Closed-loop hospital management can effectivly cope with the COVID-19 pandemic. In order to ensure the continuity of treatments for hemodialysis patients under closed-loop management and minimize possible medical and infection risks, Huashan Hospital affiliated to Fudan University and 9 hospitals in Shanghai established a hemodialysis alliance in January 2021.The alliance optimized hemodialysis resources within the region through overall planning by preparing sites, materials and personnel shifts in advance, and establishing management systems and work processes to ensure that patients could be quickly and orderly diverted to other blood dialysis centers for uninterrupted high-quality hemodialysis services, in case that some hemodialysis centers in the alliance under closed-loop management.From November 2021 to April 2022, 317 of 1 459 hemodialysis patients in the alliance were diverted to other centers for treatment, accumulating 1 215 times/cases of treatments without obvious adverse reactions. The practice could provide a reference for medical institutions to quickly establish mutual support mode under major public health events.

Objective To investigate the therapeutic effect hyperbaric oxygen ( HBO) combined with Gubentongluofang on IgA nephropathy ( IgAN) in mice and possible molecular mechanism involved .Methods The murine α1k1-CD89 Tg transgene IgAN model was developed , and the animals were randomly divided into the control group , the model group , the calcitriol group , the Chinese herbal medicine group and the Chinese herbal medicine +HBO group.The expression levels of IgA, abnormal glycosylated IgA1, interleukin 6 ( IL-6 ) and tumor necrosis factor-α( TNF-α) of peripheral blood were detected , and the expressions of C1GalT1 and Cosmc protein in intestinal mucosa , kidney damage ( urine protein, serum creatinine and urea nitrogen) and blood urea nitrogen ( BUN) as well were detected for further analyses .Results As compared with those of the control group before treatment , the levels of IgA, abnormal glycosylation IgA1, IL-6 and TNF-in peripheral blood were significantly increased in the model group , the calcitriol group , the Chinese herbal medicine group and the Chinese herbal medicine +HBO group (P<0.05), and no significant differences could be noted in the levels of Scr and BUN in various groups ( P >0.05).After treatment, the levels of urine protein, IgA1, abnormal glycosylated IgA1, IL-6 and TNF-all significantly reduced in the calcitriol group , the Chinese herbal medicine group and the Chinese herbal medicine +HBO group, as compared with the model group(P<0.05), and the rate of reduction in the Chinese herbal medicine group was greater than that of the calcitriol group, but lower than that of the Chinese herbal medicine +HBO group (P<0.05).Intestinal mucosal tissues of the mice in various groups were collected after treatment for further analyses .As compared with the control group , C1GalT1 and Cosmc expression levels in intestinal mucosa in the model group decreased significantly.When compared with those in the model group , the C1GalT1 and Cosmc expression levels in the calcitriol group , the Chinese herbal medicine group , as well as the Chinese herbal medicine +HBO group increased considerably , with the increase in the Chinese herbal medicine +HBO group being most significant (P<0.05).Conclusion HBO could enhance the therapeutic effect of Gubentongluofang on IgAN , it might be closely associated with the down-regulation of IL-6 and TNF-and inhibition of abnormal activation of B cells and promotion of CIGALT1 and Cosmc expression .

Objective To investigate the therapeutic effect hyperbaric oxygen ( HBO) combined with Gubentongluofang on IgA nephropathy ( IgAN) in mice and possible molecular mechanism involved .Methods The murine α1k1-CD89 Tg transgene IgAN model was developed , and the animals were randomly divided into the control group , the model group , the calcitriol group , the Chinese herbal medicine group and the Chinese herbal medicine +HBO group.The expression levels of IgA, abnormal glycosylated IgA1, interleukin 6 ( IL-6 ) and tumor necrosis factor-α( TNF-α) of peripheral blood were detected , and the expressions of C1GalT1 and Cosmc protein in intestinal mucosa , kidney damage ( urine protein, serum creatinine and urea nitrogen) and blood urea nitrogen ( BUN) as well were detected for further analyses .Results As compared with those of the control group before treatment , the levels of IgA, abnormal glycosylation IgA1, IL-6 and TNF-in peripheral blood were significantly increased in the model group , the calcitriol group , the Chinese herbal medicine group and the Chinese herbal medicine +HBO group (P<0.05), and no significant differences could be noted in the levels of Scr and BUN in various groups ( P >0.05).After treatment, the levels of urine protein, IgA1, abnormal glycosylated IgA1, IL-6 and TNF-all significantly reduced in the calcitriol group , the Chinese herbal medicine group and the Chinese herbal medicine +HBO group, as compared with the model group(P<0.05), and the rate of reduction in the Chinese herbal medicine group was greater than that of the calcitriol group, but lower than that of the Chinese herbal medicine +HBO group (P<0.05).Intestinal mucosal tissues of the mice in various groups were collected after treatment for further analyses .As compared with the control group , C1GalT1 and Cosmc expression levels in intestinal mucosa in the model group decreased significantly.When compared with those in the model group , the C1GalT1 and Cosmc expression levels in the calcitriol group , the Chinese herbal medicine group , as well as the Chinese herbal medicine +HBO group increased considerably , with the increase in the Chinese herbal medicine +HBO group being most significant (P<0.05).Conclusion HBO could enhance the therapeutic effect of Gubentongluofang on IgAN , it might be closely associated with the down-regulation of IL-6 and TNF-and inhibition of abnormal activation of B cells and promotion of CIGALT1 and Cosmc expression .

Objective To determine the effects of different doses of cisatracurium on motor e-voked potential of neurosurgery operation.Methods Sixty patients,36 males and 24 females,aged 18 to 65 years,ASA physical status Ⅰ or Ⅱ,scheduled for spinal surgery with motor evoked potential monitoring,were included and randomly assigned to three groups.A single dose of cisatra-curium besilate for injection was given by intravenous injection in 5 s after the induction of general an-esthesia,respectively 0.1 mg/kg (group A),0.1 5 mg/kg (group B)and 0.2 mg/kg (group C).Cas-cade Elite 32 channel monitor was used to monitor MEPs,the electrode was stimulated for once two minutes after given the muscle relaxant,and the leading time of the wave of MEPs was recorded. Cooper’s score was used to evaluate the intubation conditions.Results The appearance time of the wave of motor evoked potentials was significantly longer in group C [(39.60±1.79)min]than that in groups A [(20.10 ± 1.89 )min]and B [(20.50 ± 1.93 )min](P < 0.05 ).The intubation conditions was significantly better in group B (100%)and C (100%)than that in group A (65%)(P<0.05).Conclusion The shortest time to elicit waveform of MEPs using the dose of cisatracurium is 0.1 5 mg/kg at induction of general anesthesia,which is better for tracheal intubation.The dose 0.1 5 mg/kg of cisatracurim is recommended as the initial dose on neurosurgery operation with motor e-voked potential monitoring.

ObjectiveTo investigate the relationship of lymphotoxin β receptor (LTβR) and classical nuclear factor-κB (NF-κB) activation pathway in the pathogenesis and progress of cystitis and bladder cancer.MethodsThe LTβR and P65 mRNA expression were detected by Real-time quantitative PCR in 108 cases of fresh bladder tissue specimens (75 cases of bladder cancer,10 cases of inflammation and 23 normal bladder mucosa cases grouped by the tissue classification ),and protein expression were analyzed by immunohistochemistry assay in 118 cases of paraffin-embedded biopsy specimens (73 cases of bladder cancer,30 cases of cysitis and 15 normal bladder mucosa cases).The correlation analysis between the expressions of LTβR and P65 with clinical pathological data was then performed.Differences between LTβR and P65 mRNA and protein expression level were compared in different groups of bladder tissues using Kruskal-Wallis H test and the Chi-square test.Results( 1 )The mRNA expressions of LTβR and NF-κB/P65were higher in bladder cancer than those in normal group ( LTβR:29.4 ( 14.2 - 46.7 ) × 10 - 3/1.2 ( 0.3 -7.0) ×10-3,Z=-5.508; P65:9.7 (2.7 -21.1) ×10-3/1.0(0.8 ～1.8) ×10-3,Z=-5.030,P＜0.05 ).There were significantly differences between bladder cancer with different histological grades ( LTβR:18.2(2.1-31.3) × 10-3/ 28.4(16.6-36.2) × 10-3/47.9(34.3 -70.5) ×10-3,x2K-W=20.378;P65:4.9(1.3 - 12.0) × 10-3/7.4(3.0-21.9) × 10-3/17.0(10.0 ～28.3)× 10-3 ,x2K-W2 =15.219,P all ＜0.05) and lymph node metastasis (LTβR:27.2(9.7-40.1) ×10-3/39.4(26.7 -52.6) ×10-3,Z=-2.552; P65:7.4(2.3-15.6) ×10-3/13.4(6.7-23.3) ×10-3,Z=-2.026,P＜0.05).(2)The positive rates of LTβR and phosphorylated P65 ( p-P65 ) protein in cancer were higber than those of normal group (LTβR:69.8％/13.3％,x2 =16.600 ; p-P65:56.2％/6.7％,x2 =12.220,P ＜ 0.05 ).Upregulation of LTβR and p-P65 were associated with the histological grade (LTβR:56.3％/70.0％/90.4％,x2 =7.055; p-P65:40.6％ /60.0％/76.2％,x2 =6.679,P ＜0.05) and with lymph node metastasis (LTβR:58.3％/92.0％,x2 =8.849; p-P65:52.1％/64.0％,x2 =5.088,P ＜0.05).(3)There was a positive correlation between LTβR and P65 expression ( mRNA:r =0.654,P ＜ 0.05,protein:r =0.399,P ＜ 0.05 )in the bladder cancer and cystitis (r =0.521,P＜0.05).ConclusionsThe activation of LTβR and P65 was associated with progression and metastasis of bladder cancer.The activation of classical NF-κB pathway by LTβR may be achieved by P65.

Objective To study and analyze the MRI manifestation of miliary tuberculosis of the brain.Methods Twenty-two cases with cerebral miliary tuberculosis of the brain were retrospectively studied with MRI including plain scan and enhanced study with GD-DTPA MRI features regarding the size,shape and distribution of the lesions were summarized and analyzed.Results Miliary tuberculosis of the brain was found most frequently at the junctional area of white and gray matter.The diameter of the lesion was less than 3 mm,therefore,plain scan often failed to display the lesions,however,markedly enhanced tubercles could be demonstrated on enhanced scan.Conclusion Enhanced MRI scan proved to be very helpful in the early detection of miliary tuberculosis of the brain.