-nical ventilation, univariate and multivariate Logistic analyses were carried out. RESULTS: In the present study, 112 patients (82 male, 30 female) with severe multiple injuries having a median age of 52 (range: 16-89 years) and a median ISS of 34 (range: 16-66) were enrolled. The primary mechanism of injury was traffic accident injury and falling injury. In the study, 62 and 50 patients were assigned to MV and NMV groups, respectively. Logistic analysis showed that GCS (OR=0.72, 95%CI: 0.53-0.92, P=0.03), base excess (OR=0.56, 95%CI: 0.37-0.88, P=0.002) and multiple rib fracture (OR=1.72, 95%CI: 1.60-2.80, P=0.012) were independent significant risk factors for mechanical ventilation after severe multiple injuries. Within the mechanical ventilation group, 38 and 24 patients were assigned to PMV and SMVgroups, respectively. Compared with the SMV group, the PMV group had a higher ISS and higher rate of severe head trauma. The length of hospital stay of PMV group was longer than that of SMV groups. Meanwhile, the incidence of tracheotomy in PMV group was high. CONCLUSIONS GCS, base excess and rib fracture might be independent risk factors for mechanical ventilation. Higher ISS and lower GCS might prolong the ventilatory time and the length of hospital stay. Meanwhile, the incidence of tracheotomy was high in PMV group because of the longer ventilatory time and poor consciousness.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Injury Severity Score ; Male ; Middle Aged ; Multiple Trauma ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Young Adult

Objective:To compare the clinical effect of domestic and imported omeprazole injection in the treatment of peptic ulcer bleeding.Methods:According to the random sequence generated by the computer,118 patients who were treated in digestive department of our hospital from April 2013 to May 2015 were randomly divided into 2 groups,59 cases in each group.The control group was given treatment of imported drug losec,while the study group was given treatment of domestic drug aoxikang,and two groups were treated continuously for 7 days.The incidences of gastrointestinal reactions,dizziness and palpitations,the average treatment time,and clinical therapeutic effects were compared,in addition,the costs of treatment in the two groups were analyzed.Results:There were no significant differences in the incidences of gastrointestinal reactions,dizziness and palpitations and the average treatment time between the study group and the control group (P＞0.05).There was no significant difference between the two groups in the treatment effect after rank sum test (P＞0.05).The total effective rates (96.61％ vs 94.91％) were equivalent,the differences were not statistically significant (P＞0.05),but the costs of using domestic drugs were lower than that of imported drugs.Conclusion:The clinical curative effects of domestic aoxikang and imported losec in treatment of peptic ulcer bleeding have no significant difference,which can have a good therapeutic effect,but the economy of aoxikang is more better.

Objective To observe the effects of different compatibility ratios of Astragali Radix and Angelicae Sinensis Radix on vascular intimal hyperplasia; To ascertain the effective compatibility of Astragali Radix and Angelicae Sinensis Radix for antagonizing vascular intimal hyperplasia. Methods SD rats were divided into different groups by baseline geometric design method: Astragali Radix and Angelicae Sinensis Radix different compatibility ratios groups, Astragali Radix group, Angelicae Sinensis Radixgroup, positive medicinegroup and sham-operation group. A model of intimal hyperplasia of thoracoabdominal aorta was established by balloon catheter injury in vascular endothelium of rats. Then the thoracoabdominal aorta was taken out after gavage of Astragali Radix and Angelicae Sinensis Radix with different compatibility ratios for 14 days. Bloodletting was used to take thoracoabdominal aorta. Masson staining and Morphometric methods were used to analyze the intimal hyperplasia. Results IA, IT, HRIA and HRIT increased 14 day after intimal injury. Compared with the model group, IA, IT, HRIA and HRIT in Angelicae Sinensis Radix group, Astragali Radix and Angelicae Sinensis Radix 1:2 group, Astragali Radix and Angelicae Sinensis Radix 1:5 group, Astragali Radix and Angelicae Sinensis Radix 1:1 group and Astragali Radix and Angelicae Sinensis Radix 5:1 group were lower, and the effects of Astragali Radix and Angelicae Sinensis Radix 1:1 ratio were strongest. The effects on intimal hyperplasia in Astragali Radix group and Astragali Radix and Angelicae Sinensis 2:1 group had no significant differences compared with model group. Conclusion Astragali Radix and Angelicae Sinensis can inhibit vascular intimal hyperplasia in a certain compatibility ratios, and the effects of Astragali Radix and Angelicae Sinensis Radix 1:1 on intimal hyperplasia are the best.

[Objective]To investigate the disturbance between Th17 and Treg cell balance in ovarian endometriosis patients.[Methods]Case-control study comparing 40 women with histo-pathologically confirmed ovarian endometriosis and with 40 control infertility women without visible endometriosis foci ,pelvic inflammations who were subjected to laparoscopic surgery during the same period. Peripheral blood,peritoneal fluid,ovarian ectopic endometrial tissue and eutopic endometrial tissue of ovarian endometriosis patients and controls were collected during surgery. T lymphocytes subpopulations in peripheral blood were analyzed by flow cytometry using specific monoclonal antibodies recognizing CD4+,CD25+and CD127-markers and CD3+,CD8-and IL-17A+markers. Then, IL-17,IL-22,IL-10and TGF-βconcentration in the serum and peritoneal fluid was determined using enzyme linked immunosorbent assay(ELISA). Also,Q-PCR was performed to verify Foxp3 mRNA and ROR-γt mRNA expression differences in eutopic and ectopic endometrial tissue.[Results]1.The percentage of CD4+CD25+CD127-Treg cells was significantly decreased in the peripheral blood ofwomen with ovarian endometriosis compared with control women. On the other hand ,the proportion of CD3+CD8-IL-17A+Th17 cells was significantly increased in the peripheral blood of women with endometriosis compared with control wom en. 2. Comparing with the controls ,the concentration of IL-17 and IL-22 was significantly higher in the serum of women with ovarian endometriosis ,and the levels of IL-10 and TGF-β were significantly lower in the serum of women with endometriosis. On the contrast ,in the peritoneal fluid of women with ovarian endometriosis ,the concentration of IL-17 and IL-22 were lower ,and the concentration of IL-10 and TGF-β were significantly higher than the controls. 3.Foxp3 mRNA expression level was significantly elevated in ectopic endometrial tissue of patients with ovarian endometriosis compared with eutopic endometrial tissue ,while the ROR-γt mRNA expression level of ectopic endometrial tissue was significantly decreased than eutopic endometrial tissue.[Conclusion]The present study verifies the imbalance of Th17/Treg in peripheral blood ,peritoneal fluid and endometrial tissue in ovarian endometriosis patients ,which implies the immune dysregulation and the disturbance of immunity homeostasis in the establishment and progression of endometriosis.

Objective To study the expressions of YKL-40 and IL-1β in the cartilage of knee osteoarthritis(KOA),and analysis the possible relationship between YKL-40,IL-1β in KOA.Methods Thirty-eight patients diagnosed with KOA were selected in this hospital as observation group.Then select 30 articular cartilage cases in the same period due to knee injury knee joint examina tion or treatment of knee joint fracture surgery patients,referred to as the control group.According to KOA radiation and arthroscopic grading standards,the observation group was divided into 16 cases of mild group,10 cases of moderate group,11 cases of severe groups.Compare the expression levels of all patients including YKL-40,interleukin-1β (IL-1β),IL 6,tumor necrosis factor-α (TNF-α),while recording Mankin score and cell mortality.Results Expression of YKL 40,IL-1β,IL-6,TNFα,Mankin scores and rate of cell death about observation group were significantly higher than control group,the indicators above in mild,moderate,severe group showed a trend of rising(all P＜0.05).And the expression levels of YKL-40 and IL-1β were significantly positive correlation (r=0.738,P=0.000).In addition, The expression levels of YKL-40 had relation with IL 6 (r=0.819,P=0.000),TNF-α (r=0.871,P=0.000) and Mankin score (r=0.832,P 0.000),cells mortality deposit (r=0.832,P=0.000).Conclusion Expression levels of YKL-40 and IL-1β were significantly increased in cartilage of knee osteoarthritis patients,and there showed a significant positive correlation between YKL-40 and IL-1β.

dation, transiently inercasod food efficiency,and a faster growth rate of visceral adipose tissue versus body weight after nutritional rehabilitation. These findings are consistent with the characteristics of human catch-up growth.

Vascular endothelial growth factor (VEGF) plays an important role in tissues angiogenesis. The adaptation of animals to hypoxic environment is relative to the microvessel density (MVD) in tissues. To further explore the adaptation mechanisms of plateau zokor (Myospalax baileyi) to the hypoxic-hypercapnic burrows, the VEGF mRNA and the MVD in cerebral tissues of the plateau zokor were studied. Total RNA was isolated from liver, and VEGF cDNA was obtained by RT-PCR, then the VEGF cDNA was cloned and sequenced. The coding sequence of plateau pika (Ochotona curzniae), rat (Rattus norvegicus) and mouse (Mus musculus) VEGF cDNA are obtained from GenBank, and the nucleotide and amino acid sequence homology of plateau zokor VEGF cDNA coding sequence with that of plateau pika, rat and mouse were analyzed and compared by using of bioinformatics software. The VEGF mRNA was detected by real-time PCR, and the MVDs in cerebral tissues of the plateau zokor, plateau pika and Sprague-Dawley (SD) rat were measured by immunohistochemical staining. The results showed that the open reading frame of the plateau zokor VEGF was 645 bp, and the coding sequence of the plateau zokor VEGF cDNA shared 92.1%, 93.6% and 93.8% nucleotide sequence homology to that of the plateau pika, rat and mouse, respectively. The deduced amino acid sequence of the plateau zokor VEGF cDNA was composed of 188 amino acids and the amino acids from 1 to 26 were signal peptide sequence. The plateau zokor VEGF188 was 90.2%, 94.9% and 94.4% homologous to that of plateau pika, rat and mouse. The level of VEGF mRNA in brain of the plateau zokor was significantly lower than that of SD rat, but there was no obvious difference in VEGF mRNA level between plateau zokor and plateau pika. The MVD in brain of the plateau zokor was markedly higher than that of plateau pika and SD rat. In conclusion, plateau zokor enhances its adaptation to the hypoxic environment by increasing the MVD. The level of VEGF mRNA in the brain of plateau zokor is lower than that of SD rat, which may be as a result of inhibition by the higher concentration of carbon dioxide in the burrow.
Adaptation, Physiological ; physiology ; Amino Acid Sequence ; Animals ; Arvicolinae ; physiology ; Base Sequence ; Brain ; blood supply ; metabolism ; Hypoxia ; physiopathology ; Microvessels ; anatomy & histology ; Molecular Sequence Data ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Sprague-Dawley ; Species Specificity ; Vascular Endothelial Growth Factor A ; genetics ; metabolism

Objective:To investigate the associations of articular depression depth (ADD) and tibial plateau widening (TPW) by pre-operative CT measurement with incidence of lateral meniscal tear in patients with Schatzker type Ⅱ tibial plateau fracture.Methods:Included in this retrospective study were 131 patients who had been admitted to Emergency Center of Trauma, The Third Hospital Affiliated to Hebei Medical University from January 2016 to January 2020 for Schatzker type Ⅱtibial plateau fractures. They were 88 males and 51 females, aged from 18 to 60 years (average, 41.5 years), with 74 right and 57 left sides injured. All patients were treated with closed reduction and internal fixation assisted by bidirectional traction. Arthroscopy was used to detect the status of lateral meniscus immediately after closed reduction and internal fixation of the fracture fragments. Furthermore, patients were divided into 2 groups according to the integrity of lateral meniscus: meniscal tear group ( n=70) and tear-free group ( n=61). The 2 groups were compared in terms of age, gender, body mass index(BMI), injury side, time interval from injury to surgery, TPW and ADD. The receiver operating curve (ROC) was drafted to calculate the cut-off values of TPW and ADD in complication of lateral meniscal tear in patients with Schatzker type Ⅱ tibial plateau fracture. Results:The overall incidence of lateral meniscal tear in this cohort was 53.4% (70/131). There was no statistically significant difference in terms of age, gender, injury side, BMI or time interval from injury to surgery between the 2 groups ( P>0.05); TPW and ADD were significantly higher in the meniscal tear group than in the tear-free group ( P<0.05). To predict lateral meniscal tear in patients with Schatzker type Ⅱtibial plateau fracture, the area under ROC was 0.656 (95% CI: 0.562 to 0.750, P=0.002) for TPW and 0.709 (95% CI: 0.619 to 0.800, P<0.001) for ADD, respectively; the cut-off values of TPW and ADD were 4.3 mm and 6.1 mm. Conclusion:TPW and ADD may be effective predictors for prediction of lateral meniscal tear in patients with Schatzker type Ⅱ tibial plateau fracture.