This study was performed to evaluate the role and mechanism of Ephedra aqueous extract in alleviating lung injury of rats with Streptococcus pneumoniae pneumonia via regulating reactive oxygen species(ROS)/NOD-like receptor protein 3(NLRP3)/caspase-1 pathway.Male SD rats were randomly divided into control group,model group,Ephedra aqueous extract(100 mg/kg,200 mg/kg,400 mg/kg)groups,solvent control group(110 ml/kg DMSO),model+solvent group,high-dose Ephedra aqueous extract+solvent group,and high-dose Ephedra aqueous extract+trimethylamine N-oxide(TMAO,110 mg/kg)group.Pneumonia model was established by instilling Streptococcus pneumoniae solution into the trachea.After 24 hours of modeling,each group was given medication by gavage for 10 consecutive days.24 hours after the last gastric lavage,pathological changes in lung tissue and the contents of interleukin(IL)-1β,IL-6,tumor necrosis factor-α(TNF-α)in serum and bronchoalveolar lavage fluid(BALF)were detected;and the contents of malondialdehyde(MDA),superoxide dismutase(SOD),the activity of ROS and the expression levels of NLRP3,Caspase-1,GSDMD-N in lung tissue were detected.The model group rats demonstrated pathological changes in lung injury including thickening of alveolar septa and infiltration of inflammatory cells,as well as the contents of IL-1β,IL-6,TNF-α in BALF and serum,the content of MDA,the activity of ROS,the expression levels of NLRP3,Caspase-1 and GSDMD-N in lung tissue were higher than those of the control group,while the SOD content in lung tissue was lower than that of the control group(P<0.05).The lung injury of the low,medium,and high dose Ephedra aqueous extract groups were reduced,and the contents of IL-1β,IL-6,TNF-α in BALF and serum,the content of MDA,the activity of ROS,the expression levels of NLRP3,Caspase-1 and GSDMD-N in lung tissue were lower than that of the model group,while the SOD content in lung tissue was higher than that of the model group(P<0.05).The lung injury of rats in the high-dose ephedra aqueous extract+TMAO group worsened,the contents of IL-1β,IL-6,TNF-α in BALF and serum,the content of MDA,the activity of ROS,the expression levels of NLRP3,Caspase-1 and GSDMD-N in lung tissue were higher than those of the high-dose Ephedra aqueous extract+solvent group,while the SOD content in lung tissue was lower than that of the high-dose Ephedra aqueous extract+solvent group(P<0.05).In conclusion,Ephedra aqueous extract alleviates the lung injury of rats with Streptococcus pneumoniae pneumonia via inhibiting the inflammatory response,oxidative stress and pyroptosis mediated by ROS/NLRP3/Caspase-1 pathway.

Anxiety disorder is a common emotional handicap, which seriously affects the normal life of patients and endangers their physical and mental health. The prefrontal cortex is a key brain region which is responsible for anxiety. Action potential and behavioral data of rats in the elevated plus maze (EPM) during anxiety (an innate anxiety paradigm) can be obtained simultaneously by using the and in conscious animal multi-channel microelectrode array recording technique. Based on maximum likelihood estimation (MLE), the action potential causal network was established, network connectivity strength and global efficiency were calculated, and action potential causal network connectivity pattern of the medial prefrontal cortex was quantitatively characterized. We found that the entries (44.13±6.99) and residence period (439.76±50.43) s of rats in the closed arm of the elevated plus maze were obviously higher than those in the open arm [16.50±3.25, <0.001; (160.23±48.22) s, <0.001], respectively. The action potential causal network connectivity strength (0.017 3±0.003 6) and the global efficiency (0.044 2±0.012 8) in the closed arm were both higher than those in the open arm (0.010 4±0.003 2, <0.01; 0.034 8±0.011 4, <0.001), respectively. The results suggest that the changes of action potential causal network in the medial prefrontal cortex are related to anxiety state. These data could provide support for the study of the brain network mechanism in prefrontal cortex during anxiety.

Objective: To investigate the role of CD11b agonist leukadherin-1 (LA1) in the development of intestinal inflammation and colitis disease in a mouse model of dextran sulfate sodium (DSS)-induced colitis. Methods: The mouse model of experimental colitis was induced by DSS. Body weight changes and survival status were monitored every day. The length of colons was measured at day 7. Colon tissue sections were stained with hematoxylin and eosin (HE) and observed under an optical microscope for pathological analysis. The percentages of apoptotic cells in colon tissues were observed by TUNEL staining. Myeloperoxidase (MPO) activity was measured with MPO activity detection kit. IL-1β and TNF-α levels were detected by ELISA. Macrophages and TNF-α in colon tissues were observed using immunofluorescence staining and confocal microscopy. Flow cytometry was performed to detect the changes in TLR4 expression on macrophages after stimulating mice with LA1 for 0, 3, 6 and 12 h. Moreover, TLR4 expression was also measured by Western blot after treating bone marrow-derived macrophages (BMDMs) with LA1 for 0, 3, 6 and 12 h. Unpaired t-test was used for statistical analysis. Results: Compared with the DSS group, the LA1+ DSS group presented lower mortality rate, greater body weight and longer colon and the differences between the two groups were statistically significant. Moreover, the LA1+ DSS group showed lighter pathological damages, decreased percentage of apoptotic cells and suppressed MPO activity as compared with those of the DSS group. The number of macrophages and the relative concentrations of IL-1β and TNF-α in colon tissues were lower in the LA1+ DSS group than in the DSS group, and the differences between the two groups were statistically significant. There was no significant difference in the total expression of TLR4 on macrophages before and after LA1 treatment. However, the mean flourscence indensity (MFI) of TLR4 was weaker on the LA1-treated macrophages than on the untreated macrophages. Conclusions LA1 could alleviate the DSS-induced experimental colitis in mice through suppressing the activation of TLR4 pathway on macrophages. This study provided a new insight and theoretical reference for understanding the pathogenesis of inflammatory bowel diseases.

Objective To analyze the effect on clinical outcome of sepsis patients treated by early positive and standardized treatment in primary hospitals. Methods The clinical data of sepsis patients admitted to intensive care unit (ICU) of Dushanzi People's Hospital from January 1, 2015 to December 31, 2018 were retrospectively analyzed. The sepsis patients were further divided into a control group (from January to December, 2015) who received non-standardized treatment of sepsis, only according to doctors' experience, using routine antibiotics, fluid resuscitation, detection of lactic acid, etc. and a study group; from 2016, the patients with sepsis (the study group) received standardized diagnosis and treatment according to the Guidelines of Sepsis 3.0 and the actual conditions of our hospitals, and they were further subdivided into three periods: 2016 (from January to December, 2016), 2017 (from January to December, 2017), and 2018 (from January to December, 2018) periods. The main clinical outcome indicator of these patients in 4 time periods, 28-day mortality, the secondary clinical outcome indicators such as the length of stay in ICU and medical expenses in ICU were observed. Results Sixty-six patients with sepsis were finally enrolled, including 17 cases in 2015, 18 cases in 2016, 17 cases in 2017 and 14 cases in 2018. Compared with 2015, the length of ICU stay in 2016, 2017 and 2018 were significantly shorter (days: 17.45±9.09, 12.95±5.93, 12.14±4.92 vs. 20.85±13.45, all P <0.05), and the medical cost of ICU stay were significantly lower (ten thousand yuan: 9.93±5.35, 7.22±3.86, 5.15±2.88 vs. 13.37±14.14, all P < 0.05); the 28-day mortality was significantly decreased [16.67% (3/18), 11.76% (2/17), and 14.29% (2/14) vs. 35.3% (6/17), all P < 0.05]. Conclusion Early standardized treatment for patients with sepsis can significantly reduce the length of stay in ICU and medical expenses in ICU.

Objective To study the clinical application effect of X-ray computed tomography (DR) and spiral CT in the diagnosis of emergency thoracic and abdominal trauma. Methods A total of 174 patients with emergency thoracic and abdominal trauma admitted in our hospital from November 19, 2016 to November 19, 2017 were enrolled in this study. All patients underwent DR and spiral CT examinations. The pathological diagnosis coincidence rate between the two diagnostic methods and the satisfaction with the diagnostic methods between the two groups was compared. Results In terms of pathological diagnosis, the coincidence rate of spiral CT in subcutaneous emphysema, rib fractures, scapular fractures, clavicle fractures, pulmonary contusion, pleural effusion, pneumothorax, atelectasis, mediastinal emphysema, liver injury, spleen injury, kidney injury, pancreas injury, celiac hemorrhage, mesentery laceration and diaphragmatic injury was 100. 00％. Except for pulmonary contusion, mediastinal emphysema, hematoma and kidney injury and pancreatic injury, the pathological diagnosis coincidence rate of spiral CT in the other chest trauma was higher than that of DR diagnosis, and the difference was statistically significant (P＜0. 05). The patients' satisfaction score of spiral CT diag nosis was significantly higher than that of DR diagnosis(P＜0. 05). Conclusion The spiral CT in the diagnosis of emer gency thoracic and abdomen trauma is better, which can improve the clinical diagnosis of coincidence rate, and is worthy of further recommendation.

Objective To analyze the diagnostic value of multi-slice spiral CTin patients with emergency chest pain. Methods 81 patients with chest pain admitted in the Department of Emergency in our hospital from October 27, 2016 to October 27, 2017 were investigated. All patients underwent multi-slice spiral CTexamination. The examination results of multi-slice spiral CTexamination were compared with those of conventional coronary angiography. At the same time, the patient's heart rate and satisfaction during different examinations was compared. Results There were 64 patients with coronary artery stenosis, 9 patients with aortic dissection, 8 patients with pulmonary embolism were detected by multi-slice spiral CT, accounting for 79. 01％, 11. 11％ and 9. 88％ respectively. There were 64 cases of coronary artery stenosis, 10 cases of aortic dissection and 7 cases of pulmonary embolism detected by routine coronary angiography examination, accounting for 79. 01％, 12. 35％ and 8. 64％, respectively. There was no significant difference between the results of the two examination methods (P＞0. 05). There was no significant difference in the level of heart rate between patients with multi-slice spiral CTand those with conventional coronary angiography(P＞0. 05). The patient's satisfaction with multi-slice spiral CTwas 96. 30％, which was significantly higher (P＜0. 05). Conclusion For patients with emergency chest pain, the detection of multi-slice spiral CTis similar to that of routine coronary angiography in the cause of the disease, and has little influence on the patient's heart rate, which is an ideal method for clinical diagnosis of chest pain.

Objective To evaluate the value of acoustic radiation force impulse imaging (ARFI) technique in differential diagnosis of renal tumors.Methods Totally 86 patients with 86 renal tumors underwent conventional ultrasound and ultrasound with ARFI technique.The shear wave velocity (SWV),virtual touch tissue imaging (VTI) score between tumors and the surrounding renal parenchyma,benign and malignant tumors were compared.Results In 86 patients with renal tumors,32 cases were renal benign tumors and all them were angiomyolipomas (AML),54 cases were renal malignant tumors,inculding 26 cases of renal clear cell carcinoma (ccRCC),8 cases of renal color cell carcinoma (cRCC),5 cases of renal papillary carcinoma (pRCC),15 cases of invasive urothelial carcinoma (IUC).The difference of SWV and VTI scores between lesions and the surrounding renal parenchyma were statistically significant (both P＜0.05).The SWV and VTI score renal benign tumors were lower than those of malignant tumors (both P＜0.05).The area under the ROC curve with SWV＞1.37 m/s or VTI score＞3.83 to distinguish benign and malignant renal tumors were 0.898,0.847,sensitivity were 88.9％,83.3％,specificity were 84.4％,78.1％,respectively (P＜0.05).Among renal malignant tumors,SWV and VTI score of ccRCC significantly higher than those of other malignant tumors,and the area under the ROC curve with SWV＞2.06 m/s or VTI score＞4.31 to distinguish ccRCC and other renal malignant renal tumors were 0.766,0.729,sensitivity were 65.4％,57.7％,specificity was 82.1％,78.6％,respectively (P＜0.05).Conclusion ARFI has important value in differential diagnosis of renal tumors,and can help to distinguish ccRCC with other renal malignant tumors.

Objective To evaluate satisfaction and complications of deep inferior epigastric perforator (DIEP) flaps breast reconstruction afer mastectomy in breast cancer patients.Methods The 26 consecutive breast cancer patients who underwent DIEP flap breast reconstruction were collected.General patient satisfaction and esthetic satisfaction with DIEP flap breast reconstruction were accessed using a study-specific questionnaire modified from the Michigan Breast Reconstruction Outcome Study.Results Flap success rate was 100％.The general satisfaction of DIEP breast reconstruction was 61.9％ (13/21),and the esthetic satisfaction was 66.7％ (14/21).Age (≤40 years old was 81.8％ [9/11],＞40 years old was 40.0％ [4/10],P=0.049) and previous abdominal wall surgery (no previous abdominal wall surgery was 75.0％ [12/16] and previous abdominal wall surgery was 20.0％ [1/5],P=0.027) were significant negative factors affecting general satisfaction;Body mass index (BMI ＜25 kg/m2 was 76.5％ [11/17],BMI 25-30 kg/m2 was 50.0％ [2/4],P=0.049) was a statistically significant factor associated with esthetic satisfaction.Four flaps presented venous congestion.One patient had fat necrosis and one had flap infection of the reconstructed breast.One patient had a decrease in abdominal rotational strength.Conclusions DIEP flap breast reconstruction will offer distinct advantages to patients,in terms of decreased donor-site morbidity and shorter recovery periods.

Objective To investigate the incidence and risk factors for surgical site infection (SSI)in clean wound orthopedics surgery.Methods SSI among patients receiving clean wound orthopedic surgery from April 1 to Sep-tember 30 in 2014 were monitored,risk factors for SSI were analyzed.Results A total of 665 patients were moni-tored,14 cases(2.11 %)of SSI occurred.Univariate analysis showed that types of skin,skin preparation modes, and ASA score were risk factors for SSI in clean wound orthopedic surgery (all P <0.05 ).Multivariate logistic analysis revealed that conventional skin preparation,ASA score ≥ grade Ⅱ,and duration of operation ≥90 minutes were independent risk factors for SSI in patients receiving clean wound orthopedic surgery (OR [95%CI ],3.96 [1 .07-14.70],6.45[1 .97-21 .11],and 4.08[1 .35 -12.30]respectively).Conclusion The improved method of skin preparation,grade I ASA score,and shortening duration of operation can reduce the incidence of SSI in clean wound orthopedic surgery,on the basis of improving the autoimmunization of patients,strengthening prevention and control of healthcare-associated infection can reduce the incidence of SSI in clean wound orthopedic surgery.

Objective To observe the clinical efficacy of metronidazole tablets combined with sophora gel in treatment of bacterial vaginitis ( BV) . Methods Eighty-seven cases of BV patients were randomly divided into the study group(45cases) and the control group(42cases).The control group was given metronidazole tablets (400 mg, two times a day), oral for seven days, while the study group was given sophora gel (vaginal implantation) on the basis of control group.Seven days as a course of treatment.Pared the leukocyte esterase test positive rate in vaginal fluid and the recurrence rate within a year of the two groups before and after treatment.ResuIts After 7 days’treatment, the positive rate of leukocyte esterase (LE) in two groups were all significantly declined, which was more significant in the study group (P<0.05);the total effective rate of the study group was 95.6%, which was significantly higher than that of the control group 78.6%(P<0.05).The recurrence rate within a year of the study group was 6.7%, which was significantly lower than that of the control group 26.2%( P<0.05 ) .ConcIusion The therapy of metronidazole tablets combined with sophora gel in treating BV can significantly decline the LE positive rate and recurrence rate, and improve the clinical curative efficacy as well.